The Impact of an All-female Healthcare Environment on Mentorship and Empowerment of Female Healthcare Professionals in LMICs

Abstract Background: Low- and middle-income countries (LMICs) have the greatest need for additional healthcare providers, and women outside the workforce could help address the need. Women in healthcare need more mentorship and leadership training to advance their careers. This study evaluates how women working together on a medical team impacts mentorship, leadership and empowerment. Methods: An all-female volunteer team participating in a cleft surgery mission in Oujda, Morocco were surveyed before and after the mission. Responses were analyzed according to country of origin, national gender equality ranking, volunteer role, and prior mentorship experiences. Statistical analysis with student’s t-test or chi-squared were performed with significance defined as p<0.05. Results: 95 female volunteers from 23 countries participated and 85% completed surveys. Volunteers from HICs (32%) and LMICs (68%) had similar mission roles (p=0.58) and duration of volunteerism (p=0.69). Experience as a mission volunteer (p=0.47), team leader (p=0.28), and educator (p=0.18) were equivalent between cohorts. 73% of women had previously received mentorship but 98% wanted more. 75% had previously mentored others, but 97% wanted to be mentors. Over 90% of past mentor-mentee relationships were between women. 73% of volunteers who had no prior mentorship found their first mentor during the mission. All participants found a long-term peer relationship and felt motivated to mentor women at home. All volunteers felt empowered and enjoyed the mission. Over 95% were inspired to pursue leadership positions, advance professionally, and work with other women at home.Conclusion: Female healthcare professionals in HICs and LMICs desire more mentorship than is available. An all-female healthcare environment can provide opportunities for mentorship and create lasting motivation to teach, lead, and advance professionally. Increasing the visibility of female professionals may effectively empower women in healthcare.

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The Impact of an All-Female Healthcare Environment on Mentorship and Empowerment of Female Healthcare Professionals in LMICs

10.21203/rs.3.rs-127292/v1 ◽

2020 ◽

Author(s):

Naikhoba Munabi ◽

Allyn Auslander ◽

Meredith D. Xepoleas ◽

Libby D. Bunker ◽

Kella L. Vangsness ◽

...

Keyword(s):

Healthcare Professionals ◽

Healthcare Providers ◽

Middle Income ◽

Healthcare Environment ◽

Before And After ◽

Chi Squared ◽

Working Together ◽

Student’S T ◽

The Impact ◽

At Home

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The Influence of an All-Female Healthcare Environment on Mentorship and Empowerment of Female Healthcare Professionals

10.21203/rs.3.rs-127292/v2 ◽

2021 ◽

Author(s):

Naikhoba Munabi ◽

Allyn Auslander ◽

Meredith D. Xepoleas ◽

Libby D. Bunker ◽

Kella L. Vangsness ◽

...

Keyword(s):

Healthcare Professionals ◽

Healthcare Providers ◽

Middle Income ◽

Healthcare Environment ◽

Before And After ◽

Chi Squared ◽

Working Together ◽

Student’S T ◽

Female Professionals ◽

At Home

Abstract Background: Low- and middle-income countries (LMICs) have the greatest need for additional healthcare providers, and women outside the workforce help address the need. Women in healthcare historically need more mentorship and leadership training to advance their careers. This study evaluates how women working together on a medical team influences mentorship, leadership and empowerment. Methods: An all-female volunteer team participating in a cleft surgery mission in Oujda, Morocco were surveyed before and after the mission. Responses were analyzed according to country of origin, national gender equality ranking, volunteer role, and prior mentorship experiences. Statistical analysis with student’s t-test or chi-squared were performed with significance defined as p<0.05. Results: 95 female volunteers from 23 countries participated and 85% completed surveys. Volunteers from HICs (32%) and LMICs (68%) had similar mission roles (p=0.58) and duration of volunteerism (p=0.69). Experience as a mission volunteer (p=0.47), team leader (p=0.28), and educator (p=0.18) were equivalent between cohorts. 73% of women had previously received mentorship but 98% wanted more. 75% had previously mentored others, but 97% wanted to be mentors. Over 90% of past mentor-mentee relationships were between women. 73% of volunteers who had no prior mentorship found their first mentor during the mission. All participants found a long-term peer relationship and felt motivated to mentor women at home. All volunteers felt empowered and enjoyed the mission. Over 95% were inspired to pursue leadership positions, advance professionally, and work with other women at home. Conclusion: Our results found that this population of female healthcare professionals in HICs and LMICs overwhelmingly desired more mentorship than is felt to be available. An all-female healthcare environment appears to provide opportunities for mentorship and create lasting motivation to teach, lead, and advance professionally. Increasing the visibility of female professionals may effectively empower women in healthcare.

