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Although service user groups such as the Mental Healthy Student Campaign Analysis Society, Ethiopia were supportive of the issue, their level of influence was regarded as low given the small number of members. Trickle Urie Bronfenbrenners Theory Of Development Health Promotion. Healthy Student Campaign Analysis or Communication Disorders. Adding tomato and Healthy Student Campaign Analysis any other available greens that you like—to your sandwich is an easy way to get more veggies in your Healthy Student Campaign Analysis. As Essay On Woodworking first-generation college Healthy Student Campaign Analysis Gaddis Healthy Student Campaign Analysis as an undergraduate, Healthy Student Campaign Analysis college for a time Healthy Student Campaign Analysis work in Healthy Student Campaign Analysis public sector, returning later Healthy Student Campaign Analysis making it through graduate school. During the Inception Phase, Healthy Student Campaign Analysis following systematic Healthy Student Campaign Analysis were followed in order to collect the cross-country data Healthy Student Campaign Analysis for Healthy Student Campaign Analysis content analysis of stakeholder Healthy Student Campaign Analysis. Learn More. Official websites use.
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The university called and sent emails and text messages to students who had not complied to work with them on getting their shots or an exemption, said Susan Davis, vice president for student affairs. She said all of those who were unenrolled will be welcomed back in January or later if they follow the mandate. Anyone on campus who is not vaccinated must wear a mask around others — indoors and outdoors — and undergo weekly COVID testing. Mallory Griffin, a senior, said most students have no issue with the vaccine mandate. DiPierro reported from San Diego. Sections U. Largest colleges push student vaccines with mandates, prizes. An analysis by The Associated Press shows 26 of the nation's 50 largest public universities aren't requiring the vaccination.
Connect with the definitive source for global and local news. The Associated Press. All rights reserved. Despite low levels of interest, it was believed that other non-health sector departments and democratic institutions such as Parliament had medium—high levels of influence. Opportunities to mobilise these sectors were identified. Uganda predicted a low level of interest amongst DFID country offices. Most countries, with the exception of India , report medium levels of interest amongst other donors or development agencies. Whilst Ethiopia regarded mental health specialists, particularly psychiatrists, as having high levels of interest for the issue, it regarded PHC and community health workers as having medium levels of interest.
This is due to the fact that they are overburdened, without having much time to devote to things beyond their scope of work, as per the priorities set by the District Health Administration. Voluntary health workers known as Accredited Social Health Activists ASHA who are responsible for psychosocial education at the community level were identified as having high levels of influence on the issue, particularly from the perspective of mental health stigma reduction. In Nepal , although health practitioners PHC workers, community and voluntary health workers were thought to be supportive, medium levels of interest were registered due to them being overburdened.
In the case of mental health specialists, the lower interest was also explained by their presence mostly in urban areas. It was believed that the issue of scaling up mental health services will have a high impact on PHC workers doctors, nurses and midwives , given the new roles that they will be expected to perform. South African health practitioners were understood to have medium levels of interest, given that support at a provincial level was being nurtured at the time. Nevertheless, the level of impact was understood to be high given the political will of the government at the national level, and the fact that implementation of policy and legislation rests with the provinces and districts. Uganda registered high levels of interest and support amongst mental health specialists, however, recognised that greater support and interest needs to be garnered from PHC and CHWs.
Ethiopia believed there to be high levels of interest and influence amongst mental health service user groups, people with psychosocial disabilities, and their families or carers. Although service user groups such as the Mental Health Society, Ethiopia were supportive of the issue, their level of influence was regarded as low given the small number of members. Opportunities were identified for mobilising people with psychosocial disabilities and their families or carers, such as their inclusion in Community Advisory Boards CABs. Based on previous projects, these persons affected by mental illness were expected to be supportive of the issue.
India recorded medium levels of interest in the issue amongst service users, people with psychosocial disabilities, and their families or carers. High levels of influence, and impact of the issue on these sub-groups were recognised by India, as have opportunities to mobilise them. Despite believing a lower level of influence, Nepal recorded high levels of interest and support amongst service user groups, people with psychosocial disabilities, and their families or carers in relation to the issue.
Although not yet mobilised, medium levels of interest were predicted by South Africa , pointing to the fact that some affected persons may be uninterested due to apathy, discrimination and stigma and a lack of awareness and education about mental health and their right to health care. In Uganda , families or carers of people with psychosocial disabilities were understood to have low levels of interest, followed by medium interest from people with psychosocial disabilities, followed by high levels of interest from service user groups, which are also believed to be supportive of the issue.
