scholarly journals Assessment of Local Supply Chains and Stock Management Practices for Trauma Care Resources in Ghana: A Comparative Small Sample Cross-Sectional Study

2021 ◽  
Author(s):  
Godfred Boakye ◽  
Adam Gyedu ◽  
Melissa Stewart ◽  
Peter Donkor ◽  
Charles Mock ◽  
...  
Keyword(s):  
Supply Chain ◽  
Resource Availability ◽  
Trauma Care ◽  
Management Practices ◽  
Low Cost ◽  
The United States ◽  
Small Sample ◽  
Stock Management ◽  
Low Resource ◽  
High Resource

Abstract Background: Injuries are a major public health problem globally. With sound planning and organization, essential trauma care can be reliably provided with relatively low-cost equipment and supplies. However, availability of these resources requires an effective and efficient supply chain and good stock management practices. Therefore, this study aimed to assess trauma care resource-related supply management structures and processes at health facilities in Ghana. By doing so, the findings may allow us to identify specific structures and processes that could be improved to facilitate higher quality and more timely care. Methods: Ten hospitals were purposively selected using results from a previously performed national trauma care capacity assessment of hospitals of all levels in Ghana. Five hospitals with low resource availability and 5 hospitals with high resource availability were assessed using the United States Agency for International Development (USAID) Logistics Indicators Assessment Tool and stock ledger review. Data were described and stock management practices were correlated with resource availability. Results: There were differences in stock management practices between low and high resource availability hospitals, including frequency of reporting and audit, number of stock-outs on day of assessment (median 9 vs 2 stock-outs, range 3 – 57 vs 0 – 9 stock-outs, respectively; p=0.05), duration of stock-outs (median 171 vs 8 days, range 51 – 1,268 vs 0 – 182 days, respectively; p=0.02), and fewer of up-to-date stock cards (24 vs 31 up-to-date stock cards, respectively; p=0.07). Stock-outs were common even among low-cost, essential resources (e.g., nasal cannulas and oxygen masks, endotracheal tubes, syringes, sutures, sterile gloves). Increased adherence to stock management guidelines and higher percentage of up-to-date stock cards were correlated with higher trauma resource availability scores. However, the variance in trauma resource availability scores was poorly explained by these individual factors or when analyzed in a multivariate regression model (r2=0.72; p value for each covariate between 0.17 – 0.34). Conclusions: Good supply chain and stock management practices are correlated with high trauma care resource availability. The findings from this study demonstrate several opportunities to improve stock management practices, particularly at low resource availability hospitals.

scholarly journals Assessment of Local Supply Chains and Stock Management Practices for Trauma Care Resources in Ghana: A Comparative Small Sample Cross-Sectional Study

2021 ◽  
Author(s):  
Godfred Boakye ◽  
Adam Gyedu ◽  
Melissa Stewart ◽  
Peter Donkor ◽  
Charles Mock ◽  
...  
Keyword(s):  
Supply Chain ◽  
Resource Availability ◽  
Trauma Care ◽  
Management Practices ◽  
Low Cost ◽  
The United States ◽  
Small Sample ◽  
Stock Management ◽  
Low Resource ◽  
High Resource

Abstract Background: Injuries are a major public health problem globally. With sound planning and organization, essential trauma care can be reliably provided with relatively low-cost equipment and supplies. However, availability of these resources requires an effective and efficient supply chain and good stock management practices. Therefore, we study aimed to assess trauma care resource-related supply management structures and processes at health facilities in Ghana. By doing so, the findings may allow us to identify specific structures and processes that could be improved to facilitate higher quality and more timely care. Methods: Ten hospitals were purposively selected using results from a previously performed national trauma care capacity assessment of hospitals of all levels in Ghana. Five hospitals with low resource availability and 5 hospitals with high resource availability were assessed using the United States Agency for International Development (USAID) Logistics Indicators Assessment Tool and stock ledger review. Data were described and stock management practices were correlated with resource availability. Results: There were differences in stock management practices between low and high resource availability hospitals, including frequency of reporting and audit, number of stock-outs on day of assessment (median 9 vs 2 stock-outs, range 3 – 57 vs 0 – 9 stock-outs, respectively; p=0.05), duration of stock-outs (median 171 vs 8 days, range 51 – 1,268 vs 0 – 182 days, respectively; p=0.02), and fewer of up-to-date stock cards (24 vs 31 up-to-date stock cards, respectively; p=0.07). Stock-outs were common even among low-cost, essential resources (e.g., nasal cannulas and oxygen masks, endotracheal tubes, syringes, sutures, sterile gloves). Increased adherence to stock management guidelines and higher percentage of up-to-date stock cards were correlated with higher trauma resource availability scores. However, the variance in trauma resource availability scores was poorly explained by these individual factors or when analyzed in a multivariate regression model (r 2 =0.72; p value for each covariate between 0.17 – 0.34). Conclusions: Good supply chain and stock management practices are correlated with high trauma care resource availability. The findings from this study demonstrate several opportunities to improve stock management practices, particularly at low resource availability hospitals.

