scholarly journals Addressing Adolescent Depression in Tanzania: Positive Primary Care Workforce Outcomes Using a Training Cascade Model

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Stan Kutcher ◽  
Yifeng Wei ◽  
Heather Gilberds ◽  
Adena Brown ◽  
Omary Ubuguyu ◽  
...  
Keyword(s):  
Training Program ◽  
Low Income ◽  
Help Seeking ◽  
Adolescent Depression ◽  
Healthcare Providers ◽  
Cascade Model ◽  
Diagnosis And Treatment ◽  
Resource Setting ◽  
Primary Care Workforce ◽  
Low Resource Setting

Background. This is a report on the outcomes of a training program for community clinic healthcare providers in identification, diagnosis, and treatment of adolescent Depression in Tanzania using a training cascade model. Methods. Lead trainers adapted a Canadian certified adolescent Depression program for use in Tanzania to train clinic healthcare providers in the identification, diagnosis, and treatment of Depression in young people. As part of this training program, the knowledge, attitudes, and a number of other outcomes pertaining to healthcare providers and healthcare practice were assessed. Results. The program significantly, substantially, and sustainably improved provider knowledge and confidence. Further, healthcare providers’ personal help-seeking efficacy also significantly increased as well as the clinicians’ reported number of adolescent patients identified, diagnosed, and treated for Depression. Conclusion. To our knowledge, this is the first study reporting positive outcomes of a training program addressing adolescent Depression in Tanzanian community clinics. These results suggest that the application of this training cascade approach may be a feasible model for developing the capacity of healthcare providers to address youth Depression in a low-income, low-resource setting.

scholarly journals “It’s extremely hard but it’s not a burden”: A qualitative study of family caregiving for people living with dementia in Vietnam

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259788
Author(s):  
Huong Nguyen ◽  
Trang Nguyen ◽  
Duyen Tran ◽  
Ladson Hinton
Keyword(s):  
Family Caregivers ◽  
Family Caregiving ◽  
Help Seeking ◽  
Healthcare Providers ◽  
Structured Interviews ◽  
Resource Setting ◽  
Vietnamese Women ◽  
Low Resource Setting ◽  
The Family ◽  
Multiple Challenges

Background Vietnam is one of the fastest-aging countries in the world with a rising number of people with Alzheimer’s disease and related dementias (ADRD). Families in Vietnam provide most of the care for persons living with dementia, yet our understanding of their experiences and needs is limited. This study examined the family caregiving experience in a semi-rural region outside of central Hanoi from the perspectives of family caregivers and other key informants. Materials Semi-structured interviews were conducted with 21 key stakeholders (12 family caregivers and 9 healthcare providers and community leaders). A descriptive, thematic analysis was conducted. Results Qualitative data analysis revealed four themes related to the family caregiving experience: 1) perceptions of dementia symptoms as a normal part of aging rather than a disease, 2) caregiving as a moral and expected familial obligation, 3) patterns of caregiving that are heavily influenced by both gender and sibling order, and 4) multiple challenges or hardships, including time constraints, loss of income, increased social isolation, a toll on their perceived physical health, and emotional distress. Caregivers rejected the notion that caregiving was a “burden” and expressed their distress through terms such as frustration, sadness, and exhaustion. Conclusions In this low-resource setting, the stress of family caregiving may be amplified by lack of community resources, cultural stigma discouraging outside help-seeking, and economic impact of care provision. The study highlights the vulnerability and predicament of Vietnamese women who often face multiple challenges in their caregiving role as well as the urgent need for the development of community-based programs and supports.

scholarly journals Rapid Training and Implementation of the Pollock Technique, a Safe, Effective Newborn Circumcision Procedure, in a Low-Resource Setting

2015 ◽  
Vol 2 ◽  
pp. 2333794X1558911
Author(s):  
Noah Kojima ◽  
Claire C. Bristow ◽  
Neil Pollock ◽  
Pierre Crouse ◽  
Harry Theodore ◽  
...  
Keyword(s):  
Training Program ◽  
Sexually Transmitted Infections ◽  
Male Circumcision ◽  
Adult Health ◽  
Sexually Transmitted ◽  
Urogenital Infections ◽  
Inflammatory Conditions ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Tract Infections

Male circumcision is highly protective against urinary tract infections, inflammatory conditions of the penis, sexually transmitted infections, and urogenital cancers. We aimed to reintroduce newborn male circumcision through the creation of a training program in Port-au-Prince, Haiti—an area with a considerable burden of preventable urogenital infections, sexually transmitted infections, and low circumcision rate—after an earlier study reported that a majority of Haitian medical providers were in need of and wanted newborn circumcision training. The program was conducted at the GHESKIO Health Centers, a large, non-governmental clinic offering comprehensive pediatric and adult health services. Two Haitian obstetricians and seven nurses learned circumcision procedures. On training completion, one of two obstetricians achieved surgical competence. Introduction of a newborn male circumcision training program was feasible, achieving an acceptable rate of procedural competency and high-quality services. Permanent resources now exist in Haiti to train additional providers to perform newborn male circumcisions.

