Health policy-makers in Ghana should address issues relating to resource adequacy, compensation and the work-life balance of physicians in order to improve the overall career satisfaction of an already dwindling physician workforce.

IntroductionIn 2012, the Great Plains Public Health Training Center (Grant #UB6HP22821) conducted an online survey of state and local health departments and the American Indian (tribal clinics, tribal health departments, and urban Indian clinic) public health workforce across three professional levels. The objectives of the needs assessment were to determine the competency levels of the state’s public health workforce, assess gaps in public health competencies, identify public health training interests, needs, and preferences, and to determine the barriers and motivators to participate in public health training.MethodsThe assessment was developed using the Council on Linkages Between Academia and Public Health Practice, Core Competencies for Public Health Professionals survey (1). The final assessment was created and piloted by numerous individuals representing practice and academia.ResultsRespondents identified cultural competency and communication skills as the two most important public health competency domains. Although the public health professionals perceived that they were least proficient in the area of policy development and program planning, participants identified the greatest needs for training in financial planning and management skills and analytical/assessment skills. In general, respondents preferred instructor-led interactive training sessions offered as onsite multi-day workshops or computer-based courses. Respondents identified obesity, health disparities, physical activity, chronic diseases, and diabetes as the top five public health topical areas.ConclusionThese priorities align with State and National public health plans. The findings of the needs assessment were used to tailor educational opportunities to build the capacity of Nebraska’s public health system. Additionally, the results were used to develop workforce development plans for numerous local health departments throughout Nebraska.

The World Bank estimates that at least 25 countries in the Sub-Saharan region of Africa experience chronic power outages. However, the implications of power shortages are often discussed within the context of industrial and economic disruptions, with little attention given to the health impact. Using a nationally representative data of healthcare facilities from the 2012 Ghana Access, Bottlenecks, Cost and Equity (ABCE) Health Facility Survey, this study aims to assess the impact of power outages on in-healthcare facility mortality in Ghana, a country that has experienced worsening energy crises in the last few decades. Findings revealed a positive association between the frequency of power outages and in-facility mortality, with the risk for mortality estimated to increase by 43% for each day the power was out for over 2 h. Further, when compared to an urban healthcare facility experiencing the same frequency of power outages, the risk of mortality was found to be lower in the rural facility. These findings call for a concerted effort among all stakeholders to ensure the availability of consistent power supply in healthcare facilities, in order to provide the necessary environment for the successful provision of healthcare for the citizens of Ghana.

The purpose of this study was to examine the impact of race, cancer history, and their interaction on emotional distress among a nationally representative sample of US adults. Data utilized for this analysis were obtained from the first, second, and fourth iterations of the fourth cycle of the Health Information National Trends Survey (HINTS). The study sample included 3959, 3630, and 3677 respondents for the years 2011, 2012, and 2014, respectively, for a total sample size of 11,266. A multivariable ordered logistic regression model was used to assess the relationship between emotional distress, race, and cancer history. The effect of cancer history on emotional distress was found to be moderated by race. Specifically, emotional distress was significantly higher among African American cancer survivors. Factors found to be protective against emotional distress included healthy lifestyle, older age, and higher income. Factors associated with high levels of emotional distress included poor general health status, low self-efficacy, and being female. The authors recommend the design, advancement, and implementation of evidence-based culturally sensitive interventions aimed at effectively screening and managing psychological distress symptoms, particularly among African American long-term cancer survivor patient populations.

BackgroundPeru has high cervical cancer incidence and mortality rates compared to other Andean countries. Therefore, partnerships between governmental and international organizations have targeted rural areas of Peru to receive cervical cancer screening via outreach campaigns. Previous studies have found a relationship between a person’s social networks and cancer screening behaviors. Screening outreach campaigns conducted by the nonprofit organization CerviCusco created an opportunity for a social network study to examine cervical cancer screening history and social network characteristics in a rural indigenous community that participated in these campaigns in 2012 and 2013. The aim of this study was to explore social network characteristics in this community related to receipt of cervical cancer screening following the campaigns.MethodsAn egocentric social network questionnaire was used to collect cross-sectional network data on community participants. Each survey participant (ego) was asked to name six other women they knew (alters) and identify the nature of their relationship or tie (family, friend, neighbor, other), residential closeness (within 5 km), length of time known, frequency of communication, topics of conversation, and whether they lent money to the person, provided childcare or helped with transportation. In addition, each participant was asked to report the nature of the relationship between all alters identified (e.g., friend, family, or neighbor). Bivariate and multivariate analyses were used to explore the relationship between Pap test receipt at the CerviCusco outreach screening campaigns and social network characteristics.ResultsBivariate results found significant differences in percentage of alter composition for neighbors and family, and for mean number of years known, mean density, and mean degree centrality between women who had received a Pap test (n = 19) compared to those who had not (n = 50) (p’s < 0.05). The final logistic regression model was statistically significant (χ2 (2) = 20.911, p < .001). The model included the variables for percentage of family alter composition and mean density, and it explained 37.8 % (Nagelkerke R2) of the variance in Pap test receipt, correctly classifying 78.3 % of cases. Those women with higher percentages of family alter composition and higher mean density in their ego networks were less likely to have received a Pap test at the CerviCusco campaigns.ConclusionsAccording to this exploratory study, female neighbors more than family members may have provided an important source of social support for healthcare related decisions related to receipt of a Pap test. Future studies should collect longitudinal social network data on participants to measure the network effects of screening interventions in rural indigenous communities in Latin American countries experiencing the highest burden of cervical cancer.