Improving Childhood Development in HIV Exposed Children in ZimbabweWorldEd
Despite an increasing recognition of the importance of early childhood development, over 200 million children in developing countries are unable to achieve their full developmental potential.
To intervene at this important juncture in a child’s life, the Bantwana Initiative of World Education (Bantwana) is implementing an Early Childhood Stimulation (ECS) program in Zimbabwe, a community-based early childhood development intervention in pediatric HIV care and treatment program. The intervention includes three elements: 1) an early childhood stimulation parenting program, 2) an internal savings and lending scheme for caregivers, and 3) case management home visits by conducted by trained community case workers. This comprehensive, community-based program aims to improve early childhood development, and HIV retention and adherence outcomes among HIV-exposed and infected children aged 0-2 years. Furthermore, it improves adherence and retention in care and treatment for the mothers of these HIV-exposed children, while equipping them with important parenting knowledge and skills to better nurture their children. These critical educational parenting sessions help increase early childhood development outcomes for HIV exposed children, as well as improve retention and adherence on HIV care and treatment for the mother-baby pairs. Together, the increased parenting skills, economic resilience, and community case worker follow up aim to improve the future of this particularly-vulnerable group of children, intervening at an essential point in their developmental growth.
This was presented by Auxilia Badza at the CIES conference in March, 2018.
We'll show you how to make your school a healthy school! Parents, teachers & principals - learn how to make your school healthier using our free toolkit and find out why schools are an ideal place to focus on improving kids’ health. Presented by People for Education and the Ontario Physical and Health Education Association.
Improving Childhood Development in HIV Exposed Children in ZimbabweWorldEd
Despite an increasing recognition of the importance of early childhood development, over 200 million children in developing countries are unable to achieve their full developmental potential.
To intervene at this important juncture in a child’s life, the Bantwana Initiative of World Education (Bantwana) is implementing an Early Childhood Stimulation (ECS) program in Zimbabwe, a community-based early childhood development intervention in pediatric HIV care and treatment program. The intervention includes three elements: 1) an early childhood stimulation parenting program, 2) an internal savings and lending scheme for caregivers, and 3) case management home visits by conducted by trained community case workers. This comprehensive, community-based program aims to improve early childhood development, and HIV retention and adherence outcomes among HIV-exposed and infected children aged 0-2 years. Furthermore, it improves adherence and retention in care and treatment for the mothers of these HIV-exposed children, while equipping them with important parenting knowledge and skills to better nurture their children. These critical educational parenting sessions help increase early childhood development outcomes for HIV exposed children, as well as improve retention and adherence on HIV care and treatment for the mother-baby pairs. Together, the increased parenting skills, economic resilience, and community case worker follow up aim to improve the future of this particularly-vulnerable group of children, intervening at an essential point in their developmental growth.
This was presented by Auxilia Badza at the CIES conference in March, 2018.
We'll show you how to make your school a healthy school! Parents, teachers & principals - learn how to make your school healthier using our free toolkit and find out why schools are an ideal place to focus on improving kids’ health. Presented by People for Education and the Ontario Physical and Health Education Association.
Adolescent Sexual and Reproduction Health PresentationDeepak TIMSINA
ADRA worked to scale-up ASRH programme in Kalikot District through its Strengthening Reproductive Health (SRH) project. I worked as a 'Training Officer' in ADRA from 2012-2013.
This Information Brief was developed by WHO's Department of Child and Adolescent Health and Development to support staff of the Organization and other UN agencies working at global, regional and national levels in promoting the uptake of effective interventions to improve the sexual and reproductive health of adolescents through schools in low-income countries. The premise of the Brief is that school-based sexual and reproductive health education is one of the most important and widespread ways to help adolescents to recognize and avert risks and improve their reproductive health. This evidence-based information brief establishes ways in which the health sector can help the education sector provide appropriate information to adolescents about when and why they need to use health services and where these may be available.
I wanted to raise awareness of this council. We are a local voice to the school board. Please feel free to let me know if you would like something presented to the council for discussion.
Child Sexual Abuse as a Mental Health Issue - Tasmin Kurien, SHout ClubTasminKurien
Child Sexual Abuse: Ensuring Safe Environments & Healthy Childhoods
Presented by Tasmin Kurien, President of SHout Club, Department of Social Work, Madras Christian College on October 30, 2020
Public Health Nutritionist explains how the new food and beverage policy for schools works.
