John Zervos

Preventing Hospital-acquired Infections in Low-income and Middle-income Countries: Impact, Gaps, and Opportunities

In low-income and middle-income countries (LMIC) health care-associated infections (HAIs) are a serious concern. Many factors contribute to the impact in LMIC, including lack of infrastructure, inconsistent surveillance, deficiency in trained personnel and infection control programs, and poverty- related factors. In LMIC the risk of HAIs may be up to 25% of hospitalized patients. Building infection control capacity in LMIC is possible where strategies are tailored to the specific needs of LMIC. Strategies must start with simple, cost-effective measures then expand to include more complicated measures. Goals for short-term, medium-term, and long-term actions should be planned and resources prioritized.

Extending Care Outside of the Hospital Walls: A Case of Value Creation through Synchronous Video Communication for Knowledge Exchange in Community Health Network

In healthcare settings knowledge exchange among important stakeholders such as doctors, family and patients, and other care providers is a critical imperative. However, such a community modelled approach is missing, limited in scope or its business value not well understood. In this study, the authors illustrate the value potential and subsequent development of a business model for knowledge exchange within the healthcare delivery model outside a hospital setting. Specifically, they illustrate how Synchronous Video Consultation with social media features, in a staged approach, can support knowledge exchange among a network of community health care professionals who address global health disparities and sustain this exchange through resource generation. The authors discuss the contributions and implications of the proposed framework towards value creation in a collaborative setting in general and suggest opportunities for future research.

Antimicrobial stewardship: Strategies for a global response

The increasing antimicrobial resistance worldwide, combined with dwindling antimicrobial armamentarium, has resulted in a critical threat to the public health and safety of patients. To combat this hazard, antimicrobial stewardship programs (ASPs) have emerged. Antimicrobial stewardship programs prevent or slow the emergence of antimicrobial resistance by coordinated interventions designed to optimize antimicrobial use to achieve the best clinical outcomes and limiting selective pressures that drive the emergence of resistance. This also reduces excessive costs attributable to suboptimal antimicrobial use. Even though an ideal effective ASP should incorporate more than one element simultaneously, it also requires a multidisciplinary team, which should include an infectious diseases physician, a clinical pharmacist with infectious diseases training, infection control professionals, hospital epidemiologist, a clinical microbiologist and an information specialist. However, for antimicrobial stewardship (AMS) programs to be successful, they must address the specific needs of individual institutions, must be built on available resources, the limitations and advantages of each institution, and the available staffing and technological infrastructure.

Community Health Workers (CHWs) as Innovators: Insights from a Tele-Education Pilot for CHWs in Detroit, Michigan

Communityhealthworkers(CHWs)havealongstandingroleinimprovingthehealthandwell-being ofunderservedpopulationsinresource-limitedsettings.CHWsaretrustedinthecommunitiesthey serveandareoftenabletoseethroughsolutionsoncommunitychallengesthatoutsidepersonscannot. Notwithstanding,suchsolutionsoftenmustbelow-cost,easilyimplementable,andpermitknowledge gapsamongCHWstobefilledviaappropriatetraining.Inthissense,useofcost-effectiveinformation technology(IT)solutionscanbekeytoincreasingaccesstoknowledgeforthesecommunityagents. Thispaperhighlights insightsgleanedfromapilot studyperformed inDetroit,Michiganwitha groupofCHWsinbasicgrant-writingtrainingviaane-platform,theCommunityHealthInnovator Program(CHIP).Theresultsarediscussedwithinthecontextoflearningtheory.Itisconcludedthat e-platformsarenecessaryforCHWstoleverageknowledgefrommultiplesourcesinanadaptive environmenttowardsaddressingever-evolvingglobalhealthchallenges. KEyWoRDS Community Health Innovator Program (CHIP), Community Health Workers (CHWs), E-Platform, Global Health, Information Technology (IT), Learning Theory

Building Capacity in Infection Prevention and Antimicrobial Stewardship in Low- and Middle-Income Countries: the Role of Partnerships Inter-countries

Opinion statementAntimicrobial resistance is increasing globally at a rapid pace, and patients in low- and middle-income countries are at high risk. The need for inter-country partnerships with the ultimate goal of building capacity in the fields of infection prevention and antimicrobial stewardship in these settings is of utmost importance. Reciprocal, long-term, supported relationships between collaborators from low- and middle-income countries and high-income countries will have high benefit to all partners. This paper looks at recent literature in antimicrobial stewardship and infection prevention and offers recommendations for building sustainable partnerships benefitting all collaborators working to reduce antimicrobial resistance.

Community Health Workers as Innovators: Methods and Results from a Tele-Education Pilot for Community Health Workers in Detroit, Michigan

Community health workers (CHWs) have played an important role in improving the health of underserved populations in resource-limited settings. CHWs are trusted in communities that they serve, and are often able to see solutions to community problems that outside persons cannot. Solutions need to be low cost and easily accessible, and address the knowledge gaps among CHWs through appropriate training. Utilizing information technology solutions can be key to increasing access to knowledge for these community agents. This paper outlines the methods and results from a pilot study of the Community Health Innovator Program performed in Detroit, Michigan with a group of community health workers in basic grant-writing training, utilizing an information technology platform. The results will be discussed as a larger response to growing issues in global health and how such platforms can be used and adapted in response to ever-evolving global health challenges.