scholarly journals Assessment of local supply chains and stock management practices for trauma care resources in Ghana: a comparative small sample cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Godfred Boakye ◽  
Adam Gyedu ◽  
Melissa Stewart ◽  
Peter Donkor ◽  
Charles Mock ◽  
...  
Keyword(s):  
Supply Chain ◽  
Resource Availability ◽  
Trauma Care ◽  
Management Practices ◽  
Low Cost ◽  
The United States ◽  
Small Sample ◽  
Stock Management ◽  
Low Resource ◽  
High Resource

Abstract Background Injuries are a major public health problem globally. With sound planning and organization, essential trauma care can be reliably provided with relatively low-cost equipment and supplies. However, availability of these resources requires an effective and efficient supply chain and good stock management practices. Therefore, this study aimed to assess trauma care resource-related supply management structures and processes at health facilities in Ghana. By doing so, the findings may allow us to identify specific structures and processes that could be improved to facilitate higher quality and more timely care. Methods Ten hospitals were purposively selected using results from a previously performed national trauma care capacity assessment of hospitals of all levels in Ghana. Five hospitals with low resource availability and 5 hospitals with high resource availability were assessed using the United States Agency for International Development (USAID) Logistics Indicators Assessment Tool and stock ledger review. Data were described and stock management practices were correlated with resource availability. Results There were differences in stock management practices between low and high resource availability hospitals, including frequency of reporting and audit, number of stock-outs on day of assessment (median 9 vs 2 stock-outs, range 3–57 vs 0–9 stock-outs, respectively; p = 0.05), duration of stock-outs (median 171 vs 8 days, range 51–1268 vs 0–182 days, respectively; p = 0.02), and fewer of up-to-date stock cards (24 vs 31 up-to-date stock cards, respectively; p = 0.07). Stock-outs were common even among low-cost, essential resources (e.g., nasal cannulas and oxygen masks, endotracheal tubes, syringes, sutures, sterile gloves). Increased adherence to stock management guidelines and higher percentage of up-to-date stock cards were correlated with higher trauma resource availability scores. However, the variance in trauma resource availability scores was poorly explained by these individual factors or when analyzed in a multivariate regression model (r2 = 0.72; p value for each covariate between 0.17–0.34). Conclusions Good supply chain and stock management practices are correlated with high trauma care resource availability. The findings from this study demonstrate several opportunities to improve stock management practices, particularly at low resource availability hospitals.

scholarly journals Assessment of Local Supply Chains and Stock Management Practices for Trauma Care Resources in Ghana: A Comparative Small Sample Cross-Sectional Study 

2020 ◽  
Author(s):  
Godfred Boakye ◽  
Adam Gyedu ◽  
Melissa Stewart ◽  
Peter Donkor ◽  
Charles Mock ◽  
...  
Keyword(s):  
Supply Chain ◽  
Resource Availability ◽  
Trauma Care ◽  
Management Practices ◽  
Low Cost ◽  
The United States ◽  
Small Sample ◽  
Stock Management ◽  
Low Resource ◽  
High Resource

