Palliative Care Services within a Pediatric Hematology-Oncology Program in a Low-Resource Setting

This chapter covers a fundamentally important and often overlooked area of medicine, and outlines how even in humanitarian crises palliative care principles should be applied to relieve suffering for those with life-threatening illness. As not all humanitarian situations allow comprehensive textbook palliative care services for all patients, this chapter provides the underlying principles of palliation, implementation in low-resource environments, and key management components to allow adoption in varying contexts.

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Factors influencing men’s involvement in antenatal care services: a cross-sectional study in a low resource setting, Central Tanzania

Reproductive Health ◽

10.1186/s12978-019-0721-x ◽

2019 ◽

Vol 16 (1) ◽

Cited By ~ 1

Author(s):

Nyasiro S. Gibore ◽

Theodora A. L. Bali ◽

Stephen M. Kibusi

Keyword(s):

Antenatal Care ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Low Resource ◽

Care Services ◽

Factors Influencing ◽

Resource Setting ◽

Low Resource Setting ◽

Men’S Involvement

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Health facility service availability and readiness to provide basic emergency obstetric and newborn care in a low-resource setting: evidence from a Tanzania National Survey

BMJ Open ◽

10.1136/bmjopen-2017-020608 ◽

2019 ◽

Vol 9 (2) ◽

pp. e020608 ◽

Cited By ~ 8

Author(s):

Deogratius Bintabara ◽

Alex Ernest ◽

Bonaventura Mpondo

Keyword(s):

Quality Assurance ◽

Health Facility ◽

Newborn Care ◽

Service Availability ◽

Signal Functions ◽

Low Resource ◽

Care Services ◽

Resource Setting ◽

Low Resource Setting ◽

Maternal And Newborn

ObjectiveThis study used a nationally representative sample from Tanzania as an example of low-resource setting with a high burden of maternal and newborn deaths, to assess the availability and readiness of health facilities to provide basic emergency obstetric and newborn care (BEmONC) and its associated factors.DesignHealth facility-based cross-sectional survey.SettingWe analysed data for obstetric and newborn care services obtained from the 2014–2015 Tanzania Service Provision Assessment survey, using WHO-Service Availability and Readiness Assessment tool.Primary and secondary outcome measuresAvailability of seven signal functions was measured based on the provision of ‘parental administration of antibiotic’, ‘parental administration of oxytocic’, ‘parental administration of anticonvulsants’, ‘assisted vaginal delivery’, ‘manual removal of placenta’, ‘manual removal of retained products of conception’ and ‘neonatal resuscitation’. Readiness was a composite variable measured based on the availability of supportive items categorised into three domains: staff training, diagnostic equipment and basic medicines.ResultsOut of 1188 facilities, 905 (76.2%) were reported to provide obstetric and newborn care services and therefore were included in the analysis of the current study. Overall availability of seven signal functions and average readiness score were consistently higher among hospitals than health centres and dispensaries (p<0.001). Furthermore, the type of facility, performing quality assurance, regular reviewing of maternal and newborn deaths, reviewing clients’ opinion and number of delivery beds per facility were significantly associated with readiness to provide BEmONC.ConclusionThe study findings show disparities in the availability and readiness to provide BEmONC among health facilities in Tanzania. The Tanzanian Ministry of Health should emphasise quality assurance efforts and systematic maternal and newborn death audits. Health leadership should fairly distribute clinical guidelines, essential medicines, equipment and refresher trainings to improve availability and quality BEmONC.

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Flying Blind: Early Outcomes Following Implementation of Formal Critical Care Services in a Low-Resource Setting

International Journal of Critical Care and Emergency Medicine ◽

10.23937/2474-3674/1510106 ◽

2020 ◽

Vol 6 (3) ◽

Author(s):

Stoeckl Elizabeth M ◽

Long Kristin L ◽

Tesfaye Emnet

Keyword(s):

Critical Care ◽

Low Resource ◽

Care Services ◽

Resource Setting ◽

Low Resource Setting

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Nursing Care of Low-Risk Newborns in Low Resource Setting: Nurses' Aides May Bridge the Gap at Community Hospitals

European Journal of Clinical Medicine ◽

10.24018/clinicmed.2022.3.1.158 ◽

2022 ◽

Vol 3 (1) ◽

pp. 1-4

Author(s):

Subhashchandra Daga

Keyword(s):

Nursing Staff ◽

Health Workers ◽

Newborn Care ◽

Low Resource Settings ◽

Neonatal Deaths ◽

Low Resource ◽

General Duty ◽

Care Services ◽

Resource Setting ◽

Low Resource Setting

Objective: To study the role of a nurses' aide in the care for newborns weighing between 1500 and 2000 g at birth in a low resource setting. Study Design: Observational. Setting: The General hospital in 1994-95, in a public sector, located in a remote area in India Intervention: A female ward assistant with seven years of schooling trained, on-the-job, to keep babies warm, initiate maternal breastfeeding, and to detect rapid breathing. The nursing staff from the pediatric ward supervised her performance. A separate "warm room" appropriately heated for preterm and sick babies became a makeshift nursery. The nursing staff administered enteral feeding, oxygen, and antibiotics. Services of the resident doctors or general duty medical officers were not available. Results: The survival rate was nearly 100% for babies with birthweights between 1,500 and 2,000 g (none referred out). Conclusions: A nurses' aide may facilitate the delivery of special care for newborns where nursing personnel are grossly inadequate and saving babies weighing between 1,500 and 2,000 g may need minimal inputs. It may be worthwhile to target 1,500 and 2,000 g birthweight categories even when resources are meager. What is already known about this subject? Low resource settings face staff shortages, especially nursing staff. Health workers with midwifery skills can deliver nearly 90% of essential care services for maternal and neonatal health. A substantial proportion of neonatal deaths occur among moderately low birth weight babies. What does this study add? It is possible to train a semi-literate person to facilitate early breastfeeding and to keep a baby warm. A large proportion of deaths among babies with birthweight ranging from 1500 to 2000 g are preventable with meager resources. How might this impact on clinical practice or future developments? The facilities facing shortage of nursing staff in low resource settings, may employ nurses’ aide to deliver basic newborn care.

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