Browsing by Author "Bjegovic-Mikanovic, Vesna (6602428758)"

Aim: Agreeing on a Code of Ethical Conduct is an essential step in the formation and definition of a public health profession in its own right. In this paper we attempt to identify a limited number of key ethical principles to be reflected as professional guidance. Methods: We used a consensus building approach based on narrative review of pivotal literature and theoretical argumentation in search for corresponding terms and-in a second step-attempted to align them to a limited number of key values. The resulting draft code of ethical conduct was validated employing a framework of the Council of Europe and reviewed in two quasi Delphi rounds by members of a global think tank. Results: The alignment exercise demonstrated the acceptability of five preselected key principles: solidarity, equity, efficiency, respect for autonomy, and justice whereas three additional principles were identified during the discussion rounds: common good, stewardship, and keeping promises. Conclusions: In the context of emerging and re-emerging diseases as well as increase in lifestyle-related diseases, the proposed Code of Ethical Conduct may serve as a mirror which public health professionals will use to design and implement public health interventions. Future public health professional chambers or an analogous structure should become responsible for the acknowledgement and enforcement of the Code. © 2017 Laaser et al.

Aim: Agreeing on a Code of Ethical Conduct is an essential step in the formation and definition of a public health profession in its own right. In this paper we attempt to identify a limited number of key ethical principles to be reflected as professional guidance. Methods: We used a consensus building approach based on narrative review of pivotal literature and theoretical argumentation in search for corresponding terms and-in a second step-attempted to align them to a limited number of key values. The resulting draft code of ethical conduct was validated employing a framework of the Council of Europe and reviewed in two quasi Delphi rounds by members of a global think tank. Results: The alignment exercise demonstrated the acceptability of five preselected key principles: solidarity, equity, efficiency, respect for autonomy, and justice whereas three additional principles were identified during the discussion rounds: common good, stewardship, and keeping promises. Conclusions: In the context of emerging and re-emerging diseases as well as increase in lifestyle-related diseases, the proposed Code of Ethical Conduct may serve as a mirror which public health professionals will use to design and implement public health interventions. Future public health professional chambers or an analogous structure should become responsible for the acknowledgement and enforcement of the Code. © 2017 Laaser et al.

The Economic Community of West African States (ECOWAS) comprises 15-member states with an estimated population of 350 million. This account relates the present status of maternal, neonatal, and under-five-mortality to the Sustainable Development Goals (SDG) targets set for 2030. For each SDG indicator, progress observed was compared with that needed to meet the target (assuming linear progression). The time gap was calculated as the difference between the time remaining to the target year (2030) and the estimated time needed to achieve the target. The highest maternal mortality ratio is found in Sierra Leone (1360 in 2015), followed by Nigeria (814) and Liberia (725). Whereas Sierra Leone and Nigeria keep high positions also for the neonatal and under-five mortality rate, Liberia ranks clearly better than the ECOWAS average. Globally skilled health professionals‘ density is 25 per 10,000 population and in Nigeria close to it with 20.1 whereas Guinea takes the last position with 1. 4. The gap analysis shows that ECOWAS countries have a realistic chance to likely reach the SDG targets in 2030 with a delay of less than 4 years regarding maternal, neonatal, and under-five-mortality although their skilled health professionals‘ density is considerably lower than for the entire African region. © 2018, Women's Health and Action Research Centre. All rights reserved.

