Community and healthcare providers’ perceptions of quality of private sector outpatient malaria care in North-western Ethiopia: a qualitative study

Abstract Background Malaria is one of the most important public health problems in Ethiopia contributing to significant patient morbidity and mortality. Prompt diagnosis and effective malaria case management through public, private and community health facilities has been one of the key malaria prevention, control and elimination strategies. The objective of this study was to evaluate adult malaria patients and healthcare providers’ perception of the quality of malaria management at private sector outpatient facilities. Methods An exploratory, descriptive, contextual and qualitative research methodology was conducted with 101 participants (33 in-depth interviews (INIs) and ten focus group discussions (FGDs) with 68 participants). All interview and focus group discussions were audio recorded, transcribed verbatim and analysed, using eight steps of Tesch. Results During data analysis a single theme, two categories and six sub-categories emerged, namely (1) perceived quality of malaria management at outpatient facilities; (a) essential resources; (a1) safe outpatient services; (a2) anti-malarial drugs and supplies; (a3) health workers; (b) factors influencing service utilization; (b1) physical accessibility; (b2) “art of care’’; and (b3) efficient malaria diagnosis and treatment services. Both FGDs and INIs participants had a positive perception of the quality of malaria outpatient services at private health facilities. The positive perceptions include safe and clean facility; availability of supplies and comprehensive services; convenient working hours; short waiting hours and motivated, competent and compassionate health workers. However, some participants raised their safety concerns due to perceived poor infection control practices, small working areas, interruption of anti-malarial supplies and inefficient malaria diagnosis and treatment services. Conclusion Both community members and healthcare providers had more positive perceptions towards outpatient malaria services offered at private health facilities. However, positive behaviour must be maintained and concerns must be dealt with by enhancing functional public private partnership for malaria care services to improve private sector malaria case management; build the service providers’ capacity; ensure uninterrupted anti-malarial supplies and empower the community with early health-seeking behaviour.

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Community and healthcare providers’ perceptions of quality of private sector outpatient malaria care in North-western Ethiopia: a qualitative study

10.21203/rs.3.rs-32063/v2 ◽

2021 ◽

Author(s):

Mesele Damte Argaw ◽

Thandisizwe Redford Mavundla ◽

Kassa Daka Gidebo

Keyword(s):

Private Sector ◽

Health Workers ◽

Healthcare Providers ◽

Malaria Diagnosis ◽

Health Facilities ◽

Outpatient Services ◽

Focus Group Discussions ◽

Group Discussions ◽

Treatment Services

Abstract BackgroundsMalaria is one of the most important public health problems in Ethiopia contributing to significant patient morbidity and mortality. Prompt diagnosis and effective malaria case management through public, private and community health facilities has been one of the key malaria prevention, control and elimination strategies. The objective of this study was to evaluate adult malaria patients and healthcare providers’ perception of the quality of malaria management at private sector outpatient facilities. MethodsAn exploratory, descriptive, contextual and qualitative research methodology was conducted with 101 participants ( 33 in-depth interviews (INIs) and ten focus group discussions (FGDs) with 68 participants). All interview and focus group discussions were audio recorded, transcribed verbatim and analysed, using eight steps of Tesch (1990). Results During data analysis a single theme, two categories and six sub-categories emerged, namely (1) perceived quality of malaria management at outpatient facilities; (a) essential resources; (a1) safe outpatient services; (a2) anti-malaria drugs and supplies; (a3) health workers; (b) factors influencing service utilisation; (b1) physical accessibility; (b2) “art of care’’; and (b3) efficient malaria diagnosis and treatment services. Both FGDs and INIs participants had a positive perception of the quality of malaria outpatient services at private health facilities. The positive perceptions include safe and clean facility; availability of supplies and comprehensive services; convenient working hours; short waiting hours and motivated, competent and compassionate health workers. However, some participants raised their safety concerns due to perceived poor infection control practices, small working areas, interruption of antimalaria supplies and inefficient malaria diagnosis and treatment services. Conclusion Both community members and healthcare providers had more positive perceptions towards outpatient malaria services offered at private health facilities. However, positive behaviour must be maintained and concerns must be dealt with by enhancing functional public private partnership for malaria care services to improve private sector malaria case management; build the service providers’ capacity; ensure uninterrupted anti-malaria supplies and empower the community with early health seeking behaviour.

