Background Given the high burden of adverse sexual and reproductive health outcomes (SRH) and low... more Background Given the high burden of adverse sexual and reproductive health outcomes (SRH) and low levels of school attendance among adolescent girls in Kenya, this study sought to elucidate the association between school attendance and SRH outcomes among adolescent girls in Homa Bay and Narok counties. Methods This study uses baseline quantitative data from the mixed-methods evaluation of the In Their Hands (ITH) program which occurred between September to October 2018 in Homa Bay and Narok counties. In total, 1840 adolescent girls aged 15–19 years participated in the baseline survey, of which 1810 were included in the present analysis. Multivariable logistic regression models were used to assess the association between school attendance (in- versus out-of-school) and ever having sex, condom use during last sex, and ever pregnant, controlling for age, orphan status, income generation, religion, county, relationship status, and correct SRH knowledge. Results Across the 1810 participa...
Promotion de la santé et prévention des maladies chroniques au Canada, 2020
Introduction La formation continue peut aider les professionnels de la santé à maintenir et à dév... more Introduction La formation continue peut aider les professionnels de la santé à maintenir et à développer leurs connaissances et leurs compétences afin de s’adapter à la transformation du paysage de la santé publique. Cette revue de la portée vise à déterminer quelles sont les modalités préférées dans la formation continue des professionnels en santé publique et comment l’équité a été intégrée dans la formation en santé publique. Méthodologie En nous appuyant sur les lignes directrices PRISMA pour les revues de la portée, nous avons cherché dans quatre bases de données des études évaluées par les pairs qui évaluaient les modalités de formation continue du personnel en santé publique. Résultats La revue a porté sur 33 études, publiées dans 11 pays entre le 1er janvier 2000 et le 6 août 2019. Dans la plupart des articles, le public cible était généralement défini comme les professionnels en santé publique employés par un organisme gouvernemental ou non gouvernemental. Les méthodes de p...
ObjectivesFinancial risk protection (FRP) is an indicator of the Sustainable Development Goal 3 u... more ObjectivesFinancial risk protection (FRP) is an indicator of the Sustainable Development Goal 3 universal health coverage (UHC) target. We sought to characterise what is known about FRP in the UHC context and to identify evidence gaps to prioritise in future research.DesignScoping overview of reviews using the Arksey & O’Malley and Levac & Colquhoun framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guidelines.Data sourcesMEDLINE, PsycINFO, CINAHL-Plus and PAIS Index were systematically searched for studies published between 1 January 1995 and 20 July 2021.Eligibility criteriaRecords were screened by two independent reviewers in duplicate using the following criteria: (1) literature review; (2) focus on UHC achievement through FRP; (3) English or French language; (4) published after 1995 and (5) peer-reviewed.Data extraction and synthesisTwo reviewers extracted data using a standard form and descriptive conten...
Health Promotion and Chronic Disease Prevention in Canada, 2020
Introduction Continuing education (CE) can help public health professionals maintain and further ... more Introduction Continuing education (CE) can help public health professionals maintain and further develop their knowledge and skills to adapt to the changing public health landscape. This scoping review aims to identify the preferred modalities for delivering CE to public health professionals and to determine how equity has been incorporated into public health training. Methods Using the PRISMA extension for Scoping Reviews as a guide, we searched four databases for peer-reviewed primary research studies that evaluated public health workforce CE modalities. Results The review included 33 studies published between 1 January 2000 and 6 August 2019 from over 11 countries. Most articles broadly described their training audience as public health professionals employed by government or non-governmental organizations. Delivery methods included online, in-person or blended learning (combining online and in-person instruction). Learners strongly preferred self-directed approaches. Organizatio...
IntroductionSustainable financing of immunisation programmes is an important step towards univers... more IntroductionSustainable financing of immunisation programmes is an important step towards universal coverage of life-saving vaccines. Yet, financing mechanisms for health programmes could have consequences on the design of universal approaches to immunisation coverage. Effective implementation of immunisation interventions necessitates investigating the roles of institutions and power on interventions. This review aims to understand how sustainable financing and equitable immunisation are conceptualised by health actors like Gavi, and government-related entities across low-income and middle-income countries (LMICs) and how financing mechanisms can affect universal coverage of vaccines.Methods and analysisThis study protocol outline a scoping review of the peer-reviewed and the grey literature, using established methodological framework for scoping review. Literature will be identified through a comprehensive search of multiple databases and grey literature. All peer-reviewed impleme...
