South Eastern European Journal of Public Health (SEEJPH)

Taking up from COP26 going forward: contribution of the Book “Survival: One Health, One Planet, One Future by George R. Lueddeke”

Eliudi Saria Eliakimu — 2022-12-16

Since its publication in 2019, the book "Survival: One Health, One Planet, One Future", written by George R. Lueddeke, has proven to be timely and useful in these uncertain and tense ("rattling" – Lueddeke’s word) times we are experiencing. Indeed, we have had (and still are experiencing) the COVID-19 pandemic and the war between Russia and Ukraine that was started early 2022. In this article, we recall the urgency of climate action, the goals of COP26 (that took place from 31st October to 12th November 2021) and provide suggestions for topics that might deserve a place in a possible update of the book. These topics include (i) a critical analysis of the effects of Russia and Ukraine War and lessons from the perspective of One Health and Wellbeing; (ii) progress in various countries in using the One Health approach to address issues that affect the health and wellbeing of population (equity), the environment and ecosystems in general (including global trends in non-communicable diseases and antimicrobial resistance); and (iii) look at the current global governance systems in relation to how they can better function proactively to prevent future wars (interconnected challenges).

Acknowledgements: We acknowledge the work of the President of COP26 and the Secretariat for the draft decision document that has been one of our foundational references. We also thank all the authors of the references cited in our paper for their wonderful work.

Source of funding: No funding was received for this work.

Conflicts of interest: The authors declare that there is no any conflict of interest.

Disclaimer: The authors alone are responsible for the views expressed in this publication, and they do not represent views of their organisations.

A study on risk perception, cognitive awareness and emotional responses to identify unmet training needs of frontline health care workers for COVID-19 containment in India

Madhumita Dobe — 2022-10-29

Aim: Frontline Health Care Workers (FLHCWs) are the key workforce in the fight against ongoing COVID-19 pandemic. They hail from the community and are responsible for supporting the health system in generating awareness, implementing preventive strategies, contact tracing and isolating potential cases. In their job responsibilities, FLHCWs thus may perceive heightened risk of exposure to the virus, leading to overwhelming emotional response and psychological distress. The objective of this study was to investigate risk perception, cognitive awareness and emotional responses among FLHCWs trained to deal with Covid 19, to identify unmet needs of this training in India.

Methods: A cross-sectional study was conducted in a total of 131 frontline workers selected by a multistage sampling process from two states (Odisha and Himachal Pradesh) of India. The FLHCWs were interviewed personally (when feasible) with the help of a predesigned pretested semi-structured questionnaire.

Results: The findings suggested that majority (90%) of the FLHCWs perceived that they are susceptible to nCoV-19 infection and 77.1% of FLHCWs felt high probability of them getting infected with the nCoV-19. Almost 90% of them responded that it is something they think about all the time and 41% of FLHCWs admitted that they feel helpless in the situation. About 63% of FLHCWs perceived that the nCoV-19 infection was a severe illness and 35% perceived it to be very severe and life threatening. Although most of them had received some unstructured and non-uniform training on preventive measures against COVID-19, yet only 38% felt that the knowledge was adequate to protect themselves from the nCoV-19 infection. The training sessions lacked psychological component for capacitating them with coping skills to address their emotional and psychological responses.

Conclusion: The FLHCWs experienced heightened risk perception and symptoms of emotional distress in significant numbers even after trainings. A more inclusive public health policy dialogue to address the emotional and psychological coping skills is needed for capacitation of these frontline workers to address the challenges of Pandemic response now and in future.

Conflicts of interests: None declared.

Acknowledgments: We would like to thank all participants to our study, whose time is even more precious in this difficult situation for all the country, who participated.

Exchange and Coordiantion: Challenges of the Global One Health Movement

Ulrich Laaser — 2022-11-22

Current economic, social, and environmental trajectories within most world regions are unsustainable. Interaction between bottom-up initiatives and top-down good governance is essential to change them. The One Health movement, made up of many organizations, groups, and individuals from diverse backgrounds and disciplines, seeks to redress the present trajectories but has lacked coordination and cooperation, limiting its effectiveness to date. We take a snapshot of groups/organizations working to promote One Health, explore options to increase cooperation and coordination among global One Health stakeholders, and propose systemic strategies that could positively impact animals, people, the planet, plants, and politics.

Methods: Through a review of the compilation of Who’s Who in One Health organizations on the One Health Commission’s (OHC) website and the list of organizations that have pledged support for One Health listed on the One Health Initiative (OHI) website, 289 organizations were identified (as of 29 July 2022: 126 Civil Society Organizations, 133 academic and 30 governmental organizations). A stratified sampling approach and MAXQDA 2022 were used in a mixed-methods analysis to select a sample (N=50) of organizations to evaluate with 10 questions on purpose & focus, structure & transparency, cooperation & implementation, and publications.

Results: The words “One Health” appeared in the organizations’ names on 62.0% (N=31) of websites examined, most often those in academic settings (78.2%). As regards transparency of the organizational structures, membership was defined in 70.0% (N=35), again most often by academic organizations (82.6%). Members of the governing structures were named on 34.0% of organizational websites. Projects led in the last two years were described on 32.0%, and cooperation with other organizations was indicated on 64.0% of websites examined. Relevant publications and annual reports were listed on 46.0% and 24.0% of probed websites, respectively. Ranking the number of positive findings for each of the 50 organizations examined revealed that full information for all ten questions was provided by only 4 academic and 1 governmental organization.

