scholarly journals Research protocol for a mixed-methods study to characterise and address the socioeconomic impact of accessing TB diagnosis and care in Nepal

2020 ◽  
Vol 5 ◽  
pp. 19
Author(s):  
Kritika Dixit ◽  
Bhola Rai ◽  
Tara Prasad Aryal ◽  
Gokul Mishra ◽  
Noemia Teixeira de Siqueira-Filha ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Low Income ◽  
Group Discussion ◽  
Mixed Methods Study ◽  
Low Income Countries ◽  
Socioeconomic Impact ◽  
Poverty Level ◽  
Tb Treatment ◽  
Scientific Meetings ◽  
National Workshop

Background: WHO’s 2015 End TB Strategy advocates social and economic (socioeconomic) support for TB-affected households to improve TB control. However, evidence concerning socioeconomic support for TB-affected households remains limited, especially in low-income countries. Protocol: This mixed-methods study in Nepal will: evaluate the socioeconomic impact of accessing TB diagnosis and care (Project 1); and create a shortlist of feasible, locally-appropriate interventions to mitigate this impact (Project 2). The study will be conducted in the Chitwan, Mahottari, Makawanpur, and Dhanusha districts of Nepal, which have frequent TB and poverty. The study population will include: approximately 200 people with TB (Cases) starting TB treatment with Nepal’s National TB Program and 100 randomly-selected people without TB (Controls) in the same sites (Project 1); and approximately 40 key in-country stakeholders from Nepal including people with TB, community leaders, and TB healthcare professionals (Project 2). During Project 1, visits will be made to people with TB’s households during months 3 and 6 of TB treatment, and a single visit made to Control households. During visits, participants will be asked about: TB-related costs (if receiving treatment), food insecurity, stigma; TB-related knowledge; household poverty level; social capital; and quality of life. During Project 2, stakeholders will be invited to participate in: a survey and focus group discussion (FGD) to characterise socioeconomic impact, barriers and facilitators to accessing and engaging with TB care in Nepal; and a one-day workshop to review FGD findings and suggest interventions to mitigate the barriers identified. Ethics and dissemination: The study has received ethical approval. Results will be disseminated through scientific meetings, open access publications, and a national workshop in Nepal.  Conclusions: This research will strengthen understanding of the socioeconomic impact of TB in Nepal and generate a shortlist of feasible and locally-appropriate socioeconomic interventions for TB-affected households for trial evaluation.

scholarly journals Research protocol for a mixed-methods study to characterise and address the socioeconomic impact of accessing TB diagnosis and care in Nepal

2020 ◽  
Vol 5 ◽  
pp. 19
Author(s):  
Kritika Dixit ◽  
Bhola Rai ◽  
Tara Prasad Aryal ◽  
Gokul Mishra ◽  
Noemia Teixeira de Siqueira-Filha ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Low Income ◽  
Group Discussion ◽  
Mixed Methods Study ◽  
Low Income Countries ◽  
Socioeconomic Impact ◽  
Poverty Level ◽  
Tb Treatment ◽  
Scientific Meetings ◽  
National Workshop

Background: WHO’s 2015 End TB Strategy advocates social and economic (socioeconomic) support for TB-affected households to improve TB control. However, evidence concerning socioeconomic support for TB-affected households remains limited, especially in low-income countries. Protocol: This mixed-methods study in Nepal will: evaluate the socioeconomic impact of accessing TB diagnosis and care (Project 1); and create a shortlist of feasible, locally-appropriate interventions to mitigate this impact (Project 2). The study will be conducted in the Chitwan, Mahottari, Makawanpur, and Dhanusha districts of Nepal, which have frequent TB and poverty. The study population will include: approximately 200 people with TB (Cases) starting TB treatment with Nepal’s National TB Program and 100 randomly-selected people without TB (Controls) in the same sites (Project 1); and approximately 40 key in-country stakeholders from Nepal including people with TB, community leaders, and TB healthcare professionals (Project 2). During Project 1, visits will be made to people with TB’s households during months 3 and 6 of TB treatment, and a single visit made to Control households. During visits, participants will be asked about: TB-related costs (if receiving treatment), food insecurity, stigma; TB-related knowledge; household poverty level; social capital; and quality of life. During Project 2, stakeholders will be invited to participate in: a survey and focus group discussion (FGD) to characterise socioeconomic impact, barriers and facilitators to accessing and engaging with TB care in Nepal; and a one-day workshop to review FGD findings and suggest interventions to mitigate the barriers identified. Ethics and dissemination: The study has received ethical approval. Results will be disseminated through scientific meetings, open access publications, and a national workshop in Nepal.  Conclusions: This research will strengthen understanding of the socioeconomic impact of TB in Nepal and generate a shortlist of feasible and locally-appropriate socioeconomic interventions for TB-affected households for trial evaluation.