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Abstract WMP89: Stroke Code De-escalation: Safety and Outcomes

Stroke ◽

10.1161/str.48.suppl_1.wmp89 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Jessica Jarnot ◽

Christopher Streib ◽

Angela Heyer ◽

Amy Reichert ◽

David Anderson ◽

...

Keyword(s):

Chart Review ◽

Healthcare Providers ◽

Retrospective Chart Review ◽

Before And After ◽

Chi Squared ◽

Cost Implications ◽

The Impact ◽

Timely Treatment ◽

Iv Tpa ◽

Missed Opportunity

Introduction: “Stroke codes” (SCs) facilitate the timely treatment of acute ischemic stroke (AIS) with IV tPA or intra-arterial thrombectomy (IAT), but are inherently resource-intensive and can expose patients to unnecessary and potentially harmful interventions. While all healthcare providers are encouraged to activate SCs, this might lead to low SC-to-treatment-ratios (SCTR). We examined the impact of de-escalation of stroke codes (DSCs) on SCTR. Methods: DSCs were initiated in our institution in January 2015. All DSCs were reviewed for the patient’s eligibility for IV tPA or IAT, and reason for de-escalation. We reviewed all stroke codes 12 months before and after the initiation of this process and compared the SCTR by chi-squared testing. Results: In 2014, prior to DSCs, 253 SCs resulted in 22 AIS interventions (22 IV tPA) for a SCTR of 8.7%. In 2015, 348 SCs were activated with 64 subsequent DSCs (18.4%) and 45 AIS interventions (38 IV tPA, 7 IAT, 7 both), for a SCTR of 15.8%. The improvement in SCTR after introducing DSCs was statistically significant (p=0.012). When restricting the analysis to IV tPA interventions alone, there remained a trend (p=0.068) towards improvement in SCTR. Retrospective chart review did not reveal any DSC cases that resulted in missed opportunity for IV TPA or IAT treatment. No DSCs were due to an acute ICH. Justifications for de-escalations are summarized in figure 1. Conclusions: The introduction of DSCs resulted in a statistically significant absolute improvement in SCTR of 7.1%. Importantly, DSCs did not result in any eligible AIS patient forgoing IV tPA or IAT, nor missed ICH. More research is needed to increase the yield of stroke codes, refine the criteria for both activating and de-escalating them, and quantify the resource and cost implications of such de-escalations.

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Experiences and impact of international medical volunteering: a multi-country mixed methods study

BMJ Open ◽

10.1136/bmjopen-2020-041599 ◽

2021 ◽

Vol 11 (3) ◽

pp. e041599 ◽

Cited By ~ 1

Author(s):

Mary McCauley ◽

Joanna Raven ◽

Nynke van den Broek

Keyword(s):

