The document summarizes the findings of an institutional analysis of the Ministry of Public Health in Afghanistan at the central and provincial levels. It identifies strengths and challenges in key stewardship functions like setting strategies, developing technical guidelines, coordination, budgeting, monitoring and evaluation. It provides recommendations to address gaps in policies, guidelines, capacity and resources to help the Ministry strengthen its stewardship role over the health sector.
Performance Budgeting in the Canadian Federal Government by Kiran HanspalOECD Governance
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Titilola Munkail: Coordination as a Viable Tool Towards Achieving Integrated ...GetItTogetherNG
This abstract was presented by The Challenge Initiative (TCI) at the 6th Nigeria Family Planning Conference which happened in Abuja from December 7 - 11, 2020.
Performance Budgeting in the Canadian Federal Government by Kiran HanspalOECD Governance
Presentation by Kiran Hanspal at the 10th annual meeting of the Senior Budget Officials Performance and Results Network held on 24-25 November 2014. Find more information at http://www.oecd.org/gov/budgeting
Titilola Munkail: Coordination as a Viable Tool Towards Achieving Integrated ...GetItTogetherNG
This abstract was presented by The Challenge Initiative (TCI) at the 6th Nigeria Family Planning Conference which happened in Abuja from December 7 - 11, 2020.
Yakubu Usman Abubakar: Using Existing Community Structures to Make Family Pla...GetItTogetherNG
This abstract was presented by The Challenge Initiative (TCI) at the 6th Nigeria Family Planning Conference which happened in Abuja from December 7 - 11, 2020.
Uduak Ananaba: Getting Governments to Mobilize Locally Owned Resources for Su...GetItTogetherNG
This abstract was presented by The Challenge Initiative (TCI) at the 6th Nigeria Family Planning Conference which happened in Abuja from December 7 - 11, 2020.
Decentralisation and Regionalisation in BulgariaOECD CFE
This is the presentation delivered by Isabelle Chatry at the report launch workshop: Decentralisation and Regionalisation in Bulgaria - Towards Balanced Regional Development, on 23 February 2021.
PowerPoint presentation of 10 Principles of Budgetary Governance including background, consultation process and key contributions. The principles are currently being considered as a draft Recommendation of the OECD Council, underpinning their importance for good governance and inclusive growth.
For further information, please visit: www.oecd.org/governance/principles-budgetary-governance.htm
Best practices for performance budgeting - Ivor BEAZLEY, OECDOECD Governance
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Performance Budgeting: The French Experience by Veronique FouqueOECD Governance
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Renewable Energy in Federal, Provincial and Local LevelAashish Pradhan
Presentation shows potential roles and responsibility of AEPC at all level of government based on the Constitution 2015 and Local Governance Operational Act 2017
Budget Allocation System of Regional Government Authority (Case Study at Sela...iosrjce
One important aspect of governance and development is a financial management system as a
realization of the budget policy, which providing the spirit of efficiency and effectiveness of budget,
transparency and public accountability, sense of justice, as well as the achievement optimally. However, the
budget allocation has not demonstrated a healthy balance between the central and local government budget, so
it causing vertical gap that greatly affect to the performance of the overall development. Along with regional
autonomy, the spirit of decentralization, democratization, transparency and accountability that characterizes
governance implementation process, particularly in the process of management policy of regional budget
allocation, should be a common concern in the management of the budget allocation in Selayar Regency by
considering the principle of fairness toward the priority programs and the fulfillment of a wider public
participation
Investment planning and public investment plans: Inssues and Best PracticesJean-Marc Lepain
This presentation goes through the issues in investment appraisal that result in poor outcomes. It introduces Public Investment Plans as a systematic methodology to address these issues.
Medium Term Budget Frameworks in West Africa: Lessons learntJean-Marc Lepain
Conclusion of the five day seminar on medium trer budget framework and fiscal planning in West Africa. MTFF and MTFB have constributed to strengthen the budget preparation process. However these tools are not sufficient to ensure fiscal discipline and budget credibility that remains an issue across the region. The solution is the coordination of fiscal planning reforms with other reforms.