Background: The United Nations Assembly adopted the Sustainable Development Goals to succeed the Millennium Development Goals in September 2015. From a European perspective, the development of health in the countries of North Africa are of special interest as a critical factor of overall social development in Europe’s Mediterranean partners. In this paper, we address the mortality related SDG-3 targets, the likelihood to achieve them until 2030 and analyze how they are defined. Methods: We projected mortality trends from 2000–2015 to 2030, based on mortality estimates by inter-agency groups and the WHO in mother and child health, non-communicable diseases, and road traffic mortality. The gap analysis compares the time remaining until 2030 to the time needed to complete the target assuming a linear trend of the respective indicator. A delay of not more than 3.75 years is considered likely to achieve the target. Results: The SDG-3 targets of a Maternal Mortality Ratio below 70 per 100 000 live births and an U5MR below 25 per 1 000 live births have been achieved by Egypt, Libya, and Tunisia. Libya and Tunisia have also achieved the target for Newborn Mortality with Egypt close to achieving it as well. Algeria and Morocco are generally on track for most of the indicators, including deaths from non-communicable diseases and suicide rates; however, all of the countries are lagging when it comes to deadly Road Traffic Injuries for 2030. Mauritania is the only North African country which is not likely to reach the 2030 targets for any of the mortality indicators. Conclusions: Although mortality statistics may be incomplete there is an impressive gradient from East to West showing Mauritania and deadly road traffic injuries as the most problematic areas. Given the large differences between countries baselines, we consider it preferable to set realistic targets to be achieved until 2030. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Objectives: We sought to determine whether blended learning is an effective strategy for acquiring competence in public health biostatistics. Methods: The trial was conducted with 69 Masters’ students of public health attending the School of Public Health at University of Belgrade. Students were exposed to the traditional and blended learning styles. Blended learning included a combination of face-to-face and distance learning methodologies integrated into a single course. Curriculum development was guided by competencies as suggested by the Association of Schools of Public Health in the European Region (ASPHER). Teaching methods were compared according to the final competence score. Results: Forty-four students were enrolled in the traditional method of education delivery, and 25 to the blended learning format. Mean exam scores for the blended learning group were higher than for the on-site group for both the final statistics score (89.65 ± 6.93 vs. 78.21 ± 13.26; p < 0.001) and knowledge test score (35.89 ± 3.66 vs. 22.56 ± 7.12; p < 0.001), with estimated large effect size (d > 0.8). Conclusions: A blended learning approach is an attractive and effective way of acquiring biostatistics competence for Masters of Public Health (MPH) graduate students. © 2017, Swiss School of Public Health (SSPH+).

Aim: This study reviews the ability of the Russian Federation to reduce the high mortality until 2030 evenly across the country and in accordance with the Sustainable Development Goals (SDG). Methods: We adopted the method suggested by Haenszel for estimating Premature Years of Life Lost for the age group <70 years and applied a projected reduction of 33% by 2030 as proposed for SDG 3.4. To calculate the potential time gap we used the model of the United Nations Development Programme and standardized the rates by the OECD 1980 Standard Population employing the direct method. Results: If Russia keeps the present level of effort the reduction by one third of the level of premature mortality as in 2013 will be in reach already in 2024 i.e. 5.9 years in advance of the SDG 3 target for 2030. This target is achieved quite evenly also throughout the 8 districts of the Russian Federation between 10.6 and 5.0 years in advance and in selected special districts/republics with the highest and lowest mortality rates. Conclusion: After the steep decrease of life expectancy during the 1990ies the Russian Federation returned to the original trajectory. © 2020 Chernyavskiy et al.

Aim: This study reviews the ability of the Russian Federation to reduce the high mortality until 2030 evenly across the country and in accordance with the Sustainable Development Goals (SDG). Methods: We adopted the method suggested by Haenszel for estimating Premature Years of Life Lost for the age group <70 years and applied a projected reduction of 33% by 2030 as proposed for SDG 3.4. To calculate the potential time gap we used the model of the United Nations Development Programme and standardized the rates by the OECD 1980 Standard Population employing the direct method. Results: If Russia keeps the present level of effort the reduction by one third of the level of premature mortality as in 2013 will be in reach already in 2024 i.e. 5.9 years in advance of the SDG 3 target for 2030. This target is achieved quite evenly also throughout the 8 districts of the Russian Federation between 10.6 and 5.0 years in advance and in selected special districts/republics with the highest and lowest mortality rates. Conclusion: After the steep decrease of life expectancy during the 1990ies the Russian Federation returned to the original trajectory. © 2020 Chernyavskiy et al.

