scholarly journals Nairobi Early Childcare in Slums (NECS) Study Protocol: a mixed-methods exploration of paid early childcare in Mukuru slum, Nairobi

2020 ◽  
Vol 4 (1) ◽  
pp. e000822
Author(s):  
Robert C Hughes ◽  
Patricia Kitsao-Wekulo ◽  
Sunil Bhopal ◽  
Elizabeth W Kimani-Murage ◽  
Zelee Hill ◽  
...  

IntroductionThe early years are critical. Early nurturing care can lay the foundation for human capital accumulation with lifelong benefits. Conversely, early adversity undermines brain development, learning and future earning.Slums are among the most challenging places to spend those early years and are difficult places to care for a child. Shifting family and work structures mean that paid, largely informal, childcare seems to be becoming the ‘new normal’ for many preschool children growing up in rapidly urbanising Africa. However, little is known about the quality of this childcare.AimsTo build a rigorous understanding what childcare strategies are used and why in a typical Nairobi slum, with a particular focus on provision and quality of paid childcare. Through this, to inform evaluation of quality and design and implementation of interventions with the potential to reach some of the most vulnerable children at the most critical time in the life course.Methods and analysisMixed methods will be employed. Qualitative research (in-depth interviews and focus group discussions) with parents/carers will explore need for and decision-making about childcare. A household survey (of 480 households) will estimate the use of different childcare strategies by parents/carers and associated parent/carer characteristics. Subsequently, childcare providers will be mapped and surveyed to document and assess quality of current paid childcare. Semistructured observations will augment self-reported quality with observable characteristics/practices. Finally, in-depth interviews and focus group discussions with childcare providers will explore their behaviours and motivations. Qualitative data will be analysed through thematic analysis and triangulation across methods. Quantitative and spatial data will be analysed through epidemiological methods (random effects regression modelling and spatial statistics).Ethics and disseminationEthical approval has been granted in the UK and Kenya. Findings will be disseminated through journal publications, community and government stakeholder workshops, policy briefs and social media content.

Human Affairs ◽  
2011 ◽  
Vol 21 (4) ◽  
Author(s):  
Olayinka Akanle ◽  
Olanrewau Olutayo

AbstractUnderstanding the selves, situations and actions of Africans can never be comprehended outside kinship. Local and foreign worldviews are first pigeonholed into culture and defined within kinship realities in Nigeria and Africa. There have been studies on kinship in Africa. However, the findings from such studies portrayed the immutability of African kinship. Thus, as an important contribution to the on-going engagement of kinship in the twenty-first century as an interface between the contemporary Diaspora, this article engaged kinship within international migration. This is a major behavioural and socio-economic force in Nigeria. Methodological triangulation was adopted as part of the research design and primary data were collected through in-depth interviews (IDIs), and life histories of international migrants were documented and focus group discussions (FGDs) were held with kin of returnees. The article found and concluded that while returnees continued to appreciate local kinship infrastructures, the infrastructures were liable to reconstruction primarily determined by dominant support situations in the traditional African kinship networks.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nabil Sulaiman ◽  
Youssef Rishmawy ◽  
Amal Hussein ◽  
Maha Saber-Ayad ◽  
Hamzah Alzubaidi ◽  
...  

Abstract Background High-quality patient care is a complex phenomenon that requires collaboration among healthcare professionals. Research has shown that Interprofessional Education (IPE) carries promise to improve collaborative work and patient care. So far, collaboration among various health professionals remains a challenge. Very few focus group discussions to determine the medical students’ readiness and positive attitudes towards IPE have been reported from the Arabian context. Methods A two-staged sequential mixed methods study was conducted among medical, dental, pharmacy, and health sciences students of the University of Sharjah United Arab Emirates. The perspectives of students toward IPE and collaborative practice were first gathered by administering a validated instrument, Readiness for Interprofessional Learning Scale (RIPLS). This was followed by focused group discussions. A quantitative as well as a qualitative data analysis was performed. Results This study cohort included 282 students. All respondents showed readiness to adopt IPE as all statements of the RIPLS inventory scored high median scores. All participants showed positive attitudes and readiness towards IPE. Three main domains of themes were generated from focus group discussions; prior knowledge, need for IPE framework and its implementation. Information workload, lack of clarity and less focused teaching pedagogies of IPE were considered as perceived barriers. Conclusion This study demonstrated a substantial agreement of medical and health sciences students towards readiness and perceived effectiveness of IPE. Educators are urged to embed new IPE programs into existing curricular frameworks, which can potentially enhance collaborative learning and improve quality of patient care.


