scholarly journals Solar-powered oxygen, quality improvement and child pneumonia deaths: a large-scale effectiveness study

2020 ◽  
pp. archdischild-2020-320107
Author(s):  
Trevor Duke ◽  
Francis Pulsan ◽  
Doreen Panauwe ◽  
Ilomo Hwaihwanje ◽  
Martin Sa'avu ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Low Income ◽  
Large Scale ◽  
Incidence Rates ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Low Income Countries ◽  
Continuous Quality ◽  
Child Deaths ◽  
Solar Powered

BackgroundPneumonia is the largest cause of child deaths in low-income countries. Lack of availability of oxygen in small rural hospitals results in avoidable deaths and unnecessary and unsafe referrals.MethodWe evaluated a programme for improving reliable oxygen therapy using oxygen concentrators, pulse oximeters and sustainable solar power in 38 remote health facilities in nine provinces in Papua New Guinea. The programme included a quality improvement approach with training, identification of gaps, problem solving and corrective measures. Admissions and deaths from pneumonia and overall paediatric admissions, deaths and referrals were recorded using routine health information data for 2–4 years prior to the intervention and 2–4 years after. Using Poisson regression we calculated incidence rates (IRs) preintervention and postintervention, and incidence rate ratios (IRR).ResultsThere were 18 933 pneumonia admissions and 530 pneumonia deaths. Pneumonia admission numbers were significantly lower in the postintervention era than in the preintervention era. The IRs for pneumonia deaths preintervention and postintervention were 2.83 (1.98–4.06) and 1.17 (0.48–1.86) per 100 pneumonia admissions: the IRR for pneumonia deaths was 0.41 (0.24–0.71, p<0.005). There were 58 324 paediatric admissions and 2259 paediatric deaths. The IR for child deaths preintervention and postintervention were 3.22 (2.42–4.28) and 1.94 (1.23–2.65) per 100 paediatric admissions: IRR 0.60 (0.45–0.81, p<0.005). In the years postintervention period, an estimated 348 lives were saved, at a cost of US$6435 per life saved and over 1500 referrals were avoided.ConclusionsSolar-powered oxygen systems supported by continuous quality improvement can be achieved at large scale in rural and remote hospitals and health care facilities, and was associated with reduced child deaths and reduced referrals. Variability of effectiveness in different contexts calls for strengthening of quality improvement in rural health facilities.Trial registration numberACTRN12616001469404.

scholarly journals Evaluation of Health Facilities Capacity for the Management of Severe Preeclampsia and Eclampsia in Bayelsa State, Nigeria

2021 ◽  
pp. 78-86
Author(s):  
O. M. Alabintei ◽  
P. W. Alabrah ◽  
I. J. Abasi
Keyword(s):  
Health Care ◽  
Low Income ◽  
Care Delivery ◽  
Data Entry ◽  
Sampling Technique ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Low Income Countries ◽  
Multi Stage ◽  
Interview Guide

Background: The lack of properly-stocked facilities with basic and essential equipment and supplies as well as clinical guidelines required to successfully manage Pre-eclampsia/eclampsia (PE/E) has been reported in developing, low-income countries. It is necessary to ensure properly stocked health facilities for effective health care delivery. This study set out to assess the capacity of the health facilities in Bayelsa, Nigeria for the management of cases of eclampsia. Methods: A descriptive design was used in the conduct of this research in which 155 workers were recruited. A multi-stage sampling technique was employed to select health facilities for the study. The study instruments included a self-administered structured questionnaire, an interview guide, and an inventory checklist. Data entry, cleaning and analysis were done using the Statistical Package for Social Sciences (SPSS) version 22. Descriptive and inferential statistics were generated using the data. Results: It was found in this study that though MgSO4 was present in one (8.33%) primary and two (66.6%) secondary health facilities visited, no guide on how to administer and monitor the patients was available. The majority of the workforce in the primary health facility were the CHEW/CHO (48%), followed by midwives (16.9%) and then nurses (12.3%).Doctors constituted 7.7% while  pharmacists and pharmacist technicians constituted 6.2% and 9.2% respectively. Conclusion: In conclusion, this study revealed that facilities assessed lacked most of the basic and essential equipment, supplies and drugs, required for the successful management of PE/E. For effective management of cases of eclampsia, it is very essential that there should be a continuous supply of necessary tools, drugs and functioning equipment needed for the management of PE/E in all health care facilities.

scholarly journals Evaluation of a Low-Cost Commercial Actigraph and Its Potential Use in Detecting Cultural Variations in Physical Activity and Sleep