Yakubu Usman Abubakar: Using Existing Community Structures to Make Family Pla...GetItTogetherNG
This abstract was presented by The Challenge Initiative (TCI) at the 6th Nigeria Family Planning Conference which happened in Abuja from December 7 - 11, 2020.
Uduak Ananaba: Getting Governments to Mobilize Locally Owned Resources for Su...GetItTogetherNG
This abstract was presented by The Challenge Initiative (TCI) at the 6th Nigeria Family Planning Conference which happened in Abuja from December 7 - 11, 2020.
Decentralisation and Regionalisation in BulgariaOECD CFE
This is the presentation delivered by Isabelle Chatry at the report launch workshop: Decentralisation and Regionalisation in Bulgaria - Towards Balanced Regional Development, on 23 February 2021.
PowerPoint presentation of 10 Principles of Budgetary Governance including background, consultation process and key contributions. The principles are currently being considered as a draft Recommendation of the OECD Council, underpinning their importance for good governance and inclusive growth.
For further information, please visit: www.oecd.org/governance/principles-budgetary-governance.htm
Best practices for performance budgeting - Ivor BEAZLEY, OECDOECD Governance
This presentation was made by Ivor BEAZLEY, OECD at the 13th Annual Meeting of OECD-Asian Senior Budget Officials held in Bangkok, Thailand, on 14-15 December 2017
Performance Budgeting: The French Experience by Veronique FouqueOECD Governance
Presentation by Veronique Fouque at the 10th annual meeting of the Senior Budget Officials Performance and Results Network held on 24-25 November 2014. Find more information at http://www.oecd.org/gov/budgeting
Renewable Energy in Federal, Provincial and Local LevelAashish Pradhan
Presentation shows potential roles and responsibility of AEPC at all level of government based on the Constitution 2015 and Local Governance Operational Act 2017
Budget Allocation System of Regional Government Authority (Case Study at Sela...iosrjce
One important aspect of governance and development is a financial management system as a
realization of the budget policy, which providing the spirit of efficiency and effectiveness of budget,
transparency and public accountability, sense of justice, as well as the achievement optimally. However, the
budget allocation has not demonstrated a healthy balance between the central and local government budget, so
it causing vertical gap that greatly affect to the performance of the overall development. Along with regional
autonomy, the spirit of decentralization, democratization, transparency and accountability that characterizes
governance implementation process, particularly in the process of management policy of regional budget
allocation, should be a common concern in the management of the budget allocation in Selayar Regency by
considering the principle of fairness toward the priority programs and the fulfillment of a wider public
participation
Investment planning and public investment plans: Inssues and Best PracticesJean-Marc Lepain
This presentation goes through the issues in investment appraisal that result in poor outcomes. It introduces Public Investment Plans as a systematic methodology to address these issues.
Medium Term Budget Frameworks in West Africa: Lessons learntJean-Marc Lepain
Conclusion of the five day seminar on medium trer budget framework and fiscal planning in West Africa. MTFF and MTFB have constributed to strengthen the budget preparation process. However these tools are not sufficient to ensure fiscal discipline and budget credibility that remains an issue across the region. The solution is the coordination of fiscal planning reforms with other reforms.
NAP Training Viet Nam - Mainstreaming Climate Change Adaptation into Planning...UNDP Climate
This two-day workshop supported the Government of Viet Nam in building the necessary capacity to advance its National Adaptation Plan (NAP) process. The workshop closely focused on building National Adaptation Plans in the agricultural sector through multi-stakeholder collaboration, and increased knowledge and capacity on a number of topics including: prioritization of adaptation options, cost-benefit analysis, overview of the broad-based nature of climate change adaption impacts, analysis of challenges, and creation of an open discussion with key stakeholders on defining a road-map for the NAP process. The workshop was delivered using discussions and case studies to enhance interactive learning for participants, with supporting presentations by GiZ and SNV.
Practicum presentation on Safe Motherhood Program (SMP) and Maternal and Peri...Mohammad Aslam Shaiekh
Practicum presentation on Safe Motherhood Program (SMP) and Maternal and Perinatal Death Surveillance and Response (MPDSR) Program in MNH Section of Family Welfare Division..
