scholarly journals Setting-up a cross-border action-research project to control malaria in remote areas of the Amazon: describing the birth and milestones of a complex international project (Malakit)

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Muriel Suzanne Galindo ◽  
Yann Lambert ◽  
Louise Mutricy ◽  
Laure Garancher ◽  
Jane Bordalo Miller ◽  
...  
Keyword(s):  
Action Research ◽  
Health Care Services ◽  
Health Workers ◽  
Target Population ◽  
Design Development ◽  
Action Research Project ◽  
Care Services ◽  
Wide Range ◽  
Usual Test ◽  
Mobile Population

Abstract Background In French Guiana, gold miners working illegally represents a major reservoir of malaria. This mobile population, mainly of Brazilian descent, enters the French Guianese forest from neighbouring countries, Suriname and Brazil. A complex and innovative intervention was piloted as a cooperation with the three involved countries involved to control malaria in this specific population. The principle was that health workers called “facilitators” provide the participants with a self-diagnosis and self-treatment kit along with adequate training and material to rapidly manage an episode of malaria symptoms on their own, when they find themselves isolated from health care services. Methods This paper describes the design, development, content of the intervention and players’ organization of this multi-country project, the opportunities and constraints encountered, and the lessons learnt at this stage. Results The choice not to implement the usual “Test and Treat” approach within the community is mainly driven by regulatory reasons. The content of medical messages tends to balance the tension between thoroughness, accuracy and efficacy. The wide range of tools developed through a participatory approach was intended to cope with the challenges of the literacy level of the target population. Despite the difficulties encountered due to language, regulation differences and distance between partners, cooperation was fruitful, due to the complementary of stakeholders, their involvement at all important stages and regular face-to-face meetings. Discussion and conclusion This experience shows the feasibility of an ambitious project of action-research in a border malaria context, involving several countries and with a mobile and undocumented population. It reveals some factors of success which may be transferable in analogous settings.

Setting-Up A Cross-Border Action-Research Project to Control Malaria in Remote Areas of the Amazon: Describing the Birth and Milestones of A Complex International Project (Malakit)

2020 ◽  
Author(s):  
Muriel Suzanne Galindo ◽  
Yann Lambert ◽  
Louise Mutricy ◽  
Laure Garancher ◽  
Jane Bordalo Miller ◽  
...  
Keyword(s):  
Action Research ◽  
Health Care Services ◽  
Health Workers ◽  
Target Population ◽  
Design Development ◽  
Action Research Project ◽  
Care Services ◽  
Wide Range ◽  
Usual Test ◽  
Mobile Population

Abstract Background: In French Guiana, gold miners working illegally represents a major reservoir of malaria. This mobile population, mainly of Brazilian descent, enters the French Guianese forest from neighboring countries, Suriname and Brazil. A complex and innovative intervention was piloted in cooperation with the three involved countries to control malaria in this specific population. The principle was to provide participants through health workers called “facilitators” with a self-diagnosis and self-treatment kit along with adequate training and material to rapidly manage an episode of malaria symptoms on their own, when they find themselves isolated from health care services. Method: We describe here the design, development, content of the intervention and players’ organization of this multi-country project, the opportunities and constraints encountered, and the lessons learnt at this stage. Results: We chose not to implement a usual “Test and Treat” approach within the community mainly for regulatory reasons. The content of medical messages tend to balance the tension between thoroughness, accuracy and efficacy. The wide range of tools developed through a participatory approach was intended to cope with the challenges of the literacy level of the target population. Despite the difficulties encountered due to language, regulation differences and distance between partners, cooperation was fruitful, due to the complementary of stakeholders, their involvement at all important stages and regular face-to-face meetings. Discussion and conclusion: This experience shows the feasibility of an ambitious project of action-research in a border malaria context, involving several countries and with a mobile and undocumented population. It reveals some factors of success which may be transferable in analogous settings.

scholarly journals Attitudes and Behaviours of Health Workers and the Use of HIV/AIDS Health Care Services

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Jonathan M. Dapaah
Keyword(s):  
Health Care Services ◽  
Health Workers ◽  
Participant Observation ◽  
Care Services ◽  
Clinical Encounters ◽  
Positive Attitudes ◽  
Wide Range ◽  
Use Of Services ◽  
Depth Interviews ◽  
National Effort

Background. This article discusses how health workers relate to and communicate with clients of VCT and ART treatment. It also looks at how health worker practices in the form of attitudes and behaviours towards clients influence the use of these services. Methods. In-depth interviews, informal conversations, and participant observation were used to collect data from health workers providing VCT and ART and clients who access these services in two Ghanaian hospitals. Results. The study found that health workers providing these services, with the exception of a few, generally showed positive attitudes and behaviours towards clients during clinical encounters. Health workers warmly received clients to the facilities, addressing clients with courtesy, advising clients on a wide range of issues, sometimes supporting clients financially, and comfortably interacting with them. This is contrary to the findings of most studies in the literature that health workers often do not communicate and relate to these patients well. Conclusion. It concludes that dealing with clients well during interactions in the centres and clinics is crucial for reducing the perceived stigma associated with the use of services and increasing use as part of the national effort to reduce the infection rate of the disease in Ghana.

scholarly journals Access and participation: What factors influence the provision and utilisation of health care services by children with learning disabilities?

