Masters of Global Health

Background: Within the field of maternal, newborn and child health, a major obstacle has been undernutrition. Undernutrition is considered to be the number one health risk worldwide and is responsible for 11% of the global burden of disease, mainly concentrated in LMICs (1). In particular, proper nutrition for women and their children is vital due to the adequate nourishment required for optimum growth and development of babies in utero and post-partum (1). Several interventions have been proposed and implemented in order to lessen the detrimental effects of undernutrition categorized under nutrition-specific and nutrition-sensitive interventions (3). This paper focuses on the nutrition sensitive intervention of social safety nets.Research Question: How have microcredit programs affected the health outcomes of undernourished children in Punjab, Pakistan?Review of Literature: A broad literature review was conducted using PubMed, PAIS International, Global Health, and Google Scholar. ...

Table of Contents ABSTRACT……………………………………………………………………….……iii ACKNOWLDEGEMENTS…………………………………………………………….v LIST OF TABLES AND FIGURES………………………………………….……….ix DECLARATION OF ACADEMIC ACHIEVEMENT……………………………....x LIST OF ABBREVIATIONS………………………………………………………….xi

Background: Language barriers play a critical role in the treatment of migrant and refugee patients. In Germany, primary care interpreters are often not available especially in rural areas or if patients demand spontaneous or urgent consultations. Methods: In order to enable patients and their physicians to communicate effectively about the current illness history, we developed a digital communication assistance tool (DCAT) for 19 different languages and dialects. This paper reports the multidisciplinary process of the conceptual design and the iterative development of this cross-cultural user-centered application in an action-oriented approach. Results: We piloted our app with 36 refugee patients prior to a clinical study and used the results for further development. The acceptance and usability of the app by patients was high. Conclusion: Using digital tools for overcoming language barriers can be a feasible approach when providing health care to foreign-language patients.

BackgroundVirtual care for patients with COVID-19 allows providers to monitor COVID-19 positive patients with variable trajectories while reducing the risk of transmission to others and managing healthcare capacity in acute care facilities.ObjectiveTo develop and test the feasibility of a family medicine-led remote monitoring model of care (COVIDCare@Home program) to manage patients with COVID-19 in the community.MethodsThis multi-faceted, family medicine-led, interprofessional team-based remote monitoring program was developed at Women’s College Hospital in Toronto, Ontario. A cross-sectional chart review of the first cohort of patients was conducted and learnings from the implementation of CovidCare@Home are described.ResultsDuring the study period, April 8 to May 11, 2020, there were 97 patients (average age 48.6, 62% female) with 424 recorded virtual visits with a median virtual length of stay of 8 days (IQR 5). 5.2% required escalation to an in-person visit with no patients req...

Background Enteric parasites are endemic in many of the countries from which refugees originate. Clinical guidelines vary in approaches to screening for and treating intestinal parasites in refugee receiving countries. This study aims to investigate the prevalence and species of intestinal parasites identified in stool ova and parasite (O&P) specimens in a sample of newly arrived refugees in Toronto, Canada. Methods We conducted a retrospective chart review of 1042 refugee patients rostered at a specialized primary care clinic in Toronto from December 2011 to September 2016. Patients who completed recommended stool O&P analyses were included. Basic sociodemographic and clinical variables and results of stool O&P were examined. Results 419 patients (40.2%) had a stool O&P positive for any protozoan or helminth species. Sixty-nine patients (6.6%) had clinically significant parasite species (excluding B hominis, D fragilis, and E dispar, given their lower risk for causing symptoms/comp...

Background Virtual care quickly became of crucial importance to health systems around the world during the COVID-19 pandemic. Despite the potential of virtual care to enhance access for some communities, the scale and pace at which services were virtualized did not leave many organizations with sufficient time and resources to ensure optimal and equitable delivery of care for everyone. The objective of this paper is to outline the experiences of health care organizations rapidly implementing virtual care during the first wave of the COVID-19 pandemic and examine whether and how health equity was considered. Methods We used an exploratory, multiple case study approach involving four health and social service organizations providing virtual care services to structurally marginalized communities in the province of Ontario, Canada. We conducted semi-structured qualitative interviews with providers, managers, and patients to understand the challenges experienced by organizations and the ...