Performance budgeting in health: Outline of key issues - Ronnie Downes, OECDOECD Governance
This presentation was made by Ronnie Downes, OECD, at the 4th meeting of the Joint DELSA/GOV-SBO Network on Fiscal Sustainability of Health Systems, held in Paris on 16-17 February 2015.
Evolution of budgeting system in malaysia presentation (3 nov 3pm edit)Mohd Hasim Ujang
A group presentation slide for the subject 'Budget Administration', Master of Public Policy, University Malaya. The subject was taught by Tan Sri Sulaiman Mahbob, former Director-General of Economic Planning Unit, Prime Minister's Department and current Chairman of Felda Global Ventures (FGV).
Delivering on results - Evidence-based decision making through better metrics...OECD Governance
Presentation by Kiran Hanspal, Canada, at the 11th annual meeting of the OECD Senior Budget Officials Performance and Results network, Paris, 26-27 November 2015.
OECD Principles on Budgetary Governance - Andrew Blazey, OECDOECD Governance
This presentation was made by Andrew Blazey, OECD, at the 40th Annual Meeting of OECD Senior Budget Officials (SBO) held in Tallinn, Estonia, on 5-6 June 2019
Strategy Implementation for Institutional Services Department of PANELCO IIIJo Balucanag - Bitonio
Institutional Services Department: functions and responsibilities, organizational structure, KRAs, strategy implentation process, long term plan, medium term and short term, programs and projects
Budgetary Governance Reforms in Timor-Leste - Ronnie Downes, OECDOECD Governance
This presentation was made by Ronnie Downes, OECD, at the 12th Annual Meeting of OECD-Asian Senior Budget Officials held in Bangkok, Thailand, on 15-16 December 2016
Analysis of cross-country changes in health services IDS
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The scale and scope of private contributions to health systemsIDS
This presentation was given at a session at the Global Symposium on Health Systems Research in November 2010. Panelists included Ruth Berg, Gerry Bloom, Birger Forsberg, Kara Hanson, Gina Lagomarsino, Dominic Montagu, Stefan Nachuk
Presentation on the literature review of interventions to improve health care...IDS
This presentation was given in a Future Health System Consortium organised session at the Global Symposium on Health Systems Research in November 2010. The author is Alex Rowe from the Centers for Disease Control and Prevention.
Evidence on Improving Health Service Delivery in Developing CountriesIDS
This presentation by David Peters of the Future Health Systems Consortium was given at the Global Symposium on Health Systems Research in November 2010.
Pathways to Scaling up Health Services in Complex Adaptive SystemsIDS
This presentation by Ligia Paina & David Peters was given as part of a Future Health System Consortium session at the Global Symposium on Health Systems Research. It is part of our Beyond Scaling Up stream of work.
Implementing Rapid Medical Security reform in China: Importance of a Learning...IDS
A presentation by Zhenzhong ZHANG and Yunping WANG of the China National Health Development Research Center. This was given at a Future Health Systems Consortium organised event at the Global Symposium on Health System Research.
This presentation was given by Zhenzhong ZHANG and Yunping WANG of the China National Health Development Research Center at the Global Symposium on Health System Research.
Making the right to health a reality to Indigenous People in Brazil IDS
This presentation was given by Vera Schattan Coelho (CEBRAP) and Alex Shankland (Institute of Development Studies) at a Future Health Systems Consortium event at the Global Symposium on Health Systems Research, November, 2010.
This presentation was given at the Global Symposium on Health System Research in November 2010. The authors are L P Singh, Olakunle Alonge, Anubhav Agarwal,
Kayhan Natiq, S D Gupta and David Peters.
What must be done?Capacity building for health systems research in low & mid...IDS
This presentation was given in plenary by Sara Bennett of the Future Health Systems Consortium at the Global Symposium on Health Systems Research, November 2010.
What must be done to ehance capacity for health systems research?IDS
This presentation was written by Sara Bennett, Ligia Paina, Christine Kim, Irene Agyepong, Somsak Chunharas, Di McIntyre and Stefan Nachuk for the Global Symposium on Health Systems Research, November, 2010.