The OHC website was used as a starting point and thus was not included in the N=50 samples. It was therefore examined as an example of a Non-Profit / CSO working to support bottom-up One Health leadership. Since 2014 the OHC has supported a Global One Health Community listserv of individuals from around the globe. The analysis revealed a dominance of Directors from the US and a high proportion of organizations included on the OHC Who’s Who in One Health organizations webpage were located in North America. The social sciences - sociology and economics in particular – were underrepresented among in its .

Conclusion: These 10 questions may not have been fully appropriate for all organizations examined in academic or government settings versus stand-alone non-profit or civil society organizations. However, an examination of the 50 selected websites of organizations working to implement One Health and/or framing their projects and purpose in One Health revealed the global One Health movement to be fragmented and uncoordinated. The authors propose to form a more unified voice for One Health across the international One Health movement, a fully networked, informal global One Health alliance or community of practice that can coordinate sharing of information among the networks and with the general public, and that is able to seek synergies and joining of hands in collective/collaborative actions to effectively and efficiently promote and support bottom-up efforts.

Level of satisfaction among primary health care workers in Kosovo

Haxhi Kamberi — 2022-11-07

Aim: The objective of this study was to assess the extent and selected corelates of work satisfaction among primary healthcare professionals in Kosovo.

Methods: A cross-sectional study was conducted in selected regions of Kosovo during the period May-June 2022 including a representative sample of 500 primary healthcare workers (209 men and 291 women; overall mean age: 42.0±12.3 years). A structured 9-item questionnaire was administered to all participants aiming at assessing the level of satisfaction among primary healthcare workers (each item ranging from 1 [high] to 5 [low]). A summary score was calculated for all 9 items related to satisfaction level ranging from 9 (the highest satisfaction level) to 45 (the lowest satisfaction level). Binary logistic regression was used to assess the association of satisfaction level (dichotomized into “satisfied” vs. “unsatisfied”, based on median value of the summary score) with selected demographic factors and work characteristics of primary healthcare workers.

Results: Mean summary score of the 9 items related to the satisfaction level of primary healthcare workers was about 23±5; median score was 23 (interquartile range: 20-26). In multivariable-adjusted logistic regression models, the level of satisfaction was not significantly related to any demographic factor, but positively associated with the years of working experience of primary healthcare workers [OR_{(for 1 year increment in the work experience)}=1.03, 95%CI=1.00-1.05].

Conclusion: The evidence from this study conducted in Kosovo indicates no significant relationships of the level of satisfaction with demographic factors of primary healthcare workers, but a strong association with their working experience. Policymakers in Kosovo and in other countries should be aware of the importance of working conditions and working environment in order to gradually increase the level of satisfaction of the staff, which is a basic prerequisite for quality improvement of service delivery at primary healthcare level.

Determinants of low birth weight in the health district of Bounkiling in Senegal

Martial Coly Bop — 2022-10-10

Aim: Low birth weight (LBW), 9.1 million deaths per year, is a global health issue. The proportion of LBW in Senegal is estimated at 12% (in 2017) and is at 11.7% (in 2017) in the region of Sedhiou. In this regard, rigorous management is required to address this issue, especially in rural areas. The objective of the study was to identify the determinants of LBW.

Methodology: This is a case-control study which has been conducted in the district of Bounkiling. Socio-demographic characteristics of the mothers, their obstetrical and medical history, and information on the health status of the newborn in the case group were compared with that of the controls. Bivariate and multivariate analyses are performed using Epi info 7 software to identify the determinants.

Results: Low-weights accounted for 97.05% of LBW. The sex ratio was 0.87 in favor of girls. The Apgar score at birth was not good for 31.4% of newborns. Teenage mothers accounted for 17.08%. The multivariate analysis showed that the determinants of LBW (p < 0.05) were the female sex of the newborn, the Apgar score at birth, the maternal age <=19 years, the household income < 83.96 USD, maternal history of low birth weight and physical labor during pregnancy.

Conclusion: Strengthening communication on early marriages and pregnancies, empowering women and improving pregnancy monitoring would be levers to counter the determinants of low birth weight.

Coflicts of interests: None declared.

Human health in the flood risk management planning under the European Union Floods Directive: Pilot study in the Sava River Basin

Anniek E. E. de Jong — 2023-01-12

The EU Floods Directive (2007/60/EC) has the purpose to establish a framework for the flood risks assessment and management. It requires the implementation of coordinated measures on a basin-wide level for the reduction of adverse consequences to human health and life. However, mainly direct fatalities are taken into consideration in these plans. To develop more integrated and adaptive risk management and governance it is important to include both direct and indirect consequences. To define effective measures clearer understanding of the relation between floods and impact on human health is needed. We present a first attempt to provide a roadmap for the inclusion of health issues of concern to flood risk management within the Sava River Basin as an example. An overview of the potential flood effects to health issues was made and a roadmap plan was set up to analyse and map these flood risks. We concluded that indirect health effects can contribute significantly to the overall adverse consequences to health, and although relations are complex, a preliminary assessment could be made. Mapping of adverse consequences to health issues in the planning stages should lead to systemic insights and proposed measures in the prevention, protection, and preparedness while considering the characteristics of the river basin or sub-basins. By incorporating a health-risk-analysis in the planning process, health-oriented preparation is not only aimed at improving post-flood relief efforts, but to minimise the actual impacts and decrease post flood recovery time and costs.