Background Self-rated health (SRH) is a widely adopted tool to compare health across countries. Our aim was to examine SRH differences between Italy and Serbia and to observe the role of predictors of SRH referring to health behaviors within and between both countries. Methods We used cross-sectional population-based data from Italian and Serbian national health surveys carried out in 2013. Post hoc cross-standardization was undertaken to ensure that the information from both data sets was comparable. Results Univariate and multivariate multinomial logistic regressions showed that Serbians reported bad- SRH significantly more often than Italians. Moreover, consistently across national groups, younger participants, males, higher educated participants and participants with lower body mass index (BMI) had more chances than older, lower educated and higher BMI participants, respectively, to report better SRH. Finally, smoking and drinking behaviors did not correlate with SRH, while the frequency of fruits and vegetables intake was differently associated with SRH across countries. Conclusion Health assessments based on SRH in Italian and Serbian national surveys are directly comparable and show similar relationships with socio-demographic correlates and BMI. However, the effect of health behaviors on SRH May differ according to national and cultural contexts. © The Author 2016.

There is an error in the Acknowledgment statement. The correct number for project number is 175042. The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated. © 2021 Stamenkovic,Matejic, Djikanovic and Bjegovic-Mikanovic.

Objectives: The Government of Liberia has set ambitious national health targets for 2021 to reduce the high maternal, newborn, and child mortality rate and to improve the related health services. Additionally, Sustainable Development Goal 3 provides a long-term target for 2030. The objective of this article is to analyze the gaps between the targets and collected data. Materials and Methods: Relevant national documents were scrutinized to identify targets and related indicators which can serve as benchmarks for future achievements in Liberia's maternal, newborn, and child health. For each indicator, progress observed will be compared with that needed to meet the target, based on the indicator value in a baseline year, a later observed value, and the expected value in 2021 and 2030, respectively. Results: The Gap Analysis reveals achievements and serious delays for 21 health and health system indicators. Based on national data the reduction of the maternal mortality ratio will take an additional −8.2 years for the 2021 target and −12.5 years for the 2030 target. The Neonatal Mortality rate is experiencing similar delays of −7.9 years for 2021 and −12.9 for 2030 whereas the targets for the Under-5-Mortality rate can be achieved with small delays of −1.8 and −1.7 years. Conclusions: The Government of Liberia requires persistent efforts and international support to achieve its national targets and the Sustainable Development Goal 3 for health. © Copyright © 2019 Laaser, Broniatowski, Byepu and Bjegovic-Mikanovic.

Objectives: To assess the exit competences of public health graduates across a diverse European landscape. Methods: The target population comprised 80 full institutional members of the Association of Schools of Public Health in the European Region with a participation rate 82.5 %. The web-based questionnaire covered institutional profiles and the ranking of exit competences for master of public health programmes, grouped according to WHO Essential Public Health Operations. Results: European schools and departments usually are small units, funded from tax money. A total of 130 programmes have been indicated, together releasing 3,035 graduates in the last year before the survey. All competence groups showed high reliability and high internal consistency (α > 0.75, p < 0.01). The best teaching output has been assessed for health promotion, followed by disease prevention and identification of health hazards in the community, the least in emergency preparedness. Conclusions: Given the fragmentation of the institutional infrastructure, the harmonisation of programme content and thinking is impressive. However, the educational capacity in the European Region is far from being sufficient if compared to aspired US levels. © 2012 Swiss School of Public Health.

