No cash, no care: how user fees endanger health—lessons learnt regarding financial barriers to healthcare services in Burundi, Sierra Leone, Democratic Republic of Congo, Chad, Haiti and Mali

2011 ◽  
Vol 3 (2) ◽  
pp. 91-100 ◽  
Author(s):  
Frederique Ponsar ◽  
Katie Tayler-Smith ◽  
Mit Philips ◽  
Seco Gerard ◽  
Michel Van Herp ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Healthcare Services ◽  
User Fees ◽  
Financial Barriers ◽  
Republic Of Congo ◽  
Lessons Learnt ◽  
Barriers To Healthcare

scholarly journals Establishing a postgraduate programme in nutritional epidemiology to strengthen resource capacity, academic leadership and research in the democratic republic of Congo

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mapatano Mala Ali ◽  
Lyn Haskins ◽  
Vaughn John ◽  
Anne Hatløy ◽  
Silondile Luthuli ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Lessons Learned ◽  
Academic Leadership ◽  
Nutritional Epidemiology ◽  
Rural Site ◽  
Educational Approach ◽  
Financial Barriers ◽  
Republic Of Congo ◽  
Health And Nutrition

Abstract Background Low- and Middle-income countries (LMIC) face considerable health and nutrition challenges, many of which can be addressed through strong academic leadership and robust research translated into evidence-based practice. A North-South-South partnership between three universities was established to implement a master’s programme in nutritional epidemiology at the Kinshasa School of Public Health (KSPH), Democratic Republic of Congo (DRC). The partnership aimed to develop academic leadership and research capacity in the field of nutrition in the DRC. In this article we describe the educational approach and processes used, and discuss successes, challenges, and lessons learned. Methods Self-administered questionnaires, which included both open and closed questions, were sent to all graduates and students on the master’s programme to explore students’ experiences and perceptions of all aspects of the educational programme. Quantitative data was analysed using frequencies, and a thematic approach was used to analyse responses to open-ended questions. Results A two-year master’s programme in Nutritional Epidemiology was established in 2014, and 40 students had graduated by 2020. Key elements included using principles of authentic learning, deployment of students for an internship at a rural residential research site, and support of selected students with bursaries. Academic staff from all partner universities participated in teaching and research supervision. The curriculum and teaching approach were well received by most students, although a number of challenges were identified. Most students reported benefits from the rural internship experience but were challenged by the isolation of the rural site, and felt unsupported by their supervisors, undermining students’ experiences and potentially the quality of the research. Financial barriers were also reported as challenges by students, even among those who received bursaries. Conclusion The partnership was successful in establishing a Master Programme in Nutritional Epidemiology increasing the number of nutrition researchers in the DRC. This approach could be used in other LMIC settings to address health and nutrition challenges.

scholarly journals How should community health workers in fragile contexts be supported: Qualitative evidence from Sierra Leone, Liberia and Democratic Republic of Congo

2020 ◽  
Author(s):  
Joanna Raven ◽  
Haja Wurie ◽  
Ayesha Idriss ◽  
Abdulai Jawo Bah ◽  
Amuda Baba ◽  
...  
Keyword(s):  
Community Health ◽  
Sierra Leone ◽  
Community Health Workers ◽  
Democratic Republic ◽  
Health Workers ◽  
Democratic Republic Of Congo ◽  
Community Support ◽  
Health Coverage ◽  
Republic Of Congo ◽  
And Performance

Abstract Background: Community Health Workers (CHWs) are critical players in fragile settings, where staff shortages are particularly acute, health indicators are poor and progress towards Universal Health Coverage is slow. Like other health workers, CHWs need support to contribute effectively to health programmes and promote health equity. Yet the evidence base of what kind of support works best is weak. We present evidence from three fragile settings - Sierra Leone, Liberia and Democratic Republic of Congo on managing CHWs, and synthesise recommendations for best approaches to support this critical cadre.Methods: We used a qualitative study design to explore how CHWs are managed, the challenges they face and potential solutions. We conducted interviews with decision makers and managers (n=37), life history interviews with CHWs (n=15) and reviewed policy documents. Results: Fragility disrupts education of community members so that they may not have the literacy levels required for the CHW role. This has implications for the selection, role, training and performance of CHWs. Policy preferences about selection need discussion at the community level, so that they reflect community realities. CHWs scope of work is varied and may change over time, requiring ongoing training. The modular, local, and mix of practical and classroom training approach worked well, helping to address gender and literacy challenges and developing a supportive cohort of CHWs. A package of supervision, community support, regular provision of supplies, performance rewards and regular remuneration is vital to retention and performance of CHWs. But there are challenges with supervision, scarcity of supplies, inadequate community recognition and unfulfilled promises about allowances. Clear communication about incentives with facility staff and communities is required as is their timely delivery.Conclusions: This is the first study that has explored the management of CHWs in fragile settings. CHWs interface role between communities and health systems is critical because of their embedded positionality and the trusting relationships they (often) have. Their challenges are aligned to those generally faced by CHWs but chronic fragility exacerbates them and requires innovative problem solving to ensure that countries and communities are not left behind in reforming the way that CHWs are supported.

