Background The delivery of quality healthcare for women and children in conflict-affected settings remains a challenge that cannot be mitigated unless global health policymakers and implementers find an effective modality in these contexts. The International Committee of the Red Cross (ICRC) and the Canadian Red Cross (CRC) used an integrated public health approach to pilot a program for delivering community-based health services in the Central African Republic (CAR) and South Sudan in partnership with National Red Cross Societies in both countries. This study explored the feasibility, barriers, and strategies for context-specific agile programming in armed conflict affected settings. Methods A qualitative study design with key informant interviews and focus group discussions using purposive sampling was used for this study. Focus groups with community health workers/volunteers, community elders, men, women, and adolescents in the community and key informant interviews with program implementers were conducted in CAR and South Sudan. Data were analyzed by two independent researchers using a content analysis approach. Results In total, 15 focus groups and 16 key informant interviews were conducted, and a total of 169 people participated in the study. The feasibility of service delivery in armed conflict settings depends on well-defined and clear messaging, community inclusiveness and a localized plan for delivery of services. Security and knowledge gaps, including language barriers and gaps in literacy negatively impacted service delivery. Empowering women and adolescents and providing context-specific resources can mitigate some barriers. Community engagement, collaboration and negotiating safe passage, comprehensive delivery of services and continued training were key strategies identified for agile programming in conflict settings. Conclusion Using an integrative community-based approach to health service delivery in CAR and South Sudan is feasible for humanitarian organizations operating in conflict-affected areas. For agile, and responsive implementation of health services in conflict-affected settings, decision-makers should focus on effectively engaging communities, bridge inequities through the engagement of vulnerable groups, collaborate and negotiate for safe passage for delivery of services, keep logistical and resource constraints in consideration and contextualize service delivery with the support of local actors.
Purpose This study sought to assess gender differences among physician faculty in medical biochemistry and genetics programs in North America. It compared the distribution of academic and leadership ranks, years of active research, number of citations and publications, and Hirsch-index ( h- index) by gender. Variable associations with the h -index were assessed. Method This was a cross-sectional retrospective study for which data was collected from June 2019 to October 2019 on academic and administrative physician faculty members for medical biochemistry and genetics programs. The website of Fellowship and Residency Electronic Interactive Database, Canadian Resident Matching Service website, and the medical biochemistry profile from the Canadian Medical Association to identify relevant programs and SCOPUS was used to gather faculty data. Results The analyses included 147 faculty members. More male faculty held higher academic rank positions and first-in-command leadership positions than female faculty. Men had more median years of active research, citation numbers, publication numbers, and h -index than women across all academic ranks. Upon performing multivariable linear regression, female faculty showed 0.39 times the odds of having a higher h -index than male faculty, keeping all other variables constant (p<0.01). Conclusions In our study, it was shown that male physician faculty surveyed had higher performance than female faculty in academic rank and research productivity. Certain barriers may be contributing factors, including lack of mentorship or flexible institutional policies, women choosing clinical educator tracks, or gender bias. Considering the low retention rates of women in academic research, there is a need to address barriers in order to achieve gender parity.
In the context of shifting population demographics in the United States (US), a diverse workforce in the discipline of public health can improve outcomes for various populations through the provision of culturally competent public health policies and corresponding research. This study explored the academic, racial, and gender profile of public health faculty in the USA. MethodsIn this retrospective cross-sectional analysis, we analyzed the Association of American Medical Colleges (AAMC) annual report of faculty appointments at US medical schools. Descriptive data analysis was performed for chairperson, full professor, associate professor, assistant professor, instructor, and other positions from 2007 to 2018. ResultsThere was a decrease in appointments at all academic ranks from 2007 to 2018 with an absolute change of −239. Overall, most academic positions were occupied by Whites compared to other races, especially in leadership ranks. However, year-by-year analysis showed a gradual decrease in the number of positions held by Whites. Over the last decade, there was a positive trend with a marginally greater number of minorities appointed at academic ranks, specifically Asians. Similarly, no significant change was seen in appointments for Hispanics. Additionally, females occupied a greater number of new positions as compared to their male counterparts except for the higher academic ranks. The data obtained from the AAMC were voluntarily reported and thus may not provide a complete picture of medical faculty in academic medicine. ConclusionWomen have shown progress in public health faculty positions during our 12-year study period. However, racial and gender incongruity still exists at higher academic ranks and leadership positions. Further research is warranted to explore factors influencing faculty appointment and promotion, and strategies to reduce inequities.