Introduction: At the present time, higher education institutions dealing with education for public health in Europe and beyond are faced with a complex and comprehensive task of responding to global health challenges. Review: Literature reviews in public health and global health and exploration of internet presentations of regional and global organisations dealing with education for public health were the main methods employed in the work presented in this paper. Higher academic institutions are searching for appropriate strategies in competences-based education, which will increase the global attractiveness of their academic programmes and courses for continuous professional development. Academic professionals are taking advantage of blended learning and new web technologies. In Europe and beyond they are opening up debates about the scope of public health and global health. Nevertheless, global health is bringing revitalisation of public health education, which is recognised as one of the core components by many other academic institutions involved in global health work. More than ever, higher academic institutions for public health are recognising the importance of institutional partnerships with various organisations and efficient modes of cooperation in regional and global networks. Networking in a global setting is bringing new opportunities, but also opening debates about global harmonisation of competence-based education to achieve functional knowledge, increase mobility of public health professionals, better employability and affordable performance. Conclusions: As public health opportunities and threats are increasingly global, higher education institutions in Europe and in other regions have to look beyond national boundaries and participate in networks for education, research and practice. © 2014 Vesna Bjegovic-Mikanovic et al.

Background: The benefits of physical activity during pregnancy include lower maternal weight gain, a lower likelihood of gestational diabetes, low back pain, preeclampsia, preterm delivery, caesarian delivery, and macrosomia. This study aimed to examine the factors associated with insufficient leisure-time physical activity (LTPA) during the first trimester. Methods: A cross-sectional study was conducted at the Clinic for Obstetrics and Gynecology of Clinical Center of Serbia, Belgrade, between January and June of 2018. The final analyses included 162/175 pregnant women. The questionnaire was used to obtain social characteristics, pregnancy, and lifestyle characteristics (Pregnancy Risk Assessment Monitoring System—PRAMS), pre-pregnancy LTPA (International Physical Activity Questionnaire—IPAQ), and LTPA during the first trimester (Pregnancy Physical Activity Questionnaire—PPAQ). Women were classified into two groups of sufficient and insufficient LTPA during the first trimester based on the recommendations of the World Health Organization. Multivariate logistic regression analysis was applied. Results: A total of 27.2% of the women had insufficient LTPA during pregnancy. Insufficient LTPA during pregnancy was associated with <12 years of education (OR: 2.3, 95% CI: 1.05–5.04), self-rated financial status as poor (OR: 0.34, 95% CI: 0.14–0.79), and hours spent walking before pregnancy (OR: 0.87, 95% CI: 0.77–0.99). Conclusions: Our results can help direct health care professionals advice for women who are planning pregnancy towards walking as it seems to be sustained during pregnancy. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

Background: The benefits of physical activity during pregnancy include lower maternal weight gain, a lower likelihood of gestational diabetes, low back pain, preeclampsia, preterm delivery, caesarian delivery, and macrosomia. This study aimed to examine the factors associated with insufficient leisure-time physical activity (LTPA) during the first trimester. Methods: A cross-sectional study was conducted at the Clinic for Obstetrics and Gynecology of Clinical Center of Serbia, Belgrade, between January and June of 2018. The final analyses included 162/175 pregnant women. The questionnaire was used to obtain social characteristics, pregnancy, and lifestyle characteristics (Pregnancy Risk Assessment Monitoring System—PRAMS), pre-pregnancy LTPA (International Physical Activity Questionnaire—IPAQ), and LTPA during the first trimester (Pregnancy Physical Activity Questionnaire—PPAQ). Women were classified into two groups of sufficient and insufficient LTPA during the first trimester based on the recommendations of the World Health Organization. Multivariate logistic regression analysis was applied. Results: A total of 27.2% of the women had insufficient LTPA during pregnancy. Insufficient LTPA during pregnancy was associated with <12 years of education (OR: 2.3, 95% CI: 1.05–5.04), self-rated financial status as poor (OR: 0.34, 95% CI: 0.14–0.79), and hours spent walking before pregnancy (OR: 0.87, 95% CI: 0.77–0.99). Conclusions: Our results can help direct health care professionals advice for women who are planning pregnancy towards walking as it seems to be sustained during pregnancy. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

[No abstract available]