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Community and Health Care Providers Perception on Quality of Private Sector Outpatient Malaria Care in North West Ethiopia: A Qualitative Study

10.21203/rs.3.rs-32063/v1 ◽

2020 ◽

Author(s):

Mesele Damte Argaw ◽

Thandisizwe Redford Mavundla ◽

Kassa Daka Gidebo

Keyword(s):

Focus Group ◽

Private Sector ◽

Health Care Providers ◽

Service Providers ◽

Good Governance ◽

Health Workers ◽

Care Providers ◽

Focus Group Discussions ◽

Group Discussions

Abstract Malaria is one of the most important public health problems in Ethiopia contributing to significant patient morbidity and mortality. Prompt diagnosis and effective malaria case management-through public, private and community health facilities has been one of the key malaria prevention, control and elimination strategies. The objective of this study was to evaluate perceptions of adult malaria patients and healthcare provider on quality of malaria management at private sector outpatient facilities. An exploratory, descriptive, contextual, qualitative research methodology was conducted with 101 participants (i.e. 33 in-depth interviews and ten Focus Group Discussions with 68 discussants). All interview and Focus Group Discussions were audio recorded, transcribed verbatim and analysed using eight steps of Tesch (1990). During data analysis a single theme, two categories and six sub categories were emerged, namely (1) Perceived quality of malaria management at outpatient facilities; (a) essential resources ; (a1) safe outpatient services; (a2) antimalarial drugs and supplies; (a3) health workers; (b) factors influencing service utilization ; (b1) Physical accessibility; (b2) “Art of care’’; and (b3) efficient malaria diagnosis and treatment services. Finally, enhancing good governance and stewardship of the public sector to tap the potential of private sector, build the service providers capacity and empowering the community on seeking early medical and safety were recommended.

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Patient-centered approaches applied in inpatient and outpatient TB services in Armenia

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.403 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

Z Grigoryan ◽

N Truzyan ◽

V Petrosyan

Keyword(s):

Healthcare Providers ◽

International Standards ◽

Family Education ◽

Outpatient Services ◽

Patient Centeredness ◽

Patient Centered ◽

Group Discussions ◽

Legal Documents ◽

Source Data

Abstract Background Healthcare system performance indicators are common instruments measuring and facilitating quality improvement. The End-TB strategy urges provision of integrated patient-centered (PC) care for all forms of tuberculosis (TB). This study aimed to assess and compare quality of inpatient and outpatient TB services using international standards on specific PC indicators to identify potential targets for improvement. Methods Joint Commission International (JCI) accreditation standards, adapted to local needs and context, were used as a basic instrument for qualitative and quantitative data collection. We utilized Patient and Family Right (PFR) and Patient and Family Education (PFE) 15 standards with 49 measurable elements as PC indicators for the nationwide assessment of TB services. A scoring system and a scaling approach were used to convert all-source-data and present the overall performance of services. Results We reviewed and analyzed data from 10 legal documents, 34 medical records and 155 interviews and focus group discussions with TB healthcare providers, patients and family members from inpatient and outpatient TB services to define the degree of compliance of their practices and treatment experiences to JCI standards. Outpatient TB services met the PFR and PFE standards at the 51%-level receiving a grading of partially performed and requiring improvements. The inpatient services met the PFR and PFE standards at 39%- and 26%-level respectively, receiving a grading of minimally performed for the JCI standards, showing statistically significantly less patient centeredness compared to the outpatient services (p = 0.007, CI 0.234; 0.4234), and requiring major improvements. Conclusions Strengthening interventions towards patient-centeredness are essential in both inpatient and outpatient services, but Armenia needs to put more emphasis on inpatient care to bridge the gap between the existing and recommended practices.

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Perceptions and experiences of men and women towards acceptability and use of contraceptives in underserved areas of Karachi, Pakistan: A Midline Qualitative Assessment of Sukh Initiative, Karachi Pakistan

10.21203/rs.2.23449/v1 ◽

2020 ◽

Author(s):

Sarah Saleem ◽

Narjis Rizvi ◽

Anam Feroz ◽

Sayyeda Reza ◽

Saleem Jessani ◽

...

Keyword(s):

