Incorporating costing study results into district and service planning to enhance immunization programme performance: a Zambian case study

Abstract Donors, researchers and international agencies have made significant investments in collection of high-quality data on immunization costs, aiming to improve the efficiency and sustainability of services. However, improved quality and routine dissemination of costing information to local managers may not lead to enhanced programme performance. This study explored how district- and service-level managers can use costing information to enhance planning and management to increase immunization outputs and coverage. Data on the use of costing information in the planning and management of Zambia’s immunization programme was obtained through individual and group semi-structured interviews with planners and managers at national, provincial and district levels. Document review revealed the organizational context within which managers operated. Qualitative results described managers’ ability to use costing information to generate cost and efficiency indicators not provided by existing systems. These, in turn, would allow them to understand the relative cost of vaccines and other resources, increase awareness of resource use and management, benchmark against other facilities and districts, and modify strategies to improve performance. Managers indicated that costing information highlighted priorities for more efficient use of human resources, vaccines and outreach for immunization programming. Despite decentralization, there were limitations on managers’ decision-making to improve programme efficiency in practice: major resource allocation decisions were made centrally and planning tools did not focus on vaccine costs. Unreliable budgets and disbursements also undermined managers’ ability to use systems and information. Routine generation and use of immunization cost information may have limited impact on managing efficiency in many Zambian districts, but opportunities were evident for using existing capacity and systems to improve efficiency. Simpler approaches, such as improving reliability and use of routine immunization and staffing indicators, drawing on general insights from periodic costing studies, and focusing on maximizing coverage with available resources, may be more feasible in the short-term.

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The Costs of Introducing the Hepatitis B Birth Dose Vaccine into the National Immunization Programme in Senegal (NéoVac Study)

Vaccines ◽

10.3390/vaccines9050521 ◽

2021 ◽

Vol 9 (5) ◽

pp. 521

Author(s):

Andréa Gosset ◽

Marie Libérée Nishimwe ◽

Mamadou Yaya Diallo ◽

Lucas Deroo ◽

Aldiouma Diallo ◽

...

Keyword(s):

Hepatitis B ◽

Weighted Average ◽

Structured Interviews ◽

Cost Information ◽

African Countries ◽

Training Costs ◽

Country Level ◽

Immunization Programme ◽

Financial Costs ◽

Birth Dose

Some African countries are still reluctant to introduce the hepatitis B vaccine birth dose (HepB-BD) into their expanded program of immunization (EPI), partly because of logistical, economic, and cost information constraints. To assist decision-makers in these countries, we assessed the economic and financial costs of HepB-BD introduction in Senegal in 2016. We performed a micro-costing study in a representative sample of Senegal’s EPI sites at all levels in 2018. Information on EPI and HepB-BD activity-related inputs and costs was collected using standardized questionnaires and semi-structured interviews. Using inverse probability weighting, we computed weighted average costs associated with HepB-BD introduction for each EPI level, country-level aggregated costs and estimated costs per newborn. Economic and financial costs from a government perspective were estimated in US dollars for 2015, 2016 and 2017. Total economic costs were USD 143,364 in 2015, USD 759,406 in 2016 and USD 867,311 in 2017, while financial costs were USD 127,745, USD 82,519 and USD 29,853, respectively. When annualizing pre-introduction and initial training costs, the economic (financial) cost per vaccinated newborn was USD 2.10 (USD 0.30) in 2016 and USD 1.90 (USD 0.20) in 2017. Our estimates provide valuable information to implement HepB-BD in Sub-Saharan African countries that have not yet integrated this vaccine.

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Understanding the clinical reasoning processes involved in the management of multimorbidity in an ambulatory setting: study protocol of a stimulated recall research

BMC Medical Education ◽

10.1186/s12909-020-02459-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

M.-C. Audétat ◽

S. Cairo Notari ◽

J. Sader ◽

C. Ritz ◽

T. Fassier ◽

...

Keyword(s):