Abstract Background: Injuries are a major public health problem globally. With sound planning and organization, essential trauma care can be reliably provided with relatively low-cost equipment and supplies. However, availability of these resources requires an effective and efficient supply chain and good stock management practices. Therefore, this study aimed to assess trauma care resource-related supply management structures and processes at health facilities in Ghana. By doing so, the findings may allow us to identify specific structures and processes that could be improved to facilitate higher quality and more timely care. Methods: Ten hospitals were purposively selected using results from a previously performed national trauma care capacity assessment of hospitals of all levels in Ghana. Five hospitals with low resource availability and 5 hospitals with high resource availability were assessed using the United States Agency for International Development (USAID) Logistics Indicators Assessment Tool and stock ledger review. Data were described and stock management practices were correlated with resource availability. Results: There were differences in stock management practices between low and high resource availability hospitals, including frequency of reporting and audit, number of stock-outs on day of assessment (median 9 vs 2 stock-outs, range 3 – 57 vs 0 – 9 stock-outs, respectively; p=0.05), duration of stock-outs (median 171 vs 8 days, range 51 – 1,268 vs 0 – 182 days, respectively; p=0.02), and fewer of up-to-date stock cards (24 vs 31 up-to-date stock cards, respectively; p=0.07). Stock-outs were common even among low-cost, essential resources (e.g., nasal cannulas and oxygen masks, endotracheal tubes, syringes, sutures, sterile gloves). Increased adherence to stock management guidelines and higher percentage of up-to-date stock cards were correlated with higher trauma resource availability scores. However, the variance in trauma resource availability scores was poorly explained by these individual factors or when analyzed in a multivariate regression model (r2=0.72; p value for each covariate between 0.17 – 0.34). Conclusions: Good supply chain and stock management practices are correlated with high trauma care resource availability. The findings from this study demonstrate several opportunities to improve stock management practices, particularly at low resource availability hospitals.

scholarly journals Assessment of Local Supply Chains and Stock Management Practices for Trauma Care Resources in Ghana: A Comparative Cross-Sectional Study

2020 ◽  
Author(s):  
Godfred Boakye ◽  
Adam Gyedu ◽  
Melissa Stewart ◽  
Peter Donkor ◽  
Charles Mock ◽  
...  
Keyword(s):  
Supply Chain ◽  
Resource Availability ◽  
Trauma Care ◽  
Management Practices ◽  
Low Cost ◽  
The United States ◽  
Major Public Health Problem ◽  
Stock Management ◽  
Low Resource ◽  
High Resource

Abstract Background: Injuries are a major public health problem globally. With sound planning and organization, essential trauma care can be reliably provided with relatively low-cost equipment and supplies. However, availability of these resources requires an effective and efficient supply chain and good stock management practices. Therefore, we study aimed to assess trauma care resource-related supply management structures and processes at health facilities in Ghana. By doing so, the findings may allow us to identify specific structures and processes that could be improved to facilitate higher quality and more timely care.Methods: Ten hospitals were purposively selected using results from a previously performed national trauma care capacity assessment of hospitals of all levels in Ghana. Five hospitals with low resource availability and 5 hospitals with high resource availability were assessed using the United States Agency for International Development (USAID) Logistics Indicators Assessment Tool and stock ledger review. Data were described and stock management practices were correlated with resource availability.Results: There were differences in stock management practices between low and high resource availability hospitals, including frequency of reporting and audit, number of stock-outs on day of assessment (median 9 vs 2 stock-outs, range 3 – 57 vs 0 – 9 stock-outs, respectively; p=0.05), duration of stock-outs (median 171 vs 8 days, range 51 – 1,268 vs 0 – 182 days, respectively; p=0.02), and fewer of up-to-date stock cards (24 vs 31 up-to-date stock cards, respectively; p=0.07). Stock-outs were common even among low-cost, essential resources (e.g., nasal cannulas and oxygen masks, endotracheal tubes, syringes, sutures, sterile gloves). Increased adherence to stock management guidelines and higher percentage of up-to-date stock cards were correlated with higher trauma resource availability scores. However, the variance in trauma resource availability scores was poorly explained by these individual factors or when analyzed in a multivariate regression model (r2=0.72; p value for each covariate between 0.17 – 0.34).Conclusions: Good supply chain and stock management practices are correlated with high trauma care resource availability. The findings from this study demonstrate several opportunities to improve stock management practices, particularly at low resource availability hospitals

scholarly journals Feasibility of an At-Home Adult Stool Specimen Collection Method in Rural Cambodia