Sensors ◽  
2021 ◽  
Vol 21 (11) ◽  
pp. 3774
Author(s):  
Pavlos Topalidis ◽  
Cristina Florea ◽  
Esther-Sevil Eigl ◽  
Anton Kurapov ◽  
Carlos Alberto Beltran Leon ◽  
...  
Keyword(s):  
Physical Activity ◽  
Low Income ◽  
Large Scale ◽  
Low Cost ◽  
Low Income Countries ◽  
Time Data ◽  
Cultural Variations ◽  
Step Counts ◽  
Scale Step ◽  
Potential Use

The purpose of the present study was to evaluate the performance of a low-cost commercial smartwatch, the Xiaomi Mi Band (MB), in extracting physical activity and sleep-related measures and show its potential use in addressing questions that require large-scale real-time data and/or intercultural data including low-income countries. We evaluated physical activity and sleep-related measures and discussed the potential application of such devices for large-scale step and sleep data acquisition. To that end, we conducted two separate studies. In Study 1, we evaluated the performance of MB by comparing it to the GT3X (ActiGraph, wGT3X-BT), a scientific actigraph used in research, as well as subjective sleep reports. In Study 2, we distributed the MB across four countries (Austria, Germany, Cuba, and Ukraine) and investigated physical activity and sleep among these countries. The results of Study 1 indicated that MB step counts correlated highly with the scientific GT3X device, but did display biases. In addition, the MB-derived wake-up and total-sleep-times showed high agreement with subjective reports, but partly deviated from GT3X predictions. Study 2 revealed similar MB step counts across countries, but significant later wake-up and bedtimes for Ukraine than the other countries. We hope that our studies will stimulate future large-scale sensor-based physical activity and sleep research studies, including various cultures.

scholarly journals Local characterization of the Covid19 Response in low-income country: The case of a Lockdown in Zambia

2021 ◽  
Author(s):  
Choolwe Muzyamba
Keyword(s):  
Low Income ◽  
Mental Health Problems ◽  
Incidence Rates ◽  
Low Income Countries ◽  
Gender Based Violence ◽  
Low Income Country ◽  
Phone Calls ◽  
Heated Debate ◽  
Local Characterization

Abstract Background The onset of the covid19 pandemic has sparked heated debate among scholars on the relevance of lockdowns. There are those in favor of the lockdown and others who are critical of it. However, despite the increased interest in understanding the relevance of lockdowns, there still has not been much focus on its relevance in low income countries like Zambia. Thus with the help of the SRT, we set out to explore and document the local characterization of the lockdown by residents of Lusaka, Zambia.Methods A qualitative study in the form of interviews was conducted in Lusaka, Zambia involving a sample of 68 participants. Due to the lockdown measures that were in place during the study, the interviews were conducted via phone calls and the data collected were later analyzed by use of thematic analysis technique.Results The lockdown was on one hand lauded for slowing down the incidence rates, preventing fatalities, and for protecting the healthcare system from collapse. On the other hand, it was criticized for exacerbating poverty levels, unemployment rates, increasing the rate of mental health problems, aiding gender based violence, and intensifying political repression and corruption. The results speak to the complexity in the characterization of the lockdown as a response to covid19 in Zambia. This observation demonstrates the folly of viewing, applying and characterizing the covid19 lockdown as a ‘one-size-fits-all’ approach in Zambia.Conclusion Thus rather than definitely establishing the lockdown as an incontestable good, as it is depicted by some scholars or as useless by its critics, our findings instead demonstrate the diversity and complexity in how it is locally viewed by Zambians. The study provides grounds for caution on simplistic and binary characterization of lockdowns. It indicates the need for careful dialog between the designers of lockdowns and citizens in order to tailor such interventions to local realities in context-specific ways. It also shows that though the development of such interventions, all the various and complex elements it embodies must be taken into account in order to realize optimum outcomes.

ICT and Distance Learning for Agricultural Extension in Low Income Countries

2008 ◽  
pp. 1554-1560
Author(s):  
Colin R. Latchem ◽  
Ajit Maru
Keyword(s):  
Land Tenure ◽  
Low Income ◽  
Large Scale ◽  
Low Income Countries ◽  
Environmental Damage ◽  
Land Reforms ◽  
Economic Changes ◽  
Pests And Diseases ◽  
Sub Saharan ◽  
Value Add

About 2 billion people in low-income countries are dependent upon smallholding farming for their livelihoods. These are among the world’s poorest people. Most of them lack land tenure and farm in regions with limited land and water resources. Many must cope with drought, desertification, and environmental damage caused by failed land reforms, large-scale monocropping, overgrazing, logging, destroyed watersheds, and the encroachment of new pests and diseases. They use only the most primitive of tools and they lack the knowledge and skills to improve their farming methods, value-add their produce, and compete in national and global markets. Many of these smallholder communities have been devastated by HIV/AIDS. In some regions of sub-Saharan Africa, food production has dropped by 40%, and it is estimated that over the next 20 years, 26% of the agricultural labour force will be lost to this pandemic. And demographic and economic changes in the low-income nations are increasingly leaving farming in the hands of women, who lack the knowledge and resources to farm efficiently.

scholarly journals COVID-19, an Opportunity for Developing Countries?