Background Over the last decade, health literacy has become a vibrant area of research. Our objective was to evaluate health literacy and its association with socio-demographic variables, self-perception of health and the presence of chronic conditions in primary health-care patients. Methods A cross-sectional study among 120 patients was conducted in two primary health-care centers. The test of functional health literacy in adults, a 50-item reading comprehension and 17-item numerical ability test (score, 0-100) were administered. Chi-square test and logistic regression analyses were applied. Results Inadequate and marginal health literacy existed in 43 participants (41.0%), and adequate health literacy was present in 62 participants (59.0%). Functional health literacy was significantly different by location, gender, age, marital status, employment, education, material status, selfperception of health and presence of chronic conditions. Based on the multivariate analysis, health literacy was significantly associated with the participant's age (odds ratio [OR], 4.86; 95% confidence interval [CI], 2.41-9.80; P = 0.000), level of education (OR, 4.48; 95% CI, 1.73-11.57; P = 0.002) and chronic conditions (OR, 1.90; 95% CI, 1.16-3.11; P = 0.010). Conclusion These results provide evidence that limitations in functional health literacy are widespread among primary health-care patients and encourage efforts for further monitoring. Low health literacy may impair a patient's understanding of health messages and limit their ability to attend to their medical problems.

Purpose: To investigate the impact of lower urinary tract symptoms on health-related quality of life (QoL) in Serbian population considering socio-demographic characteristics, habits, and health status. Materials and Methods: The study was conducted in the Primary Healthcare Center «Novi Beograd», Serbia. The study included 1424 male participants, aged 40 years and above. QoL was assessed by using the -36Item Short Form Health Survey (SF36-) questionnaire, while voiding and incontinence symptoms were measured using the International Continence Society Male Short Form (ICS male SF) questionnaire. Results: Voiding and incontinence symptoms significantly correlate with all domains of QoL. Voiding and incontinence symptoms have a high influence on general health, social functioning, physical functioning and body pain. After adjusting for age and education, voiding and incontinence symptoms had a similar influence on QoL. In the multivariate model the influence of cardiovascular diseases and income on QoL was lower than voiding and incontinence symptoms.. Conclusion: Voiding and incontinence symptoms affect QoL domains differently. Incontinence symptoms have a greater impact on QoL than voiding symptoms.

