Initial Experience with Cancer Guidelines Navigator, a tool to standardize and improve the quality of cancer care in Sub-Saharan Africa, at Ocean Road Cancer Institute in Tanzania.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14106-e14106
Author(s):  
Fernando Jose Suarez Saiz ◽  
Leemor Yuravlivker ◽  
Jerry Ndumbalo ◽  
Julius Mwaiselage ◽  
Sadiq Maalim Siu ◽  
...  

e14106 Background: The IBM Cancer Guidelines Navigator (CGN) is a digital reference system to support treatment planning that allows clinicians to enter a cancer patient’s clinical characteristics and presents the corresponding treatment options in the NCCN Harmonized Guidelines (TM) for Sub-Saharan Africa. In October 2019, Ocean Road Cancer Institute (ORCI) in Tanzania became the first site in Africa to initiate a hospital-wide implementation of the tool to help clinicians reduce cancer treatment variability by increasing adherence to standard evidence-based care. We describe training and lessons learned from system introduction. Methods: Training for clinical staff at ORCI occurred over one week and included daily one-hour lectures, followed by personalized hands-on training. A survey was administered to assess usability and use cases of the tool. Results: Thirty-one ORCI clinical and IT staff members participated in training, and 12 completed the survey. Responses indicated that the most beneficial uses for CGN were at point of care and for self-learning. Participants indicated that the top benefits of the tool were quick access to guidelines and evidence (75%) and ease of use (58%). Expanding cancer coverage (42%), offline access and better integration into the workflow (25%) were identified as areas for improvement. Post-training, ORCI implemented easier access to CGN on each computer and tablet used for consultation and care management. Conclusions: CGN is a digital reference system that is designed to support easy and efficient access to regionalized cancer-treatment guidelines for point-of-care treatment planning and education. Expansion of this program has been planned for other hospitals in Tanzania. Future studies will examine whether CGN usage affects guideline adherence.

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kufre Joseph Okop ◽  
Kathy Murphy ◽  
Estelle Victoria Lambert ◽  
Kiya Kedir ◽  
Hailemichael Getachew ◽  
...  

Abstract Background In sub-Saharan Africa (SSA), which experiences a disproportionately high cardiovascular disease (CVD) burden, population-based screening and prevention measures are hampered by low levels of knowledge about CVD and associated risk factors, and inaccurate perceptions of severity of risk. Methods This protocol describes the planned processes for implementing community-driven participatory research, using a citizen science method to explore CVD risk perceptions and to develop community-specific advocacy and prevention strategies in the rural and urban SSA settings. Multi-disciplinary research teams in four selected African countries will engage with and train community members living in rural and urban communities as citizen scientists to facilitate conceptualization, co-designing of research, data gathering, and co-creation of knowledge that can lead to a shared agenda to support collaborative participation in community-engaged science. The emphasis is on robust community engagement, using mobile technology to support data gathering, participatory learning, and co-creation of knowledge and disease prevention advocacy. Discussion Contextual processes applied and lessons learned in specific settings will support redefining or disassembling boundaries in participatory science to foster effective implementation of sustainable prevention intervention programmes in Low- and Middle-income countries.


Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Neema Toto ◽  
Elaine Douglas ◽  
Markus Gmeiner ◽  
Lynn K. Barrett ◽  
Robert Lindblad ◽  
...  

Author(s):  
Herbert G. Masigati ◽  
Grant W. Potter ◽  
Masahiro J. Morikawa ◽  
Rashid S. Mfaume

Background: Rural hospitals in sub-Saharan Africa suffer from numerous disparities in resources and practices, and subsequently patient care is affected.Methods: In order to assess current practices and opportunities for improvement in pulse oximetry use and patient-care handoffs, a cross-sectional survey was administered to clinicians at a referral level hospital serving a large rural area in Shinyanga, Tanzania.Results: Respondents (n=46) included nurses (50%), medical doctors (48%), and clinical officers (2%). A response rate of 92% was achieved, and 81% of clinicians acknowledged routine difficulties in the use of current devices when obtaining pulse oximetry. Although 83% of respondents reported using a written handoff at shift change, information reporting was inconsistent and rarely included specific management guidance.Conclusions: Further research is needed to elucidate handoff practices in developing settings, but there is a large opportunity for novel point-of-care devices and tools to improve both pulse oximetry use and patient care handoffs in rural Africa.


Author(s):  
Yianna Vovides ◽  
Kristine Korhumel

This chapter describes the conceptualization and implementation of a cyberlearning environment as a community of inquiry (CoI). This environment includes 13 medical schools from Sub-Saharan Africa and their 50-plus partners from around the world. The theoretical foundations of Communities of Inquiry provided the framework that drove the design of the web-based platform used in this project. Through an emphasis on learning from conversations, the resulting cyberlearning environment was designed to foster engagement among faculty, staff, and students of the 13 medical schools and their partners. Recognizing that generating a virtual community of inquiry framed around the cognitive, social, and teaching presence is no easy task, the approach taken for the design was based on conceptualizing the development of such a community along a continuum that addressed the depth of interaction for each presence. This type of design assumes a phased-in implementation. The chapter describes this conceptualization by addressing the core communication strategy used, which underlies the interactions to support learning from conversations. In addition, the chapter addresses key environmental constraints and how these constraints guided operational decisions during implementation. In addition, the chapter discusses challenges and solutions, as well as lessons learned.


2016 ◽  
pp. 1208-1227
Author(s):  
Monica Gray

Diarrhea is the second leading cause of death and is the major cause of malnutrition in children under age 5 worldwide. More than 50 percent of the cases occur in developing countries, particularly in sub-Saharan Africa and Southeast Asia. Open defecation, substandard fecal disposal systems, and contaminated water supplies are the typical causes of diarrheal diseases. This public health crisis in low income countries mirrors the experiences of today's industrialized nations two centuries ago. The lessons learned from their sanitary evolution can be instructive in charting a sustainable path towards saving the lives of almost 2 million children annually. In this chapter a case study of Cuba's sanitary reformation is also presented to showcase successes, similar to those of developed countries, within a developing country and economically challenging context.


2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Milena Foerster ◽  
Benjamin O. Anderson ◽  
Fiona McKenzie ◽  
Moses Galukande ◽  
Angelica Anele ◽  
...  

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