Primary Care ◽

Clinical Reasoning ◽

Primary Care Physicians ◽

Video Sequence ◽

Structured Interview ◽

Ambulatory Setting ◽

Structured Interviews ◽

Stimulated Recall ◽

Study Results

Abstract Background Primary care physicians are at the very heart of managing patients suffering from multimorbidity. However, several studies have highlighted that some physicians feel ill-equipped to manage these kinds of complex clinical situations. Few studies are available on the clinical reasoning processes at play during the long-term management and follow-up of patients suffering from multimorbidity. This study aims to contribute to a better understanding on how the clinical reasoning of primary care physicians is affected during follow-up consultations with these patients. Methods A qualitative research project based on semi-structured interviews with primary care physicians in an ambulatory setting will be carried out, using the video stimulated recall interview method. Participants will be filmed in their work environment during a standard consultation with a patient suffering from multimorbidity using a “button camera” (small camera) which will be pinned to their white coat. The recording will be used in a following semi-structured interview with physicians and the research team to instigate a stimulated recall. Stimulated recall is a research method that allows the investigation of cognitive processes by inviting participants to recall their concurrent thinking during an event when prompted by a video sequence recall. During this interview, participants will be prompted by different video sequence and asked to discuss them; the aim will be to encourage them to make their clinical reasoning processes explicit. Fifteen to twenty interviews are planned to reach data saturation. The interviews will be transcribed verbatim and data will be analysed according to a standard content analysis, using deductive and inductive approaches. Conclusion Study results will contribute to the scientific community’s overall understanding of clinical reasoning. This will subsequently allow future generation of primary care physicians to have access to more adequate trainings to manage patients suffering from multimorbidity in their practice. As a result, this will improve the quality of the patient’s care and treatments.

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Reintegration of Ex-Offenders Convicted of Violent Crimes into the Community in the Iranian Context: A Qualitative Study

International Journal of Offender Therapy and Comparative Criminology ◽

10.1177/0306624x211022669 ◽

2021 ◽

pp. 0306624X2110226

Author(s):

Mohammad Sabzi Khoshnami ◽

Fardin Alipour ◽

Maliheh Arshi ◽

Hassan Rafiey ◽

Mohhamad Hossein Javadi

Keyword(s):

Social Capital ◽

Qualitative Study ◽

Structured Interviews ◽

Violent Crimes ◽

Institutional Review ◽

Main Challenge ◽

Improved Outcomes ◽

Study Results ◽

Reducing Recidivism ◽

Iranian Context

Community reintegration of ex-offenders is a main issue for reducing recidivism. This article aims to explain the process of reintegration into the community based on the experiences of people who have been convicted of violent crimes in Iran. A qualitative study based on grounded theory was conducted in 2020 in Tehran/Iran. Data was collected through in-depth semi-structured interviews with 26 participants. An institutional review board approved the study. Results indicate that the “worry trap” is the main challenge that those convicted of violent crimes face upon reentry into society. If these individuals are provided with governmental and non-governmental services and support, they can move toward “restoring their lost social capital.” The “redefinition of an independent identity” is a consequence of released individuals’ struggle to restore their lost social capital. Further research exploring the causality of social capital and improved outcomes after release from prison and reentry to community is needed.

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Internet of Things for Mental Health: Open Issues in Data Acquisition, Self-Organization, Service Level Agreement, and Identity Management

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18031327 ◽

2021 ◽

Vol 18 (3) ◽

pp. 1327

Author(s):

Leonardo J. Gutierrez ◽

Kashif Rabbani ◽

Oluwashina Joseph Ajayi ◽

Samson Kahsay Gebresilassie ◽

Joseph Rafferty ◽

...

Keyword(s):

Mental Health ◽

Internet Of Things ◽

Data Acquisition ◽

Identity Management ◽

Service Level Agreement ◽

Service Level ◽

Self Organization ◽

Future Research ◽

Study Results ◽

Open Issues

The increase of mental illness cases around the world can be described as an urgent and serious global health threat. Around 500 million people suffer from mental disorders, among which depression, schizophrenia, and dementia are the most prevalent. Revolutionary technological paradigms such as the Internet of Things (IoT) provide us with new capabilities to detect, assess, and care for patients early. This paper comprehensively survey works done at the intersection between IoT and mental health disorders. We evaluate multiple computational platforms, methods and devices, as well as study results and potential open issues for the effective use of IoT systems in mental health. We particularly elaborate on relevant open challenges in the use of existing IoT solutions for mental health care, which can be relevant given the potential impairments in some mental health patients such as data acquisition issues, lack of self-organization of devices and service level agreement, and security, privacy and consent issues, among others. We aim at opening the conversation for future research in this rather emerging area by outlining possible new paths based on the results and conclusions of this work.

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Evaluating Stress Relief from Architecture: A Case Study Based on Buildings in Taiwan, China and Japan

Sustainability ◽

10.3390/su13147899 ◽

2021 ◽

Vol 13 (14) ◽

pp. 7899

Author(s):

Ming-Chyuan Ho ◽

Yung-Chia Chiu

Keyword(s):

Urban Landscape ◽

Stress Relief ◽

Future Trend ◽

Differential Method ◽

City Image ◽

Structured Interviews ◽

Architectural Styles ◽

Stress Relieving ◽

Study Results ◽

Image Identity

The urban landscape can be improved to reduce the stress experienced by citizens. Therefore, stress-relieving buildings constitute a crucial topic and a future trend in architecture and design. In this study, different architectural styles were investigated to explore design methods for and characteristics of stress-relieving building shapes and to identify indicators for measuring participant stress relief while viewing buildings. To understand stress relief from architecture, we performed semi-structured interviews with 60 participants who viewed images of 30 buildings. The semantic differential method with a 7-point image scale was used to rate stress relief from different architectural styles. The study results revealed that the participants perceived curvilinear buildings as interesting but do not relieve stress. The participants identified as feeling high pressure considering rectilinear patterns to relieve more stress. To support this observation, we identified three principles—city image, identity, and spiritual atmosphere—as fundamental loci of designing cities for livability. We illustrate the three principles with several cases that facilitate a detailed understanding of their applicability in biodesign practices.

