Strengthening Health Systems and Public Institutions Humanitarian Crises: Health Workforce and Governance
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1 Strengthening Health Systems and Public Institutions Humanitarian Crises: Health Workforce and Governance Marilyn A DeLuca, PhD, RN Assistant Professor, School of Medicine & Associate Professor, College of Nursing, NYU; President, Global Health-Systems-Philanthropy Lisa Meadowcroft, MA Executive Director, ALIMA USA Nadia M Cobb, PA-C, PhDc Associate Professor, Director, Office for Global Healthcare Equity, Division Physician Assistant Studies, Dept of Medicine, University of Utah Juan Carlos Negrette, MBA Director, Global Health Program, University of Utah Consortium of Universities for Global Health March 16, 2018 New York
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3 ALIMA s partners and countries of operation
4 What ALIMA does: Maternal & Child Health Emergency & Epidemic Response Medical Intervention Research & Innovation Capacity Building Surgery
5 Innovation in action: Mothers are trained to use a MUAC (mid-upper arm circumference) to screen their children for malnutrition. Screenings are usually conducted by health workers but ALIMA has found that giving MUAC to the mothers, teaching them how to use it, results in earlier detection of malnutrition.
6 Research and Innovation: Individual isolation and treatment unit the Biosecure Emergency Chamber (Chambre d Urgence Biosécurisée or CUB) allows for quality care with minimal contamination risks by isolating the patient rather than the health worker.
7 Attache s de Sante en Chirurgie/Physician Associate/ Associate Clinician/Health Extension Officer Accelerated Medically Trained Clinicians [AMTCs] since the 1600 s Clinical health professional known many names Regionally / culturally appropriate Trained in the medical model Responsive / resilient skills mix Clinical Officer/Clinical Associate/Health Officer/Medical Licentiate/Feldsher/Community Health Officer/Medical Attaches Desante/Physician Assistant/Associate Medical Officer/Health Assistant/Health Officer
8 Human Resources for Health Country Pop Physicians/ 1000 Nurses & Midwives/1000 AMTCs/1000 Sierra Leone 7.7 m 0.02 (2010) (2010) Community Health Officers: 0.19 Established 1980 Surgical Assistant CHOs: 20 Established 2011 Myanmar 53.7 m (2012) 0.93 (2012) Health Assistants 0.57 Established 1953 Malawi 19 m (2009) (2009) Medical Assistants: 0.12 Established 1980 s Clinical Officers: 0.15 Established
9 Readiness around the globe Patiya, Bangladesh, 2011 A personal tragedy Bogotá, Colombia, 1993 Shopping mall bombing New Orleans, US, 2005 Hurricane Katrina Port au Prince, Haiti, 2010 Large-scale earthquake
10 Conceptual model: Emergency Planning Source: Emergency Planning and Management in Healthcare, 2014
11 Management Functions (Henri Fayol, Circa 1900s) plan organize coordinate command/direct control Modern Healthcare Administration (US) 1920s 1930s Professionalization of Healthcare Management country context (demand for management) national framework (management role) standards healthcare management (monitoring and adherence) graduate level education path professional associations
12 Overdose Death Rates Designed by L. Rossen, B. Bastian & Y. Chong. SOURCE: CDC/NCHS, National Vital Statistics System
13 Rx Opioids Dispensed Opioid Deaths Heroin Retail Price per pure gram Fentanyl Supply and Fentanyl Deaths Supply Deaths
14 Photo Credits AMTC Bhutan Health Assistants: courtesy of Nadia Cobb Ebola: website Ukraine Feldshers: courtesy of Nina Multak Mongolia Baga Emch : courtesy of Enkhtuya Vankhuu Ghana: courtesy of Nadia Cobb Myanmar: courtesy of Prof Dr Htin Zoe Navajo Reservation: courtesy of Revina Talker PA-C Nepal: courtesy of Anil Shrestha HA Sierra Leone: courtesy of Dr Maria Milland Utah Refugee: courtesy Wagma Mohmand PA-C Management Haiti Earthquake News National Geographic ( Revolutionary Socialism in the 21 st Century (revolutionarysocialism.tumblr.com) SCRIBD (
15 contact us.. Marilyn A DeLuca marilyn.deluca@gmail.com Nadia M Cobb nadia.m.cobb@utah.edu Lisa Meadowcroft lisa.meadowcroft@alima.ngo Juan Carlos Negrette juancarlos.negrette@hsc.utah.edu
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