scholarly journals Staff Perspectives Toward Challenges in a Newly Established Cancer Center in Tanzania: A Qualitative Study

2019 ◽  
pp. 1-8
Author(s):  
Zainab Alwash ◽  
Oliver Henke ◽  
Furaha Serventi ◽  
Eva Johanna Kantelhardt
Keyword(s):  
Health Care ◽  
Low Income ◽  
Health Care Professionals ◽  
Qualitative Content Analysis ◽  
Low Income Countries ◽  
Health Concern ◽  
Cancer Center ◽  
Health Seeking ◽  
Training And Education ◽  
The Government

PURPOSE Cancer is a growing public health concern in low-income countries (LICs). From 14 million new patient cases identified worldwide each year, 8 million are diagnosed in LICs. The fatality rate is 75% in LICs compared with 46% in high-income countries. Causes are low literacy levels, lack of awareness and knowledge about cancer, and limited education of health care professionals that leads to late detection and diagnosis. In Tanzania, cancer incidence will double to 60,000 in 2030. The referral hospital of Northern Tanzania established a new cancer unit in December 2016 to meet these needs. However, there is limited knowledge about perceptions of health care professionals toward cancer care in LICs. This study aims to understand attitudes and perspectives of those professionals and the treatment-related challenges in a newly established center to assist future efforts in this field. METHODS A qualitative method approach using in-depth interviews was chosen to achieve inductive conceptualization. Analysis of data was performed according to qualitative content analysis. RESULTS Eleven interviews were conducted. Five main categories were found: training and education of staff, availability of financial support, challenges in management, interests in future developments, and job satisfaction. Subcategories elaborated in more detail within the main categories. CONCLUSION Limitations in staffing, training, and education were major concerns. The importance of sustainable funding and the needed cooperation of the government with international aid were identified as key points. The involvement of different stakeholders requires guidance by health care management. Health care professionals expressed their satisfaction with the possibilities of treating cancer and the rewarding feedback from patients. Misconceptions and poor knowledge by patients were mentioned as reasons for delayed health-seeking behavior. Screening and awareness programs were seen as useful interventions.

Formal assessment of teamwork among cancer health care professionals in 3 large tertiary centers in Nigeria.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18126-e18126 ◽  
Author(s):  
Abiola Falilat Ibraheem ◽  
Olutosin Alaba Awolude ◽  
Myhammad-yaqub Murtazha Habeebu ◽  
Anthonia Chima Sowunmi ◽  
Popoola Abiodun Olaniyi ◽  
...  
Keyword(s):  
Health Care ◽  
Low Income ◽  
Health Care Professionals ◽  
Cancer Care ◽  
Developing World ◽  
Low Income Countries ◽  
Major Barrier ◽  
Optimal Outcomes ◽  
Quality Cancer Care ◽  
Key Stakeholders

e18126 Background: Cancer is fast becoming a common cause of death in developing world. Over the last decade, there have been strategies to bring quality cancer care to underserved patients around the world. In low-income countries, poor utilization of principles of teamwork is a major barrier to achieving quality services. The intent of this study is to assess teamwork as perceived by the health care workers caring for cancer patients Methods: We conducted a survey among health care professionals involved in cancer care in 3 tertiary centers in the southwestern part of Nigeria from July to November 2016. Respondents rated teamwork using the previously validated ÒSafety Attitudes QuestionnaireÓ. For this analysis we focused on the teamwork climate subscale. This subscale is scored on a scale of 0-100 with mean (SD) values,in US ambulatory population of 69.7 (17). We compared ratings by professionals using analysis of variance Results: Overall 373 professionals completed the survey: Physicians (47%), nurses (14%), pharmacists (6%) and others (33%). Some results are shown in table Conclusions: Cancer care is complex and depends on teamwork amongst health care professionals to achieve optimal outcomes. While overall teamwork scores was consistent with US ambulatory studies , there are important variations that provide targets for intervention. Physicians rated teamwork poorly both intra and inter professionally. Pharmacists rated inter professional teamwork with nurses particularly poorly. Further data on additional subscales of the instrument and by individual centers will be presented. Efforts to transform cancer care need to focus on building trust among the key stakeholders. This is true in developing world where there is a need to maximize the use of limited resources to improve patient outcomes. [Table: see text]

scholarly journals Perceptions of Child Body Size and Health Care Seeking for Undernourished Children in Southern Malawi