Exclusive breastfeeding (EBF) for 6 months is a global public health goal, but measuring its achi... more Exclusive breastfeeding (EBF) for 6 months is a global public health goal, but measuring its achievement as a marker of population breastmilk feeding practices is insufficient. Additional measures are needed to understand variation in non‐EBF practices and inform intervention priorities. We collected infant feeding data prospectively at seven time points to 6 months post‐partum from a cohort of vulnerable women (n = 151) registered at two Canada Prenatal Nutrition Program sites in Toronto, Canada. Four categories of breastmilk feeding intensity were defined. Descriptive analyses included the (i) proportion of participants in each feeding category by time point, (ii) use of formula and non‐formula supplements to breastmilk, (iii) proportion of participants practising EBF continuously for at least 3 months; and (iv) frequency of transitions between feeding categories. All participants initiated breastmilk feeding with 70% continuing for 6 months. Only 18% practised EBF for 6 months, b...
We examined the association between adolescents’ sexual and reproductive health (SRH) service uti... more We examined the association between adolescents’ sexual and reproductive health (SRH) service utilization in the past 12 months and structural, health facility, community, interpersonal, and individual level factors in Kenya. This cross-sectional analysis used baseline data collected in Homa Bay and Narok counties as part of the In Their Hands intervention evaluation from September to October 2018. In total, 1840 adolescent girls aged 15 to 19 years were recruited to complete a baseline survey. We used unadjusted and adjusted logistic regression to model factors associated with SRH utilization across the social-ecological framework levels. Overall, 36% of participants reported visiting a health facility for SRH services in the past 12 months. At the structural level being out-of-school (AOR: 2.12 95% CI: 1.60–2.82) and not needing to get permission to go (AOR: 1.37 95%CI: 1.04–1.82) were associated with SRH service utilization. At the interpersonal level, participants who reported b...
INQUIRY: The Journal of Health Care Organization, Provision, and Financing
The COVID-19 pandemic rapidly forced Canadian post-secondary students into remote learning method... more The COVID-19 pandemic rapidly forced Canadian post-secondary students into remote learning methods, with potential implications on their academic success and health. In recent years, the use of social media to promote research participation and as a strategy for communicating health messages has become increasingly popular. To better understand how the pandemic has impacted this population, we used social media platforms to recruit students to participate in a national bilingual COVID-19 Health Literacy Survey. The purpose of the survey was to assess the health literacy levels and online information-seeking behaviors of post-secondary students in relation to the coronavirus. This paper outlines the social media recruitment strategies used for promoting participation in the survey among Canadian post-secondary students during the pandemic. Facebook, Twitter, and Instagram accounts were created to promote the online survey. The objective of this paper is to examine the use of Instagra...
IntroductionWomen researchers find it more difficult to publish in academic journals than men, an... more IntroductionWomen researchers find it more difficult to publish in academic journals than men, an inequity that affects women’s careers and was exacerbated during the pandemic, particularly for women in low-income and middle-income countries. We measured publishing by sub-Saharan African (SSA) women in prestigious authorship positions (first or last author, or single author) during the time frame 2014–2016. We also examined policies and practices at journals publishing high rates of women scientists from sub-Saharan Africa, to identify potential structural enablers affecting these women in publishing.MethodsThe study used Namsor V.2, an application programming interface, to conduct a secondary analysis of a bibliometric database. We also analysed policies and practices of ten journals with the highest number of SSA women publishing in first authorship positions.ResultsBased on regional analyses, the greatest magnitude of authorship inequity is in papers from sub-Saharan Africa, wher...
Background Given the high burden of adverse sexual and reproductive health outcomes (SRH) and low... more Background Given the high burden of adverse sexual and reproductive health outcomes (SRH) and low levels of school attendance among adolescent girls in Kenya, this study sought to elucidate the association between school attendance and SRH outcomes among adolescent girls in Homa Bay and Narok counties. Methods This study uses baseline quantitative data from the mixed-methods evaluation of the In Their Hands (ITH) program which occurred between September to October 2018 in Homa Bay and Narok counties. In total, 1840 adolescent girls aged 15–19 years participated in the baseline survey, of which 1810 were included in the present analysis. Multivariable logistic regression models were used to assess the association between school attendance (in- versus out-of-school) and ever having sex, condom use during last sex, and ever pregnant, controlling for age, orphan status, income generation, religion, county, relationship status, and correct SRH knowledge. Results Across the 1810 participa...
Promotion de la santé et prévention des maladies chroniques au Canada, 2020
Introduction La formation continue peut aider les professionnels de la santé à maintenir et à dév... more Introduction La formation continue peut aider les professionnels de la santé à maintenir et à développer leurs connaissances et leurs compétences afin de s’adapter à la transformation du paysage de la santé publique. Cette revue de la portée vise à déterminer quelles sont les modalités préférées dans la formation continue des professionnels en santé publique et comment l’équité a été intégrée dans la formation en santé publique. Méthodologie En nous appuyant sur les lignes directrices PRISMA pour les revues de la portée, nous avons cherché dans quatre bases de données des études évaluées par les pairs qui évaluaient les modalités de formation continue du personnel en santé publique. Résultats La revue a porté sur 33 études, publiées dans 11 pays entre le 1er janvier 2000 et le 6 août 2019. Dans la plupart des articles, le public cible était généralement défini comme les professionnels en santé publique employés par un organisme gouvernemental ou non gouvernemental. Les méthodes de p...