Clear and easy to understand. This is the information you need to implement the new food guidelines for schools. She also shares tips on how public health is working with school communities to help implement the guidelines in Ontario.
Explore the measures and metrics that aided the Snohomish County Health Leadership Coalition, in their search of a Strategic Focus and how the LiveHealthy2020 initiative came to be. Consider the ways that Snohomish County can work together and measure their success of a Countywide scale.
Nonprofit Board Roles, On the Board vs. On BoardRebecca Gordon
Deep diving into nonprofit board engagement this presentation looks at how your inspire and engage your board of directors for long term financial success.
Adolescent Sexual and Reproduction Health PresentationDeepak TIMSINA
ADRA worked to scale-up ASRH programme in Kalikot District through its Strengthening Reproductive Health (SRH) project. I worked as a 'Training Officer' in ADRA from 2012-2013.
This Information Brief was developed by WHO's Department of Child and Adolescent Health and Development to support staff of the Organization and other UN agencies working at global, regional and national levels in promoting the uptake of effective interventions to improve the sexual and reproductive health of adolescents through schools in low-income countries. The premise of the Brief is that school-based sexual and reproductive health education is one of the most important and widespread ways to help adolescents to recognize and avert risks and improve their reproductive health. This evidence-based information brief establishes ways in which the health sector can help the education sector provide appropriate information to adolescents about when and why they need to use health services and where these may be available.
I wanted to raise awareness of this council. We are a local voice to the school board. Please feel free to let me know if you would like something presented to the council for discussion.
Child Sexual Abuse as a Mental Health Issue - Tasmin Kurien, SHout ClubTasminKurien
Child Sexual Abuse: Ensuring Safe Environments & Healthy Childhoods
Presented by Tasmin Kurien, President of SHout Club, Department of Social Work, Madras Christian College on October 30, 2020
Public Health Nutritionist explains how the new food and beverage policy for schools works.
Clear and easy to understand. This is the information you need to implement the new food guidelines for schools. She also shares tips on how public health is working with school communities to help implement the guidelines in Ontario.
Explore the measures and metrics that aided the Snohomish County Health Leadership Coalition, in their search of a Strategic Focus and how the LiveHealthy2020 initiative came to be. Consider the ways that Snohomish County can work together and measure their success of a Countywide scale.
Nonprofit Board Roles, On the Board vs. On BoardRebecca Gordon
Deep diving into nonprofit board engagement this presentation looks at how your inspire and engage your board of directors for long term financial success.
Making ourselves redundant: Delivering impact by building design capabilities...Service Experience Camp
This is Simone Carrier’s key talk from Service Experience Camp 2016 on Delivering impact by building design capabilities, held on Day 2 on the big stage.
Symposium 2016 : Workshop 704 SYNERGY BETWEEN PROJECT MANAGEMENT AND PEOPLE C...PMI-Montréal
« Déployer et faire adopter des projets de nouvelles technologies, qui occasionnent des changements humains et culturels, sont des défis de taille!!! Pendant cette session, nous allons partager l’importance de la synergie entre les pratiques de Gestion de projets et de Gestion du changement pour optimiser le partage et la gestion des connaissances de même que la collaboration interne. Nous vous invitons à assister à notre session pour apprendre de « notre histoire et parcours », vécus à travers différentes unités d’affaires chez Bombardier, de la conception du projet en passant par le projet pilote, le retour d’expérience et le déploiement complet de l’outil de collaboration. »
BIOGRAPHIE
Mme Sapene détient un baccalauréat en Administration des affaires et une maîtrise en Système
d’intervention humaine de l’Université Concordia, un certificat en Responsabilité sociale corporative de l’Université de Toronto ainsi qu’un diplôme comme APMG CM Global Facilitateur. Durant les 25 dernières années, elle a cumulé de l’expérience en Gestion de projets et en Gestion du changement, particulièrement en analyse stratégique, en réorganisation, en processus et en déploiement de système. À titre de directrice du département de Gestion du changement – Gestion du cycle de vie du produit – Ingénierie chez Bombardier, Mme Sapene dirige une équipe à l’avant-garde de l’innovation dans un environnement d’affaires internationale, complexe et multiculturelle en perpétuel transformation. En partenariat avec Aéro Montréal, elle était aussi à la tête de la conceptualisation, du prototypage et du déploiement du programme « Passion pour l’aviation » destiné à inspirer les jeunes dans leur choix de carrière vers les sciences et les technologies. Ce programme est maintenant déployé dans plusieurs pays. En ce moment, elle est à la tête d’un projet majeur de gestion de changement en Gestion des connaissances – le déploiement de SharePoint chez Bombardier. Elle donne aussi fréquemment des conférences à des événements tant locaux qu’internationaux, incluant PMI, HEC, McGill, IT Chapter Montreal, Alia et autres. Merling enseigne la Gestion du changement au programme de Gestion de projet à l’Université McGill, et membre du conseil d’administration HPIC, sante et espoir, et IScoa.