2021 ◽  
Vol 18 (23) ◽  
pp. 12430
Author(s):  
Jordie A. J. Fischer ◽  
Crystal D. Karakochuk
Keyword(s):  
Stool Specimen ◽  
Low Cost ◽  
Controlled Trial ◽  
Health Centre ◽  
Human Microbiome ◽  
Low Resource ◽  
High Resource ◽  
Specimen Collection ◽  
Straightforward Method ◽  
At Home

The human microbiome has received significant attention over the past decade regarding its potential impact on health. Epidemiological and intervention studies often rely on at-home stool collection methods designed for high-resource settings, such as access to an improved toilet with a modern toilet seat. However, this is not always appropriate or applicable to low-resource settings. Therefore, the design of a user-friendly stool collection kit for low-resource rural settings is needed. We describe the development, assembly, and user experience of a simple and low-cost at-home stool collection kit for women living in rural Cambodia as part of a randomized controlled trial in 2020. Participants were provided with the stool collection kit and detailed verbal instruction. Enrolled women (n = 480) provided two stool specimens (at the start of the trial and after 12 weeks) at their home and brought them to the health centre that morning in a sterile collection container. User specimen collection compliance was high, with 90% (n = 434) of women providing a stool specimen at the end of the trial (after 12 weeks). This feasible and straightforward method has strong potential for similar or adapted use among adults residing in other rural or low-resource contexts.

scholarly journals Vegetable Production Best Management Practices to Minimize Nutrient Loss

2006 ◽  
Vol 16 (3) ◽  
pp. 398-403 ◽  
Author(s):  
T.K. Hartz
Keyword(s):  
Best Management Practices ◽  
Management Practices ◽  
Nutrient Management ◽  
Low Cost ◽  
Environmental Water ◽  
The United States ◽  
Nutrient Loss ◽  
Vegetable Production ◽  
Nitrogen And Phosphorus ◽  
Best Management

Nutrient loss from commercial vegetable fields has become a significant environmental issue in all the major vegetable-producing regions of the United States. Growers are facing potentially disruptive regulations aimed at improving the quality of both surface and ground water. Significant improvement in nutrient management will be required to meet this regulatory challenge. This paper discusses five practical, low-cost nutrient best management practices (BMPs). These BMPs are widely applicable, relatively inexpensive to implement, and can dramatically reduce nitrogen and phosphorus loss from vegetable fields. However, even with careful application of these BMPs, runoff and leachate from vegetable fields may periodically exceed environmental water quality standards, which are very stringent.

scholarly journals Systematic review of clinical effectiveness, components, and delivery of pulmonary rehabilitation in low-resource settings

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
GM Monsur Habib ◽  
Roberto Rabinovich ◽  
Kalyani Divgi ◽  
Salahuddin Ahmed ◽  
Samir Kumar Saha ◽  
...  
Keyword(s):  
Pulmonary Rehabilitation ◽  
Low Cost ◽  
Mode Of Delivery ◽  
Well Being ◽  
Chronic Obstructive ◽  
Low Resource Settings ◽  
Chronic Respiratory Diseases ◽  
Low Resource ◽  
Breathing Exercises ◽  
High Resource

AbstractPulmonary rehabilitation (PR) is a guideline-recommended multifaceted intervention that improves the physical and psychological well-being of people with chronic respiratory diseases (CRDs), though most of the evidence derives from trials in high-resource settings. In low- and middle-income countries, PR services are under-provided. We aimed to review the effectiveness, components and mode of delivery of PR in low-resource settings. Following Cochrane methodology, we systematically searched (1990 to October 2018; pre-publication update March 2020) MEDLINE, EMBASE, CABI, AMED, PUBMED, and CENTRAL for controlled clinical trials of adults with CRD (including but not restricted to chronic obstructive pulmonary disease) comparing PR with usual care in low-resource settings. After duplicate selection, we extracted data on exercise tolerance, health-related quality of life (HRQoL), breathlessness, included components, and mode of delivery. We used Cochrane risk of bias (RoB) to assess study quality and synthesised data narratively. From 8912 hits, we included 13 studies: 11 were at high RoB; 2 at moderate RoB. PR improved functional exercise capacity in 10 studies, HRQoL in 12, and breathlessness in 9 studies. One of the two studies at moderate RoB showed no benefit. All programmes included exercise training; most provided education, chest physiotherapy, and breathing exercises. Low cost services, adapted to the setting, used limited equipment and typically combined outpatient/centre delivery with a home/community-based service. Multicomponent PR programmes can be delivered in low-resource settings, employing a range of modes of delivery. There is a need for a high-quality trial to confirm the positive findings of these high/moderate RoB studies.