IMPROVING HEALTH SERVICE DELIVERY IN DEVELOPING COUNTRIES: FROM EVIDENCE TO ...IDS
This presentation was given by David Peters, Sameh El-Saharty, Banafsheh Siadat, Katja Janovsky, and Marko Vujicic at the Global Symposium on Health Systems Research, November 2010.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Institutional Analysis of the Ministry of Public Health at Central and Provincial Levels
1. Institutional Analysis of the Ministry
of Public Health at Central and
Provincial Levels
First Global Symposium on Health System Research
November 18, 2010
3. Background
• Dilapidated health system and extremely poor health status
• MOPH assumed a stewardship role in the health sector and
left direct service provision to NGOs
• The division contributed to important gains in health for the
Afghan population
• At the central level, the Grants and Contracts Management
Unit (GCMU) provided a strong role in overseeing contracts
and coordinating donor inputs
4. Objectives
• To identify the strengths and weaknesses of MOPH at central
and provincial levels
• To help the Ministry to effectively carry out its stewardship
functions
5. Methodology
• Semi-structured Interviews with Ministry’s officials at the
central and provincial levels
• Field visits to Parwan, Baghlan, Samangan and Balkh
provinces
• Review of Ministry’s key documents
6. Stewardship Functions
– Setting strategies and objectives
– Development of technical guidelines
– Coordination
– Regulation and promotion of the private sector
– Budgeting and resource mobilization
– Accountability and public relations
– Monitoring and evaluation
– Human resource development
– IEC/BCC
– Emergency response
7. Setting Strategies and Objectives
Strengths Challenges
1. Clear and known
mechanisms for developing
strategies
2. Many guiding documents
developed by the MOPH
3. Senior MOPH officials
heavily involved
4. Documents widely shared
with development partners
1. Lack of an effective
mechanism for
dissemination and
explanation of key
documents to central and
provincial staff
2. Lack of involvement of
provincial officials
8. Technical Guidelines and Supervision
Strengths Challenges
1. Relevant technical
guidelines developed for
several components of the
Basic Package of Health
Services
2. Guidelines made available
to the NGOs
3. Staff of the health facilities
trained on how to use the
technical guidelines
1. Lack of technical guidelines
for mental health,
disability, and IEC
components of the BPHS
and treatment guidelines
for the EPHS
2. Inconsistencies in the
training of provincial staff
9. Coordination
Strengths Challenges
1. Several coordination
mechanisms exist at the
central and provincial levels
2. Results presented to and
discussed in certain
coordination mechanisms
1. Variations among
coordination meetings at
the central and provincial
levels in terms of discussing
the results, decision making
and follow up
2. Some NGOs not sharing
their reports with provincial
officials
10. Private Sector
Strengths Challenges
1. Central and provincial
officials have a positive
view about the private
sector
2. Private sector rapidly
growing in the cities
3. Signs of its expansion in
rural areas
1. Lack of updated policies,
strategies, quality
assurance guidelines,
monitoring checklists, etc
2. Low capacity of
departments dealing with
the private sector
11. Budgeting & Resource Mobilization
Strengths Challenges
1. Many central and provincial
officials involved in
mobilizing external
resources
2. Managers have adequate
knowledge about their
development budgets
3. Budget expenditure
relatively high compared to
other ministries
1. Lack of specific operational
budget for departments
2. Limited involvement in
operation budget preparation
3. Complicated administrative
and procurement procedures
4. Centralized financial
authority
5. Delay in the reform of the
General Directorate of
Administration
12. Accountability & Public Relation
Strengths Challenges
1. Extensive presence of
leadership in media
2. Availability of relatively
extensive information on
MOPH website
3. Regular meetings with
community representatives
at the national and
provincial levels
1. Lack of formal policies and
guidelines about
accountability and public
relations
2. Unavailability of MOPH
website in local languages
3. No disclosure of MOPH
datasets and financial
figures on the website
13. Monitoring & Evaluation
Strengths Challenges
1. Existence of national
M&E mechanism
2. Unified HMIS across
the country
3. Extensive use of data
at certain
departments of the
MOPH
1. Variations in data use at the central
and provincial levels
2. No regular feedback to provincial
officials