BMJ Leader ◽  
2021 ◽  
pp. leader-2021-000458
Author(s):  
William O Cooper ◽  
Nancy M Lorenzi ◽  
Heather A Davidson ◽  
Cynthia A Baldwin ◽  
Daniel M Feinberg ◽  
...  

BackgroundCrisis plans for healthcare organisations most often focus on operational needs including staffing, supplies and physical plant needs. Less attention is focused on how leaders can support and encourage individual clinical team members to conduct themselves as professionals during a crisis.MethodsThis qualitative study analysed observations from 79 leaders at 160 hospitals that participate in two national professionalism programmes who shared their observations in focus group discussions about what they believed were the essential elements of leading and addressing professional accountability during a crisis.ResultsAnalysis of focus group responses identified six leadership practices adopted by healthcare organisations, which were felt to be essential for organisations to navigate the crisis successfully. Unique aspects of maintaining professionalism during each phase of the pandemic were identified and described.ConclusionsLeaders need a plan to support an organiation’s pursuit of professionalism during a crisis. Leaders participating in this study identified practices that should be carefully woven into efforts to support the ongoing safety and quality of the care delivered by healthcare organisations before, during and after a crisis. The lessons learnt from the COVID-19 pandemic may be useful during subsequent crises and challenges that a healthcare organisation might experience.


2021 ◽  
Vol 80 (1) ◽  
pp. 49-60
Author(s):  
Justin Raycraft

This paper addresses how Makonde Muslim villagers living on the Swahili coast of southern Tanzania conceptualize and discuss environmental change. Through narratives elicited during in-depth interviews and focus group discussions, I show that respondents associate various forms of environmental change—ecological, climatic, political, and socioeconomic—with God’s plan. Respondents had a sound grasp of the material workings of their lived realities and evoked religious causality to fill in the residual explanatory gaps and find meaning in events that were otherwise difficult to explain. Such narratives reveal both a culturally engrained belief system that colors people’s understandings of change and uncertainty and a discursive idiom for making sense of social suffering. On an applied note, I submit that social science approaches to studying environmental change must take into account political and economic contexts relative to local cosmologies, worldviews, and religious faiths, which may not disaggregate the environment into distinct representational categories.


2019 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Muslimah Muslimah ◽  
Dian Ayubi

Measles and Rubella (MR) is a disease that is highly contagious and usually occurs in children aged 9 months until the age of 15 years. One effort that can be done to reduce the incidence of the disease is through health promotion about the importance of immunization. Purpose the promotion was packaged in the form of advertisements on electronic media with the aim of building perceptions that the importance of immunization for public health. Methods this research was a qualitative study with a method of collecting in-depth interviews and focus group discussions. The number of informants in this study was 19 mothers who had children aged 0.9 to 15 years in one of the Puskesmas work areas in Merangin District, Jambi Province. Before the data collection process, all informants were asked to see two MR immunization advertisements. Results that immunization advertisements are interesting and contain humor. Meanwhile, informants who did not give MR immunization to their children tended to be negative towards MR immunization advertisements and tended to ignore the effects that arose if they did not give immunizations to their children. The recommendation that MR immunization advertisements should avoid using the fear arousal method and use the pay off idea method in those ads


2016 ◽  
Vol 55 (4) ◽  
pp. 293 ◽  
Author(s):  
Tina Klomsri ◽  
Matti Tedre

Information and Communication Technology (ICT) is increasingly used in Tanzanian education. Knowing how to operate ICT alone is incomplete without knowing how to use it as a tool for organization, communication, research, and problem-solving. In recognition of this challenge, information literacy (IL) has been identified as a key attribute to students as they progress through their learning paths. Based on a mixed methods strategy, using questionnaires and focus group discussions, this study measured the level of IL skills among University of Dar es Salaam’s (UDSM) postgraduate students, to gain insights into the students’ perceptions and experiences with information problems. A total of 102 students from four institutions answered the online questionnaire and 22 students participated in six focus group discussions. The questionnaire scores of the students were poor in the majority of IL categories, suggesting ineffectiveness of the current IL training in imparting IL knowledge and skills. The study ends by discussing recommendations to improve current IL practices at the university.


Author(s):  
Joseph M. Zulu ◽  
Patricia Maritim ◽  
Adam Silumbwe ◽  
Hikabasa Halwiindi ◽  
Patricia Mubita ◽  
...  

