Interorganisational collaboration to improve accessibility of diagnostic evaluations for children

Abstract Background Children with a suspected developmental disability need early diagnostic evaluations and support, to maximize developmental opportunities. Accessibility to diagnostic settings in Flanders, Belgium, is poor, with waiting periods up to two years. Interorganisational coordination of activities using a public health and needs of the population perspective is needed to strengthen the system. This study aims to evaluate current practices and opportunities for interorganisational collaboration of organisations active in the field of diagnostics. Methods It concerns a qualitative, policy-support research project. 6 homogeneous focus groups were organised for the 6 types of organisations subsidized by the government to perform diagnostic evaluations of children with a (suspected) developmental disorders. Data were thematically analysed and categorized in a process of researcher and data-triangulation. A member check validation was done. Results 59 persons participated. We classified the hampering and facilitating factors for collaboration Current interorganisational collaboration is mostly limited to referral. Organisational differences in vision and goals, working processes and quality requirements, regulations and financial support criteria, a problem of accessibility and communication problems are hampering factors. Knowledge of mutual expertise and working processes, personal contacts and open communication are facilitating factors. Conclusions A population public health based organisation of the field of multidisciplinary diagnostic evaluations for children with a developmental disorder, with interorganisational collaboration and coordination of activities in mandated networks, sharing experience and knowledge, would increase the accessibility for all children and strenghten the health system. The implementation of interorganisational networks would benefit from a functional and institutional analysis of organisations. Key messages • Coordination of activities and interorganisational collaboration in mandated networks, could potentially improve the accessibility of diagnostic evaluations for children with a developmental disorder. • Implementation of interorganisational networks would benefit from a functional and institutional analysis of organisations.


Background:
Increases in life expectancy over the last 50 years has been matched by an increase in the burden of diseases (e.g.herpes zoster (HZ)) in adults 50 years of age (YOA).Without intervention, around 30% of individuals can expect to develop HZ in their lifetime, which would impact their daily activities and healthy ageing.

Methods:
We conducted a narrative review on published literature on the impact of developing HZ on healthy ageing and the ability of vaccination to prevent the burden of disease due to HZ.Specifically, we describe HZ impact on quality of life (QoL), and impact of the adjuvanted recombinant zoster vaccine (RZV) on reducing the burden of HZ in adults 50 YOA.

Results:
In adults 50 YOA with HZ, 65.1% and 15.8% reported severe pain and worst imaginable pain, respectively.Pain persisted for up to 90 days (defined as post-herpetic neuralgia) in 10-20% of HZ patients, and occasionally for years after initial symptoms.Pain due to HZ impacted all domains of QoL (psychological, physical and social).Evidence suggested that RZV reduced HZ burden of illness and burden of interference on daily activities by > 90%.Reports also suggested that RZV retained vaccine efficacy of > 90% in all frailty subgroups, who typically respond poorly to other vaccinations.Long-term follow-up data reported vaccine efficacy against HZ of 84.1% (95% confidence interval, 64.4% -94.0%), 8 years post-vaccination.Modelling studies demonstrated that vaccination resulted in reduced hospitalization and other healthcare visits related to HZ.

Conclusions:
Vaccination with RZV can protect older adults from HZ, thus maintaining QoL and promoting active and healthy ageing.

Key messages:
There is significant burden of disease due to HZ among adults 50 YOA due to ageing and immunosenescence.Vaccination can reduce burden of disease among the elderly and frail individuals and maintain QoL.
Abstract citation ID: ckac131.014Interorganisational collaboration to improve accessibility of diagnostic evaluations for children

Results:
Ranking and proportion of thyroid cancer in female population of Georgia in 2015-2019 according to the regions and municipalities, its age specifics and dynamics were determined.Incidence of thyroid cancer in women in Tbilisi (ASR = 52.4%000;AAR = 64.1%000),compared to Georgia (ASR = 34.4%000;AAR = 41.0%000),indicates that Tbilisi is the geographically highest prevalence zone for this site cancer and the highest levels were observed in the 25-69 age group (TASR25-69 -Georgia = 110.8%000,Tbilisi = 190.1%000).
In dynamics, the incidence of thyroid cancer in the 27-year period (2015-2019 vs 1988-1992) according to the SIR, increased by 66.4%.According to the cumulative risk index (CR64, CR74), the municipalities, where the risk of developing thyroid cancer is almost 1.5 times higher than the total rate in Georgia, were identified.According to the PIR, the ratio of thyroid cancer to the share of thyroid cancer in the structure of cancer in the regions of Georgia (including Tbilisi) showed that the proportion of thyroid cancer in Tbilisi (PIR = 117.7) is 17.7% higher compared to proportion of total thyroid cancer in Georgia.

Conclusions:
It is recommended that the epidemiological map of thyroid cancer incidence be used in planning national, regional, and municipal preventive programs.

Key messages:
It is recommended to continue study in this direction: retrospective review of histological and histochemical features of each case of thyroid cancer.
It is recommended: to conduct molecular (oncogenes) studies in conjunction with histological and histochemical studies.
Abstract citation ID: ckac131.016Evaluation of primary health care system in Yangon Region, Myanmar: a mixed-method approach

Background:
Many low-and middle-income countries and international organizations have invested resources to strengthen primary health care services.Despite efforts from the Ministry of Health on primary health care, barriers to accessing health care services and health inequality in Myanmar still exist.This study aimed to identify the challenges and unmet needs in the current primary health care services by assessing the experiences and perceptions of healthcare workers and local leaders in three townships (Htantabin, Hmawbi, and Taikkyi) in Yangon, Myanmar.

Methods:
The study was conducted among healthcare professionals and community leaders in three townships.By adopting a mixedmethod approach, a cross-sectional health needs assessment survey was conducted for quantitative data (n = 66), and focus group discussions (15 group discussions) were conducted online for qualitative data.

Results:
As a result of the survey regarding six domains; hygiene, primary medical care, maternal and child health, infectious diseases, non-communicable diseases, and leadership, enhancing the management and leadership capacity had the lowest average score on the current achievement (2.81 out of 5), while strengthening infectious disease control service and accessibility was perceived as the highest mean on the priority of intervention (4.28 out of 5) and the impact of the intervention (4.7).The focus group discussions revealed that while specific infrastructures and equipment necessary for the category were addressed, the need for financial support has been the recurrent theme throughout the discussions.

Conclusions:
Utilizing the World Health Organization's six-building block framework, our findings suggest that a long-term targeted financial investment in the primary health care system is critical in Myanmar by increasing health care expenditure per capita.At the same time, related barriers and facilitators should be considered to optimize the effectiveness of prioritized interventions.

Key messages:
Health care providers and local leaders perceived the management and leadership capacity as the lowest current achievement.
15th European Public Health Conference 2022 Data were thematically analysed and categorized in a process of researcher and data-triangulation.A member check validation was done.
mental opportunities.Accessibility to diagnostic settings in Flanders, Belgium, is poor, with waiting periods up to two years.Interorganisational coordination of activities using a public health and needs of the population perspective is needed to strengthen the system.This study aims to evaluate current practices and opportunities for interorganisational collaboration of organisations active in the field of diagnostics.Methods: It concerns a qualitative, policy-support research project.6 homogeneous focus groups were organised for the 6 types of organisations subsidized by the government to perform diagnostic evaluations of children with a (suspected) developmental disorders.