SYMPOSIUM 2016 : CONFÉRENCE D'OUVERTURE 600 - LES ENJEUX DE LA TRANSFORMATION...PMI-Montréal
Roger Tessier, vice-président et chef du Programme Évolution des projets chez Desjardins, a comme mandat la réalisation d’un vaste chantier visant à optimiser la gestion et la livraison des projets.
Lors de sa conférence, les participants pourront découvrir comment le Mouvement Desjardins a mis en place les fondations requises pour créer une gestion des projets plus performante, en s’appuyant sur des objectifs de simplification et d’efficacité.
Il y présentera une approche s’appuyant sur un déploiement de projets par types d’initiatives. En effet, les responsables de projets sont appelés à mettre en place les conditions gagnantes à tout démarrage de projet en plus d’instaurer un véritable dialogue de performance. Les initiatives de fondation font appel à la gouvernance et à la structure de projet. Viennent ensuite les initiatives de performance qui sont en lien avec le mode de livraison, le plan de projet et la reddition des comptes. La dernière étape consiste à assurer le suivi et l’amélioration continue des projets ayant mis en place ces initiatives. Une étape essentielle pour la pérennité des changements.
Évidemment, l’accompagnement des personnes est un enjeu de taille au sein d’une grande organisation. C’est un élément essentiel qui permet de concrétiser cette évolution et en assurer le succès. Chez Desjardins, on a misé sur une équipe de navigateurs qui a pour rôle d’accompagner les équipes clés de projets vers les nouvelles façons de travailler. Voyez aussi comment le programme d’évolution de projets chez Desjardins a mis en place différentes initiatives pour assurer le développement des compétences pour les postes identifiés en gestion de projet.
BIOGRAPHIE
Roger Tessier occupe la fonction de vice-président et chef du Programme Évolution des projets depuis 2014. Son mandat consiste à mettre en place des pratiques structurantes et harmonisées au sein du Mouvement Desjardins. Il assume aussi depuis peu, et sur une base intérimaire, les fonctions de vice-président et chef de l’exploitation du Centre de services partagés du réseau des caisses.
Excellent communicateur, Roger Tessier est un gestionnaire orienté vers l’action ainsi que sur l’atteinte de résultats. Très à l’écoute : il peut tirer le meilleur parti des commentaires des gens qui l’entourent. Il favorise la collaboration et l’innovation dans les façons de travailler facilitant l’atteinte des objectifs d’affaires de Desjardins. De plus, il sait faire preuve de vision stratégique et de leadership tant au sein de son équipe qu’auprès de ses pairs. Il détient un baccalauréat et est titulaire d'un MBA en gestion de l’Université de Sherbrooke.
Improvement Story session at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter.
Population and Public Health Branch of Saskatoon Health Region deployed improvement methods to develop a comprehensive strategy to improve outcomes for small children ages 0 to 5. The Early Years Health and Development Strategy (EYHDS) team comprised of 5 front line staff and an improvement consultant worked intensively over three months (Feb, Mar, and April, 2012) to Define, Measure and Analyze the opportunity for improvement and generated 25 recommendations. The result was a set of related recommendations for health planners, governments and community organizations. The presentation will demonstrate how improvement methods can be used effectively in community based health promotion areas of health care.