3. Concerns about the BSC: (i) known
timing; (ii) prolonged gap between
data collection and report; (iii)
potential conflicts of interest; (iv) still
not understood and used by many
officials
14. Human Resources
Strengths Challenges
1. Draft national human resource
policy and strategy available
2. Provincial and several central
departments reformed
3. Many officials paid salaries close
to market rates
4. Community midwifery training
program implemented in many
provinces
1. Same level of provincial staffing
and salaries regardless of
population size, number of
health facilities, and remoteness
2. Too long recruitment process
3. Lack of a strategic plan for
addressing human resource
issues
4. Issues with the gender, location and
knowledge of health workers
15. IEC/BCC
Strengths Challenges
1. Draft policy and strategy
available
2. IEC/BCC an integral part of
the BPHS
3. External resources available
for IEC/BCC
1. Shortage of technical
expertise
2. Delay in finalization of
strategies and guideline
16. Emergency
Strengths Challenges
1. National plans available for
Avian Influenza
2. DEWS established
1. Lack of national documents
for other emergencies
2. No preparation for certain
emergencies
3. The function divided among
several directorates
4. Emergency subcommittees
not present in some
provinces
17. Conclusions
– Good progress in strengthening the stewardship functions
required for rapid expansion of services
– Many key areas still need to be reformed for sustaining
the momentum
• Budget and financial management
• Capacity building for peripheral levels
• …
– Need for a systematic approach to strengthening the
stewardship functions
19. Setting Strategies and Objectives
– Establish a formal mechanism for the distribution and
explanation of guiding documents to staff
– Consider reinitiating the provincial health quarterly
workshop
– Involve the provinces in the development and revision of
documents
– Finalize and publish the draft list of health indicators and
summary sheets
20. Technical Guidelines and Supervision
– Develop guidelines for mental health, disability, and IEC
parts of the BPHS and treatment guidelines for EPHS
– Conduct training need assessment and training on
technical guidelines at the provincial level
21. Coordination
– Make available the national and provincial profiles on
regular basis and make sure they are always part of
agenda
– Make sure NGOs are submitting their activity and financial
reports to provincial offices
– Hire provincial consultants
22. Private Sector
– Establish a technical and coordination mechanism among
the departments dealing with private sector
– Develop norms and standards
– Reform and strengthen the capacity of concerned
departments
23. Budgeting & Resource Mobilization
– Build on program budgeting initiative
– Decentralize budgeting and financial authority
– Reform the General Directorate of Administration
– Simplify procedures
– Develop resource mobilization strategy and guidelines
– Improve the negotiation and proposal writing skills of
the officials at the provincial level
24. Accountability & Public Relation
– Finalize and publish the draft public relation strategy and
guidelines
– Publish the website in local languages (requires more staff,
translators, and IT equipment; could be contracted out)
– Make the datasets and financial figures publicly available
25. Monitoring & Evaluation
– Finalize, prepare, and disseminate summary national and
provincial profiles on regular basis
– Conduct training need assessment and provide tailored
training on HMIS, BSC, etc
– Increase the salary of HMIS officers to levels paid by NGOs
– Evaluate the feasibility of: (i) making BSC entirely
independent; (ii) using M&E staff only for quality control
and double check; (iii) doing continuous on demand data
collection and analysis through out the year.
26. Human Resources
– Evaluate the feasibility of introducing differential staffing
and market rate salaries depending on size and
remoteness of provinces
– Introduce incentives, organize informal events, etc to
boost morale
– Translate the human resource strategy to an action plan
with a focus on developing local human resources
– Expedite recruitment by strengthening and authorizing the
General Directorate of Human Resources
27. IEC/BCC
– Hire a short-term consultant to finalize the documents
– Reform the department
– Integrate the IEC with health care delivery departments
28. Emergency
– Bring the function under one reformed umbrella
– Develop general guidelines and instructions
– Conduct regular assessment of potential emergencies and
resources
– Make sure subcommittees exist in all provinces