Focus Group ◽

Qualitative Study ◽

Contraceptive Use ◽

Health Workers ◽

Healthcare Providers ◽

Reproductive Age ◽

Qualitative Assessment ◽

Focus Group Discussions ◽

Group Discussions ◽

Men And Women

Abstract Background: Family planning (FP) is an essential component of Sustainable Development Goals (SDG) and contributes directly to SDG targets 3.7 and 5.6. In Pakistan, contraceptive use has remained stagnant over the past 5 years. This change has been very slow when compared to the FP2020 pledge. The Sukh initiative project was conceived and implemented to alleviate these challenges by providing access to quality contraceptive methods in some underserved areas of Karachi, Pakistan. A qualitative study was been conducted to understand the perceptions and experiences of men and women towards acceptability and contraceptive use.Methods: A qualitative study was conducted at ten Sukh stations located in four towns of Karachi. Focus group discussions (FGDs) were conducted with Married Women of Reproductive Age (MWRA) and married men who received FP services through the Sukh initiative. Study participants were purposively sampled for focus group discussions (FGDs). Interview data was manually transcribed and analyzed using thematic analysis.Results: A total of 20 FDGs(Men=10 FGDs; MWRA=10 FGDs) were conducted. Three overarching themes were identified: (I) Appropriateness and means to promote contraceptive use; (II) Equity and Accessibility to contraceptives; and (III) Perspective on available FP services. Generally, both men and women were informed about FP methods but women were more cognizant of FP information. The Door to Door services by community health workers in Sukh initiative areas was largely appreciated both by women and men as it has made the accessibility and availability of the information and services easy. Women suggested that the Sukh initiative should bring some strategies that can help men broaden their perspective towards FP. The study informed that the men feel left out from the FP programs. Therefore, male participants expressed keen interest in initiatives for men in their communities that would cater to their FP needs.Conclusions: This qualitative study provided a unique opportunity to understand the perceptions of men and women towards the phenomena of contraceptive use. The study identified the need for trained and qualified female and male healthcare providers and well-established health facilities alongside door-to-door services.

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Perceptions and experiences of men and women towards acceptability and use of contraceptives in underserved areas of Karachi, Pakistan: A Midline Qualitative Assessment of Sukh Initiative, Karachi Pakistan

10.21203/rs.2.23449/v2 ◽

2020 ◽

Author(s):

Sarah Saleem ◽

Narjis Rizvi ◽

Anam Feroz ◽

Sayyeda Reza ◽

Saleem Jessani ◽

...

Keyword(s):

Focus Group ◽

Qualitative Study ◽

Contraceptive Use ◽

Health Workers ◽

Healthcare Providers ◽

Reproductive Age ◽

Qualitative Assessment ◽

Focus Group Discussions ◽

Group Discussions ◽

Men And Women

Abstract Background: Family planning (FP) is an essential component of Sustainable Development Goals (SDG) and contributes directly to SDG targets 3.7 and 5.6. In Pakistan, contraceptive use has remained stagnant over the past 5 years. This change has been very slow when compared to the FP2020 pledge. The Sukh initiative project was conceived and implemented to alleviate these challenges by providing access to quality contraceptive methods in some underserved areas of Karachi, Pakistan. A qualitative study was conducted to understand the perceptions and experiences of men and women towards acceptability and contraceptive use.Methods: A qualitative study was conducted at ten Sukh stations located in four towns of Karachi. Focus group discussions (FGDs) were conducted with Married Women of Reproductive Age (MWRA) and married men who received FP services through the Sukh initiative. Study participants were purposively sampled for focus group discussions (FGDs). Interview data was manually transcribed and analyzed using thematic analysis.Results: A total of 20 FDGs (Men=10 FGDs; MWRA=10 FGDs) were conducted. Three overarching themes were identified: (I) Appropriateness and means to promote contraceptive use; (II) Equity and Accessibility to contraceptives; and (III) Perspective on available FP services. Generally, both men and women were informed about FP methods but women were more cognizant of FP information. The Door to Door services by community health workers in Sukh initiative areas was largely appreciated both by women and men as it has made the accessibility and availability of the information and services easy. Women suggested that the Sukh initiative should bring some strategies that can help men broaden their perspective towards FP. The study informed that the men feel left out from the FP programs. Therefore, male participants expressed keen interest in initiatives for men in their communities that would cater to their FP needs.Conclusions: This qualitative study provided a unique opportunity to understand the perceptions of men and women towards the phenomena of contraceptive use. The study identified the need for trained and qualified female and male healthcare providers and well-established health facilities alongside door-to-door services.

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Food Choices During Pregnancy Periods In Pulau Godang Kari

Jurnal Kesehatan Komunitas ◽

10.25311/keskom.vol5.iss2.361 ◽

2019 ◽

Vol 5 (2) ◽

pp. 96-100

Author(s):

Vella Yovinna Tobing ◽

Yati Afiyanti ◽

Imami Nur Rachmawati

Keyword(s):

Cultural Practices ◽

Health Workers ◽

Food Choices ◽

Cultural Practice ◽

Focus Group Discussions ◽

Group Discussions ◽

Dietary Restrictions ◽

Birth Attendance ◽

Nutritional Needs

Cultural practice of nutritional consumption during pregnancy can affect the quality of maternal and fetal health. Mothers need sufficient nutrients to be able to adapt of pregnancy changes. The growth and development of the fetus is depends on the mother. Some cultural practices believe that some types of food have a bad impact on both the mother and the fetus, so that the food is prohibited to be consumed during the pregnancy period. The purpose of the study was to explore the types of prohibited foods during pregnancy in Pulau Godang Kari, Kuantan Singingi. This is an ethnographic research was conducted on 15 informants consisting of pregnant women, families, midwife and traditioanl birth attendance. Data collection used direct observation, focus group discussions and interviews that are analyzed by using content analysis. Prohibition of certain types of food based on the type of food that was believed that the properties are not good, so it was believed to have a bad effect on the mother and fetus. The implementation of cultural practices related to dietary restrictions is still being carried out, because of the belief that something unwanted will happen if you choose to consume these foods. Therefore, health workers must be able to provide culturally sensitive health services, so they can provide alternative food choices to fulfill nutritional needs during pregnancy period