scholarly journals Global PRoMiSe (Perioperative Recommendations for Medication Safety): protocol for a mixed-methods study

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e038313
Author(s):  
Karen C Nanji ◽  
Alan Forbes Merry ◽  
Sofia D Shaikh ◽  
Christina Pagel ◽  
Hao Deng ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Low Income ◽  
Medication Safety ◽  
Massachusetts General Hospital ◽  
Perioperative Period ◽  
Income Group ◽  
Mixed Methods Study ◽  
Low Income Countries ◽  
Research Committee ◽  
Dissemination Strategy

IntroductionMedication errors (MEs), which occur commonly in the perioperative period, have the potential to cause patient harm or death. Many published recommendations exist for preventing perioperative MEs; however, many of these recommendations conflict and are often not applicable to middle-income and low-income countries. The goal of this study is to develop and disseminate consensus-based recommendations for perioperative medication safety that are tailored to country income level.Methods and analysisThe primary site of this mixed-methods study is Massachusetts General Hospital/Harvard Medical School. Participants include a minimum of 108 international medication safety experts, 27 from each of the World Bank’s four country income groups (high, upper-middle, lower-middle and low-income). Using the Delphi method, participants will rate the appropriateness of candidate medication safety recommendations by completing online surveys using RedCAP. We will use Condorcet ranking methods to prioritise the final recommendations for each country income group. We will execute a comprehensive dissemination strategy for the recommendations across each country income group. Finally, we will conduct semistructured interviews with our participants to evaluate the initial adoption and implementation of the recommendations in each country income group.Ethics and disseminationThis study was approved by the Human Research Committee/Institutional Review Board at Partners Healthcare (2019P003567). Findings will be published in peer-reviewed journals and presented at local and international conferences.Trial registration numberNCT04240301.

scholarly journals Drowning among fishing communities on the Tanzanian shore of lake Victoria: a mixed-methods study to examine incidence, risk factors and socioeconomic impact

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032428 ◽  
Author(s):  
Hilary S Whitworth ◽  
Joyce Pando ◽  
Christian Hansen ◽  
Natasha Howard ◽  
Amen Moshi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mixed Methods ◽  
Lake Victoria ◽  
Family Members ◽  
Significant Risk ◽  
Mixed Methods Study ◽  
Sensitivity Analyses ◽  
Socioeconomic Impact ◽  
Fishing Communities ◽  
Socioeconomic Impacts

ObjectivesTo estimate the incidence of unintentional fatal drowning and describe associated risk factors among Lake Victoria fishing communities, and to assess perceived social, financial and other impacts among families and colleagues of persons who drowned.DesignA retrospective, observational mixed-methods study, conducted between September 2017 and February 2018.SettingEight Tanzanian fishing communities on Lake Victoria.ParticipantsPersons who drowned in the preceding 24 months were identified using an extensive community networking approach. Adult family members, colleagues or community members familiar with the habits and behaviours of people who drowned and/or circumstances of drowning incidents participated in surveys (n=44) and in-depth interviews (n=22).Main outcome measuresPooled drowning incidence, with sensitivity analyses allowing for uncertainties in population estimates. Risk factors were identified through the evaluation of behavioural characteristics of persons who drowned and circumstances of drowning incidents. Perceived socioeconomic impacts were assessed through semi-structured interviews with their family members and colleagues.ResultsThe estimated drowning incidence was 217/100 000 person-years (95% CI 118 to 425/100 000). Of 86 victims identified, 70 (81%) were fishermen (79% aged 18–40 years; all men) and 9 were children (all ≤10 years). All deaths occurred in the lake. Most adults (65/77; 84%) were fishing from a boat when they drowned; 57/77 (74%) died in the evening (from ~5 pm) or at night. Six children (67%) drowned while swimming/playing at the lakeshore unsupervised. Few victims (2/86; 2%) were wearing a life jacket at the time of death. Reported socioeconomic impacts of these deaths ranged from income loss to family break-up.ConclusionsDrowning is a significant risk in Tanzanian lakeside fishing communities, with estimated mortality exceeding national incidence rates of fatal malaria, tuberculosis or HIV, but preventative strategies appear uncommon. Socioeconomic impact at the family level may be substantial. Intervention strategies are required to reduce the drowning burden among this neglected at-risk population.