Background: Competency-based education is increasingly popular, especially in the area of continuing professional development. Many competency frameworks have been developed; however, few address leadership competencies for European public health professionals. The aim of this study was to develop a public health leadership competency framework to inform a leadership curriculum for public health professionals. The framework was developed as part of the Leaders for European Public Health project - supported by the EU Lifelong Learning Programme. Methods: The study was carried out in three phases: a literature review, consensus development panel and Delphi survey. The public health leadership competency framework was initially developed from a literature review. A preliminary list of competencies was submitted to a panel of experts. Two consensus development panels were held to evaluate and make changes to the initial draft competency framework. Then two rounds of a Delphi survey were carried out in an effort to reach consensus. Both surveys were presented through Survey Monkey to members of the Association of the Schools of Public Health in the European Region Working Group on Innovation in Public Health Teaching and Education. Results: The framework was developed consisting of 52 competencies organized into eight domains: Systems Thinking; Political Leadership; Collaborative Leadership: Building and Leading Interdisciplinary Teams; Leadership and Communication; Leading Change; Emotional Intelligence and Leadership in Team-based Organizations; Leadership, Organizational Learning and Development and Ethics and Professionalism. Conclusion: The framework can serve as a useful tool in identifying gaps in knowledge and skills, and shaping competency-based continuing professional development leadership curricula for public health professionals in Europe. © 2013 © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Aim: Over the past two decades, two catastrophic events caused a steep decline in health services in Liberia: the long-lasting civil war (1989-2003) and the weak response of the health system to the Ebola Viral Disease (EVD) outbreak (2013-2015). In early 2015 The Liberian Government reacted and developed a strategic health policy framework. This paper reviews that framework with a focus on maternal and newborn health. Methods: The study is designed as a narrative review executed during the second half of 2017 in Monrovia. It takes advantage of triangulation, derived from recent international and national documents, relevant literature, and available information from primary and secondary sources and databases. Results: In 2015 the severely compromised health system infrastructure included lack of functional refrigerators, low availability of vaccines and child immunization guidelines, high stock-out rates, and an absence of the cold chain minimum requirements in 46% of health facilities. The public health workforce on payroll during 2014/15 included only 117 physicians. Skilled birth attendance as an indicator of maternal health services performance was 61%. Presently, approximately 4.5 women die each day in Liberia due to complications of pregnancy, delivery, and during the post-partum period, equalling about 1,100 women per 100,000 live births. Of particular note is the adolescent birth rate of 147 per 1000 women aged 15-19 years, three times higher than the world average of 44. Additionally, with a neonatal mortality rate of 19.2 neonatal deaths per 1,000 live births, Liberia stands higher than the world average as well. The high mortality rates are caused by multiple factors, including a delay in recognition of complications and the need for medical care, the time it takes to reach a health facility due to a lack of suitable roads and transportation, and a delay in receiving competent care in the health facilities. Conclusions: The fact that performance is above average for some indicators and far below for other points to unexplained discrepancies and a mismatch of international and national definitions or validity of data. Therefore, it is recommended to concentrate on the core of tracer indicators adopted at the global level for Universal Health Coverage and the Sustainable Development Goals to enable a permanent update of relevant information for policymaking and adjustment. At present all health policy documents miss a thorough application of the SMART objectives (Specific, Measurable, Attainable, Relevant and Timely), notably missing in most documents are realistic and detailed budgeting and obligatory timelines for set targets. © 2019 Bjegovic-Mikanovic et al.

Aim: Over the past two decades, two catastrophic events caused a steep decline in health services in Liberia: the long-lasting civil war (1989-2003) and the weak response of the health system to the Ebola Viral Disease (EVD) outbreak (2013-2015). In early 2015 The Liberian Government reacted and developed a strategic health policy framework. This paper reviews that framework with a focus on maternal and newborn health. Methods: The study is designed as a narrative review executed during the second half of 2017 in Monrovia. It takes advantage of triangulation, derived from recent international and national documents, relevant literature, and available information from primary and secondary sources and databases. Results: In 2015 the severely compromised health system infrastructure included lack of functional refrigerators, low availability of vaccines and child immunization guidelines, high stock-out rates, and an absence of the cold chain minimum requirements in 46% of health facilities. The public health workforce on payroll during 2014/15 included only 117 physicians. Skilled birth attendance as an indicator of maternal health services performance was 61%. Presently, approximately 4.5 women die each day in Liberia due to complications of pregnancy, delivery, and during the post-partum period, equalling about 1,100 women per 100,000 live births. Of particular note is the adolescent birth rate of 147 per 1000 women aged 15-19 years, three times higher than the world average of 44. Additionally, with a neonatal mortality rate of 19.2 neonatal deaths per 1,000 live births, Liberia stands higher than the world average as well. The high mortality rates are caused by multiple factors, including a delay in recognition of complications and the need for medical care, the time it takes to reach a health facility due to a lack of suitable roads and transportation, and a delay in receiving competent care in the health facilities. Conclusions: The fact that performance is above average for some indicators and far below for other points to unexplained discrepancies and a mismatch of international and national definitions or validity of data. Therefore, it is recommended to concentrate on the core of tracer indicators adopted at the global level for Universal Health Coverage and the Sustainable Development Goals to enable a permanent update of relevant information for policymaking and adjustment. At present all health policy documents miss a thorough application of the SMART objectives (Specific, Measurable, Attainable, Relevant and Timely), notably missing in most documents are realistic and detailed budgeting and obligatory timelines for set targets. © 2019 Bjegovic-Mikanovic et al.