Predictors of Complication Following Cleft Lip and Palate Surgery in a Low-Resource Setting: A Prospective Outcomes Study in Nicaragua

2021 ◽  
pp. 105566562110468
Author(s):  
Marco A. Swanson ◽  
Allyn Auslander ◽  
Tatiana Morales ◽  
Breanna Jedrzejewski ◽  
William P. Magee ◽  
...  
Keyword(s):  
Low Income ◽  
Cleft Lip ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Surgeon Experience ◽  
Duration Of Surgery ◽  
Operative Evaluation ◽  
Palate Repair ◽  
Outcomes Study

Background Higher rates of postoperative complication following cleft lip or palate repair have been documented in low resource settings, but their causes remain unclear. This study sought to delineate patient, surgeon, and care environment factors in cleft complications in a low-income country. Design Prospective outcomes study. Setting Comprehensive Cleft Care Center. Patients Candidate patients presenting for cleft lip or palate repair or revision. Interventions Patient anthropometric, nutritional, environmental and peri- and post-operative care factors were collected. Post-operative evaluation occurred at standard 1-week and 2-month postoperative intervals. Main Outcome Measures Complication was defined as fistula, dehiscence and/or infection. Results Among 408 patients enrolled, 380 (93%) underwent surgery, of which 208 (55%) underwent lip repair (124) or revision (84), and 178 (47%) underwent palate repair (96) or revision (82). 322 (85%) were evaluated 1 week and 166 (44%) 2 months postoperatively. 50(16%) complications were identified, including: 25(8%) fistulas, 24(7%) dehiscences, 17(5%) infections. Mid-upper arm circumference (MUAC) ≤12.5 cm was associated with dehiscence after primary lip repair (OR = 28, p = 0.02). Leukocytosis ≥11,500 on pre-operative evaluation was associated with dehiscence (OR = 2.51, p = 0.04) or palate revision fistula (OR = 64, p < 0.001). Surgeons who performed fewer previous-year palate repairs had higher likelihood of palate complications, (OR = 3.03, p = 0.01) although there was no difference in complication rate with years of surgeon experience or duration of surgery. Conclusions Multiple patient, surgeon, and perioperative factors are associated with higher rates of complication in a low-resource setting, and are potentially modifiable to reduce complications following cleft surgery.

scholarly journals Early Diagnosis and Treatment of Vesicouterine Fistula Using Low-Tech Methods in Low Resource Setting of Northern Ghana. A Case Report

2021 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Early Diagnosis ◽  
Diagnosis And Treatment ◽  
Northern Ghana ◽  
Vesicouterine Fistula ◽  
Obstetric Practice ◽  
Resource Setting ◽  
Low Resource Setting

Vesicouterine fistula is a rare but increasing phenomenon in obstetric practice. Early diagnosis and treatment will go a long way to reduce the associated morbidity as well as improve the quality of life of its victims. Our case exemplifies how the use of simple techniques can diagnose and bring great relief to such patients.

scholarly journals Development of a comprehensive and sustainable gynecologic oncology training program in western Kenya, a low resource setting

2017 ◽  
Vol 21 ◽  
pp. 122-127 ◽  
Author(s):  
Barry Rosen ◽  
Peter Itsura ◽  
Philip Tonui ◽  
Alan Covens ◽  
Luc van Lonkhuijzen ◽  
...  
Keyword(s):  
Training Program ◽  
Gynecologic Oncology ◽  
Western Kenya ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting

scholarly journals Effect of a Neonatal Resuscitation Course on Healthcare Providers’ Performances Assessed by Video Recording in a Low-Resource Setting

PLoS ONE ◽  
2015 ◽  
Vol 10 (12) ◽  
pp. e0144443 ◽  
Author(s):  
Daniele Trevisanuto ◽  
Federica Bertuola ◽  
Paolo Lanzoni ◽  
Francesco Cavallin ◽  
Eduardo Matediana ◽  
...  
Keyword(s):  
Video Recording ◽  
Healthcare Providers ◽  
Neonatal Resuscitation ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting

Implementation of m-health applications in botswana: telemedicine and education on mobile devices in a low resource setting

2013 ◽  
Vol 19 (2) ◽  
pp. 120-125 ◽  
Author(s):  
Ryan Littman-Quinn ◽  
Chikoti Mibenge ◽  
Cynthia Antwi ◽  
Amit Chandra ◽  
Carrie L Kovarik
Keyword(s):  
Mobile Devices ◽  
Healthcare Providers ◽  
Medical Knowledge ◽  
University Of Pennsylvania ◽  
Middle Income ◽  
Social Challenges ◽  
University Of Botswana ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Specialized Care

Although Botswana has recently been categorised as an upper middle income country, it is burdened by a scarcity of resources, both human and technological. There are barriers to patients’ access to specialized care and healthcare providers’ access to medical knowledge. Over the past three years, the Botswana-University of Pennsylvania Partnership (BUP) has piloted four mobile telemedicine projects in the specialties of women's health (cervical cancer screening utilizing visual inspection with acetic acid), radiology, oral medicine and dermatology. Mobile telemedicine has been used in 11 locations in Botswana, training a total of 24 clinicians and successfully contributing to the management of 643 cases. In addition to mobile telemedicine, BUP has initiated an m-learning programme with the University of Botswana School of Medicine. While successfully providing patients and providers with improved access to healthcare resources, the m-health projects have faced numerous technical and social challenges. These include malfunctioning mobile devices, unreliable IT infrastructure, accidental damage to mobile devices, and cultural misalignment between IT and healthcare providers. BUP has worked with its local partners to develop solutions to these problems. To ensure sustainability, m-health programmes must have strategic goals that are aligned with those of the national health and education system, and the initiatives must be owned and led by local stakeholders. Whenever possible, open source technology and local IT expertise and infrastructure should be employed.

scholarly journals National Egyptian Model of Breast Cancer Care Project As a Model for Low Resource–Setting Countries to Improve Outcomes From Early Screening Early Treatment

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 124s-124s
Author(s):  
I. Sallam ◽  
G. Amira ◽  
A. Youssri
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Low Income ◽  
Screening Program ◽  
High Rate ◽  
Standards Of Care ◽  
Cancer Center ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting

Background: 40% of Egyptians has access to public health system, 60% served by NGOs and private centers. The problem is the late presentation and inadequate access to services due to lack of a structured screening program and awareness. Aim: To present a model of breast cancer (BC) care in low resource setting (LRS) and to assess risk factors for BC in Egypt the high BC incidence country based on registry estimates stating that about 22000 new BC cases will be diagnosed by 2020. Strategy: In Giza region there used to be no mammographic (MMG) reference service. Women with breast symptoms were referred to the NCI, where they were offered the services (diagnosis, treatment). With very long waiting times. Women aged 20 years or older visiting one of the 5 participating centers were evaluated in a cross-sectional study, which included: (1) Data entry form questionnaire of risk factors for breast cancer - including family history of cancer - and presence of breast symptoms, and (2) Breast examination by a trained professional (nurse or medical doctor). All patients with breast complaints or an abnormal physical exam were referred to NCI, MISR Cancer Center, Kasr El Aini, Agouza and Bahia Hospital for further evaluation. Women 40-69 years of age were invited to participate in the screening both actively (digital invitations, Facebook groups, brochures distributed in governmental buildings and WhatsApp groups) and passively (women that attended for any reason to other hospitals in the region are called and delivered brochures and vouchers to join the project). The screening program is based on annual MMG in women between the ages of 40 and 69 years, which are always preceded by physical examination performed by a breast surgeon or a trained nurse. Program: Close control of the frequency of visits using a simple computer program with patient listing and reminder. The close contact and continuous feedback that helped adherence to the screening program. The proposal of the project includes the performance of all clinical, imaging and pathology exams, as well as clinical visits and surgical treatment, in the same center in the shortest time and the highest standards of care. The health care approach is multidisciplinary, including nurses, breast surgeons and a nutritionist. Outcomes: High rate of compliance is the main strength of project, achieved by patient education about the importance of the screening, intense contact with the primary trained staff, with provision of lists of patients who should come next visits. Free transportation for women with very low income is arranged. Every 3-4 months, we established jointly a charity workshops and projects of handmade cloths and bags for BCPs and encouraged social clubs and societies to adopt parties and to host educational BC advocacy campaigns. What was learned: A simple project is successful and its cost-effectiveness is balanced in Egypt as a developing country where the mortality associated with this disease is very high.

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