2016 ◽  
Vol 26 (14) ◽  
pp. 1939-1948 ◽  
Author(s):  
Valerie L. Flax ◽  
Chrissie Thakwalakwa ◽  
Ulla Ashorn
Keyword(s):  
Health Care ◽  
Low Income ◽  
Child Growth ◽  
Low Income Countries ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Health Seeking ◽  
Poor Child ◽  
Child Undernutrition ◽  
Growth Faltering

Child undernutrition affects millions of children globally, but little is known about the ability of adults to detect different types of child undernutrition in low-income countries. We used focused ethnographic methods to understand how Malawian parents and grandparents describe the characteristics they use to identify good and poor child growth, their actual or preferred patterns of health seeking for undernourished children, and the perceived importance of child undernutrition symptoms in relation to other childhood illnesses. Malawians value adiposity rather than stature in assessing child growth. Symptoms of malnutrition, including wasting and edema, were considered the least severe childhood illness symptoms. Parents delayed health care seeking when a child was ill. When they sought care, it was for symptoms such as diarrhea or fever, and they did not recognize malnutrition as the underlying cause. These findings can be used to tailor strategies for preventing and treating growth faltering in Malawian children.

scholarly journals The Need for Expanding Pulmonary Rehabilitation Services

Life ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1236
Author(s):  
Aroub Lahham ◽  
Anne E. Holland
Keyword(s):  
Health Care ◽  
Lung Disease ◽  
Chronic Lung Disease ◽  
Low Income ◽  
Health Care Professionals ◽  
Pulmonary Rehabilitation ◽  
Health Care Systems ◽  
Low Income Countries ◽  
Related Factors ◽  
Care Systems

Pulmonary rehabilitation is a strongly recommended and effective treatment for people with chronic lung disease. However, access to pulmonary rehabilitation is poor. Globally, pulmonary rehabilitation is accessed by less than 3% of people with chronic lung disease. Barriers to referral, uptake and completion of pulmonary rehabilitation are well documented and linked with organizational, practitioner and patient-related factors. Enhancing the knowledge of health care professionals, family carers, and people with chronic lung disease about the program and its benefits produces modest increases in referral and uptake rates, but evidence of the sustainability of such approaches is limited. Additionally, initiatives focusing on addressing organizational barriers to access, such as expanding services and implementing alternative models to the conventional center-based setting, are not yet widely used in clinical practice. The COVID-19 pandemic has highlighted the urgent need for health care systems to deliver pulmonary rehabilitation programs remotely, safely, and efficiently. This paper will discuss the pressing need to address the issue of the low accessibility of pulmonary rehabilitation. It will also highlight the distinctive challenges to pulmonary rehabilitation delivery in rural and remote regions, as well as low-income countries.

Multimorbidity in Mentally Ill People: The Need for a Person-centered Integrated Approach

2015 ◽  
Vol 5 (1) ◽  
pp. 28-33
Author(s):  
Helen Millar ◽  
Mohammed T Abou-Saleh
Keyword(s):  
Health Care ◽  
Low Income ◽  
Mentally Ill ◽  
Health Care Professionals ◽  
Metabolic Diseases ◽  
Medical Condition ◽  
Low Income Countries ◽  
Easy Access ◽  
Chronic Medical Condition ◽  
Model Of Care

 The need for person-centered integrated care is particularly compelling for people who experience multimorbidity. The concept of multimorbidity has attracted increasing interest in the past decade with the recognition of multiple burdens of disease and their escalating costs for the individual and the community. It is evident in clinical practice that multimorbidity has become the norm rather than the exception, occurring in an increasingly younger population particularly in areas of socioeconomic deprivation and in low income countries.  It is now well established that the mentally ill have a markedly reduced life expectancy due to predominantly cardiovascular and metabolic diseases. The combination of a chronic medical condition and a mental health problem presents specific complex challenges for the single disease model of care which continues to prevail as the current delivery system in which health care professionals are trained and operate. The growing evidence and experience for adopting an integrated collaborative person-centered approach demonstrates the need for a more effective model of care which is individualised, and focused on patient engagement to prevent disease and manage multiple conditions systematically. Given the limited resources in our current health care systems, this approach requires innovation and redesign of the system to provide comprehensive person-centered care encompassing early detection, co-ordinated multidisciplinary working across specialities as well as between primary and secondary care with easy access to basic healthy lifestyle care programs. 

