Bias in patient satisfaction surveys: a threat to measuring healthcare quality

Patient satisfaction surveys are an increasingly common element of efforts to evaluate the quality of healthcare. Many patient satisfaction surveys in low/middle-income countries frame statements positively and invite patients to agree or disagree, so that positive responses may reflect either true satisfaction or bias induced by the positive framing. In an experiment with more than 2200 patients in Nigeria, we distinguish between actual satisfaction and survey biases. Patients randomly assigned to receive negatively framed statements expressed significantly lower levels of satisfaction (87%) than patients receiving the standard positively framed statements (95%—p<0.001). Depending on the question, the effect is as high as a 19 percentage point drop (p<0.001). Thus, high reported patient satisfaction likely overstates the quality of health services. Providers and policymakers wishing to gauge the quality of care will need to avoid framing that induces bias and to complement patient satisfaction measures with more objective measures of quality.

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Children with Developmental Disabilities in Low- and Middle-Income Countries: More Neglected and Physically Punished

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17197009 ◽

2020 ◽

Vol 17 (19) ◽

pp. 7009 ◽

Cited By ~ 1

Author(s):

Andrea Bizzego ◽

Mengyu Lim ◽

Greta Schiavon ◽

Gianluca Esposito

Keyword(s):

Developmental Disabilities ◽

Middle Income ◽

Middle Income Countries ◽

Large N ◽

Research Bias ◽

Quality Of Childcare ◽

Developmental Conditions ◽

To Receive ◽

Low And Middle Income

Little is known about parenting in the context of developmental disabilities in low- and middle-income countries (LMIC), penalized by both lack of data and a research bias toward western societies. In this study, we apply data mining methods on a large (N = 25,048) dataset from UNICEF to highlight patterns of association between developmental disabilities of children and parental involvement. We focus on the co-presence of multiple disabilities and the quality of childcare in three parenting domains: discipline, caregiving, and education. Our results show that, in LMIC, children with more severe developmental conditions are also more likely to receive low-quality parental care. Specific policies of parental training are needed to improve parental practices in LMIC.

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The Identification and Evaluation of Methodologies to Assess the Quality of mHealth apps in High, Low & Middle-Income Countries: a Rapid Review (Preprint)

10.2196/preprints.28384 ◽

2021 ◽

Author(s):

Fionn Woulfe ◽

Philip Kayode Fadahunsi ◽

Simon Smith ◽

Griphin Baxter Chirambo ◽

Emma Larsson ◽

...

Keyword(s):

Quality Assessment ◽

Healthcare Professionals ◽

Rapid Review ◽

Screening Process ◽

Middle Income ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Mhealth Apps ◽

Low And Middle Income

BACKGROUND There has been a rapid growth in the availability and use of mobile health (mHealth) apps around the world in recent years. However, consensus regarding an accepted standard to assess the quality of such apps does not exist. Differing interpretations of quality add to this problem. Consequently, it has become increasingly difficult for healthcare professionals to distinguish apps of high quality from those of lower quality. This exposes both patients and healthcare professionals to unnecessary risk. Despite progress, limited understanding of contributions by those in low- and middle- income countries (LMIC) on this topic exists. As such, the applicability of quality assessment methodologies in LMIC settings remains unexplored. OBJECTIVE The objectives of this rapid review are to; 1) Identify current methodologies within the literature to assess the quality of mHealth apps. 2) Understand what aspects of quality these methodologies address. 3) Determine what input has been made by authors from LMICs. 4) Examine the applicability of such methodologies in low- and middle- income settings. METHODS The review is registered with Prospero (CRD42020205149). A search of PubMed, EMBASE, Web of Science and Scopus was performed for papers relating to mHealth app quality assessment methodologies, published in English between 2005 and the 28th of December, 2020. A thematic and descriptive analysis of methodologies and papers was performed. RESULTS Electronic database searches identified 841 papers. After the screening process, 53 papers remained for inclusion; 6 proposed novel methodologies which could be used to evaluate mHealth apps of diverse medical areas of interest; 8 proposed methodologies which could be used to assess apps concerned with a specific medical focus; 39 used methodologies developed by other published authors to evaluate the quality of various groups of mHealth apps. Authors of 3 papers were solely affiliated to institutes in LMICs. A further 8 papers had at least one co-author affiliated to an institute in a LMIC. CONCLUSIONS Quality assessment of mHealth apps is complex in nature and at times, subjective. Despite growing research on this topic, to date an all-encompassing, appropriate means for evaluating the quality of mHealth apps does not exist. There has been engagement with authors affiliated to institutes in LMICs, however limited consideration of current generic methodologies for application in a LMIC settings have been identified.