2017 ◽  
Vol 41 (S1) ◽  
pp. S452-S452
Author(s):  
A. Rebowska
Keyword(s):  
Health Care ◽  
Learning Disabilities ◽  
Young People ◽  
Intellectual Disabilities ◽  
Health Care Services ◽  
Healthcare Services ◽  
Children And Young People ◽  
Care Services ◽  
Healthcare Needs ◽  
Wide Range

AimsThe aim of this literature review is to explore the range of factors that influence the degree of access to health care services by children and young people with learning disabilities.BackgroundChildren with learning disabilities are at increased risk of a wide range of health conditions comparing with their peers. However, recent reports by UK government as well as independent charities working with children and young people with learning disabilities demonstrated that they are at risk of poor health outcomes as a result of barriers preventing them from accessing most appropriate services.MethodsComprehensive searches were conducted in six databases. Articles were also obtained through review of references, a search of the grey literature, and contacting experts in the field. The inclusion criteria were for studies evaluating access to healthcare services, identification and communication of health needs, organisational aspects impacting on access and utilisation, staff attitudes where they impacted on access, barriers, discrimination in patients with intellectual disabilities age 0–18. The literature search identified a sample of 36 papers. The marked heterogeneity of studies excluded conducting a meta-analysis.ResultsBarriers to access included problems with identification of healthcare needs by carers and healthcare professionals, communication difficulties, the inadequacy of facilities, geographical and physical barriers, organisational factors such as inflexible appointment times, attitudes and poor knowledge base of healthcare staff.ConclusionThe factors identified can serve as a guide for managers and clinicians aiming to improve access to their healthcare services for children and young people with intellectual disabilities.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals An Action Research on Design, Delivery, and Evaluation of a Distance Course in a Vocational Higher Education Institution

2015 ◽  
pp. 138-166
Author(s):  
Erman Uzun ◽  
M. Yaşar Özden ◽  
Ali Yildirim
Keyword(s):  
Higher Education ◽  
Action Research ◽  
Web Design ◽  
Evaluation Process ◽  
Education Institution ◽  
Design Development ◽  
Higher Education Institution ◽  
Face To Face ◽  
Wide Range ◽  
Vocational Higher Education

In this chapter, the main purpose is to explain design, development, delivery, and evaluation process of a new distance web design course for the needs of students in a vocational higher education institution. It is important to highlight how wisely instructional technology was designed and used to mitigate problems to effectively support the course. Proactive action research was used as a framework of the study. This research focused on an analysis of the existing face-to-face course to mitigate its problems in the new design. Then, strengths and weaknesses of the new design in the new context were investigated. It is important to highlight that technology comes with its unique problems and opportunities. Thus, teaching in a technological environment confronts instructors with a wide range of pedagogical, technological, and physical challenges.

Clustering Diagnoses from 58M Patient Visits in Finland 2015–2018 (Preprint)

2021 ◽  
Author(s):  
Pasi Fränti ◽  
Sami Sieranoja ◽  
Katja Wikström ◽  
Tiina Laatikainen
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Clustering Algorithm ◽  
Target Population ◽  
Care Process ◽  
Care Services ◽  
System P ◽  
Integration Of Services ◽  
Effective Organization ◽  
Using Data

BACKGROUND Patients with multiple chronic diseases cause a major burden to the health service system. Currently, diseases are mostly treated separately without paying enough attention to their relationships, which results in a fragmentation of the care process. Better integration of services can lead to more effective organization of the overall health care system. OBJECTIVE To analyze the connections between diseases based on their co-occurrences in order to support decision-makers in better organizing health care services. METHODS We performed cluster analysis of diagnosis using data from the Finnish Health Care Registers for primary and specialized health care visits and inpatient care. The target population of this study comprised all individuals aged 18 years or older who used health care services during the years 2015–2018. Clustering was performed based on the co-occurrence of diagnoses. The more the same pair of diagnoses appears in the records of same patients, the more the diagnoses correlate. Based on the co-occurrences, we calculated the relative risk of each pair of diagnoses and clustered the data using a graph-based clustering algorithm called M-algorithm, a variant of k-means. RESULTS The results reveal multimorbidity clusters, of which some are expected, for example one representing hypertensive and cardiovascular diseases. Other clusters are more unexpected, such as a cluster containing lower respiratory tract diseases and systemic connective tissue disorders. We also report the estimated cost effect of each cluster to society. CONCLUSIONS The method and achieved results provide new insight to identify key multimorbidity groups, especially ones resulting in burden and costs in health care services.