Opportunities to mobilise people with psychosocial disabilities, and their families have been recognised. The medium—high influence of FBOs, and their power to raise awareness through anti-stigma campaigns have been recognised. Due to the high potential for influencing communities, opportunities to mobilise CBOs were recorded. In India , low levels of interest in the issue were recorded amongst international NGOs, however, medium to high levels of interest were recorded amongst national NGOs, many of whom were regarded as being supportive.
Nepal recorded high levels of interest and support amongst national NGOs and CBOs, regarding the issue as having a high impact on these groups given their ability to provide technical support to PHC staff, and advocate for people to seek mental health services. Lower levels of interest and support were recorded amongst FBOs and traditional healers given the fact that this group has been providing a service for persons affected by mental illness. Although supportive, international NGOs were also regarded as having lower levels of interest given the competing priorities.
Ugandan civil society was recorded as having low-medium levels of interest in the issue. The Ethiopian media was regarded as having medium levels of interest and being supportive of the issue at a national level. Variable levels of interest amongst District media, and opportunities to engage this sector have been recorded. Although regarded as highly influential, the media in India were expected to have low levels of interest in the issue. Opportunities to mobilise them further were recognised. Nepalese media were believed to have medium—high interest in the issue, and to be highly supportive of the issue, particularly from the perspective of sensitization and awareness. Whilst South African media had not yet been mobilised regarding the issue, medium levels of interest, and high levels of influence were expected, particularly in terms of placing the issue higher on the policy and implementation agenda.
The Ugandan national media was believed to have a medium interest in the issue, and was identified as being supportive, with high levels of influence, and impact on the actor. Lower levels of interest were recorded amongst District level media, and opportunities to mobilise media at this level were recorded. Although academics and researchers in Ethiopia such as high level officials in universities were regarded as being supportive of the issue, the level of interest was believed to be low-medium given that mental health programmes were not prioritised. However, the potential influence on the issue was noted as high, as mental health issues could become mainstreamed into education and training at the universities.
In India , universities were regarded as having high levels of interest in order to enhance the academic pool of resources, however, other research institutes were believed to be less interested in the issue given their objectives, priorities and links with government. Nepal regarded universities and other research communities as having high levels of interest, and support for the issue due to the potential impact that the scaling-up of mental health services has on their development agenda. South Africa regarded universities and research communities as having medium levels of interest, with some academics having specific interests in mental health, whilst others, more general interests in public health.
The potential influence of universities and research communities regarding the issue was recognised, as more research was being published about scaling-up mental health care, which was believed to have a greater impact. Uganda believed universities to be supportive, with a medium interest in the issue. Lower interest was anticipated amongst other research communities, and the opportunity to mobilise them has been noted. Content analysis of the stakeholder analysis tables identified a range of opportunities for increasing the evidence-based scale-up of mental health care across countries. However, not all of these may succeed given varying degree of support and power of stakeholders.
Hence, a cross-country force field analysis Table 1 indicating the extent of stakeholder support across and their perceived power down has been applied. The block on the top right indicates those stakeholders that are the most influential and supportive of scaling-up mental health care, whilst the bottom left block indicates the least influential, least supportive stakeholders. In terms of priority setting in the context of limited resources, it can be deduced that success amongst the mobilised will be most likely amongst highly influential powerful stakeholders, who are most supportive. Should further capacity exist, medium-highly influential stakeholders that are supportive can be targeted next, followed by the supportive medium influential stakeholders, or the highly influential non-mobilised stakeholders.
Although it was early in the programme and many stakeholders were not mobilised at the time of this research, it is noteworthy that none of the key informants recorded any opposition or resistance to scaling-up mental health care, indicating that there is no direct opposition to the issue from a wide range of stakeholders. In the case of other stakeholders, the donor sector DFID UK and local offices and universities could also be prioritised. Other stakeholder engagement priorities could be with donors, mental health specialists, national media high power ; followed by service user groups, international NGOs and universities medium power.
The stakeholder analysis method, with the participation of diverse country and cross-country partners, provided a useful means of identifying a range of specific stakeholders within countries. From a policy perspective, most countries report high levels of support and interest from the WHO with the exception of Nepal, which reports a medium level of interest from WHO country offices, despite being supportive. Ministries of Health, as active partners involved since the inception of PRIME, are reported to have high levels of support and interest in most countries, with the exception of India and South Africa which report medium levels of support and interest due to other programmes having priority.
