scholarly journals Train-the-Trainer as an Effective Approach to Building Global Networks of Experts in Genomic Surveillance of AMR

2021 ◽  
Author(s):  
Monica Abrudan ◽  
Alice Matimba ◽  
Dusanka Nikolic ◽  
Darren Hughes ◽  
Silvia Argimon ◽  
...  
Keyword(s):  
Group Project ◽  
Global Networks ◽  
Middle Income ◽  
Train The Trainer ◽  
Middle Income Countries ◽  
Sequencing Technologies ◽  
Training Research ◽  
Trained Staff ◽  
Genomics Tools ◽  
Building Program

Advanced genomics and sequencing technologies are increasingly becoming critical for global health applications such as pathogen and antimicrobial resistance (AMR) surveillance. Limited resources challenge capacity development in low- and middle-income countries (LMICs), with few countries having genomics facilities and adequately trained staff. Training research and public health experts who are directly involved in the establishment of such facilities offers an effective, but limited, solution to a growing need. Instead, training them to impart their knowledge and skills to others provides a sustainable model for scaling up the much needed capacity and capability for genomic sequencing and analysis locally with global impact. We designed and developed a Train-the-Trainer course integrating pedagogical aspects with genomic and bioinformatics activities. The course was delivered to 18 participants from 12 countries in Africa, Asia, and Latin America. A combination of teaching strategies culminating in a group project created a foundation for continued development at home institutions. Upon follow-up after 6 months, at least 40% of trainees had initiated training programs and collaborations to build capacity at local, national, and regional level. This work provides a framework for implementing a training and capacity building program for the application of genomics tools and resources in AMR surveillance.

Cancer Treatment in Low- and Middle-Income Countries

2020 ◽  
pp. 90-96
Author(s):  
Elizabeth Molyneux ◽  
Trijn Israels ◽  
Scott C. Howard
Keyword(s):  
Cancer Treatment ◽  
Continuous Quality Improvement ◽  
Paediatric Oncology ◽  
Global Networks ◽  
Middle Income ◽  
Treatment Regimens ◽  
Middle Income Countries ◽  
Continuous Quality ◽  
Treatment Abandonment ◽  
Low And Middle Income

eCancer treatment in low- and middle-income countries (LMIC) differs substantially from that in high-income countries (HIC), and these differences are the focus of this chapter. In looking at these differences in cancer treatment, this chapter discusses healthcare disparities between LMIC and HIC, the importance of paediatric cancer units (PCU) (recruitment, training, and retention of personnel, continuous quality improvement, development of PCUs, and national paediatric oncology programmes), protocol-based care (adapted treatment regimens and clinical research, regional and global networks), treatment challenges in LMIC (toxicity of treatment, abandonment of treatment, palliative care), and advocacy.

scholarly journals A Cambodian-Norwegian Competence Building Program in Child Mental Health: A Qualitative Focus-Group Study

2020 ◽  
Author(s):  
Marit Hafting ◽  
Puthy Pat ◽  
Gunn Aadland ◽  
Krister Fjermestad ◽  
Bhoomikumar Jegannathan
Keyword(s):  
Mental Health ◽  
Focus Group ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
High Income ◽  
Middle Income ◽  
Knowledge And Skills ◽  
Middle Income Countries ◽  
Building Program ◽  
Low And Middle Income

Abstract BackgroundThe prevalence of mental health and neurodevelopmental disorders in young people is high in low- and middle-income counties, such as Cambodia, as risk factors in the perinatal period, malnutrition, infections and adverse childhood experiences can be abundant due to poverty and/or conflict. Collaboration between institutions from high-income countries and institutions in resource-poor settings for professional development can improve service providers’ knowledge and skills, which is key to bridging the gap between service needs and the ability to meet those needs.MethodsA Norwegian team comprised of a pediatrician, a child and adolescent psychiatrist and a child psychologist implemented a participatory program for competence building at Centre for Child and Adolescent Mental Health in Cambodia (Caritas-CCAMH) two weeks per year over a 14-year period. Herein, we explore some aspects of this Cambodian-Norwegian collaboration from the perspective of the Caritas-CCAMH staff with a qualitative approach using thematic analysis of the transcripts from a focus-group interview with 11 staff members at the end of the 14-year period. Results The multidisciplinary team at Caritas-CCAMH described the learning process with the Norwegian team as a “meeting between experts” characterized by collaboration in planning and implementation, which enhanced the contextual relevance of the project. Mixing theory and practice in clinical case discussions with a bio-psycho-social perspective was perceived as the cornerstone of the pedagogical process. Learning by observation and supervision from the Norwegian team led to mastering skills and enhancing self-confidence and job satisfaction. A pedagogical strategy that involved constant reflection back and forth enabled the customization of the content and method of knowledge exchange despite the difference in socio-economic conditions and learning styles that were unfamiliar to the mental health professionals from high-income countries.ConclusionsBuilding knowledge and skills within a dialogic partnership over a significant period of time contributed to learning across cultures. This model of continuity, low-investment and low-intensity collaborative capacity building may enrich the child and adolescent mental health settings in high-, low- and middle-income countries. Furthermore, the model appears feasible for Western professionals who collaborate with institutions for child and adolescent mental health in low- and middle-income countries.