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The Identification and Evaluation of Methodologies to Assess the Quality of mHealth apps in High, Low & Middle-Income Countries: a Rapid Review (Preprint)

JMIR mhealth and uhealth ◽

10.2196/28384 ◽

2021 ◽

Author(s):

Fionn Woulfe ◽

Philip Kayode Fadahunsi ◽

Simon Smith ◽

Griphin Baxter Chirambo ◽

Emma Larsson ◽

...

Keyword(s):

Rapid Review ◽

Middle Income ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Mhealth Apps

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COVID-19 Vaccine Hesitancy among Parents of Children and Adolescents Living in Brazil

Vaccines ◽

10.3390/vaccines9101115 ◽

2021 ◽

Vol 9 (10) ◽

pp. 1115

Author(s):

Leonardo Evangelista Bagateli ◽

Edna Yayoi Saeki ◽

Marta Fadda ◽

Carlo Agostoni ◽

Paola Marchisio ◽

...

Keyword(s):

Children And Adolescents ◽

Response Rate ◽

Vaccine Hesitancy ◽

Middle Income ◽

Middle Income Countries ◽

Survey Response Rate ◽

Validated Questionnaire ◽

Low Middle Income Countries ◽

Pediatric Vaccination ◽

To Receive

Background: The immunization of large portions of populations in low/middle-income countries is considered one of the key measures to limit the development of new SARS-CoV-2 variants. However, parental vaccine hesitancy might be an important obstacle to pediatric vaccination. The aim of this survey was to study the prevalence and extent of COVID-19 vaccine hesitancy among parents of children and adolescents living in Brazil. Methods: Caregivers of children and adolescents referred to the emergency department of Hospital Estadual de Bauru, São Paulo (Brazil) were invited to fill in a validated questionnaire on vaccine hesitancy and to report their willingness for themselves and their offspring to receive a COVID-19 vaccine. Results: A total of 501 consecutive caregivers filled in the survey. Response rate was 100%. A minority (N = 14, 2.8%) of caregivers were hesitant about vaccines. Despite this, half of them declared they were willing to vaccinate their offspring against COVID-19. Conclusions: This survey identifies that vaccine hesitancy is very low among caregivers living in Brazil and that even many of the hesitant caregivers are willing to vaccinate their offspring against COVID-19. This study highlights the importance of offering the COVID-19 vaccination to the whole population, including subjects that present uncertainty about other vaccines.

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Assessment of the Pharmaceutical Quality of some Brands of Omeprazole Capsules Marketed in Maiduguri Metropolis, Borno, Nigeria.

Journal of Basic and Social Pharmacy Research ◽

10.52968/27451085 ◽

2021 ◽

Vol 2 (1) ◽

pp. 47-57

Author(s):

F. Yusuf ◽

◽

S.J. Madu ◽

A.O. Abdussalam ◽

A.S. Ibrahim ◽

...

Keyword(s):

Law Enforcement ◽

Visual Inspection ◽

Quality Parameters ◽

Content Uniformity ◽

Middle Income ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Uniformity Test ◽

Rate Test

BACKGROUND: The proliferation of counterfeit, substandard and inferior quality drugs is a major challenge in low- middle income countries like Nigeria where drug regulation and law enforcement are constrained by limited resources. OBJECTIVES: The aim of the study was to assess the quality parameters of some brands of Omeprazole capsules marketed in Maiduguri Metropolis, Borno State, Nigeria. METHODS: The uniformity of weight, disintegration test, content uniformity and dissolution rate test were the official tests carried out using Pharmacopoeial methods. Organoleptic tests and other non-official tests were carried out. RESULTS: Ten brands of omeprazole capsules were assessed for purity using omeprazole sample as standard for comparison. All the ten brands tested passed the visual inspection, organoleptic tests, weight uniformity and disintegration tests. Three (3) brands (OMC 1, 4 and 6) out of the ten (10) brands passed the content uniformity test, while the other seven (7) brands were either below or above the acceptable Pharmacopoeial limit. For the dissolution test, only three (3) brands (OMC 1, 3 and 8) passed the test. CONCLUSION: The results therefore, indicated that some of the brands of the Omeprazole capsules marketed in Maiduguri Metropolis failed to comply with some Pharmacopoeial standards.

