scholarly journals Standard operating procedures improve acute neurologic care in a sub-Saharan African setting

Neurology ◽  
2017 ◽  
Vol 89 (2) ◽  
pp. 144-152 ◽  
Author(s):  
Lamin E.S. Jaiteh ◽  
Stefan A. Helwig ◽  
Abubacarr Jagne ◽  
Andreas Ragoschke-Schumm ◽  
Catherine Sarr ◽  
...  
Keyword(s):  
Emergency Management ◽  
Low Cost ◽  
Intervention Group ◽  
Vital Signs ◽  
Standard Operating Procedures ◽  
Sub Saharan Africa ◽  
Standard Operating ◽  
Sub Saharan ◽  
Neurologic Emergency

Objective:Quality of neurologic emergency management in an under-resourced country may be improved by standard operating procedures (SOPs).Methods:Neurologic SOPs were implemented in a large urban (Banjul) and a small rural (Brikama) hospital in the Gambia. As quality indicators of neurologic emergency management, performance of key procedures was assessed at baseline and in the first and second implementation years.Results:At Banjul, 100 patients of the first-year intervention group exhibited higher rates of general procedures of emergency management than 105 control patients, such as neurologic examination (99.0% vs 91.4%; p < 0.05) and assessments of respiratory rate (98.0% vs 81.9%, p < 0.001), temperature (60.0% vs 36.2%; p < 0.001), and glucose levels (73.0% vs 58.1%; p < 0.05), in addition to written directives by physicians (96.0% vs 88.6%, p < 0.05), whereas assessments of other vital signs remained unchanged. In stroke patients, rates of stroke-related procedures increased: early CT scanning (24.3% vs 9.9%; p < 0.05), blood count (73.0% vs 49.3%; p < 0.01), renal and liver function tests (50.0% vs 5.6%, p < 0.001), aspirin prophylaxis (47.3% vs 9.9%; p < 0.001), and physiotherapy (41.9% vs 4.2%; p < 0.001). Most effects persisted until the second-year evaluation. SOP implementation was similarly feasible and beneficial at the Brikama hospital. However, outcomes did not significantly differ in the hospitals.Conclusions:Implementing SOPs is a realistic, low-cost option for improving process quality of neurologic emergency management in under-resourced settings.Classification of evidence:This study provides Class IV evidence that, for patients with suspected neurologic emergencies in sub-Saharan Africa, neurologic SOPs increase the rate of performance of guideline-recommended procedures.

scholarly journals Positioning for success: building capacity in academic competencies for early-career researchers in sub-Saharan Africa

2019 ◽  
Vol 6 ◽  
Author(s):  
C. Merritt ◽  
H. Jack ◽  
W. Mangezi ◽  
D. Chibanda ◽  
M. Abas
Keyword(s):  
Mental Health ◽  
Capacity Building ◽  
Low Cost ◽  
Early Career ◽  
Sub Saharan Africa ◽  
Training Experience ◽  
African Countries ◽  
Early Career Researchers ◽  
Academic Competencies ◽  
Sub Saharan

Background. Capacity building is essential in low- and middle-income countries (LMICs) to address the gap in skills to conduct and implement research. Capacity building must not only include scientific and technical knowledge, but also broader competencies, such as writing, disseminating research and achieving work–life balance. These skills are thought to promote long-term career success for researchers in high-income countries (HICs) but the availability of such training is limited in LMICs. Methods. This paper presents the contextualisation and implementation of the Academic Competencies Series (ACES). ACES is an early-career researcher development programme adapted from a UK university. Through consultation between HIC and LMIC partners, an innovative series of 10 workshops was designed covering themes of self-development, engagement and writing skills. ACES formed part of the African Mental Health Research Initiative (AMARI), a multi-national LMIC-led consortium to recruit, train, support and network early-career mental health researchers from four sub-Saharan African countries. Results. Of the 10 ACES modules, three were HIC-LMIC co-led, four led by HIC facilitators with LMIC training experience and three led by external consultants from HICs. Six workshops were delivered face to face and four by webinar. Course attendance was over 90% and the delivery cost was approximately US$4500 per researcher trained. Challenges of adaptation, attendance and technical issues are described for the first round of workshops. Conclusions. This paper indicates that a skills development series for early-career researchers can be contextualised and implemented in LMIC settings, and is feasible for co-delivery with local partners at relatively low cost.

