scholarly journals Facility assessment and qualitative analysis of health worker perspectives on neonatal health in Malawi

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Mai-Lei Woo Kinshella ◽  
Alinane Linda Nyondo-Mipando ◽  
Queen Dube ◽  
David M. Goldfarb ◽  
Kondwani Kawaza
Keyword(s):  
Low Income ◽  
Service Providers ◽  
Health Centre ◽  
Newborn Health ◽  
World Health ◽  
Neonatal Health ◽  
Facility Assessment ◽  
Health Innovations ◽  
Care Assessment ◽  
Implementation Factors

Abstract Objectives The “Integrating a neonatal healthcare package for Malawi” (IMCHA#108030) project conducted mixed-methods to understand facility-based implementation factors for newborn health innovations in low-resourced health settings. The objective of the two datasets was to evaluate: (a) capacity of quality newborn care in three districts in southern Malawi, and (b) barriers and facilitators the scale up of bubble continuous positive airway pressure (CPAP), a newborn health innovation to support babies with respiratory distress. Data description The Integrated Maternal, Neonatal and Child Quality of Care Assessment and Improvement Tool (version April-2014) is a standardized facility assessment tool developed by the World Health Organization (WHO) that examines quality as well as quantity and availability. The facility survey is complemented by a qualitative dataset of illustrative quotes from health service providers and supervisors on bubble CPAP implementation factors. Research was conducted in one primary health centre (facility assessment only), three district-level hospitals (both) and a tertiary hospital (qualitative only) in southern Malawi. These datasets may be used by other researchers for insights into health systems of low-income countries and implementation factors for the roll-out of neonatal health innovations as well as to frame future research questions or preliminary exploratory research on similar topics.

scholarly journals “So sometimes, it looks like it’s a neglected ward”: Health worker perspectives on implementing kangaroo mother care in southern Malawi

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243770
Author(s):  
Mai-Lei Woo Kinshella ◽  
Sangwani Salimu ◽  
Brandina Chiwaya ◽  
Felix Chikoti ◽  
Lusungu Chirambo ◽  
...  
Keyword(s):  
Low Birthweight ◽  
Service Providers ◽  
Health Workers ◽  
Health Management ◽  
Low Cost ◽  
Newborn Health ◽  
Kangaroo Mother Care ◽  
World Health ◽  
District Health ◽  
Skin Contact

Introduction Kangaroo mother care (KMC) involves continuous skin-to-skin contact of baby on mother’s chest to provide warmth, frequent breastfeeding, recognizing danger signs of illness, and early discharge. Though KMC is safe, effective and recommended by the World Health Organization, implementation remains limited in practice. The objective of this study is to understand barriers and facilitators to KMC practice at tertiary and secondary health facilities in southern Malawi from the perspective of health workers. Methods This study is part of the “Integrating a neonatal healthcare package for Malawi” project in the Innovating for Maternal and Child Health in Africa initiative. In-depth interviews were conducted between May-Aug 2019 with a purposively drawn sample of service providers and supervisors working in newborn health at a large tertiary hospital and three district-level hospitals in southern Malawi. Data were analyzed using a thematic approach using NVivo 12 software (QSR International, Melbourne, Australia). Findings A total of 27 nurses, clinical officers, paediatricians and district health management officials were interviewed. Staff attitudes, inadequate resources and reliance on families emerged as key themes. Health workers from Malawi described KMC practice positively as a low-cost, low-technology solution appropriate for resource-constrained health settings. However, staff perceptions that KMC babies were clinically stable was associated with lower prioritization in care and poor monitoring practices. Neglect of the KMC ward by medical staff, inadequate staffing and reliance on caregivers for supplies were associated with women self-discharging early. Conclusion Though routine uptake of KMC was policy for stable low birthweight and preterm infants in the four hospitals, there were gaps in monitoring and maintenance of practice. While conceptualized as a low-cost intervention, sustainable implementation requires investments in technologies, staffing and hospital provisioning of basic supplies such as food, bedding, and KMC wraps. Strengthening hospital capacities to support KMC is needed as part of a continuum of care for premature infants.

scholarly journals Gender discrimination as a barrier to high-quality maternal and newborn health care in Nigeria: findings from a cross-sectional quality of care assessment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chioma Oduenyi ◽  
Joya Banerjee ◽  
Oniyire Adetiloye ◽  
Barbara Rawlins ◽  
Ugo Okoli ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Family Planning ◽  
Health Services ◽  
Gender Discrimination ◽  
Newborn Health ◽  
Maternal And Newborn Health ◽  
Gender Based Violence ◽  
Cross Sectional ◽  
Care Assessment