Low Income ◽

Online Survey ◽

Positive Impact ◽

Healthcare Providers ◽

International Medical ◽

Middle Income ◽

Use Of Resources ◽

The Uk ◽

Medical Volunteers ◽

The Impact

ObjectiveTo assess the experience and impact of medical volunteers who facilitated training workshops for healthcare providers in maternal and newborn emergency care in 13 countries.SettingsBangladesh, Ghana, India, Kenya, Malawi, Namibia, Nigeria, Pakistan, Sierra Leone, South Africa, Tanzania, UK and Zimbabwe.ParticipantsMedical volunteers from the UK (n=162) and from low-income and middle-income countries (LMIC) (n=138).Outcome measuresExpectations, experience, views, personal and professional impact of the experience of volunteering on medical volunteers based in the UK and in LMIC.ResultsUK-based medical volunteers (n=38) were interviewed using focus group discussions (n=12) and key informant interviews (n=26). 262 volunteers (UK-based n=124 (47.3%), and LMIC-based n=138 (52.7%)) responded to the online survey (62% response rate), covering 506 volunteering episodes. UK-based medical volunteers were motivated by altruism, and perceived volunteering as a valuable opportunity to develop their skills in leadership, teaching and communication, skills reported to be transferable to their home workplace. Medical volunteers based in the UK and in LMIC (n=244) reported increased confidence (98%, n=239); improved teamwork (95%, n=232); strengthened leadership skills (90%, n=220); and reported that volunteering had a positive impact for the host country (96%, n=234) and healthcare providers trained (99%, n=241); formed sustainable partnerships (97%, n=237); promoted multidisciplinary team working (98%, n=239); and was a good use of resources (98%, n=239). Medical volunteers based in LMIC reported higher satisfaction scores than those from the UK with regards to impact on personal and professional development.ConclusionHealthcare providers from the UK and LMIC are highly motivated to volunteer to increase local healthcare providers’ knowledge and skills in low-resource settings. Further research is necessary to understand the experiences of local partners and communities regarding how the impact of international medical volunteering can be mutually beneficial and sustainable with measurable outcomes.

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CAPACITY BUILDING IN AGENCIES FOR EFFICIENT AND EFFECTIVE HEALTH TECHNOLOGY ASSESSMENT

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462316000490 ◽

2016 ◽

Vol 32 (4) ◽

pp. 292-299 ◽

Cited By ~ 4

Author(s):

Debjani Mueller ◽

Iñaki Gutiérrez-Ibarluzea ◽

Tara Schuller ◽

Marco Chiumente ◽

Jeonghoon Ahn ◽

...

Keyword(s):

Health Technology Assessment ◽

Capacity Building ◽

Technology Assessment ◽

Health Technology ◽

Group Discussions ◽

Middle Income ◽

Working Together ◽

Effective Decision ◽

Effective Decision Making ◽

The Impact

Objectives: Health technology assessment (HTA) yields information that can be ideally used to address deficiencies in health systems and to create a wider understanding of the impact of different policy considerations around technology reimbursement and use. The structure of HTA programs varies across different jurisdictions according to decision-maker needs. Moreover, conducting HTA requires specialized skills. Effective decision making should include multiple criteria (medical, economic, technical, ethical, social, legal, and cultural) and requires multi-disciplinary teams of experts working together to produce these assessments. A workshop explored the multi-disciplinary skills and competencies required to build an effective and efficient HTA team, with a focus on low- and middle-income settings.Methods: This proceeding summarizes main points from a workshop on capacity building, drawing on presentations and group discussions among attendees including different points of view.Results and Conclusions: The workshop and thus this study would have benefited from a larger variety of stakeholders. Therefore, the conclusions arising from the workshop are not the opinion of a representative sample of HTA professionals. Nonetheless, organizations and speakers were carefully selected to provide a valuable approach to this theme. Thus, these proceedings highlight some of the gaps and needs in the education and training programs offered worldwide and calls for further investigation.

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Importance of physiotherapy/nursing multidisciplinary integration about update newborn position in the neonatal intensive care unit

Fisioterapia em Movimento ◽

10.1590/0103-5150.028.003.ao02 ◽

2015 ◽

Vol 28 (3) ◽

pp. 437-445 ◽

Cited By ~ 3

Author(s):

Vanessa da Silva Neves Moreira Arakaki ◽

Alana Monteiro de Oliveira ◽

Trícia Bogossian ◽

Viviane Saraiva de Almeida ◽

Gustavo Dias da Silva ◽

...

Keyword(s):