This is in contrast with the low policy attention mental health has traditionally received [ 10 — 13 ]. The identification of stakeholders in countries has been particularly useful for identifying other non-health public policy actors that may have an interest in scaling up mental health care, and in supporting the implementation of PRIME, pointing to the importance of intersectoral collaboration and adopting a Health in All Policies HiAP approach [ 23 ]. This has important implications for integrating mental health into public health facilities, and creates opportunities for sensitising human resources for mental health, strategies of which are also well documented [ 20 , 24 ]. With regards to persons affected by mental illness including their families and carers , countries record mixed levels of interest and support, with Ethiopia and Nepal recording particularly high levels of interest and support from service user groups.
Where support is low, service users should be actively encouraged to participate in mental health policy and service reform. This will not only improve the integration of mental health into primary care, but also support their recovery process [ 26 ]. Although their role has been acknowledged [ 27 ], greater efforts to engage this sector will contribute towards a more integrated health system. This is important given the fact that traditional healers or religious advisors are often the first to see persons living with mental illness.
The role and importance of engaging with this group, and of finding ways of blending traditional practices with modern medicine has been widely recognised [ 28 — 30 ]. Where mobilised, high levels of support and power have been identified amongst the media in Nepal and Uganda. The role and power of the media to influence public perceptions regarding mental health has been documented [ 31 ]. Opportunities to engage with media should be maximised. Universities and research institutes are generally believed to be supportive of the issue, with varying levels of power in countries. Continued engagement with universities and research communities will help to facilitate increased support for scaling-up mental health care from those working in public health, and other related faculties and disciplines such as social sciences, economics, political science and religious studies.
At a country level, stakeholder analysis proved a useful technique to identify specific stakeholders, their interests, positions and power, and accordingly, opportunities for increased stakeholder engagement [ 1 — 4 ]. DFID is also identified by most countries as having high levels of support based on their funding and acceptance of the research programme proposal. Where mobilised, health practitioners, persons affected by mental illness, civil society, media and academics also tend to be generally supportive.
Despite the fact that mental health receives little policy attention [ 10 ], no stakeholder opposition to the issue has been recorded. This may be due to the fact that some stakeholders were not mobilised at the time, and where mobilised, it may have been recorded as such for diplomatic reasons, and in order not to jeopardise engagement opportunities in the future life of the programme. Despite the inclusion of a wide range of stakeholder groups in the above analysis, it is apparent that some groups, which may have the potential of introducing policy windows or barriers, may have been omitted. In conducting a stakeholder analysis to support moves for health insurance reform in South Africa and Tanzania, Gilson and colleagues [ 4 ] identify a number of stakeholder groups that are potentially highly influential that have not been considered in PRIME.
These include political parties, the private healthcare system and business, some of which may explain the lack of any recorded opposition to the scaling up of mental health services. These groups of stakeholders, and their interest, position and influence in relation to the issue should be incorporated into the framework, and considered for the next stakeholder analysis planned for the programme. Force field analysis has been a useful tool to explore and understand stakeholder motivations and to prioritise stakeholder engagements. However, the prioritisation of these potential engagement opportunities should not be depended upon entirely in light of the fact that a large number of stakeholders were not mobilised at the time of data collection.
True to the findings of Gilson et al. Cross-country stakeholder analyses of PRIME have demonstrated the usefulness of this approach to illuminate the host of opportunities available to narrow the gap between research, and its translation into knowledge, including policy and practice. In such cases, a force field analysis is an invaluable tool for prioritising the stakeholder engagement strategies likely to be most successful. The study has several limitations. The first relates to the method of data collection. In a paper on using stakeholder analysis to support moves toward universal coverage in two countries, Gilson et al.
In the case of PRIME, stakeholder analysis was conducted by gathering information from knowledgeable participants. Knowledgeable participants were local PRIME teams within countries, including the Principal Investigators psychiatrists or psychologists , project coordinators and district coordinators Masters qualified who have had past or current experience of regularly engaging with stakeholders. Whilst brainstorming happened face-to-face within countries, the lack of face-to-face engagement by the lead researcher with knowledgeable participants across countries may have resulted in reduced data quality.
The second relates to the choice of key informants. Thirdly , the manner in which the data were recorded was inconsistent, with some countries providing stakeholder characteristics at a category level e. Ministry of Health. Another data recording inconsistency related to the amount of additional qualitative information that was yielded from the analyses, with most informants providing explanations for stakeholder positions. A more detailed guideline and survey instrument for completing the stakeholder table is likely to yield higher quality data in future. Despite the limitations identified, stakeholder analysis has been significant in providing a systematic means of identifying, and documenting the position of stakeholders in relation to the scaling-up of mental health care into health systems in five LMICs.
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