Abstract Background Poor reproductive, maternal, newborn, child, and adolescent health outcomes in Nigeria can be attributed to several factors, not limited to low health service coverage, a lack of quality care, and gender inequity. Providers’ gender-discriminatory attitudes, and men’s limited positive involvement correlate with poor utilization and quality of services. We conducted a study at the beginning of a large family planning (FP) and maternal, newborn, child, and adolescent health program in Kogi and Ebonyi States of Nigeria to assess whether or not gender plays a role in access to, use of, and delivery of health services. Methods We conducted a cross-sectional, observational, baseline quality of care assessment from April–July 2016 to inform a maternal and newborn health project in health facilities in Ebonyi and Kogi States. We observed 435 antenatal care consultations and 47 births, and interviewed 138 providers about their knowledge, training, experiences, working conditions, gender-sensitive and respectful care, and workplace gender dynamics. The United States Agency for International Development’s Gender Analysis Framework was used to analyze findings. Results Sixty percent of providers disagreed that a woman could choose a family planning method without a male partner’s involvement, and 23.2% of providers disagreed that unmarried clients should use family planning. Ninety-eight percent believed men should participate in health services, yet only 10% encouraged women to bring their partners. Harmful practices were observed in 59.6% of deliveries and disrespectful or abusive practices were observed in 34.0%. No providers offered clients information, services, or referrals for gender-based violence. Sixty-seven percent reported observing or hearing of an incident of violence against clients, and 7.9% of providers experienced violence in the workplace themselves. Over 78% of providers received no training on gender, gender-based violence, or human rights in the past 3 years. Conclusion Addressing gender inequalities that limit women’s access, choice, agency, and autonomy in health services as a quality of care issue is critical to reducing poor health outcomes in Nigeria. Inherent gender discrimination in health service delivery reinforces the critical need for gender analysis, gender responsive approaches, values clarification, and capacity building for service providers.

scholarly journals Delivery of Community Support Services for Older Adults in Social Housing

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 910-911
Author(s):  
Matthew Yau ◽  
Christine Sheppard ◽  
Jocelyn Charles ◽  
Andrea Austen ◽  
Sander Hitzig
Keyword(s):  
Older Adults ◽  
Service Delivery ◽  
Low Income ◽  
Support Services ◽  
Social Housing ◽  
Service Providers ◽  
Community Support ◽  
Community Agencies ◽  
Visible Minorities ◽  
Community Support Services

Abstract Community support services are an integral component of aging in place. In social housing, older adult tenants struggle to access these services due to the siloed nature of housing and health services. This study aims to describe the relationship between community support services and social housing for older adults and examine ways to optimize delivery. Data on government-funded community support services delivered to 74 seniors’ social housing buildings in Toronto, Ontario was analyzed. Neighbourhood profile data for each building was also collected, and correlational analyses were used to examine the link between neighbourhood characteristics and service delivery. Fifty-six community agencies provided 5,976 units of services across 17 service categories, most commonly mental health supports, case management and congregate dining. On average, each building was supported by nine agencies that provided 80 units of service across 10 service categories. Buildings in neighbourhoods with a higher proportion of low-income older adults had more agencies providing on-site services (r = .275, p < .05), while those in neighbourhoods with more immigrants (r = -.417, p < .01), non-English speakers (r = -.325, p < .01), and visible minorities (r = -.381, p < .01) received fewer services. Findings point to a lack of coordination between service providers, with multiple agencies offering duplicative services within the same building. Vulnerable seniors from equity-seeking groups, including those who do not speak English and recent immigrants, may be excluded from many services, and future service delivery for seniors should strive to address disparities in availability and access.

scholarly journals Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

2021 ◽  
Vol 18 (5) ◽  
pp. 2439
Author(s):  
Brendon Stubbs ◽  
Kamran Siddiqi ◽  
Helen Elsey ◽  
Najma Siddiqi ◽  
Ruimin Ma ◽  
...  
Keyword(s):  
Health Survey ◽  
Low Income ◽  
World Health ◽  
Low Income Countries ◽  
Multivariable Logistic Regression Analysis ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Low And Middle Income

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

scholarly journals Designing Age-Friendly Communities: Exploring Qualitative Perspectives on Urban Green Spaces and Ageing in Two Indian Megacities