Nomadic Clinics as Innovative Concept that Transforms Health Care Services in Mobile Population

2015 ◽  
pp. 90-102
Author(s):  
Siyat Moge Gure
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Resource Constraints ◽  
Evaluation Study ◽  
Staff Perceptions ◽  
Health Delivery ◽  
Care Services ◽  
Nomadic Pastoralists ◽  
North Eastern ◽  
Mobile Population

Nomads have the shared habit of migrating from one area to another. They contribute enormously to the economic development of the world. In Kenya's North Eastern counties, 60-70% of the population practices nomadic pastoralists. These counties has the poorest health indicator as a result of inadequate strategies in extending conventional health care to the nomadic population. In an effort to address this, a unique health delivery model dubbed ‘nomadic clinic'; was unveiled. An evaluation study was carried out to assess access, utilization, impact and cost- effectiveness of the clinic as well as to establish the community and staff perceptions on health service it provides. This was done in comparison to three static health facilities. Nearly all assessed indicators favoured the nomadic clinics. However, the mobile clinics faced myriad of challenges principally due to resource constraints. Fortunately, the new devolved system of governance provides unequivocal opportunities.

iKure Techsoft: Providing Technology Enabled Affordable Health Care in Rural India

2018 ◽  
Vol 22 (02) ◽  
pp. 385-411
Author(s):  
Atanu Chaudhuri ◽  
Venkatramanaiah Saddikutti ◽  
Thim Prætorius
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Health Workers ◽  
Care Delivery ◽  
Rural India ◽  
Medical Team ◽  
Hub And Spoke ◽  
Care Services ◽  
Primary Health ◽  
Care Delivery Model

iKure Techsoft was established in 2010 with the main objective to provide affordable and high quality primary health care to the rural population in India and to build a sustainable for-profit business model. To that end, iKure’s cloud based, and patent pending, Wireless Health Incident Monitoring System (WHIMS) technology along with their hub-and-spoke operating model are central, but also essential to exploit and explore further if iKure is to scale-up. iKure provides primary health care services through three hub clinics and 28 rural health centres (RHCs). Each hub clinic employs between one and up to six medical teams (each consisting of 1 doctor, 1 nurse, 1 paramedic and 2 health workers stationed at the hub) & 1 mobile medical team (1 doctor, 1 paramedic, 2 health workers) for catering to the RHCs). Each medical team manages six RHCs. Paramount in iKure’s health care delivery model is their self-developed software called WHIMS, which is a cloud-based award-winning application that runs on low internet bandwidths. WHIMS allow for (a) centralized monitoring of key metrics such as doctor’s attendance, treatment prescribed, patient record management, pharmacy stock management, and (b) supports effective communication, integration and contact that connects RHCs with hub clinics, but also city-based multi-specialty hospitals with whom iKure has formal tie-ups. iKure, moreover, also works extensively with Non-Governmental Organizations (NGOs). Collaboration with local NGOs in the target areas helps to build trust with the rural villagers and their local knowledge and access helps to assess service demand. NGOs also provide the necessary local logistical support and basic infrastructure in the rural areas where iKure works. Moreover, collaboration, for example, with corporate organizations are central as they contribute with part of their corporate social responsibility (CSR) funds to support iKure initiatives. At present, iKure is planning to add diagnostic services to its six hub clinics as well as expand its presence in other parts of West Bengal and other states across India. Expanding rural health care services even with the technology support of WHIMS is challenging because, for example, health is a very local issue (due to, among other things, local customs and languages) and it requires investing significant amount of time and resources to build relationship with the rural people as well as collaborators such as NGOs and corporates. The accompanying case describes iKure’s journey so far in terms of understanding: (a) the state of health care and government health care services provided in rural India, (b) the establishment and evolution of the iKure business and health care model, (c) iKure’s operations and health care delivery model including the WHIMS technology solution and hub-and-spoke set-up of operations, (d) the collaborative model which relies on NGOs and private corporates, and (e) finally iKure’s challenges related to scaling-up.

scholarly journals Video-based telehealth in Australian primary health care: current use and future potential

2013 ◽  
Vol 19 (4) ◽  
pp. 283 ◽  
Author(s):  
Melissa Raven ◽  
Caryn Butler ◽  
Petra Bywood
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
Health Workers ◽  
Geographic Distance ◽  
Care Services ◽  
Primary Health ◽  
Video Consultation ◽  
Restricted Mobility

Many Australians have limited access to health-care services due to a range of barriers, including geographic distance and restricted mobility, which telehealth can potentially address. This paper reviews the current and potential use of video consultation in primary health care in Australia, drawing on international literature. There is substantial evidence of high patient satisfaction, but many studies have methodological limitations. Overall, evidence of effectiveness and cost-effectiveness is weak. There is reasonable evidence for diagnosis, home care and specialist consultations by GPs with patients present. Two telehealth initiatives using video consultation are briefly presented. Both provide evidence that video consultation has a valuable role to play, but does not obviate the need for face-to-face consultations. Video consultation challenges traditional professional roles, particularly those of nurses, and can improve health workers’ skills and job satisfaction. More fundamentally, telehealth challenges the traditional distinction between primary and secondary care. This can be a source of resistance but may ultimately be one of its strengths. Appropriately targeted video consultation has much potential to improve the delivery of primary health care in Australia, particularly in rural and remote regions.

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