scholarly journals Research gaps in the organisation of primary healthcare in low-income and middle-income countries and ways to address them: a mixed-methods approach

2019 ◽  
Vol 4 (Suppl 8) ◽  
pp. e001482 ◽  
Author(s):  
Felicity Goodyear-Smith ◽  
Andrew Bazemore ◽  
Megan Coffman ◽  
Richard D W Fortier ◽  
Amanda Howe ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Low Income ◽  
Primary Healthcare ◽  
Models Of Care ◽  
Global Networks ◽  
Middle Income ◽  
Diverse Range ◽  
Middle Income Countries ◽  
Delphi Round ◽  
Research Questions

IntroductionSince the Alma-Ata Declaration 40 years ago, primary healthcare (PHC) has made great advances, but there is insufficient research on models of care and outcomes—particularly for low-income and middle-income countries (LMICs). Systematic efforts to identify these gaps and develop evidence-based strategies for improvement in LMICs has been lacking. We report on a global effort to identify and prioritise the knowledge needs of PHC practitioners and researchers in LMICs about PHC organisation.MethodsThree-round modified Delphi using web-based surveys. PHC practitioners and academics and policy-makers from LMICs sampled from global networks. First round (pre-Delphi survey) collated possible research questions to address knowledge gaps about organisation. Responses were independently coded, collapsed and synthesised. Round 2 (Delphi round 1) invited panellists to rate importance of each question. In round 3 (Delphi round 2), panellists ranked questions into final order of importance. Literature review conducted on 36 questions and gap map generated.ResultsDiverse range of practitioners and academics in LMICs from all global regions generated 744 questions for PHC organisation. In round 2, 36 synthesised questions on organisation were rated. In round 3, the top 16 questions were ranked to yield four prioritised questions in each area. Literature reviews confirmed gap in evidence on prioritised questions in LMICs.ConclusionIn line with the 2018 Astana Declaration, this mixed-methods study has produced a unique list of essential gaps in our knowledge of how best to organise PHC, priority-ordered by LMIC expert informants capable of shaping their mitigation. Research teams in LMIC have developed implementation plans to answer the top four ranked research questions.

scholarly journals Helping Babies Survive Training Programs: Evaluating a Teaching Cascade in Ethiopia

1970 ◽  
Vol 29 (6) ◽  
Author(s):  
Weinberg Steven ◽  
Jones Denise ◽  
Worku Bogale ◽  
Kumera Megerssa ◽  
Bose Carl ◽  
...  
Keyword(s):  
Skill Acquisition ◽  
Middle Income ◽  
Future Studies ◽  
Train The Trainer ◽  
Middle Income Countries ◽  
Clinical Evaluations ◽  
Regional Workshop ◽  
Facility Level ◽  
The Cost ◽  
Widespread Dissemination

Background: 2.6 million neonates die annually; the vast majority of deaths occur in low- and middle-income countries (LMICs). The Helping Babies Survive (HBS) programs are commonly used in LMICs to reduce neonatal mortality through education. They are typically disseminated using a train-the-trainer cascade. However, there is little published literature on the extent and cost of dissemination. In 2015, the Ethiopian Ministry of Health and partner organizations implemented a countrywide HBS training cascade for midwives in 169 hospitals.Methods: We quantified the extent of HBS dissemination, and characterized barriers that impeded successful hospital-based training by surveying a representative from each of the 169 participant hospitals. This occurred from September 2017 to April 2018. We also assessed the cost of the training cascade. To assess acquisition of knowledge and skill in the training cascade, multiple-choice question examinations (MCQE) and objective structured clinical evaluations (OSCE) were conducted.Results: Hospital-based training occurred in 132 participant hospitals (78%). 1,146 midwives, 69% of those employed by participant hospitals, received hospital-based training. Barriers included lack of preparation of hospital-based educators and limited logistical support. The cascade cost an average of 2,105 USD per facility or 197 USD per trainee. Knowledge improved and skills were adequate for regional workshop attendees based on MCQE and OSCE performance.Conclusion: The train-the-trainer strategy is an effective and affordable strategy for widespread dissemination of the HBS programs in LMICs. Future studies should assess knowledge and skill acquisition following the variety of pragmatic training approaches that may be employed at the facility-level.

scholarly journals A New Framework for Assessing Equid Welfare: A Case Study of Working Equids in Nepalese Brick Kilns

Animals ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 1074
Author(s):  
Stuart L. Norris ◽  
Laura M. Kubasiewicz ◽  
Tamlin L. Watson ◽  
Holly A. Little ◽  
Atish K. Yadav ◽  
...  
Keyword(s):  
Middle Income ◽  
Attitudes And Practices ◽  
Middle Income Countries ◽  
Brick Kilns ◽  
Key Indicator ◽  
Resource Limited ◽  
Trained Staff ◽  
Poor Welfare ◽  
New Framework