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Women’s lives in times of Zika: mosquito-controlled lives?

Cadernos de Saúde Pública ◽

10.1590/0102-311x00178917 ◽

2018 ◽

Vol 34 (5) ◽

Cited By ~ 7

Author(s):

Ana Rosa Linde ◽

Carlos Eduardo Siqueira

Keyword(s):

Coping Strategies ◽

Sampling Technique ◽

Well Being ◽

Snowball Sampling ◽

Structured Interviews ◽

International Agencies ◽

The Us ◽

Women's Lives ◽

Heavy Burden ◽

The Impact

Zika virus infection during pregnancy is a cause of congenital brain abnormalities. Its consequences to pregnancies has made governments, national and international agencies issue advices and recommendations to women. There is a clear need to investigate how the Zika outbreak affects the decisions that women take concerning their lives and the life of their families, as well as how women are psychologically and emotionally dealing with the outbreak. We conducted a qualitative study to address the impact of the Zika epidemic on the family life of women living in Brazil, Puerto Rico, and the US, who were affected by it to shed light on the social repercussions of Zika. Women were recruited through the snowball sampling technique and data was collected through semi-structured interviews. We describe the effects in mental health and the coping strategies that women use to deal with the Zika epidemic. Zika is taking a heavy toll on women’s emotional well-being. They are coping with feelings of fear, helplessness, and uncertainty by taking drastic precautions to avoid infection that affect all areas of their lives. Coping strategies pose obstacles in professional life, lead to social isolation, including from family and partner, and threaten the emotional and physical well-being of women. Our findings suggest that the impacts of the Zika epidemic on women may be universal and global. Zika infection is a silent and heavy burden on women’s shoulders.

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Embedding continuous quality improvement processes in multidisciplinary teams in cancer care: exploring the boundaries between quality and implementation science

Australian Health Review ◽

10.1071/ah16052 ◽

2017 ◽

Vol 41 (3) ◽

pp. 291 ◽

Cited By ~ 7

Author(s):

Tracy E. Robinson ◽

Anna Janssen ◽

Paul Harnett ◽

Kylie E. Museth ◽

Pamela J. Provan ◽

...

Keyword(s):

Quality Improvement ◽

Translational Research ◽

Implementation Science ◽

Cancer Care ◽

Administrative Support ◽

Quality Data ◽

Multidisciplinary Teams ◽

Structured Interviews ◽

Time Data ◽

Enabling Factors

Objective The aim of the present study was to identify key enabling factors for engaging multidisciplinary teams (MDTs) in cancer care across the spectrum of translational research and quality improvement (QI) projects. Methods The study was conducted in two large Sydney metropolitan hospitals. Qualitative methods, including structured observations of MDT meetings and semi-structured interviews with MDT leaders and champions, were used to identify how teams interact with and generate research and implementation initiatives. Enabling factors for and barriers to the engagement of MDTs in translational research and QI were identified. Results Four key enabling factors emerged from the analysis of data generated from observing 43 MDT meetings and 18 semi-structured interviews: (1) access to high-quality data around individual and team performance; (2) research-active team leaders; (3) having experts, such as implementation scientists, embedded into teams; and (4) having dedicated research or QI-focused meetings. Barriers included a lack of time, administrative support, research expertise and access to real-time data. Conclusions The identification of enabling factors for and barriers to translational research and QI provides evidence for how multidisciplinary cancer care teams may best be engaged in research and QI that aims to improve service and care outcomes. What is known about the topic? MDTs are key to the delivery of cancer care in Australia, but there is scant research into how teams can best be engaged in translating research from basic science through to implementation science and QI. What does this paper add? This paper provides new evidence from an immersive study of cancer care MDTs in two large metropolitan hospitals in Sydney (NSW, Australia), regarding the key enabling factors for and barriers to successful engagement in translational research and QI in cancer care. What are the implications for practitioners? Cancer care professionals in MDTs are presented with an opportunity to embed translational research and QI into cancer care. MDTs can operate as an ideal vehicle to look beyond individual patient outcomes to broader trends and population health outcomes.