Better Health
Mary Smillie; Dr. Julie Kryzanowski, Saskatoon Health Region
iHV regional conf: Theresa bishop - Strengthening Health Visiting into the fu...Julie Cooper
Presentation by Theresa Bishop at the Institute of Health Visiting Regional Professional Conferences 2015.
Theresa Bishop is Professional Lead for Health Visiting for Warwickshire.
iHV regional conf: Theresa Bishop - Strengthening Health Visiting into the fu...Julie Cooper
Presentation by Theresa Bishop at the Institute of Health Visiting Regional Professional Conferences 2015.
Theresa Bishop is Professional Lead for Health Visiting in Warwickshire.
iHV regional conf London: Professor Viv Bennett - The Future is HV 456!Julie Cooper
Presentation by Professor Viv Bennett at the Institute of Health Visiting Regional Professional Conferences 2015 - London.
Professor Viv Bennett is Director of Nursing for Department of Health and Public Health England.
Identifying and Serving Children with Health Complexity: Spotlight on Pediatr...LucilePackardFoundation
Children with health complexity face unique medical and social factors that impact their health and engagement of health care services. Health systems play an important role in addressing both factors to build health and resilience. Speakers will share their approach to using system and practice-level data to better identify appropriate care coordination and health management supports for these children. We will also spotlight how this approach was implemented in Kaiser Permanente Northwest through the Pediatric Care Together complex health management program.
Going Where the Kids Are: Starting, Growing, and Expanding School Based Healt...CHC Connecticut
Webinar broadcast on: June 28 | 3 P.M. EST
This webinar will address the benefits, challenges, and strategic advantages of a school based health center program from a clinical, data, quality, operational viewpoint, communications, and community engagement perspective. Experts will share the strategy for integrating oral health and behavioral health to ensure the best outcomes for patients.
GA House Study Committee on Health, Education, and School-Based Health Centers
Dr. Veda Johnson , Director of Partners for Equity in Child & Adolescent Health, Emory Univ School of Medicine
www.gacommissiononwomen.org
Mental Health Policy Briefing: Raising the Priority of California Children wi...LucilePackardFoundation
Mental health services and supports for children with special health care needs (CSHCN) must be a priority for California. This briefing will provide an overview of the mental health services to which CSHCN are entitled, highlight current state policy priorities, and share ways to engage in advocacy efforts. Speakers will be available after the briefing for questions.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
3. Objectives for today…
• What are the some of our challenges
and opportunities in improving health
and health services for children
• How can we move to improve health
of children and youth?
• How do we improve the health
service system for children and
youth?
• Learning from one another
3
4. Objectives for today…
• What are the some of our
challenges and opportunities in
improving health and health
services for children
• How can we move to improve health
of children and youth?
• How do we improve the health
service system for children and
youth?
• Learning from one another
4
19. Challenges
• Proportionately few children in the population
• Proportionately more children in more rural and remote areas
• Vast geography
– with relatively low population and low population of children
• The health status of Canadian children remains a concern
• Health system sustainability/cost remains a concern
– How well can we describe “health” related costs for children?
– Health system reform, health service integration
19
21. Strengths and opportunities
• Publically funded health care system
– Multi-sectoral especially for children and youth
• Data – national and provincial
21
22. National:
•Canadian Community Health Survey
•National Housing Survey
•LIM –AT (Low Incomes Measures – After Tax)
•Statistics Canada Labour Force Survey
Provincial:
•VISTA BC Vital Statistics
•Perinatal Services BC Data Base
•McCreary Centre Society Adolescent Health Survey
•Early Development Instrument – Human Early Learning Partnership
•BEST
•BC Centre for Disease Control
•Ministry for Children and Family Development Data Base
•Ministry of Education Data Base
•Ministry of Health – Public Health Surveillance and Epidemiology, Chronic Disease
Registries
•Ministry of Health – HealthIdeas database
Example – BC child health status report
23. Strengths and opportunities
• Publically funded health care system
– Multisectoral, especially for children and youth
• Data – national and provincial
• Data analysis, interpretation
– Academic knowledge with respect to children/ excellence in health
services researchers
– Partnerships e.g. CAPHC and CIHI
– Emphasis on children – CIHI
23
24. Strengths and opportunities
• Evidence-based policy
• Evidence-based practice, including national endeavors
– E.g. TREKK, Child-Bright SPOR
• Academically strong training programs
– Well trained health providers
• System innovation
– Including learning from eachother
• Tremendous philanthropic support
• We collaborate rather than compete 24
25. Objectives for today…
• What are the some of our challenges
and opportunities in improving health
and health services for children
• How can we move to improve health
of children and youth?