scholarly journals Evaluation of diabetic peer support in Malawi

2021 ◽  
Vol 33 (2) ◽  
pp. 108-113
Author(s):  
Henry T Mwakalinga ◽  
Yamikani M Nuka ◽  
Patrick C Banda ◽  
Thuy D Bui
Keyword(s):  
Health Care ◽  
Peer Support ◽  
Health Care Providers ◽  
Low Income ◽  
Self Efficacy ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Health Concern ◽  
Diabetic Patients ◽  
Care Providers

BackgroundType 2 diabetes is a major health concern worldwide and requires urgent attention from health care providers and policy makers. Due to shortage of health care workers in low-income countries, peer support programs have been viewed as a viable option in management of diabetes and have shown to be effective in sub-Saharan Africa. ObjectiveThe aim of this study is to assess and evaluate the Kamuzu Central Hospital (KCH) diabetic peer support program’s (DPSP) impact 4 years after its establishment by assessing knowledge, self-efficacy and behaviours of DPSP members compared to non-members.Methodology This is a cross-sectional study done among diabetic patients attending clinics between 12th August and 25th September 2018 at KCH. Self and interviewer-administered questionnaires (designed based on validated survey instruments) were used. The participants (n=176) were recruited consecutively after consenting. Results Results showed DPSP members were more knowledgeable regarding the effects of skipping meals and sweet juice on blood glucose and conditions not associated with diabetes. In terms of self-efficacy and behaviour changes, DPSP members believe that they are more able to correct hypoglycaemia, to communicate their concerns to health workers and to perform daily foot exam compared to non-members.Conclusion The KCH (Lilongwe) Diabetes Peer Support program has positively impacted its members and should be scaled up to engage all diabetic patients in Malawi. Ongoing training for peer supporters is necessary to update and reinforce management, knowledge and skills, and to ensure fidelity in program implementation.

scholarly journals Experiences of care in the context of payment for performance (P4P) in Tanzania

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Victor Chimhutu ◽  
Marit Tjomsland ◽  
Mwifadhi Mrisho
Keyword(s):  
Health Service ◽  
Low Income ◽  
Health Workers ◽  
Qualitative Content Analysis ◽  
Health Sector ◽  
Governing Committee ◽  
Low Income Countries ◽  
Service Users ◽  
Health Coverage ◽  
The Government

Abstract Background Tanzania is one of many low income countries committed to universal health coverage and Sustainable Development Goals. Despite these bold goals, there is growing concern that the country could be off-track in meeting these goals. This prompted the Government of Tanzania to look for ways to improve health outcomes in these goals and this led to the introduction of Payment for Performance (P4P) in the health sector. Since the inception of P4P in Tanzania a number of impact, cost-effective and process evaluations have been published with less attention being paid to the experiences of care in this context of P4P, which we argue is important for policy agenda setting. This study therefore explores these experiences from the perspectives of health workers, service users and community health governing committee members. Methods A qualitative study design was used to elicit experiences of health workers, health service users and health governing committee members in Rufiji district of the Pwani region in Tanzania. The Payment for Performance pilot was introduced in Pwani region in 2011 and data presented in this article is based on this pilot. A total of 31 in-depth interviews with health workers and 9 focus group discussions with health service users and health governing committee members were conducted. Collected data was analysed through qualitative content analysis. Results Study informants reported positive experiences with Payment for Performance and highlighted its potential in improving the availability, accessibility, acceptability and quality of care (AAAQ). However, the study found that persistent barriers for achieving AAAQ still exist in the health system of Tanzania and these contribute to negative experiences of care in the context of P4P. Conclusion Our findings suggest that there are a number of positive aspects of care that can be improved by Payment for Performance. However its targeted nature on specific services means that these improvements cannot be generalized at health facility level. Additionally, health workers can go as far as they can in improving health services but some factors that act as barriers as demonstrated in this study are out of their control even in the context of Payment for Performance. In this regard there is need to exercise caution when implementing such initiatives, despite seemingly positive targeted outcomes.

scholarly journals Using Prospective Methods to Identify Fieldwork Locations Favourable to Understanding Divergences in Health Care Accessibility