2020 ◽  
Vol 8 ◽  
Author(s):  
Lee Smith ◽  
Nicola Veronese ◽  
Vincenzo Racalbuto ◽  
Damiano Pizzol
Keyword(s):  
Low Income ◽  
Large Scale ◽  
World Health ◽  
Low Income Countries ◽  
Prevention Measures ◽  
Viral Reservoirs ◽  
Case Scenario ◽  
Worst Case ◽  
Global Pandemic ◽  
Health Organization

The COVID-19 outbreak was declared by the World Health Organization (WHO) as global pandemic in March 2020. Considering the necessity to implement rapid response to control the pandemic and the fragility and the state of need of low income countries, it will be mandatory to develop a global approach in order to reduce the spread of infection and the creation of community viral reservoirs. So far, we could hypothesize a worst case scenario in which when the COVID-19 outbreak hits a peak in Africa and in low-income countries, the majority of such countries will be unprepared, with low resources allocated for affording the viral emergency and the consequences will be catastrophic with no lesson learnt. In the best case scenario, the COVID-19 will not affect Africa or South America on a large scale and, if the prevention measures will be implemented, we could register a lower incidence of hygiene linked diseases that still represent leading causes of death.

scholarly journals Return to Treatment in the Formal Health Care Sector: Evidence from Tanzania

2015 ◽  
Vol 7 (3) ◽  
pp. 29-57 ◽  
Author(s):  
Achyuta Adhvaryu ◽  
Anant Nyshadham
Keyword(s):  
Public Health ◽  
Health Care ◽  
Low Income ◽  
Health Care Sector ◽  
Health Facilities ◽  
Low Income Countries ◽  
Formal Sector ◽  
Health Goal ◽  
Public Health Goal ◽  
Formal Health Care

Improving access to the formal health care sector is a primary public health goal in many low-income countries. But the returns to this access are unclear, given that the quality of care at public health facilities is often considered inadequate. We exploit temporal and geographic variation in the cost of traveling to formal sector health facilities to show that treatment at these facilities improves short-term health outcomes for acutely ill children in Tanzania. Our results suggest that these improvements are driven in part by more timely receipt of and better adherence to antimalarial treatment. (JEL I11, I12, I15, I18, J13, O15)

The Evolution of a Quality Programme within a Changing Environment

1997 ◽  
Vol 64 (1) ◽  
pp. 16-24 ◽  
Author(s):  
Deborah Rudman ◽  
Mary Hall ◽  
Sylvia Langlois
Keyword(s):  
Quality Assurance ◽  
Quality Improvement ◽  
Occupational Therapy ◽  
Continuous Quality Improvement ◽  
Performance Outcomes ◽  
Health Care Facilities ◽  
Leadership Roles ◽  
Clinical Indicators ◽  
Continuous Quality ◽  
Supporting Structures

Health care facilities have been forced to re-evaluate traditional methods of quality assurance and consider quality improvement techniques. The Toronto Hospital Occupational Therapy Department has developed a quality programme that incorporates a foundation and supporting structures that can be adapted to accommodate the shift from quality assurance to continuous quality improvement. The foundation consists of a philosophy and principal functions, while the supporting structures include mechanisms to monitor principal functions and for communication. With a shift to continuous quality improvement, the quality programme was expanded to include clinical indicators and greater involvement of front-line staff and consumers. The programme also incorporates a framework that directs the development and implementation of clinical indicators related to occupational performance outcomes. Issues pertaining to the implementation and adaptation of the quality programme are discussed. Although initially developed in an occupational therapy environment, the framework and processes of this quality programme are being applied to multidisciplinary quality programmes in which occupational therapists are taking on leadership roles.

scholarly journals Factors associated with the preference of institutional delivery after antenatal care attendance in Northwest Ethiopia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Araya Mesfin Nigatu ◽  
Kassahun Alemu Gelaye
Keyword(s):  
Health Education ◽  
Antenatal Care ◽  
Low Income ◽  
Institutional Delivery ◽  
Statistical Significance ◽  
Health Facilities ◽  
Low Income Countries ◽  
Contributing Factors ◽  
Place Of Delivery ◽  
Factors Associated