ObjectivesFinancial risk protection (FRP) is an indicator of the Sustainable Development Goal 3 u... more ObjectivesFinancial risk protection (FRP) is an indicator of the Sustainable Development Goal 3 universal health coverage (UHC) target. We sought to characterise what is known about FRP in the UHC context and to identify evidence gaps to prioritise in future research.DesignScoping overview of reviews using the Arksey & O’Malley and Levac & Colquhoun framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guidelines.Data sourcesMEDLINE, PsycINFO, CINAHL-Plus and PAIS Index were systematically searched for studies published between 1 January 1995 and 20 July 2021.Eligibility criteriaRecords were screened by two independent reviewers in duplicate using the following criteria: (1) literature review; (2) focus on UHC achievement through FRP; (3) English or French language; (4) published after 1995 and (5) peer-reviewed.Data extraction and synthesisTwo reviewers extracted data using a standard form and descriptive conten...
Health Promotion and Chronic Disease Prevention in Canada, 2020
Introduction Continuing education (CE) can help public health professionals maintain and further ... more Introduction Continuing education (CE) can help public health professionals maintain and further develop their knowledge and skills to adapt to the changing public health landscape. This scoping review aims to identify the preferred modalities for delivering CE to public health professionals and to determine how equity has been incorporated into public health training. Methods Using the PRISMA extension for Scoping Reviews as a guide, we searched four databases for peer-reviewed primary research studies that evaluated public health workforce CE modalities. Results The review included 33 studies published between 1 January 2000 and 6 August 2019 from over 11 countries. Most articles broadly described their training audience as public health professionals employed by government or non-governmental organizations. Delivery methods included online, in-person or blended learning (combining online and in-person instruction). Learners strongly preferred self-directed approaches. Organizatio...
IntroductionSustainable financing of immunisation programmes is an important step towards univers... more IntroductionSustainable financing of immunisation programmes is an important step towards universal coverage of life-saving vaccines. Yet, financing mechanisms for health programmes could have consequences on the design of universal approaches to immunisation coverage. Effective implementation of immunisation interventions necessitates investigating the roles of institutions and power on interventions. This review aims to understand how sustainable financing and equitable immunisation are conceptualised by health actors like Gavi, and government-related entities across low-income and middle-income countries (LMICs) and how financing mechanisms can affect universal coverage of vaccines.Methods and analysisThis study protocol outline a scoping review of the peer-reviewed and the grey literature, using established methodological framework for scoping review. Literature will be identified through a comprehensive search of multiple databases and grey literature. All peer-reviewed impleme...
Exclusive breastfeeding (EBF) for 6 months is a global public health goal, but measuring its achi... more Exclusive breastfeeding (EBF) for 6 months is a global public health goal, but measuring its achievement as a marker of population breastmilk feeding practices is insufficient. Additional measures are needed to understand variation in non‐EBF practices and inform intervention priorities. We collected infant feeding data prospectively at seven time points to 6 months post‐partum from a cohort of vulnerable women (n = 151) registered at two Canada Prenatal Nutrition Program sites in Toronto, Canada. Four categories of breastmilk feeding intensity were defined. Descriptive analyses included the (i) proportion of participants in each feeding category by time point, (ii) use of formula and non‐formula supplements to breastmilk, (iii) proportion of participants practising EBF continuously for at least 3 months; and (iv) frequency of transitions between feeding categories. All participants initiated breastmilk feeding with 70% continuing for 6 months. Only 18% practised EBF for 6 months, b...
We examined the association between adolescents’ sexual and reproductive health (SRH) service uti... more We examined the association between adolescents’ sexual and reproductive health (SRH) service utilization in the past 12 months and structural, health facility, community, interpersonal, and individual level factors in Kenya. This cross-sectional analysis used baseline data collected in Homa Bay and Narok counties as part of the In Their Hands intervention evaluation from September to October 2018. In total, 1840 adolescent girls aged 15 to 19 years were recruited to complete a baseline survey. We used unadjusted and adjusted logistic regression to model factors associated with SRH utilization across the social-ecological framework levels. Overall, 36% of participants reported visiting a health facility for SRH services in the past 12 months. At the structural level being out-of-school (AOR: 2.12 95% CI: 1.60–2.82) and not needing to get permission to go (AOR: 1.37 95%CI: 1.04–1.82) were associated with SRH service utilization. At the interpersonal level, participants who reported b...