Background: Surgery for hydrocele is commonly promoted as part of morbidity management and disability prevention (MMDP) services for lymphatic filariasis (LF). However, uptake of these surgeries has been suboptimal owing to several community level barriers that have triggered mistrust in such services. This study aimed at documenting mechanisms of unlocking trust in community health systems (CHS) in the context of a LF hydrocele management project that was implemented in Luangwa District, Zambia. Methods: Qualitative data was collected through in-depth interviews and focus group discussions (n=45) in February 2020 in Luangwa District. Thirty-one in-depth interviews were conducted with hydrocele patients, CHWs, health workers, traditional leaders and traditional healers. Two focus group discussions were also conducted with CHWs who had been involved in project implementation with seven participants per group. Data was analyzed using a thematic analysis approach. Results: The use of locally appropriate communication strategies, development of community driven referral systems, working with credible community intermediaries as well as strengthening health systems capacity through providing technical and logistical support enhanced trust in surgery for hydrocele and uptake of the surgeries. Conclusion: Implementation of community led communication and referral systems as well as strengthening health services are vital in unlocking trust in health systems as such mechanisms trigger authentic partnerships, including mutual respect and recognition in the CHS. The mechanisms also enhance confidence in health services among community members.


2021 ◽  
Author(s):  
Aliya Karim ◽  
Don de Savigny ◽  
Serge Ngaima ◽  
Daniel Mäusezahl ◽  
Daniel Cobos Muñoz ◽  
...  

BACKGROUND Integrated community case management (iCCM) is a child health program designed to provide integrated, community-based care for pneumonia, malaria and diarrhea for children in hard-to-reach areas of low- and middle-income countries (LMICs). The foundation of the intervention is service-delivery by community health workers (CHWs) who depend on reliable provision of drugs and supplies, consistent supervision, comprehensive training, and community acceptance and participation to perform optimally. The effectiveness of the program may also depend on a number of other elements, including an enabling policy environment, financing mechanisms from the national to the local level, data transmission systems, and appropriate monitoring and evaluation. The extent to which these factors act upon each other to influence the effectiveness and viability of iCCM is both variable and challenging to assess, especially across different implementation contexts. OBJECTIVE In this paper, we describe a mixed-methods systems-based study protocol to assess the programmatic components of iCCM which are associated with intervention effectiveness, and report preliminary results of data collection. METHODS This protocol employs a mixed qualitative and quantitative study design based on a Systems Thinking approach within four iCCM programs in Malawi, Democratic Republic of the Congo, Niger State, and Abia State, Nigeria. Routine monitoring data is collected to determine intervention effectiveness, namely testing, treatment and referral outcomes. Surveys with CHWs, supervisors, and caregivers are performed to collect quantitative data on their demographics, activities, and experiences within the program, and how these relate to the areas of intervention effectiveness. Focus group discussions are conducted with these stakeholders as well as local traditional leaders to contextualize this data. Key informant interviews are undertaken with national and district-level program stakeholders and officers knowledgeable in critical program processes. RESULTS We performed 3,836 surveys and 45 focus group discussions with CHWs, supervisors, and caregivers, and traditional leaders; 120 key informant interviews with district and national-level program managers, health officers, and ministry officials. Policy and program documents were additionally collected for review. CONCLUSIONS Evidence from this study will inform child health programs and practice in low- and middle-income settings, and future policy development within the iCCM intervention.


2020 ◽  
Vol 11 (3) ◽  
pp. 62
Author(s):  
Maheran Zakaria ◽  
Rahayu Abdul Rahman ◽  
Hasnun Anip Bustaman

A municipal council is one of the local authorities established under the auspice of Malaysian local government. The objective is to deliver services to a community under its jurisdiction in a sustainable manner, but evidences indicated that the service qualities have deteriorated due to numerous malpractices. The malpractices could be prevented should any of the insiders who witness the incidences whistle blow to those who have power to act. However, not many are willing to report for fear of reprisal, retaliation and even life threatening. Despite that a whistleblowing system is established to encourage whistleblowing, such system has yet to be formed in any of Malaysian municipal councils. Intrigued with the issue, the objective of this study is to explore a model of whistle blowing system for a Malaysian municipal council. A hermeneutic phenomenography study was conducted in which data were gathered through in-depth interviews and focus group discussions. The participants consisted of four top management and sixty officials from a Malaysian municipal council. Data were analyzed qualitatively using Nvivo 14 and triangulated with other source of documents. The findings from emergent themes proposed a model of the whistleblowing system that consisted of four elements namely protection, internal control policies, incentives and ethical culture. This discovery provides useful insights to policy makers, relevant authorities, and academic fraternities of the model of whistle blowing system that will alleviate malpractices and thus elevate the transparency, efficiency and integrity of the municipal council to the fullest.


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