• How do we improve the health
service system for children and youth?
• Learning from one another
25
26. Two pronged approach to improving child health
26
Improve health status Improve health services
27. Objectives for today…
• What are the some of our challenges
and opportunities in improving health
and health services for children
• How can we move to improve
health of children and youth?
• How do we improve the health service
system for children and youth?
• Learning from one another
27
30. What do we
know about
the health
status of
Canada’s
children?
UNICEF Office of Research (2013). ‘Child Well-being in Rich Countries:
A comparative overview’, Innocenti Report Card 11, UNICEF Office of
Research, Florence.
31. Do you know how healthy children in your province
are?
•
31
32. • UBC Departments
of Pediatrics,
Surgery
• Canadian Child
Health Coalition
• BC Pediatric
Society
• DOBC: Society of
GPs
• BC Principals, Vice
Principals
• Fraser
• Interior
• Island
• Northern
• Van-Coastal
• PHSA
• First Nations
• Ministry of Health
• Ministry of
Child/Family
Development
• Ministry of
Education
Government
Ministries
Provincial
Health
Authorities
Academic
Partners
Professional
Societies
Child Health BC - Steering Committee
33. Is “Good” Good Enough?
• A BC report
• For release November 3, 2016
– “Book” version
– Online version
34. Dimensions of Child and Youth Health &
Well-being
In 2013, the PHO and the
Canadian Institute for Health
Information (CIHI) released a
suite of 51 valid indicators
• The indicators reflect five
dimensions:
35. THE INDICATORS:
Physical Health & Well-being
• Physical health and well-being is more than the absence of
disease. It includes a healthy start in life, preventive care, healthy
development, safe environments, and much more.
• This dimension includes 21 indicators:
#1 Low Birth Weight
#2 Smoking during Pregnancy
#3 Alcohol Use during Pregnancy
#4 Breastfeeding
#5 Fruit & Vegetable Consumption
#6 Vision Screening
#7 Hearing Screening
#8 Dental Caries Prevalence
#9 Percentage of Children with Healthy
Weight
#10 Positive Self-rated Health
#11 Youth Physical Activity Levels
#12 Frequency of Tobacco Use
#13 Binge Drinking
#14 Marijuana Use
#15 Immunization Rates
#16 Asthma Prevalence
#17 Serious Injury among Children & Youth
#18 Chlamydia Incidence
#19 Teenage Birth Rate
#20 Physical Health & Well-being Skills
#21 Infant Mortality Rate
36. THE INDICATORS:
Mental & Emotional Health & Well-being
• Mental and emotional health and well-being refers to a range of
personal characteristics, self-regulating abilities, capacity for
connectedness, and freedom from anxiety and depression.
• This dimension includes 7 indicators:
#22 Incidence & Prevalence of Most Common
Mental Health Disorders
#23 Positive Self-esteem
#24 Positive Self-rated Mental Health
#25 Positive Life Satisfaction
#26 Considered Suicide
#27 Suicide Rate
#28 Most Common Prescription Mental
Health Drugs
37. THE INDICATORS:
Social Relationships
• Social relationships are key components of child and youth health
and well-being, and includes having relationships that are close,
trusted, accepting, affirming and reciprocal with peers, parents,
teachers, coaches and others.