scholarly journals The BabySaver: Design of a New Device for Neonatal Resuscitation at Birth with Intact Placental Circulation

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 526
Author(s):  
James Ditai ◽  
Aisling Barry ◽  
Kathy Burgoine ◽  
Anthony K. Mbonye ◽  
Julius N. Wandabwa ◽  
...  
Keyword(s):  
Low Cost ◽  
Neonatal Resuscitation ◽  
Sub Saharan Africa ◽  
Skilled Birth Attendants ◽  
New Device ◽  
Birth Attendants ◽  
Premature Babies ◽  
Sub Saharan ◽  
The Uk ◽  
The University

The initial bedside care of premature babies with an intact cord has been shown to reduce mortality; there is evidence that resuscitation of term babies with an intact cord may also improve outcomes. This process has been facilitated by the development of bedside resuscitation surfaces. These new devices are unaffordable, however, in most of sub-Saharan Africa, where 42% of the world’s 2.4 million annual newborn deaths occur. This paper describes the rationale and design of BabySaver, an innovative low-cost mobile resuscitation unit, which was developed iteratively over five years in a collaboration between the Sanyu Africa Research Institute (SAfRI) in Uganda and the University of Liverpool in the UK. The final BabySaver design comprises two compartments; a tray to provide a firm resuscitation surface, and a base to store resuscitation equipment. The design was formed while considering contextual factors, using the views of individual women from the community served by the local hospitals, medical staff, and skilled birth attendants in both Uganda and the UK.

scholarly journals Quality of care in the free maternal healthcare era in sub-Saharan Africa: a scoping review of providers’ and managers’ perceptions

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Monica Ansu-Mensah ◽  
Frederick Inkum Danquah ◽  
Vitalis Bawontuo ◽  
Peter Ansu-Mensah ◽  
Tahiru Mohammed ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Research Question ◽  
Healthcare Providers ◽  
Poor Quality ◽  
Sub Saharan Africa ◽  
Healthcare Financing ◽  
Maternal Healthcare ◽  
Sub Saharan ◽  
The Impact

Abstract Background Free maternal healthcare financing schemes play an essential role in the quality of services rendered to clients during antenatal care in sub-Saharan Africa (SSA). However, healthcare managers’ and providers’ perceptions of the healthcare financing scheme may influence the quality of care. This scoping review mapped evidence on managers’ and providers’ perspectives of free maternal healthcare and the quality of care in SSA. Methods We used Askey and O’Malley’s framework as a guide to conduct this review. To address the research question, we searched PubMed, CINAHL through EBSCOhost, ScienceDirect, Web of Science, and Google Scholar with no date limitation to May 2019 using keywords, Boolean terms, and Medical Subject Heading terms to retrieve relevant articles. Both abstract and full articles screening were conducted independently by two reviewers using the inclusion and exclusion criteria as a guide. All significant data were extracted, organized into themes, and a summary of the findings reported narratively. Results In all, 15 out of 390 articles met the inclusion criteria. These 15 studies were conducted in nine countries. That is, Ghana (4), Kenya (3), and Nigeria (2), Burkina Faso (1), Burundi (1), Niger (1), Sierra Leone (1), Tanzania (1), and Uganda (1). Of the 15 included studies, 14 reported poor quality of maternal healthcare from managers’ and providers’ perspectives. Factors contributing to the perception of poor maternal healthcare included: late reimbursement of funds, heavy workload of providers, lack of essential drugs and stock-out of medical supplies, lack of policy definition, out-of-pocket payment, and inequitable distribution of staff. Conclusion This study established evidence of existing literature on the quality of care based on healthcare providers’ and managers’ perspectives though very limited. This study indicates healthcare providers and managers perceive the quality of maternal healthcare under the free financing policy as poor. Nonetheless, the free maternal care policy is very much needed towards achieving universal health, and all efforts to sustain and improve the quality of care under it must be encouraged. Therefore, more research is needed to better understand the impact of their perceived poor quality of care on maternal health outcomes.