Intensive Care ◽

Neonatal Intensive Care ◽

Physical Therapist ◽

Body Position ◽

Effective Care ◽

Before And After ◽

Student’S T ◽

The Impact ◽

Clinical Stability

AbstractIntroduction The high-risk newborns may require long periods of hospitalization until they reach clinical stability for hospital discharge. Avoiding babies to be in only one body position may be an effective way to cause respiratory and neuro-psycho-motor benefits, comfort and preventing pressure ulcers.Objectives This study investigated the impact of physiotherapy/nursing integration in update on body positioning of the newborn in the Neonatal Intensive Care Unit.Methods A questionnaire was administered to nurses and nursing technicians of the neonatal unit of Maternity School of UFRJ and nurses of the Advanced Course in Neonatal Nursing from the same institution. Two classes were taught by the physical therapist of the sector and the questions answered before and after these lessons. It was also a brief characterization of professional participants of the study. We used the Student's t test to compare the correct answers before (PRE) and after (POST) the classes, considering p < 0.05.Results There was a significant increase in the degree of knowledge of nurses and nursing technicians when compared the responses before (nurses: 68.8%; technicians: 70.1%) and after classes (nurses: 78.4 %; technicians: 88.9%). The nurses were less than five years of graduated (45%) and little time of professional experience in neonatology (60%). Forty-seven percent of technicians had less than five years of training and 82% had less than 10 years of experience.Conclusion The use of training by the nursing staff was significant, showing the importance of multidisciplinary approach and the integration of knowledge in the search for a humanized and effective care.

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‘It’s a real fine balancing act’: directly employed care workers’ experiences of engaging with health services

International Journal of Care and Caring ◽

10.1332/239788221x16099486601224 ◽

2021 ◽

Author(s):

Jane Wilcock ◽

Jill Manthorpe ◽

Jo Moriarty ◽

Steve Iliffe

Keyword(s):

Health Services ◽

Healthcare Professionals ◽

Healthcare Providers ◽

Well Being ◽

Care Work ◽

Structured Interviews ◽

Care Workers ◽

The Impact ◽

Health And Well Being

Little is known of the experiences of directly employed care workers communicating with healthcare providers about the situations of their employers. We report findings from 30 in-depth semi-structured interviews with directly employed care workers in England undertaken in 2018–19. Findings relate to role content, communication with healthcare professionals and their own well-being. Directly employed care workers need to be flexible about the tasks they perform and the changing needs of those whom they support. Having to take on health liaison roles can be problematic, and the impact of care work on directly employed workers’ own health and well-being needs further investigation.

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In-home monitoring evaluation by home-dwelling older adults, caregivers and healthcare providers

European Journal of Public Health ◽

10.1093/eurpub/ckz185.301 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Cited By ~ 1

Author(s):

B Pais ◽

P Buluschek ◽

T Nef ◽

N Schütz ◽

H Saner ◽

...

Keyword(s):

Older Adults ◽

Home Care ◽

Older People ◽

Healthcare Providers ◽

Home Monitoring ◽

Daily Activities ◽

Healthcare Needs ◽

Monitoring Technologies ◽

The Impact ◽

At Home

Abstract Background In Europe, population ageing is increasing the healthcare needs and costs. Both frailty and chronic diseases affecting older people reduce their ability to live independently. However, most older people prefer to age in their own homes. New development of in-home monitoring can play a role in staying independent, active and healthy. Our objective was to evaluate a new in-home monitoring system among home-dwelling older adults (OA), their family caregivers (FC), and their healthcare providers (HCP) for the support of home care. Methods The system continuously monitored OA’s daily activities (e.g., mobility, sleep habits, fridge visits, door events) at home by ambient sensor system (DomoCare®) and health-related events by wearable sensors (Fitbit®, ECG). In case of deviations in daily activities (e.g., changes in mobility), alerts were transmitted to HCP via email. Using specific questionnaires, the opinion of 13 OA, 13 FC, and 20 HCP were collected at the end of 12-month of follow-up focusing on their user experience and the impact of in-home monitoring on home care services. Results These preliminary results underlined that the majority of OA, FC, and HCP consider that in-home sensors can help staying at home, improving home care, reducing family stress, and preventing domestic accidents. The opinion tended to be more favourable toward ambient sensors (80%) than toward Fitbit® (67%) and ECG (64%). On average, OA (80%) and FC (73%) tended to be more enthusiast than HCP (63%). Some barriers reported by HCP were a fear of weakening of the relationship with OA and an excessive surveillance. Conclusions Overall, the opinion of OA, FC and HCP were positive related to in-home sensors, with HCP being more mixed about their use in clinical practice. Key messages In-home monitoring technologies seem to be generally well accepted. In-home monitoring technologies could be help facilitating home care of older people.