Equids fulfil many different roles within communities. In low- to middle-income countries (LMICs), in addition to providing a source of income, equids also provide essential transport of food, water, and goods to resource-limited and/or isolated communities that might otherwise lack access. The aim of this investigation was to understand the welfare conditions that donkeys, mules, and horses are exposed to whilst working in Nepalese brick kilns. To understand the welfare conditions of equids in Nepalese brick kilns, the Welfare Aggregation and Guidance (WAG) tool in conjunction with the Equid Assessment, Research and Scoping (EARS) tool was used to understand the health, behaviour, nutrition, living and working conditions in brick kilns. Further analysis of individual EARS responses focused on key indicator questions relating to demographic information was used to investigate specific areas of welfare concern and attitudes of handlers towards their equids. Trained staff carried out welfare assessments between December 2018 and April 2019. The information gathered using the EARS tool was summarised using the WAG tool to pinpoint areas of welfare concern and suggest possible strategies to mitigate poor welfare conditions and suggest areas to improve the welfare of equids. Overall, the results indicate that to improve the welfare of equids working in Nepalese brick kilns, there should be better provision of clean water, both when working and stabled, equipment should be removed and shade provided during rest periods, with improvements made to housing to allow the equids to rest and recuperate when not working. Further work should also focus on collaborating with owners and equid handlers to improve their attitudes and practices towards their equids. Such improvements can be implemented via training of equid handlers and kiln owners whilst using the EARS and WAG tools to provide a sound basis on which to monitor the effectiveness and impact of education programs on equid welfare.

scholarly journals Continued nursing education in low-income and middle-income countries: a narrative synthesis

2020 ◽  
Vol 5 (2) ◽  
pp. e001981
Author(s):  
Amee Azad ◽  
Jung-Gi Min ◽  
Sharjeel Syed ◽  
Sara Anderson
Keyword(s):  
Nursing Education ◽  
Patient Outcomes ◽  
Low Income ◽  
Cultural Context ◽  
Educational Interventions ◽  
Middle Income ◽  
Mortality And Morbidity ◽  
Train The Trainer ◽  
Middle Income Countries ◽  
Quasi Experimental

IntroductionContinued nursing education and development can reduce mortality and morbidity of patients and can alleviate the shortage of healthcare workers by training of nurses for high-demand skill sets. We reviewed patterns of educational interventions and strategies in initiating behaviour change, improving patient outcomes or knowledge for nurses in low- and middle-income countries (LMICs).MethodsThe study searched the MEDLINE (PubMed), Embase, CINAHL, Google Scholar and Web of Science databases. The study included interventional studies on continued nursing education from 2007 to 2017. Of the 6216 publications retrieved, 98 articles were included and analysed by three independent reviewers.ResultsOf the 98 studies that met inclusion criteria, five were randomised controlled trials, two were qualitative in design and the remaining 91 were quasi-experimental, before-and-after studies. Of these studies, the median sample size of participants was 64, and the majority were conducted in Asia (53.1%). During the 10-year study period, 20.4% was conducted in 2015, the highest proportion, with a general increase in number of studies over time from 2007 to 2017. Main themes that arose from the review included train-the-trainer models, low-dose/high-frequency models, use of multiple media for training, and emphasis on nurse empowerment, strong international partnerships, and the integration of cultural context. Overall, the studies were limited in quality and lacked rigorous study design.ConclusionContinued nursing education in LMICs is essential and effective in improving nurses’ knowledge base, and thus patient outcomes and quality of care. Long-term, randomised studies are needed to understand how training strategies compare in impact on nurses and patients.

scholarly journals Sharing road safety education and enforcement knowledge and practice throughout developing nations - challenges create opportunities!

2019 ◽  
Vol 30 (1) ◽  
pp. 58-65
Author(s):  
Ray Shuey
Keyword(s):  
Road Safety ◽  
Behavioural Change ◽  
Safety Education ◽  
Middle Income ◽  
Train The Trainer ◽  
Middle Income Countries ◽  
Adequate Funding ◽  
Safety Strategies ◽  
Knowledge And Practice ◽  
Traffic Law Enforcement

This paper presents a practitioner’s perspective of implementing road safety strategies in low and middle-income countries. It identifies a gap in traffic law enforcement capability and describes professional development train the trainer programs to build capacity. The costs and benefits of road safety reform are raised in conjunction with the need to provide adequate funding to support the behavioural change of drivers. Understanding the challenges of piecemeal reform, policing capability, corruption and under-reporting of crashes provides opportunities to use this knowledge to impact behavioural change and road trauma reduction. The findings confirm education and enforcement as a successful methodology for reform as well as the need to create the perception of certainty of being caught and punished when breaking the law.

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