Towards biomarker-based tests that can facilitate decisions about prevention and management of preeclampsia in low-resource settings

2016 ◽  
Vol 54 (1) ◽  
Author(s):  
Nathalie Acestor ◽  
Jane Goett ◽  
Arthur Lee ◽  
Tara M. Herrick ◽  
Susheela M. Engelbrecht ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Clinical Performance ◽  
Point Of Care ◽  
Low Cost ◽  
Care Providers ◽  
Low Resource Settings ◽  
Low Resource ◽  
High Resource ◽  
Rapid Assays ◽  
Urine Biomarkers

AbstractIn recent years, an increasing amount of literature is emerging on candidate urine and blood-based biomarkers associated with incidence and severity of preeclampsia (PE) in pregnant women. While enthusiasm on the usefulness of several of these markers in predicting PE is evolving, essentially all work so far has focused on the needs of high-resource settings and high-income countries, resulting primarily in multi-parameter laboratory assays based on proteomic and metabolomics analysis techniques. These highly complex methods, however, require laboratory capabilities that are rarely available or affordable in low-resource settings (LRS). The importance of quantifying maternal and perinatal risks and identifying which pregnancies can be safely prolonged is also much greater in LRS, where intensive care facilities that can rapidly respond to PE-related health threats for women and infants are limited. For these reasons, simple, low cost, sensitive, and specific point-of-care (POC) tests are needed that can be performed by antenatal health care providers in LRS and that can facilitate decisions about detection and management of PE. Our study aims to provide a comprehensive systematic review of current and emerging blood and urine biomarkers for PE, not only on the basis of their clinical performance, but also of their suitability to be used in LRS-compatible test formats, such as lateral flow and other variants of POC rapid assays.

scholarly journals Evaluation of Application of Effective Vaccine Management in Wassit Governorate, Iraq

2020 ◽  
Vol 11 (02) ◽  
pp. 242-246
Author(s):  
Jalal A R Zayer ◽  
Ishraq A Chiad
Keyword(s):  
Supply Chain ◽  
Management Practices ◽  
Storage Capacity ◽  
Storage Temperature ◽  
Health Facilities ◽  
Effective Vaccine ◽  
Stock Management ◽  
Cross Sectional ◽  
Average Percentage ◽  
Minimum Score

Background: Immunization helps save a life, protect serious illness, and improve quality of life. It is recognized as one of the most cost-effective public health interventions available around the globe. However, the success of this program is heavily dependent on strong immunization supply chain practices. Proper immunization supply chain management ensures availing potent and live vaccines to the community. Objective: To evaluate the application of effective vaccine management in health facilities of Wassit Governorate, Iraq. Subjects and Methods: It was a cross-sectional study involving a multistage sampling. A total of 45 health facilities sites were selected, as follows: one sub-national store (SN), six district store (LD), and thirty eight service point (SP) by using effective vaccine management (EVM) questionnaire, interview, reviewing the records, and observations for the agreed review period. Results: The overall scores of this assessment for all levels (SN, LD, and SP) of the supply chain 66.6% demonstrates a need for more improvement in most areas of the vaccine and supply management system as only two criteria (storage capacity E3 and vaccine management practices E8) exceeds the WHO recommended minimum score of 80%. Performance levels of one criteria (building, equipment E4) were about 72% storage temperature (E2), maintenance(E5) and stock management (E6) were between 61 and 68%, while the vaccine distribution (E7), and information management (E9) were notably very weak with performance in each category less than 60%. Conclusions: The national average percentage at all levels was below the WHO recommended minimum score of 80%. Recommendation: The future vaccine storage capacity must be recalculated and stored to enter any new vaccine, receive large quantities of the influenza vaccine, and replace vaccine refrigerators at the sector level with cold rooms to accommodate current and future increases.

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