Background The delivery of quality healthcare for women and children in conflict-affected settings remains a challenge that cannot be mitigated unless global health policymakers and implementers find an effective modality in these contexts. CRC and ICRC used an integrated public health approach to pilot a program for delivering community-based health services in the Central African Republic (CAR) and South Sudan in partnership with National Red Cross Societies in both countries. This study explored the feasibility, barriers, and strategies for context-specific agile programming in armed conflict affected settings. Methods A mixed-methods study design was used for this study. Focus groups with community health workers/volunteers, community elders, men, women, and adolescents in the community and key informant interviews with program implementers were conducted in CAR and South Sudan. Additional data related to program activities and qualitative data to validate findings from focal group discussions and key informant interviews were extracted from program implementation reports. Data were analyzed using a content analysis approach and triangulated during the study analysis and inference. Results In total, 15 focus groups and 16 key informant interviews were conducted, and 169 people participated in the study. Engaging community elders emerged as an overarching theme underpinning the importance of gaining community trust. The feasibility of service delivery in armed conflict settings depends on well-defined and clear messaging, community inclusiveness and a localized plan for delivery of services. Security and knowledge gaps, including language barriers and gaps in literacy, impacted service delivery. Empowering women and adolescents and providing context-specific resources can mitigate some barriers. Community engagement, collaboration and negotiating safe passage, comprehensive delivery of services and continued training were key strategies identified for agile programming in conflict settings. Conclusion Using an integrative community-based approach to health service delivery in CAR and South Sudan is an effective approach for humanitarian organizations operating in conflict-affected areas. To achieve successful, agile, and responsive implementation of health services in a conflict-affected setting, decision-makers should focus on effectively engaging communities, bridge inequities through the engagement of vulnerable groups, and contextualize service delivery with the support of local actors.
Background The delivery of quality healthcare for women and children in conflict-affected settings remains a challenge that cannot be mitigated unless global health policymakers and implementers find an effective modality in these contexts. CRC and ICRC used an integrated public health approach to pilot a program for delivering community-based health services in the Central African Republic (CAR) and South Sudan in partnership with National Red Cross Societies in both countries. This study explored the feasibility, barriers, and strategies for context-specific agile programming in armed conflict affected settings. Methods A mixed-methods study design was used for this study. Focus groups with community health workers/volunteers, community elders, men, women, and adolescents in the community and key informant interviews with program implementers were conducted in CAR and South Sudan. Additional data related to program activities and qualitative data to validate findings from focal group discussions and key informant interviews were extracted from program implementation reports. Data were analyzed using a content analysis approach and triangulated during the study analysis and inference. Results In total, 15 focus groups and 16 key informant interviews were conducted, and 169 people participated in the study. Engaging community elders emerged as an overarching theme underpinning the importance of gaining community trust. The feasibility of service delivery in armed conflict settings depends on well-defined and clear messaging, community inclusiveness and a localized plan for delivery of services. Security and knowledge gaps, including language barriers and gaps in literacy, impacted service delivery. Empowering women and adolescents and providing context-specific resources can mitigate some barriers. Community engagement, collaboration and negotiating safe passage, comprehensive delivery of services and continued training were key strategies identified for agile programming in conflict settings. Conclusion Using an integrative community-based approach to health service delivery in CAR and South Sudan is an effective approach for humanitarian organizations operating in conflict-affected areas. To achieve successful, agile, and responsive implementation of health services in a conflict-affected setting, decision-makers should focus on effectively engaging communities, bridge inequities through the engagement of vulnerable groups, and contextualize service delivery with the support of local actors.
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