2021 ◽  
Vol 18 (4) ◽  
pp. 1491
Author(s):  
Deepti Adlakha ◽  
Mina Chandra ◽  
Murali Krishna ◽  
Lee Smith ◽  
Mark A. Tully
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Later Life ◽  
Healthy Ageing ◽  
World Health ◽  
Social Resilience ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Urban Green ◽  
Activity Promotion

The World Health Organization and the United Nations have increasingly acknowledged the importance of urban green space (UGS) for healthy ageing. However, low- and middle-income countries (LMICs) like India with exponential ageing populations have inadequate UGS. This qualitative study examined the relationships between UGS and healthy ageing in two megacities in India. Participants were recruited using snowball sampling in New Delhi and Chennai and semi-structured interviews were conducted with consenting participants (N = 60, female = 51%; age > 60 years; fluent in English, Hindi, or Tamil). Interviews were recorded, transcribed, translated, and analysed using inductive and thematic analysis. Benefits of UGS included community building and social capital, improved health and social resilience, physical activity promotion, reduced exposure to noise, air pollution, and heat. Poorly maintained UGS and lack of safe, age-friendly pedestrian infrastructure were identified as barriers to health promotion in later life. Neighbourhood disorder and crime constrained older adults’ use of UGS in low-income neighbourhoods. This study underscores the role of UGS in the design of age-friendly communities in India. The findings highlight the benefits of UGS for older adults, particularly those living in socially disadvantaged or underserved communities, which often have least access to high-quality parks and green areas.

scholarly journals Design and Development of an Instrument on Knowledge of Food Safety, Practices, and Risk Perception Addressed to Children and Adolescents from Low-Income Families

2021 ◽  
Vol 13 (4) ◽  
pp. 2324
Author(s):  
Sueny Andrade Batista ◽  
Elke Stedefeldt ◽  
Eduardo Yoshio Nakano ◽  
Mariana de Oliveira Cortes ◽  
Raquel Braz Assunção Botelho ◽  
...  
Keyword(s):  
Food Safety ◽  
Risk Perception ◽  
Low Income ◽  
Raw Materials ◽  
World Health ◽  
Low Income Students ◽  
Level Of Knowledge ◽  
Low Income Families ◽  
Health Organization ◽  
Rules Set

In the fight against foodborne diseases, expanding access to information for different groups is needed. In this aspect, it is crucial to evaluate the target audience’s particularities. This study constructed and validated an instrument containing three questionnaires to identify the level of knowledge, practices, and risk perception of food safety by low-income students between 11 and 14 years old. The following steps were used: systematic search of the databases; conducting and analyzing focus groups; questionnaires development; and questionnaires analysis. After two judges’ rounds, the final version was reached with 11 knowledge items, 11 practice items, and five risk perception items. The content validation index values were higher than 0.80. The adopted methodology considered the students’ understanding and perceptions, as well the appropriate language to be used. Besides, it allowed the development of questionnaires that directly and straightforwardly covers the rules set by the World Health Organization for foodborne disease control called Five Keys to Safer Food (keep clean; separate raw and cooked; cook thoroughly; keep food at safe temperatures; and use safe water and raw materials). Its use can result in a diagnosis for elaborating educational proposals and other actions against foodborne illness in the most vulnerable population.

scholarly journals Training physicians in India to interpret pediatric chest radiographs according to World Health Organization research methodology

2021 ◽  
Author(s):  
Eric D. McCollum ◽  
Melissa M. Higdon ◽  
Nicholas S. S. Fancourt ◽  
Jack Sternal ◽  
William Checkley ◽  
...  
Keyword(s):  
World Health Organization ◽  
Primary Endpoint ◽  
Low Income ◽  
Chest Radiography ◽  
Epidemiological Studies ◽  
Chest Radiographs ◽  
World Health ◽  
Average Score ◽  
Pediatric Chest ◽  
Health Organization