scholarly journals Aging, Health, and Quality of Life for Older People Living With HIV in Sub-Saharan Africa: A Review and Proposed Conceptual Framework

2017 ◽  
Vol 31 (1) ◽  
pp. 109-138 ◽  
Author(s):  
Mark J. Siedner
Keyword(s):  
Quality Of Life ◽  
Conceptual Framework ◽  
Care Delivery ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Sub Saharan ◽  
Living With Hiv ◽  
The Impact

Objective: The number of people living with HIV (PLWH) over 50 years old in sub-Saharan Africa is predicted to triple in the coming decades, to 6-10 million. Yet, there is a paucity of data on the determinants of health and quality of life for older PLWH in the region. Methods: A review was undertaken to describe the impact of HIV infection on aging for PLWH in sub-Saharan Africa. Results: We (a) summarize the pathophysiology and epidemiology of aging with HIV in resource-rich settings, and (b) describe how these relationships might differ in sub-Saharan Africa, (c) propose a conceptual framework to describe determinants of quality of life for older PLWH, and (d) suggest priority research areas needed to ensure long-term gains in quality of life for PLWH in the region. Conclusions: Differences in traditional, lifestyle, and envirnomental risk factors, as well as unique features of HIV epidemiology and care delivery appear to substantially alter the contribution of HIV to aging in sub-Saharan Africa. Meanwhile, unique preferences and conceptualizations of quality of life will require novel measurement and intervention tools. An expanded research and public health infrastructure is needed to ensure that gains made in HIV prevention and treamtent are translated into long-term benefits in this region.

scholarly journals Penerapan Standar Operasional Prosedur Pada Klinik Utama Vincentius Kristus Raja Surabaya

2021 ◽  
Vol 13 (2) ◽  
pp. 146-155
Author(s):  
Jeanne Asteria Wawolangi ◽  
Anita Permatasari
Keyword(s):  
Research Study ◽  
Standard Operating Procedures ◽  
Quality Of Services ◽  
Public Health Services ◽  
Clinic Foundation ◽  
Health Clinics ◽  
Standard Operating ◽  
Long Time

Vincentius Kristus Raja (KR) Main Clinic aims to serve patients effectively and economically in an effort to improve the quality of public health services, especially in Surabaya. This type of research is descriptive qualitative in the form of a case study, to assess the implementation of standard operating procedures at the Vincentius Kristus Raja Main Clinic. Relevant data collection was carried out using questionnaires distributed to personnel related to standard operating procedures. The results of the research study according to the questionnaire indicate that the operational implementation is in accordance with the standard operating procedures that have been set based on the policies of the leadership and the Vincentius Kristus Raja Main Clinic Foundation. Compliance with standard operating procedures is very important because standard operating procedures are guidelines or references for carrying out tasks and work in accordance with their functions. The conclusions and suggestions from this study are that although compliance with standard operating procedures is adequate, the Vincentius Kristus Raja Main Clinic needs to develop and improve the quality of services, especially better communication with patients, both new patients and patients who have been on treatment for a long time at the Vincentius Kristus Raja Main Clinic. Considering that there are now many new health clinics that can be competitors for the Vincentius Kristus Raja Main Clinic, there must be a good response to this phenomenon. The emergence of these new competitors requires the Vincentius Kristus Raja Main Clinic to be able to be competitive in order to face the existing competition by improving the quality and quality of service for patients.

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