INQUIRY: The Journal of Health Care Organization, Provision, and Financing
The COVID-19 pandemic rapidly forced Canadian post-secondary students into remote learning method... more The COVID-19 pandemic rapidly forced Canadian post-secondary students into remote learning methods, with potential implications on their academic success and health. In recent years, the use of social media to promote research participation and as a strategy for communicating health messages has become increasingly popular. To better understand how the pandemic has impacted this population, we used social media platforms to recruit students to participate in a national bilingual COVID-19 Health Literacy Survey. The purpose of the survey was to assess the health literacy levels and online information-seeking behaviors of post-secondary students in relation to the coronavirus. This paper outlines the social media recruitment strategies used for promoting participation in the survey among Canadian post-secondary students during the pandemic. Facebook, Twitter, and Instagram accounts were created to promote the online survey. The objective of this paper is to examine the use of Instagra...
IntroductionWomen researchers find it more difficult to publish in academic journals than men, an... more IntroductionWomen researchers find it more difficult to publish in academic journals than men, an inequity that affects women’s careers and was exacerbated during the pandemic, particularly for women in low-income and middle-income countries. We measured publishing by sub-Saharan African (SSA) women in prestigious authorship positions (first or last author, or single author) during the time frame 2014–2016. We also examined policies and practices at journals publishing high rates of women scientists from sub-Saharan Africa, to identify potential structural enablers affecting these women in publishing.MethodsThe study used Namsor V.2, an application programming interface, to conduct a secondary analysis of a bibliometric database. We also analysed policies and practices of ten journals with the highest number of SSA women publishing in first authorship positions.ResultsBased on regional analyses, the greatest magnitude of authorship inequity is in papers from sub-Saharan Africa, wher...
Governments deploy comprehensive strategies to address complex social problems with various New P... more Governments deploy comprehensive strategies to address complex social problems with various New Public Governance and horizontal initiatives. Minimal attention, however, has focused on developing evidence-informed strategy de- sign for such initiatives. Using a systematic literature review, five strategy design principles were identified: 1) proper selection of interventions; 2) system enablers; 3) a guiding purpose; 4) substantive political commitment; and 5) joined-up gov- ernance. Three case studies including document review and interviews tested strat- egy design principles. Empirical work supported, expanded, and further refined these principles. Application of these principles would likely contribute to improv- ing the success of horizontal strategy initiatives. Real-world political pressures and public administration constraints can be somewhat alleviated through learnings from well-designed strategies and experiences.
Sommaire : Les gouvernements utilisent des stratégies globales pour répondre à des problèmes sociaux complexes avec diverses initiatives horizontales et de la Nouvelles gouvernance publique. Néanmoins, ces initiatives n’ont recu que peu d’attention en ce qui concerne l’élaboration d’une conception stratégique fondée sur des données probantes. À l’aide d’un examen systématique de la littérature, nous avons identifié cinq principes de conception stratégique : 1) une sélection ap- propriée des interventions; 2) des facilitateurs du système; 3) un objectif directeur; 4) un engagement politique réel; et 5) une gouvernance conjointe. Trois études de cas comprenant un examen de documents et des entretiens ont testé les principes de conception stratégique. Ces principes ont été soutenus, élargis et affinés par des tra- vaux empiriques. L’application de ces principes contribuerait probablement à amé- liorer le succès des initiatives stratégiques horizontales. Les enseignements tirés de stratégies et d’expériences bien conçues peuvent pallier les pressions politiques du monde réel et les contraintes de l’administration publique.
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Papers by Erica Di Ruggiero
Sommaire : Les gouvernements utilisent des stratégies globales pour répondre à des problèmes sociaux complexes avec diverses initiatives horizontales et de la Nouvelles gouvernance publique. Néanmoins, ces initiatives n’ont recu que peu d’attention en ce qui concerne l’élaboration d’une conception stratégique fondée sur des données probantes. À l’aide d’un examen systématique de la littérature, nous avons identifié cinq principes de conception stratégique : 1) une sélection ap- propriée des interventions; 2) des facilitateurs du système; 3) un objectif directeur; 4) un engagement politique réel; et 5) une gouvernance conjointe. Trois études de cas comprenant un examen de documents et des entretiens ont testé les principes de conception stratégique. Ces principes ont été soutenus, élargis et affinés par des tra- vaux empiriques. L’application de ces principes contribuerait probablement à amé- liorer le succès des initiatives stratégiques horizontales. Les enseignements tirés de stratégies et d’expériences bien conçues peuvent pallier les pressions politiques du monde réel et les contraintes de l’administration publique.