• This dimension includes 11 indicators:
#29 Positive Parent Relationship
#30 Trusting Adult Relationship
#31 School Connectedness Rate
#32 Community Connectedness Rate
#33 Incidence of Abuse/Neglect
#34 Incidence of Sexual Abuse
#35 Rate of Children in Care
#36 Discrimination Rate
#37 Bullying Rate
#38 Youth Conviction Rate
#39 After-school Activities
38. Advisory Committee members include representatives:
– Health Officer’s Council
– Ministry of Health
– Ministry of Education
– Ministry for Children and Family Development
– First Nations Health Authority
– Health Authorities
– Doctors of BC
– BC Pediatric Society
– BC Children’s Hospital
– BC Centre for Disease Control
– Perinatal Services BC
– BC Representative for Children and Youth
– UBC
– Researchers from McCreary Centre Society, HELP
A collaborative effort
39. Some indicators demonstrate improvement over time
Language and Cognitive Development Domain – Vulnerability on EDI
40. Some indicators show stability over time
Physical Health domain – Immunization rates
45. Some examples of how we are responding in BC
• Trying to deliver the “critical messages” about health status of our children
– Including through work of our Healthy Child Development Alliance
45
46. Some examples of how we are responding in BC
• Trying to deliver the “critical messages” about health status of our children
– Including through work of our Healthy Child Development Alliance
• Measured health status – so we have the knowledge of health status to work
with
• Worked with the Ministry of Health’s so ensure their “Lifetime Prevention
Schedule” has a focus on evidence-based interventions for children. E.g
flouride varnish for prevention of caries
46
47. Some examples of how we are responding in BC
• Trying to deliver the “critical messages” about health status of our children
– Including through work of our Healthy Child Development Alliance
• Measured health status – so we have the knowledge of health status to work
with
• Worked with the Ministry of Health’s so ensure their “Lifetime Prevention
Schedule” has a focus on evidence-based interventions for children e.g.
flouride varnish for the prevention of caries
• Working on implementation strategy for flouride varnish for children
• Continuing/ renewed immunization efforts
• Reinforcing efforts regarding mental health promotion/health literacy
• Linkages with First Nations Health Authority
• Province standards and resources for healthy physical activity and healthy
eating in child care settings (Ministry grant)
47
48. Some examples of how we are responding in BC
• Trying to deliver the “critical messages” about health status of our children
– Including through work of our Healthy Child Development Alliance
• Measured health status – so we have the knowledge of health status to work
with
• Worked with the Ministry of Health’s so ensure their “Lifetime Prevention
Schedule” has a focus on evidence-based interventions for children e.g.
flouride varnish for the prevention of caries
• Working on implementation strategy for flouride varnish for children
• Continuing/ renewed immunization efforts
• Reinforcing efforts regarding mental health promotion/health literacy
• Linkages with First Nations Health Authority
• Province standards and resources for healthy physical activity and healthy
eating in child care settings (Ministry grant)
• Must link with and support youth! 48
50. How do we respond as health care providers and
managers?
• Deliver the critical messaging
• But does it influence…
– What services we provide?
– How we provide our services?
– For example, how do geographic disparities/inequities influence what
you provide?
50
51. Our call to action: I’ll hope you’ll join in thinking
about…
• What do you know about the health/health status of children in your
province?
• What is your province measuring about the health of its children?
• What population health initiatives are supporting child health?
• How are pediatric/child health experts involved in
supporting/influencing child health (promotion) programs and policy?
• For those of us delivering health services, how do we consider
health status and social vulnerabilities in our hospitals?
51
52. Two pronged approach to improving child health
52
Improve health status Improve health services
53. Objectives for today…
• What are the some of our challenges
and opportunities in improving health
and health services for children
• How can we move to improve health
of children and youth?
• How do we improve the health
service system for children and
youth?
• Learning from one another
53
54. How do support the system of health services for
children? And do we even need a “system?”
54
55.
56.
57. • Challenges service planning given relatively
low volumes & large geography
(Rural/remote and small urban needs)
• Desire to ensure primary care is optimized
while simplifying referral paths and access to
specialty and sub-specialty services.
• Build a foundational to quality and the
development of appropriate:
– Practice guidelines/care pathways
– Care pathways
– Team-based practice models (on-site & via
outreach/telehealth)
– Provincial health human resource strategy
• Sustainability of quality services
What issues did we need to tackle?
57
63. What does each module “outline?”
• Responsibilities:
– Clinical
– Knowledge Sharing and Transfer
– Quality Improvement and Research
• Requirements:
– Providers
– Equipment and Supplies
– Facilities
– Medications
– Interdependencies
63
64. • key individuals – across
disciplines & geography
• Use outcome evidence
• Use service utilization data
• Guided consensus meetings
(series)
• Broad stakeholder feedback on
draft, including provincial
councils/committees,
• Acceptance by provincial ministry
councils/committees
How do we develop a Tiers of Service Module?