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Saudi EFL University Instructors’ Barriers to Teaching the Speaking Skills: Causes and Solutions

10.31235/osf.io/69yeq ◽

2019 ◽

Author(s):

Noura Abdulaziz Abdulmohsen Al HAssan

Keyword(s):

Structured Interviews ◽

Preparation Programs ◽

King Saud University ◽

Self Confidence ◽

Study Results ◽

University Instructors ◽

Speaking Skill ◽

Barriers To Teaching ◽

Preparatory Year ◽

Speaking Skills

The aim of this study was to investigate the causes and the solutions of Saudi EFL university instructors’ barriers to teaching the speaking skill. The sample of the study consisted of 132 randomly-selected EFL preparatory year instructors at Al-Imam Mohammad Ibn Saud Islamic University, Princess Nourah Bint Abdulrahman University, and King Saud University in Riyadh city. Three instruments were utilized to collect data for the study: the first one was a questionnaire, the second was semi-structured interviews, and the third one was lectures observations. The researcher designed a five-point Likert scale questionnaire to collect the data of the study which was validated by a panel of raters consisting of ten university professors and instructors. To ensure reliability, Cronbach Alpha formula was calculated. Besides, The findings of the study revealed that the causes of Saudi EFL university instructors’ barriers to teaching the speaking skill in the preparatory year were as follows: students’ use of L1 during group work or pair work, lack of vocabulary, fear of making mistakes, lack of self-confidence, and lack of motivation. Furthermore, the study results advocated the following solutions to Saudi EFL university instructors’ barriers to teaching the speaking skill: enhancing students’ self-confidence to speak without fear, correcting students’ mistakes kindly, meeting students’ needs in speaking textbooks, and adopting recent motivating techniques, increasing the motivating speaking activities in textbooks, and testing the speaking skill. Finally, the study concluded that teacher training and preparation programs should help EFL instructors overcome and avoid such teaching barriers in teaching the speaking skills

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The libraries in students’ and undergraduates’ educational reading

Scientific and Technical Libraries ◽

10.33186/1027-3689-2021-1-77-98 ◽

2021 ◽

Vol 1 (1) ◽

pp. 77-98

Author(s):

T. Yu. Cherkashina ◽

E. A. Chernyshova ◽

S. N. Lyutov

Keyword(s):

Social Relationship ◽

Organizational Context ◽

Academic Research ◽

Educational Process ◽

Reading Practices ◽

Structured Interviews ◽

Internet Resources ◽

Academic Center ◽

The University

The goal of the study was to reveal distinction between the reading practices at different educational levels and to specify the libraries’ place in these practices. The reading practices are determined not only by the new technological (digital) environment but also by the institutional and organizational context and social relationship within the educational environment. The case study of educa-tional institutions of Novosibirsk Academic Center (namely Novosibirsk State Uni-versity and the University’s specialized Academic Research Center) was accom-plished. The data was acquired through structured interviews, questionnaire-based survey supplemented with the statistical data of RAS SB State Public Scien-tific and Technological Library. The majority of high-graders use the library for textbooks and/or if recommended by the teacher. The university library is less involved in the educational process; the students visit the library occasionally (e.g. searching for rare publications or lacking alternatives). The university is not their source of digital documents or full texts either; the students prefer not to scruti-nize the specificity of every database and access procedure and turn to searchable Internet-resources. The library, in student’s opinion, needs modernization for less formal and disciplinary regulations, for more comfort, and polyfunctional envi-ronment of reading rooms.

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Institutional Drivers of Internet Voting Adoption in Ghana: A Qualitative Exploratory Studies

Nordic and Baltic Journal of Information and Communications Technologies ◽

10.13052/nbjict1902-097x.2020.003 ◽

2020 ◽

Author(s):

Samuel Agbesi

Keyword(s):

Political Parties ◽

Thematic Analysis ◽

Organizational Context ◽

The Internet ◽

Top Management ◽

Management Support ◽

Structured Interviews ◽

Internet Voting ◽

Voting System ◽

The Government

Internet voting system adoption in elections can bring enormous benefits to an electoral process. Though few countries have adopted it for their legally binding elections, others have discontinued its use because of perceived vulnerabilities. But it has been argued that the benefits the internet voting system provide outweigh the perceived vulnerabilities. The main purpose of this study is to examine the drivers of the internet voting system from the organizational context. The study is purely qualitative using semi-structured interviews. The interview participants were top management of EC staff, political parties’ executives and experts who were purposively selected, and thematic analysis was used to extract patterns from the data collected. The main themes that emerged from the thematic analysis include pressure from political parties, pressure from the government, legal framework, financial readiness of EC, EC top management support, convenience, accuracy, and increase voter turnouts. The discussion of the findings and the implication of the results were discussed in the study.

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