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

BMJ Paediatrics Open ◽

10.1136/bmjpo-2020-000822 ◽

2020 ◽

Vol 4 (1) ◽

pp. e000822

Author(s):

Robert C Hughes ◽

Patricia Kitsao-Wekulo ◽

Sunil Bhopal ◽

Elizabeth W Kimani-Murage ◽

Zelee Hill ◽

...

Keyword(s):

Mixed Methods ◽

Focus Group ◽

Early Years ◽

Epidemiological Methods ◽

Focus Group Discussions ◽

Group Discussions ◽

Early Childcare ◽

Depth Interviews ◽

Childcare Providers

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.

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Supporting the pursuit of professionalism during a crisis

BMJ Leader ◽

10.1136/leader-2021-000458 ◽

2021 ◽

pp. leader-2021-000458

Author(s):

William O Cooper ◽

Nancy M Lorenzi ◽

Heather A Davidson ◽

Cynthia A Baldwin ◽

Daniel M Feinberg ◽

...

Keyword(s):

Focus Group ◽

Essential Elements ◽

Healthcare Organisation ◽

Focus Group Discussions ◽

Group Discussions ◽

Crisis Plans ◽

Team Members ◽

Professional Accountability ◽

Physical Plant

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.

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Youth perspective on social media discourse on “Lazy Nigerian Youths” conversations

INFORMASI ◽

10.21831/informasi.v50i2.31334 ◽

2020 ◽

Vol 50 (2) ◽

pp. 111-122

Author(s):

Nkiru Comfort Ezeh ◽

Augustine Godwin Mboso

Keyword(s):

Social Media ◽

Political Communication ◽

Freedom Of Expression ◽

Media Discourse ◽

Focus Group Discussions ◽

Group Discussions ◽

Political Issues ◽

The Social ◽

Youth Perspective

The Social Media has emerged as a new platform for discourses. It has no doubt provided people with easier and faster accessibility to information and has become an outlet for them to share their views on socio-political issues. It has also been observed that negative and hate comments seem to dominate on social networks used for social and political communication. Anchored on Public Sphere Theory, focus group discussions were conducted with undergraduate youths in South-east Nigeria examined on the issue of President Mohammadu Buhari’s referring to Nigerian youths as lazy, while speaking at the Commonwealth Business Forum in Westminster on 18th April 2018. This article, therefore, explored the opinions advanced in the discourse based on the principles of freedom of expression and responsibility. The study suggests that while Twitter platform was more objective in the discussion of the issue of the day because it allows the use of filters to ensure that contents posted on the platform adhere strictly to rules and fair usage; Facebook and Whatsapp trailed with abuses and hate comments. The study recommended that owners of blogs and media houses who now post their contents on the social media should coordinate comments on such platforms and continue developing mechanisms that work to regulate the quality of posted content.

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SARCASM AND THE TRANSLATION QUALITY IN THE SUBTLE ART OF NOT GIVING A FUCK BOOK

LiNGUA Jurnal Ilmu Bahasa dan Sastra ◽

10.18860/ling.v15i2.8913 ◽

2020 ◽

Vol 15 (2) ◽

pp. 253-260

Author(s):

Moh. Zawawi ◽

Devi Laila Maghfiroh

Keyword(s):

Document Analysis ◽

Focus Group Discussions ◽

Group Discussions ◽

Translation Quality ◽

Translation Study ◽

Modulation Techniques ◽

Translation Techniques ◽

Qualitative Descriptive ◽

High Level

Sarcasm is a harsher style of satire in hurtful jokes with a specific purpose. Sarcasm is the dominant language style used in Mark Manson's The Subtle Art of Not Giving A Fuck. This study aims to identify sentence forms of sarcasm and analyze the translation quality of sarcastic expressions. This translation study employs a qualitative descriptive design. The research data takes the form of sentences containing sarcasm and its translation. The data is collected through document analysis, interviews, and focus group discussions. The results showed four types of sarcasm in the book The Subtle Art of Not Giving A Fuck, including ridicule, satire, proximity, and humor. Besides, the translation quality of the book The Subtle Art of Not Giving A Fuck has a high level of accuracy, acceptability, and readability, evidenced by the proper use of eleven translation techniques applied by the translator to 145 data. The frequent techniques contributing to the quality of translation are compensation, adaptation, transposition, and modulation techniques.

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