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The growing use of the WHO Safe Childbirth Checklist: Lessons learned at the Yaounde Gyneco-Obstetric and Pediatric Hospital, Cameroon

10.21203/rs.2.14441/v4 ◽

2020 ◽

Author(s):

Julius Sama DOHBIT ◽

Namanou Ines Emma WOKS ◽

Carlin Héméry KOUDJINE ◽

Willy TAFEN ◽

Pascal FOUMANE ◽

...

Keyword(s):

Quality Of Care ◽

Post Partum ◽

Middle Income ◽

Middle Income Countries ◽

Perineal Tears ◽

Safe Childbirth Checklist ◽

Low Middle Income Countries ◽

Post Partum Haemorrhage ◽

Safe Childbirth

Abstract Background: Safe childbirth remains a daunting challenge, particularly in low middle income countries, where most pregnancy-related deaths occur. Cameroon’s maternal mortality rate, estimated at 529 per 100,000 live births in 2017 is significantly high. Adherence to essential birth practices by birth attendants is key to improving pregnancy outcomes. The WHO Safe Childbirth Checklist (SCC) was designed as a tool to improve the quality of care provided to women giving birth. It was implemented at the Yaounde Gynaeco-Obsteric and Paediatric Hospital in order to improve quality of care. The purpose of this study was to determine the adoption rate of the SCC and its association with maternal (eclampsia, perineal tears, post-partum haemorrhage) and neonatal (foetal death, neonatal asphyxia and neonatal death) complications, six months after introduction at the maternity. Methods: A retrospective study was conducted from January – June 2018. Six months was chosen because research conducted on the SCC in India showed that adherence to essential birth practices was optimal within this period. Data collection sheets were used to document information from delivery records. The Chi square test was used to compare categorical variables, while the student’s T test was used to compare continuous variables. Results: Out of 1611 deliveries conducted, only 1001 records could be traced, giving 38% of missing data. Twenty-five records were excluded. During the study period, checklists were used in 828 clinical notes, giving an adoption rate of 84.8%. Fewer cases of severe pre-ecclampsia/eclampsia were associated with the use of SCC (2·1% Vs 5·4%, p = 0·017). The difference in the proportion of perineal tears, post-partum haemorrhage, stillbirths, neonatal asphyxia and neonatal deaths observed between the checklist and non-checklist groups was not statistically significant. Conclusion: Our results suggest that the SCC program is a cost effective intervention that could potentially reduce maternal mortality and morbidity, most of reduction coming from prevention of severe pre-eclampsia, eclampsia in low-middle income countries.

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The Impact of Covid 19 on Pregnant Women and Child Health

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl1.3645 ◽

2020 ◽

Vol 11 (SPL1) ◽

pp. 1367-1373

Author(s):

Nikhil Sanjay Mujbaile ◽

Smita Damke

Keyword(s):

Social Issues ◽

Middle Income ◽

Web Based ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

The Social ◽

Social Separation ◽

The Impact ◽

And Child Health ◽

General Wellbeing

The Covid illness (COVID-19) pandemic has spread rapidly all through the world and has had a drawn-out impact. The Pandemic has done incredible damage to society and made genuine mental injury to numerous individuals. Mental emergencies frequently cause youngsters to deliver sentiments of relinquishment, despondency, insufficiency, and fatigue and even raise the danger of self-destruction. Youngsters with psychological instabilities are particularly powerless during the isolate and colonial removing period. Convenient and proper assurances are expected to forestall the event of mental and social issues. The rising advanced applications and wellbeing administrations, for example, telehealth, web-based media, versatile wellbeing, and far off intuitive online instruction can connect the social separation and backing mental and conduct wellbeing for youngsters. Because of the mental advancement qualities of youngsters, this investigation additionally outlines intercessions on the mental effect of the COVID-19 Pandemic. Further difficulties in Low Middle-Income Countries incorporate the failure to actualize successful general wellbeing estimates, for example, social separating, hand cleanliness, definitive distinguishing proof of contaminated individuals with self-disconnection and widespread utilization of covers The aberrant impacts of the Pandemic on youngster wellbeing are of extensive concern, including expanding neediness levels, upset tutoring, absence of admittance to the class taking care of plans, decreased admittance to wellbeing offices and breaks in inoculation and other kid wellbeing programs. Kept tutoring is critical for kids in Low Middle-Income Countries. Arrangement of safe situations is mainly testing in packed asset obliged schools.

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