64
67. • Clinical Services:
– Emergency Department
– Medicine
– Medical Subspecialties
– Surgery (Adult & Pediatric Surgical Specialists)
– Intensive Care for children
– Child Development & Rehabilitation
– Mental Health & Substance Use
– Home-based Services
• Clinical Diagnostic & Therapeutic Services:
– Laboratory, Pathology & Transfusion Medicine (in conjunction with
PSBC and the Provincial Lab Agency)
– Diagnostic imaging
– Pharmacy
A series of Tiers of Service Modules (for child health)
67
68. Sample page– Surgery
Example of one area of clinical responsibilities
68
Refer to details in “Surgical Tiers “in brief”
and/or “in full””
69. • Clinical Services:
– Emergency Department
– Medicine
– Medical Subspecialties
– Surgery (Adult & Pediatric Surgical Specialists)
– Intensive Care
– Child Development & Rehabilitation
– Home-based Services
– Mental Health & Substance Use
• Clinical Diagnostic & Therapeutic Services:
– Laboratory, Pathology & Transfusion Medicine (in conjunction with
PSBC)
– Diagnostic imaging
– Pharmacy
Where are we at with the child health tiers?
69
70. 109/109 ED’s in BC completed self-assessment
Module developed, self-assessments completed
70
74. Example – HA map putting tier alignment in context of driving time
74
75. Emergency Tiers
What action has happened since the self-assessment
• Close collaboration between CHBC and the
MOH’s Committee (ESAC)
• Sites and regional action:
– Received their reports
– Site and regional “opportunities”
• Province wide action:
– ESAC and CHBC have created provincial
working group
– Agreed to a common work plan on
September 8, 2016 – heavily T1 and T2.
– Links to academic health network and
mental health services
– Links to national endeavours (e.g. TREKK) 75
78. What is the value in proceeding?
Why is Tiers of Service work of assistance?
Clinical Services:
• Planning and standardization of appropriate services: To reduce
risk/improve quality. To improve efficiency within and across sites.
• Standardization of appropriate care: To set the stage for layering
on clinical standards which are appropriate to tier of service offered
• Rural and Remote focus: Useful across province, especially in
rural and remote settings.
• Capital planning: To focus capital projects to the service needs
appropriate to the community and volumes served – the Tiers
necessary.
• Health human resource planning/Credentialing: To assist in
predicting the nature of the services and subsequent HHR needs at
a given Tier.
78
79. What is the value in proceeding?
Why is Tiers of Service work of assistance?
Quality Improvement/CQI:
• Self-assessment identifies themes for QI and leads to QI action that
is appropriate by tier - enhances focus and efficiency of QI efforts
with less duplication across sites and regions.
Health provide learning/KT
• Educational competencies are identified for each Tier with then
suitable educational content and deliver methods (“Tiers of
Learning”)
Formal Education and Research roles
• Supports the academic mandate/health science network concept in
clear and appropriate ways.
79
81. Linked with Doctors of BC, MOH and “BC Guidelines”
Mary Lou Matthews, Jennifer Scarr, Dr. C Yang (and advisory
group)
Supporting Tiers 1 (Primary Care)
Asthma Guideline and Tool Kit
82. Provincial childhood diabetes planning
Involves Provincial Advisory Committee and 4 working groups
-multi-disciplinary including schools
- all HA’s involved
– Care guidelines for BC (based on review of international standards)
– Service plan for BC (aligned with Tiers of Service)
– Education and resources – for parents and providers
– Information and data
– Research and Evaluation
Pediatric early warning system – PEWS – for inpatient care
– Large scale provincial implementation with research project and embedded QI
– >30 hospitals in BC by end of 2016
Tier 4- leaders and impacted on both
Supporting Tiers 2 and 3
83. • Outreach
• Tele-health – Technology-enhanced access
To care for children
– 19 community sites in BC are now
“pediatric-enhanced”
Telehealth sites
– Surgical patient Journey
– Pediatric medicine subspecialties
– Tele-PICU now live!