Barriers to healthcare for sickle cell disease patients in the Democratic Republic of Congo

2017 ◽  
Vol 1 (1) ◽  
pp. 3-9
Author(s):  
Salomon Agasa Batina ◽  
◽  
Paul Kombi Kambale ◽  
Marcel Poyo Sabiti ◽  
Charles Tshilumba Kayembe ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Cell Disease ◽  
Republic Of Congo ◽  
Barriers To Healthcare

scholarly journals How should community health workers in fragile contexts be supported: Qualitative evidence from Sierra Leone, Liberia and Democratic Republic of Congo

2020 ◽  
Author(s):  
Joanna Raven ◽  
Haja Wurie ◽  
Ayesha Idriss ◽  
Abdulai Jawo Bah ◽  
Amuda Baba ◽  
...  
Keyword(s):  
Community Health ◽  
Sierra Leone ◽  
Community Health Workers ◽  
Democratic Republic ◽  
Health Workers ◽  
Democratic Republic Of Congo ◽  
Community Support ◽  
Health Coverage ◽  
Republic Of Congo ◽  
And Performance

Abstract Background Community Health Workers (CHWs) are critical players in fragile settings, where staff shortages are particularly acute, health indicators are poor and progress towards Universal Health Coverage is slow. Like other health workers, CHWs need support to contribute effectively to health programmes and promote health equity. Yet the evidence base of what kind of support works best is weak. We present evidence from three fragile settings - Sierra Leone, Liberia and Democratic Republic of Congo on managing CHWs, and synthesise recommendations for best approaches to support this critical cadre.Methods We used a qualitative study design to explore how CHWs are managed, the challenges they face and potential solutions. We conducted interviews with decision makers and managers (n = 37), life history interviews with CHWs (n = 15) and reviewed policy documents.Results Fragility disrupts education of community members so that they may not have the literacy levels required for the CHW role. This has implications for selection, role, training and performance of CHWs. Policy preferences about selection need discussion at the community level, so that they reflect community realities. CHWs scope of work is varied and may change over time, requiring ongoing training. The modular, local, and mix of practical and classroom training approach worked well, helping to address gender and literacy challenges and develop a supportive cohort of CHWs. A package of supervision, community support, regular provision of supplies, performance rewards and regular remuneration is vital to retention and performance of CHWs. But there are challenges with supervision, scarcity of supplies, inadequate community recognition and unfulfilled promises about allowances. Clear communication about incentives with facility staff and communities is required as is their timely delivery.Conclusions This is the first study that has explored the management of CHWs in fragile settings. CHWs interface role between communities and health systems is critical because of their embedded positionality and the trust they (often) have. Their challenges are aligned to those generally faced by CHWs but chronic fragility exacerbates them and requires innovative problem solving to ensure that countries and communities are not left behind in reforming the way that CHWs are supported.

Meliola clerodendricola. [Descriptions of Fungi and Bacteria].

2006 ◽  
Author(s):  
D. W. Minter
Keyword(s):  
Host Range ◽  
Sierra Leone ◽  
Geographical Distribution ◽  
Democratic Republic ◽  
West Bengal ◽  
Democratic Republic Of Congo ◽  
Republic Of Congo

Abstract A description is provided for M. clerodendricola. Information on symptoms of the disease caused by this fungus, host range (Clerodendrum spp., Gmelina spp., Lantana spp. and Vitex spp.), geographical distribution (Cameroon; Democratic Republic of Congo; Ghana; Nigeria; Sierra Leone; Sudan; Togo; Uganda; Hainan, China; West Bengal, India; Indonesia; Japan; Malaysia; Myanmar; Philippines; Vietnam; Queensland, Australia; and Cuba) and transmission is included.

Meliola clavulata. [Descriptions of Fungi and Bacteria].

2006 ◽  
Author(s):  
D. W. Minter
Keyword(s):  
Puerto Rico ◽  
Costa Rica ◽  
Dominican Republic ◽  
Trinidad And Tobago ◽  
Sierra Leone ◽  
Geographical Distribution ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Republic Of Congo ◽  
Sao Tome And Principe

Abstract A description is provided for M. clavulata. Information on the symptoms of the disease caused by this fungus, hosts (Argyreia spp., Calonyction spp., Hewittia sublobata, Ipomoea spp., Merremia spp., Quamoclit coccinea [I. coccinea], Rivea corymbosa, Stictocardia tiliifolia and Turbina corymbosa), geographical distribution (Cameroon; Democratic Republic of Congo; Ghana; São Tomé and Principe; Sierra Leone; Tanzania; Uganda; Mexico; Costa Rica; Honduras; Panama; Pernambuco and Rio de Janeiro, Brazil; Ecuador; Guyana; Dominica; Dominican Republic; Jamaica; Puerto Rico; and Trinidad and Tobago) and transmission is included.

Effectiveness of Chlorine Dispensers in Emergencies: Case Study Results from Haiti, Sierra Leone, Democratic Republic of Congo, and Senegal

2015 ◽  
Vol 49 (8) ◽  
pp. 5115-5122 ◽  
Author(s):  
Travis M. Yates ◽  
Elise Armitage ◽  
Lilian V. Lehmann ◽  
Ariel J. Branz ◽  
Daniele S. Lantagne
Keyword(s):  
Sierra Leone ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Republic Of Congo ◽  
Study Results

Meliola hyptidis. [Descriptions of Fungi and Bacteria].

2006 ◽  
Author(s):  
D. W. Minter
Keyword(s):  
South Africa ◽  
Sierra Leone ◽  
Geographical Distribution ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Republic Of Congo ◽  
Ocimum Gratissimum

Abstract A description is provided for M. hyptidis. Information on symptoms of the disease caused by this fungus, hosts (Coleus sp., Hoslundia opposita, H. oppositifolia, Hyptis capitata, H. suaveolens, Hyptis sp., Leucas sp., Ocimum gratissimum, O. viride, Ocimum sp., Platystoma africana, Plectranthus ciliatus and Stachys sp.), geographical distribution (Democratic Republic of Congo, Ghana, Sierra Leone, South Africa, Sudan, Togo, Uganda, Brazil, Venezuela and Philippines), and transmission is included.

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