2021 ◽  
Vol 10 (8) ◽  
pp. 506
Author(s):  
Jan Ketil Rød ◽  
Arne H. Eide ◽  
Thomas Halvorsen ◽  
Alister Munthali
Keyword(s):  
Health Care ◽  
Low Income ◽  
Access To Health Care ◽  
Health Care Services ◽  
Good Health ◽  
Low Income Countries ◽  
Care Services ◽  
Health Care Accessibility ◽  
Barriers To Health ◽  
Walking Time

Central to this article is the issue of choosing sites for where a fieldwork could provide a better understanding of divergences in health care accessibility. Access to health care is critical to good health, but inhabitants may experience barriers to health care limiting their ability to obtain the care they need. Most inhabitants of low-income countries need to walk long distances along meandering paths to get to health care services. Individuals in Malawi responded to a survey with a battery of questions on perceived difficulties in accessing health care services. Using both vertical and horizontal impedance, we modelled walking time between household locations for the individuals in our sample and the health care centres they were using. The digital elevation model and Tobler’s hiking function were used to represent vertical impedance, while OpenStreetMap integrated with land cover map were used to represent horizontal impedance. Combining measures of walking time and perceived accessibility in Malawi, we used spatial statistics and found spatial clusters with substantial discrepancies in health care accessibility, which represented fieldwork locations favourable for providing a better understanding of barriers to health access.

scholarly journals Will Households Invest in Safe Sanitation? Results from an Experimental Demand Trial in Nakuru, Kenya

2021 ◽  
Vol 18 (9) ◽  
pp. 4462
Author(s):  
Rachel Peletz ◽  
Caroline Delaire ◽  
Joan Kones ◽  
Clara MacLeod ◽  
Edinah Samuel ◽  
...  
Keyword(s):  
Low Income ◽  
Low Income Countries ◽  
Health Concern ◽  
High Quality ◽  
Market Prices ◽  
Price Point ◽  
Improved Sanitation ◽  
Sanitation Infrastructure ◽  
The City ◽  
Experimental Demand

Unsafe sanitation is an increasing public health concern for rapidly expanding cities in low-income countries. Understanding household demand for improved sanitation infrastructure is critical for planning effective sanitation investments. In this study, we compared the stated and revealed willingness to pay (WTP) for high-quality, pour-flush latrines among households in low-income areas in the city of Nakuru, Kenya. We found that stated WTP for high-quality, pour-flush latrines was much lower than market prices: less than 5% of households were willing to pay the full costs, which we estimated between 87,100–82,900 Kenyan Shillings (KES), or 871–829 USD. In addition, we found large discrepancies between stated and revealed WTP. For example, 90% of households stated that they would be willing to pay a discounted amount of 10,000 KES (100 USD) for a high-quality, pour-flush latrine, but only 10% of households redeemed vouchers at this price point (paid via six installment payments). Households reported that financial constraints (i.e., lack of cash, other spending priorities) were the main barriers to voucher redemption, even at highly discounted prices. Our results emphasize the importance of financial interventions that address the sizable gaps between the costs of sanitation products and customer demand among low-income populations.

scholarly journals Results From Screening Immigrants of Low‐Income Countries: Data From a Public Primary Health Care

2014 ◽  
Vol 21 (2) ◽  
pp. 92-98 ◽  
Author(s):  
Olga Hladun ◽  
Albert Grau ◽  
Esther Esteban ◽  
Josep M. Jansà
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Low Income ◽  
Low Income Countries ◽  
Primary Health

scholarly journals Breast Cancer in Low- and Middle-Income Countries: An Emerging and Challenging Epidemic

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Arafat Tfayli ◽  
Sally Temraz ◽  
Rachel Abou Mrad ◽  
Ali Shamseddine
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Low Income ◽  
Therapeutic Interventions ◽  
Low Income Countries ◽  
Middle Income ◽  
Major Health ◽  
Middle Income Countries ◽  
Low And Middle Income

Breast cancer is a major health care problem that affects more than one million women yearly. While it is traditionally thought of as a disease of the industrialized world, around 45% of breast cancer cases and 55% of breast cancer deaths occur in low and middle income countries. Managing breast cancer in low income countries poses a different set of challenges including access to screening, stage at presentation, adequacy of management and availability of therapeutic interventions. In this paper, we will review the challenges faced in the management of breast cancer in low and middle income countries.

Sign in / Sign up

Export Citation Format

Share Document