– Tele-ED under very early development
Supporting Tiers 2 and 3
84. Cross-Tier Priorities
Delivered at every tier – unique role/capacity of each
tier must be considered
• Child and youth mental health
• Complex care – “frail children”
• Home care for children…
84
86. Two pronged approach to improving child health
86
Improve health status Improve health services
87.
88. Enablers of success so far - examples
• Legacy of Dr. Clyde Hertzman
– Long standing awareness of child health and development issues – HELP
• Child Health BC table
– Key players affecting policy, accountable for delivery, training and influence
– Cohesive network with collaborative spirit
– Expansion from focus on health services to cross continuum
– Strong trusting relationships being built
• Focus on tiers has helped us
– Generate improvement activities across tiers
– Understand data – different meaning at different tiers
– Have a common language
– Understand the relationship between volume and quality
88
89. Enablers of success
• BC Children’s Hospital Foundation and its donors
• Leveraging
89
90. Much more to do
• Evaluate all initiatives
– Process measures
– Outcomes measures
– Health status
• Learn from others
90
91. Objectives for today…
• What are the some of our challenges
and opportunities in improving health
and health services for children
• How can we move to improve health
of children and youth?
• How do we improve the health service
system for children and youth?
• Learning from one another
91
Some indicators demonstrate improvement over time.
Example #1: There has been a decline in the percentage of children identified as “vulnerable” for language and cognitive development. This means children are entering formal education more prepared for literacy and numeracy.
Note: "Vulnerable" means receiving a score below the cut-off on this domain of the Early Development Instrument.
Data source: Human Early Learning Partnership, Early Development Instrument, 2004/05-2012/13. Prepared by the Surveillance and Epidemiology Team, BC Office of the Provincial Health Officer, 2016.
Example #2: Many children in BC have up-to-date immunizations by age 7, but almost one-third do not.
Up-to-date immunization rates in 2014 were lowest in Island Health (61%) and Fraser Health (64%).
Data sources: BC Centre for Disease Control, Immunization Programs and Vaccine Preventable Disease Service. Immunization data are from Panorama, BC Centre for Disease Control, 2014; the Public Health Information System, BC Centre for Disease Control, 2012 to 2014; Primary Access Regional Information System, Vancouver Coastal Health Authority, 2012 to 2014. School enrolment data are from the BC Ministry of Education, 2012 to 2014. Prepared by the Surveillance and Epidemiology Team, BC Office of the Provincial Health Officer, 2016.
Example #3: It is concerning that about 20% of youth don’t have a trusting relationship with an adult—and that this is decreasing, particularly for females.
Notes: Responses are based on youth who felt that they had an adult to talk to if they were having a serious problem. The difference between years was statistically significant for all groups.
Data source: McCreary Centre Society, BC Adolescent Health Survey, 2003, 2008, 2013. Prepared by the Surveillance and Epidemiology Team, BC Office of the Provincial Health Officer, 2016.
There are disparities based on sex/gender across many indicators, particularly relating to mental and emotional health and well-being.
Example #1: There are 3 positive mental health indicators: positive self-esteem, self-rated mental health and positive life satisfaction. In comparison to females, more males report feeling good about themselves, having “good” or “excellent” mental health, and being satisfied with their lives, than females.
Notes: "Positive mental health" means youth reported their mental health as either "good" or "excellent." Data are not available for 2003 or 2008.
Data source: McCreary Centre Society, BC Adolescent Health Survey, 2013. Prepared by the Surveillance and Epidemiology Team, BC Office of the Provincial Health Officer, 2016.
All 109 sites in the Province- 36 in IHA completed the surveys
The survey was designed to assess against module responsibilities and requirements using fluid survey
Beta tested the tool-accuracy, usability and data
Comprehensive education & communication process from ED Directors through to site leads and physician leads
CHBC supported sites how ever was needed
Once the survey was closed, the management of the data began.
Over 50,000 cells of Survey data exported to Excel Spreadsheet
Extraction, transformation processes were done to ensure data integrity and usability. Virtually every question and answer can be searched by filters including health authorities, sites, and all aspects of the survey.
Validity testing done, some poor performing questions removed from analysis
Reports for each site created on the resulting gaps and overachievements for their volume aligned Tier and verification though 1:1 teleconferences held with all sites.
Data corrected based on verification