Falling through the net: An adaptive assessment of the ‘Three Delays’ encountered by patients seeking emergency maternal and neonatal care within a remote health system on Lake Victoria, Kenya

2021 ◽  
pp. 1-20
Author(s):  
Charles Reinisch Salmen ◽  
Louisa Ndunyu ◽  
John M. Ssenkusu ◽  
David Marshall ◽  
Nicholas DesLauriers ◽  
...  
Keyword(s):  
Health System ◽  
Lake Victoria ◽  
Neonatal Care ◽  
Adaptive Assessment ◽  
Three Delays ◽  
Remote Health

scholarly journals Assessing trauma care systems in low-income and middle-income countries: a systematic review and evidence synthesis mapping the Three Delays framework to injury health system assessments

2021 ◽  
Vol 6 (5) ◽  
pp. e004324
Author(s):  
John Whitaker ◽  
Nollaig O'Donohoe ◽  
Max Denning ◽  
Dan Poenaru ◽  
Elena Guadagno ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health System ◽  
Evidence Synthesis ◽  
Rapid Assessment ◽  
Sub Saharan Africa ◽  
Trauma Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Three Delays

BackgroundThe large burden of injuries falls disproportionately on low/middle-income countries (LMICs). Health system interventions improve outcomes in high-income countries. Assessing LMIC trauma systems supports their improvement. Evaluating systems using a Three Delays framework, considering barriers to seeking (Delay 1), reaching (Delay 2) and receiving care (Delay 3), has aided maternal health gains. Rapid assessments allow timely appraisal within resource and logistically constrained settings. We systematically reviewed existing literature on the assessment of LMIC trauma systems, applying the Three Delays framework and rapid assessment principles.MethodsWe conducted a systematic review and narrative synthesis of articles assessing LMIC trauma systems. We searched seven databases and grey literature for studies and reports published until October 2018. Inclusion criteria were an injury care focus and assessment of at least one defined system aspect. We mapped each study to the Three Delays framework and judged its suitability for rapid assessment.ResultsOf 14 677 articles identified, 111 studies and 8 documents were included. Sub-Saharan Africa was the most commonly included region (44.1%). Delay 3, either alone or in combination, was most commonly assessed (79.3%) followed by Delay 2 (46.8%) and Delay 1 (10.8%). Facility assessment was the most common method of assessment (36.0%). Only 2.7% of studies assessed all Three Delays. We judged 62.6% of study methodologies potentially suitable for rapid assessment.ConclusionsWhole health system injury research is needed as facility capacity assessments dominate. Future studies should consider novel or combined methods to study Delays 1 and 2, alongside care processes and outcomes.

scholarly journals Reduction of Neonatal Mortality Requires Strengthening of the Health System: A Situational Analysis of Neonatal Care Services in Ballabgarh

2017 ◽  
pp. fmw098
Author(s):  
Mudita Gosain ◽  
Akhil D. Goel ◽  
Pradeep Kharya ◽  
Ramesh Agarwal ◽  
Ritvik Amarchand ◽  
...  
Keyword(s):  
Health System ◽  
Neonatal Mortality ◽  
Neonatal Care ◽  
Situational Analysis ◽  
Care Services ◽  
System A

The MOMENTUM study: Putting the ‘Three Delays’ to work to evaluate access to emergency obstetric and neonatal care in a remote island community in Western Kenya

2020 ◽  
Vol 15 (7) ◽  
pp. 1016-1029
Author(s):  
Nicholas R. DesLauriers ◽  
Evance Ogola ◽  
Gor Ouma ◽  
Marcus Salmen ◽  
Lily Muldoon ◽  
...  
Keyword(s):  
Neonatal Care ◽  
Western Kenya ◽  
Remote Island ◽  
Island Community ◽  
Three Delays

scholarly journals The All Babies Count Initiative: Impact of a Health System Improvement Approach on Neonatal Care and Outcomes in Rwanda

2020 ◽  
Vol 8 (3) ◽  
pp. 505-517
Author(s):  
Hema Magge ◽  
Evrard Nahimana ◽  
Jean Claude Mugunga ◽  
Fulgence Nkikabahizi ◽  
Elisabeth Tadiri ◽  
...  
Keyword(s):  
Health System ◽  
Neonatal Care ◽  
Health System Improvement ◽  
System Improvement

scholarly journals Scaling up of Facility-Based Neonatal Care--A District Health System Experience

2006 ◽  
Vol 53 (2) ◽  
pp. 107-112 ◽  
Author(s):  
B. Shantharam Baliga ◽  
K. Raghuveera ◽  
B. Vivekananda Prabhu ◽  
R. Shenoy ◽  
A. Rajeev
Keyword(s):  
Health System ◽  
Scaling Up ◽  
Neonatal Care ◽  
District Health ◽  
District Health System

scholarly journals Educational Methods and Technological Innovations for Introductory Experiential Learning Given the Contact-Related Limitations Imposed by the SARS-CoV2/COVID-19 Pandemic

Pharmacy ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 47
Author(s):  
Paul M. Reynolds ◽  
Erica Rhein ◽  
Monika Nuffer ◽  
Shaun E. Gleason
Keyword(s):  
Health System ◽  
Course Design ◽  
Pharmacy Practice ◽  
Community Setting ◽  
Simulation Software ◽  
Community Activities ◽  
Before And After ◽  
Level Of Knowledge ◽  
Course Outcomes ◽  
Remote Health

Background: Acute respiratory syndrome related coronavirus disease (COVID-19) has led to substantial changes in pharmacy curricula, including the ability to provide in-person introductory experiential practice experiences (IPPEs) to University of Colorado’s International-Trained PharmD (ITPD) students. Methods: The IPPE course for ITPD students was redesigned to offer remote educational activities in the health system setting and simulated practice and communication activities in the community setting. Students were evaluated via surveys regarding the perceived value of these changes, and changes in knowledge, skills and abilities before and after activities. Results: A total of 6 students were enrolled in the revised IPPE course. Students agreed or strongly agreed that the overall distance-based IPPE experience, the remote health system activities, and the community activities were valuable. Students also strongly agreed that course design successfully met course outcomes and was relevant to pharmacy practice. In terms of knowledge, skills and abilities, numeric improvements were observed in remote health system activities and community-based simulated patient interactions, but results were not statistically significant. A high baseline level of knowledge led to minimal improvements in perceptions of improvement in community pharmacy skills regarding pharmacy simulation software. Conclusion: Implementation of distance-based IPPE activities may be an alternate educational modality.

Private health system in India and neonatal care

2009 ◽  
Vol 23 (3) ◽  
pp. 234-243
Author(s):  
Arvind Shenoi ◽  
Jyoti Raman ◽  
Srinivas Murki ◽  
Naveen Jain ◽  
Satish Saluja
Keyword(s):  
Health System ◽  
Neonatal Care
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