scholarly journals The burden of drug resistant tuberculosis in a predominantly nomadic population in Uganda: a mixed methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Brenda Nakafeero Simbwa ◽  
Achilles Katamba ◽  
Elizabeth B. Katana ◽  
Eva A. O. Laker ◽  
Sandra Nabatanzi ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Low Income ◽  
Conditional Logistic Regression ◽  
Drug Resistant ◽  
Cross Sectional ◽  
Drug Resistant Tuberculosis ◽  
Public Health Burden ◽  
Factors Associated ◽  
Tb Treatment ◽  
Resistant Tuberculosis

Abstract Background Emergence of drug resistant tuberculosis (DR-TB) has aggravated the tuberculosis (TB) public health burden worldwide and especially in low income settings. We present findings from a predominantly nomadic population in Karamoja, Uganda with a high-TB burden (3500 new cases annually) and sought to determine the prevalence, patterns, factors associated with DR-TB. Methods We used mixed methods of data collection. We enrolled 6890 participants who were treated for tuberculosis in a programmatic setting between January 2015 and April 2018. A cross sectional study and a matched case control study with conditional logistic regression and robust standard errors respectively were used to the determine prevalence and factors associated with DR-TB. The qualitative methods included focus group discussions, in-depth interviews and key informant interviews. Results The overall prevalence of DR-TB was 41/6890 (0.6%) with 4/64,197 (0.1%) among the new and 37/2693 (1.4%) among the previously treated TB patients respectively. The drug resistance patterns observed in the region were mainly rifampicin mono resistant (68.3%) and Multi Drug-Resistant Tuberculosis (31.7%). Factors independently associated with DR-TB were previous TB treatment, adjusted odds ratio (aOR) 13.070 (95%CI 1.552–110.135) and drug stock-outs aOR 0.027 (95%CI 0.002–0.364). The nomadic lifestyle, substance use, congested homesteads and poor health worker attitudes were a great challenge to effective treatment of TB. Conclusion Despite having the highest national TB incidence, Karamoja still has a low DR-TB prevalence. Previous TB treatment and drug stock outs were associated with DR-TB. Regular supply of anti TB medications and health education may help to stem the burden of TB disease in this nomadic population.

scholarly journals Early Childhood Junk Food Consumption, Severe Dental Caries, and Undernutrition: A Mixed-Methods Study from Mumbai, India

2020 ◽  
Vol 17 (22) ◽  
pp. 8629
Author(s):  
Priyanka Athavale ◽  
Nehaa Khadka ◽  
Shampa Roy ◽  
Piyasree Mukherjee ◽  
Deepika Chandra Mohan ◽  
...  
Keyword(s):  
Early Childhood ◽  
Mixed Methods ◽  
Oral Health ◽  
Focus Groups ◽  
Low Income ◽  
Mixed Methods Study ◽  
Maternal Child Health ◽  
Junk Food ◽  
Sugary Drinks ◽  
Maternal Child

In India, globalization has caused a nutrition transition from home-cooked foods to processed sugary snacks and drinks, contributing to increased early childhood caries (ECC). This mixed-methods study describes risk factors for ECC and associations with undernutrition in low-income communities in Mumbai. Interviews with mothers of 959 children, ages six-months through six-years, addressed maternal-child nutrition and oral health, and children received dental exams and anthropometric assessments. Focus groups with community health workers and mothers explored experiences and perceptions of oral health, nutrition, and ECC. Descriptive and logistic regression analyses of quantitative data, and content analysis of qualitative data were performed. Eighty percent of children lived 5 min from a junk-food store, over 50% consumed junk-food and sugary tea daily, 50% experienced ECC, 19% had severe deep tooth decay, 27% experienced mouth pain, and 56% experienced chronic and/or acute malnutrition. In children ages 3–6, each additional tooth with deep decay was associated with increased odds of undernutrition (Odds Ratio [OR] 1.10, Confidence Interval [CI] 1.02–1.21). Focus groups identified the junk-food environment, busy family life, and limited dental care as contributors to ECC. Policy interventions include limits on junk-food marketing and incorporating oral health services and counseling on junk-food/sugary drinks into maternal–child health programs.

Sign in / Sign up

Export Citation Format

Share Document