Abstract Background Chest radiography is the standard for diagnosing pediatric lower respiratory infections in low-income and middle-income countries. A method for interpreting pediatric chest radiographs for research endpoints was recently updated by the World Health Organization (WHO) Chest Radiography in Epidemiological Studies project. Research in India required training local physicians to interpret chest radiographs following the WHO method. Objective To describe the methodology for training Indian physicians and evaluate the training’s effectiveness. Materials and methods Twenty-nine physicians (15 radiologists and 14 pediatricians) from India were trained by two WHO Chest Radiography in Epidemiological Studies members over 3 days in May 2019. Training materials were adapted from WHO Chest Radiography in Epidemiological Studies resources. Participants followed WHO methodology to interpret 60 unique chest radiographs before and after the training. Participants needed to correctly classify ≥80% of radiographs for primary endpoint pneumonia on the post-training test to be certified to interpret research images. We analyzed participant performance on both examinations. Results Twenty-six of 29 participants (89.7%) completed both examinations. The average score increased by 9.6% (95% confidence interval [CI] 5.0–14.1%) between examinations (P<0.001). Participants correctly classifying ≥80% of images for primary endpoint pneumonia increased from 69.2% (18/26) on the pretraining to 92.3% (24/26) on the post-training examination (P=0.003). The mean scores of radiologists and pediatricians on the post-training examination were not statistically different (P=0.43). Conclusion Our results demonstrate this training approach using revised WHO definitions and tools was successful, and that non-radiologists can learn to apply these methods as effectively as radiologists. Such capacity strengthening is important for enabling research to support national policy decision-making in these settings. We recommend future research incorporating WHO chest radiograph methodology to consider modelling trainings after this approach.

scholarly journals Evaluation of Prescribing Indicators in a Paediatric Population Seen in an Outpatient Consultation at the Gaspard Kamara Health Centre in 2019 (Senegal)

Pharmacy ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 113
Author(s):  
Oumar Bassoum ◽  
Mouhamadou Faly Ba ◽  
Ndèye Marème Sougou ◽  
Djibril Fall ◽  
Adama Faye
Keyword(s):  
Descriptive Analysis ◽  
Health Centre ◽  
Paediatric Population ◽  
Essential Medicines ◽  
World Health ◽  
Bivariate Analysis ◽  
Prescribing Indicators ◽  
Outpatient Consultation ◽  
International Nonproprietary Name ◽  
Health Organization

Introduction: Data on drug use in paediatrics are scarce in Senegal. The objective of this study was to assess the prescribing indicators in a paediatric population seen in an outpatient consultation at a Health Centre in Dakar, Senegal. Methods: A retrospective and analytical study was conducted. The study population consisted of prescriptions for children aged 0 to 14 years who were seen in ambulatory consultation between 1 June and 30 November 2019. The sample size was 600 prescriptions. The systematic survey was then conducted. Five prescription indicators recommended by the World Health Organization were calculated. The R software was used for descriptive analysis, bivariate analysis and binomial logistic regression. Results: The average number of drugs per prescription was 2.56. The proportion of drugs prescribed under the International Nonproprietary Name (INN) was 18.9%, while the proportion of drugs on the National Essential Medicines List (NEML) was 41.3%. The proportions of prescriptions with at least one antibiotic and one injectable product were 41.5% and 1.3%, respectively. Conclusions: This study showed that prescribing habits were inadequate. Thus, it would be necessary to move towards continuing training of prescribers in the wise use of medicines.

Training health workers to provide person-centred maternal and newborn health care in Burkina Faso

2013 ◽  
Vol 3 (2) ◽  
pp. 154-159
Author(s):  
Janet Perkins ◽  
Aminata Bargo ◽  
Cecilia Capello ◽  
Carlo Santarelli
Keyword(s):  
Health Care ◽  
Burkina Faso ◽  
Health Care Providers ◽  
Health Workers ◽  
Healthcare Providers ◽  
Newborn Health ◽  
World Health ◽  
Maternal And Newborn Health ◽  
Care Providers ◽  
Maternal And Newborn

Assuring the provision of person-centred care is critical in maternal and newborn health (MNH). As a component of the national strategy to improve MNH, Burkina Faso Ministry of Health, supported by Enfants du Monde, La Fondation pour le Développement Communautaire/Burkina Faso and UNFPA, is implementing the World Health Organization’s (WHO) framework for Working with Individuals, Families and Communities (IFC) to improve MNH. As a first step in district implementation, participatory community assessments were conducted. These assessments consistently revealed that poor interactions with healthcare providers posed one important barrier preventing women from seeking MNH services. In order to address this barrier, healthcare providers were trained to improve their interpersonal skills and in counselling women. During 2011-12 a total of 175 personnel were trained over a 5-day course developed using a WHO manual. The course was met with enthusiasm as providers expressed their need and desire for such training. Immediate post-test results revealed an impressive increase in knowledge and anecdotal evidence suggests that training has influenced provider’s behaviours in their interactions with women. In addition, health care providers are taking concrete action to build the capabilities of women to experience pregnancy and birth safely by engaging directly with communities.  While early findings are promising, an evaluation will be necessary to measure how the training has influenced practices, whether this translates into a shift of perceptions at community level and ultimately its contribution toward promoting person-centred care in Burkina Faso.

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