RESUMO
BACKGROUND: Global partnerships amplify nursing leadership capacity in low-resource countries through targeted education efforts. PURPOSE: We examined a nursing faculty partnership between US and Haitian universities, where Haitian faculty completed graduate-level degrees highlighting leadership and education. This marked the first time a Haitian university awarded a master's of nursing degree. METHODS: Longitudinal qualitative research data collection included interviews and observations among 28 participants. Recurrent cross-sectional analysis explored themes and perceived changes in leadership behaviors. RESULTS: Advanced professional stature, leadership as a nurse educator and in the clinical setting, transformational leadership, and challenges to leadership practice were key themes. Graduate nursing education resulted in an improved vision of nursing, increased perceptions of leadership capacities, and advanced management strategies. CONCLUSIONS: This partnership led to an Office of Nursing Education at the State University of Haiti, a milestone in the advancement of nursing in this low-resource country.
Assuntos
Educação de Pós-Graduação em Enfermagem , Liderança , Estudos Transversais , Docentes de Enfermagem , Haiti , Humanos , Pesquisa em Educação em EnfermagemRESUMO
BACKGROUND: Vaccines may cause non-specific effects (NSEs) on morbidity and mortality through immune-mediated mechanisms that are not explained by the prevention of the targeted disease. Much of the evidence for NSEs comes from observational studies with a high risk of bias, and there is a clear need for new data from randomized controlled trials. Recently, it was proposed that rabies vaccine has protective NSEs in people and in animals. The aim of the proposed study is to determine whether rabies vaccine reduces the incidence rate of episodes of common infectious disease syndromes in a population of veterinary students on the island of St. Kitts. METHODS: The trial design is a single-site, two-arm, parallel-group, participant-blinded, randomized, placebo-controlled, two-sided comparative study, with an internal pilot study for blinded sample size re-estimation. Allocation to study arm is by block randomization stratified by sex within cohort with a 1:1 allocation ratio. The primary study outcome is the number of new weekly episodes of common infectious diseases including respiratory, diarrheal and febrile illnesses. A vaccine immunogenicity ancillary study is planned. DISCUSSION: Demonstration of a non-specific protective effect of rabies vaccine against unrelated respiratory, gastrointestinal and febrile illnesses would provide supportive evidence for the design of similar studies in children in populations with a high burden of these illnesses. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03656198. Registered on 24 August 2018.
Assuntos
Imunidade Heteróloga , Vacina Antirrábica/imunologia , Ensaios Clínicos Fase IV como Assunto , Diarreia/epidemiologia , Diarreia/prevenção & controle , Febre/epidemiologia , Febre/prevenção & controle , Humanos , Incidência , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Projetos Piloto , Vacina Antirrábica/administração & dosagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/prevenção & controle , São Cristóvão e NévisRESUMO
Haiti is the poorest country in the Western Hemisphere and has the highest number of people living with HIV in the Caribbean, the region most impacted by HIV outside of Africa. Despite continuous political, socioeconomic and natural catastrophes, Haiti has mounted a very successful response to the HIV epidemic. Prevention and treatment strategies implemented by the government in collaboration with non-governmental organizations have been instrumental in decreasing the national HIV prevalence from a high of 6.2% in 1993 to 2.2% in 2012. We describe the history and epidemiology of HIV in Haiti and the expansion of antiretroviral therapy (ART) over the past decade, with the achievement of universal access to ART for patients meeting the 2010 World Health Organization guidelines. We also describe effective models of care, successes and challenges of international funding, and current challenges in the provision of ART. We are optimistic that the goal of providing ART for all in need remains in reach.
Assuntos
Fármacos Anti-HIV/economia , Terapia Antirretroviral de Alta Atividade/economia , Programas Governamentais/economia , Infecções por HIV/tratamento farmacológico , Saúde Pública/economia , Fármacos Anti-HIV/provisão & distribuição , Guias como Assunto , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Haiti/epidemiologia , Humanos , Cooperação Internacional , Prevalência , Parcerias Público-Privadas/economia , Recursos Humanos , Organização Mundial da SaúdeRESUMO
The vulnerability of children in Haiti has increased dramatically since the earthquake in January 2010. Prior to the earthquake, the prevalence of orphans and at-risk children was high but since the earthquake, more than 1 million people-with more than 380,000 children remaining displaced and living in over 1200 displacement sites. These existing conditions leave orphans and at-risk children vulnerable to exploitation, abuse, and increased risk of HIV/AIDS. This article will focus on the complex issues affecting orphans and at-risk children and the intersection with HIV/AIDS and human rights. Specific recommendations by United Nations Children's Fund are discussed. Nursing in Haiti must address the policy-related and population-specific approaches for the care of children living with or affected by HIV/AIDS.
Assuntos
Serviços de Saúde da Criança/ética , Crianças Órfãs , Terremotos , Infecções por HIV/epidemiologia , Infecções por HIV/enfermagem , Direitos Humanos , Cuidados de Enfermagem/organização & administração , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/enfermagem , Criança , Desastres , Haiti/epidemiologia , Política de Saúde , Humanos , Populações VulneráveisRESUMO
This article combines health and water research results, evidence from confidential documents released under the Freedom of Information Act, legal analysis, and discussion of historical context to demonstrate that actions taken by the international community through the Inter-American Development Bank are directly related to a lack of access to clean water in Haiti. The article demonstrates that these actions constitute a clear violation of Haitians' right to water under both domestic and international law. The article exposes the United States governments role in blocking the disbursal of millions of dollars in international bank loans that would have had life-saving consequences for the Haitian people. The loans were derailed in 2001 by politically-motivated interventions on behalf of the US and other members of the international community in direct violation of the Inter-American Development Bank charter. To demonstrate the impact of these interventions, the article presents data gathered in a study that employed human rights and public health methodologies to assess the right to water in Haiti. The data reveal that Haitians experience obstacles concerning every aspect of the right to water: diffculties with water availability, limited physical and economic accessibility, and poor water quality. The article provides a framework of concrete duties and obligations that should be followed by all actors involved in Haiti in order to realize Haitians' human right to water. In response to the undeniable link between the international community's political interference and the intolerably poor state of potable water in Haiti, the article concludes with a recommendation that all actors in Haiti follow a rights-based approach to the development and implementation of water projects in Haiti. The full report of Wòch nan Soley: The Denial of the Right to Water in Haiti is available online at http://www.pih.org/inforesources/Reports/Hait_Report_FINAL.pdf.