Abstract Background Even though maternal mortality during the time of delivery can be prevented with proper medical care in the health facilities with skilled healthcare professionals, unexpectedly death is still high and is a persistent challenge for low-income countries. Therefore identifying factors affecting the preference of institutional delivery after antenatal care service attendance is a key intervention to reduce maternal morbidity and mortality. Method A community-based cross-sectional study was conducted using face to face using interviewer-administered questionnaire from a total of 528 women who gave their last birth within 12 months prior to the study period who attended antenatal care (ANC) services. Descriptive statistics, bivariable and multivariable logistic regressions analysis were performed. Statistical significance was considered at p < 0.05 and odds ratio with 95% CI were calculated to examine factors associated with institutional delivery. Results Of the 528 pregnant women attending ANC services, 250 (47.3%) gave birth in health facilities (95% CI: 43.2, 51.7%). Urban residence [AOR = 7.8, 95% CI: 4.1, 15.6], four or more ANC visits [AOR = 4.5, 95% CI: 1.6, 12.3], those who got health education on ANC [AOR = 2.9, 95% CI: 1.5, 5.6] and decision on place of delivery with her partner agreement [AOR = 3.3, 95% CI: 1.3, 8.7] were found to be contributing factors for the preference of institutional delivery. Conclusion Institutional delivery was not adequate. Residence, number of antenatal care visits, health education, decisions making on a place of delivery and having awareness of the difference of place of delivery were contributing factors for the preference of institutional delivery.

scholarly journals Policy and Science for Global Health Security: Shaping the Course of International Health

2019 ◽  
Vol 4 (2) ◽  
pp. 60 ◽  
Author(s):  
Kavita Berger ◽  
James Wood ◽  
Bonnie Jenkins ◽  
Jennifer Olsen ◽  
Stephen Morse ◽  
...  
Keyword(s):  
Public Health ◽  
Low Income ◽  
Large Scale ◽  
Scientific Information ◽  
International Health ◽  
Decision Makers ◽  
Low Income Countries ◽  
Policy And Practice ◽  
Health Security ◽  
Public Health Decision

The global burden of infectious diseases and the increased attention to natural, accidental, and deliberate biological threats has resulted in significant investment in infectious disease research. Translating the results of these studies to inform prevention, detection, and response efforts often can be challenging, especially if prior relationships and communications have not been established with decision-makers. Whatever scientific information is shared with decision-makers before, during, and after public health emergencies is highly dependent on the individuals or organizations who are communicating with policy-makers. This article briefly describes the landscape of stakeholders involved in information-sharing before and during emergencies. We identify critical gaps in translation of scientific expertise and results, and biosafety and biosecurity measures to public health policy and practice with a focus on One Health and zoonotic diseases. Finally, we conclude by exploring ways of improving communication and funding, both of which help to address the identified gaps. By leveraging existing scientific information (from both the natural and social sciences) in the public health decision-making process, large-scale outbreaks may be averted even in low-income countries.

scholarly journals Entitlements, Capabilities, and Crisis in the United Kingdom

2020 ◽  
Vol 14 (1) ◽  
pp. 40-54
Author(s):  
Christopher Hartworth ◽  
Carol Richards ◽  
Ian Convery
Keyword(s):  
United Kingdom ◽  
Social Welfare ◽  
Low Income ◽  
Large Scale ◽  
Low Income Countries ◽  
Political Debate ◽  
Social Welfare Programs ◽  
The United Kingdom ◽  
Poverty And Inequality ◽  
Causes Of Poverty

This paper examines whether Amartya Sen’s entitlements and capabilities concepts can be transferred in their application from low-income countries to high-income countries, specifically Cumbria, Northern England. Originally used to understand the causes of famine, these concepts have previously been used in several different geographical contexts to broadly understand poverty and inequality but almost entirely in low-income countries. This paper applies these concepts to a United Kingdom context in an attempt to understand the causes of poverty and inequality among people experiencing “livelihood crisis.” The research uses data from two nongovernmental social welfare projects to examine the causes of crisis and the remedial effects of the intervention. Our findings indicate that these concepts can help to explain how people find themselves in crisis in Cumbria. On a broader level, they can also be used to explain poverty, inequality, and disadvantage in communities in the United Kingdom. The authors put forward that entitlements and capabilities provide a useful framework to advance the policy and political debate on the causes of poverty by providing a straightforward language and broad application. Entitlement and capabilities can also assist social welfare programs in framing their aims and objectives and through improved understanding about the causes of inequality, will be better able to support people out of disadvantage by strengthening entitlements and building capabilities, without the necessity of large-scale investment.

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