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The TEAM (Trauma Evaluation and Management) course: medical student knowledge gains and retention in the USA versus Ghana

Trauma Surgery & Acute Care Open ◽

10.1136/tsaco-2018-000287 ◽

2019 ◽

Vol 4 (1) ◽

pp. e000287 ◽

Cited By ~ 2

Author(s):

Allison E Berndtson ◽

Martin Morna ◽

Samuel Debrah ◽

Raul Coimbra

Keyword(s):

Trauma Care ◽

Level Of Evidence ◽

Middle Income ◽

Institutional Review ◽

Knowledge Deficit ◽

Life Years ◽

Before And After ◽

The Usa ◽

Knowledge Gains ◽

The Impact

IntroductionTrauma and injury are significant contributors to the global burden of disease, with 5 million deaths and 250 million disability-adjusted life years lost in 2015. This burden is disproportionally borne by low- and middle-income countries (LMICs). Solutions are complex, but one area for improvement is basic trauma education. The American College of Surgeons has developed the Trauma Evaluation and Management (TEAM) course as an introduction to trauma care for medical students. We hypothesized that the TEAM course would be an effective educational program in LMICs and result in increased knowledge gains and retention similar to students in high-income countries (HICs).MethodsThe TEAM course was taught and students evaluated at two sites, one LMIC (Ghana) and one HIC (USA), after obtaining approval from the HIC Institutional Review Board and medical schools at both sites. Participation was optional for all students and results were de-identified. The course was administered by a single educator for all sessions. Multiple-choice exams were given before and after the course, and again 6 months later.ResultsA total of 62 LMIC and 64 HIC students participated in the course and completed initial testing. Demographics for the two groups were similar, as was participant attrition over time. LMIC students started with a relative knowledge deficit, scoring lower on both pre-course and post-course tests than HIC students, but gained more knowledge during the initial teaching session. After 6 months, the LMIC students continued to improve, whereas the HIC students’ knowledge had regressed. Most students recommended course expansion.ConclusionThe TEAM course is a useful tool to provide the basic principles of trauma care to students in LMICs, and should be expanded. Further study is needed to determine the impact of TEAM education on patient care in LMICs.Level of evidenceLevel III; Care Management

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“Burnt by the scorching sun”: climate-induced livelihood transformations, reproductive health, and fertility trajectories in drought-affected communities of Zambia

BMC Public Health ◽

10.1186/s12889-021-11560-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Joseph G. Rosen ◽

Drosin Mulenga ◽

Lyson Phiri ◽

Natasha Okpara ◽

Caila Brander ◽

...

Keyword(s):

Reproductive Health ◽

Healthcare Providers ◽

Adult Women ◽

Middle Income ◽

Civic Leaders ◽

Household Resources ◽

Income Sources ◽

Climate Resilience ◽

Female Headed Households ◽

The Impact

Abstract Background Climate-induced disruptions like drought can destabilize household and community livelihoods, particularly in low- and middle-income countries. This qualitative study explores the impact of severe and prolonged droughts on gendered livelihood transitions, women’s social and financial wellbeing, and sexual and reproductive health (SRH) outcomes in two Zambian provinces. Methods In September 2020, in-depth interviews (n = 20) and focus group discussions (n = 16) with 165 adult women and men in five drought-affected districts, as well as key informant interviews (n = 16) with civic leaders and healthcare providers, were conducted. A team-based thematic analysis approach, guided by the Framework Method, was used to code transcript text segments, facilitating identification and interpretation of salient thematic patterns. Results Across districts, participants emphasized the toll drought had taken on their livelihoods and communities, leaving farming households with reduced income and food, with many turning to alternative income sources. Female-headed households were perceived as particularly vulnerable to drought, as women’s breadwinning and caregiving responsibilities increased, especially in households where women’s partners out-migrated in search of employment prospects. As household incomes declined, women and girls’ vulnerabilities increased: young children increasingly entered the workforce, and young girls were married when families could not afford school fees and struggled to support them financially. With less income due to drought, many participants could not afford travel to health facilities or would resort to purchasing health commodities, including family planning, from private retail pharmacies when unavailable from government facilities. Most participants described changes in fertility intentions motivated by drought: women, in particular, expressed desires for smaller families, fearing drought would constrain their capacity to support larger families. While participants cited some ongoing activities in their communities to support climate change adaptation, most acknowledged current interventions were insufficient. Conclusions Drought highlighted persistent and unaddressed vulnerabilities in women, increasing demand for health services while shrinking household resources to access those services. Policy solutions are proposed to mitigate drought-induced challenges meaningfully and sustainably, and foster climate resilience.

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