scholarly journals Investigating COVID-19 in Low-income Settings: Protocol for a Multidisciplinary Mixed Methods Research in Burkina Faso

2021 ◽  
Author(s):  
Isidore Traoré ◽  
Samiratou Ouedraogo ◽  
Dramane Kania ◽  
Nongodo Firmin ◽  
Blahima Konaté Kaboré ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Burkina Faso ◽  
Low Income ◽  
Mixed Methods Research ◽  
Lessons Learned ◽  
Low Income Countries ◽  
Preventive Strategies ◽  
Structured Interviews ◽  
Hygiene Measures ◽  
Bobo Dioulasso

Abstract Background: The world has high hopes of vaccination against COVID-19 to protect the population, boost economies and return to normal life. Vaccination programmes are being rolled out in high income countries, but the pandemic continues to rage in many low-income countries (LICs) despite implementation of strict hygiene measures. We aim to present a comprehensive research protocol that will generate epidemiological, sociological, and anthropological data about the COVID-19 epidemic in Burkina Faso a landlocked country in West Africa with scares resources. Methods: We will perform a multidisciplinary research using mixed methods in the two main cities in Burkina Faso (Ouagadougou and Bobo-Dioulasso). Data will be collected in general population and in COVID-19 patients, caregivers and health care professional in reference care centers: (i) to determine cumulative incidence of SARS-CoV-2 infection in the Burkinabe population using blood samples collected from randomly selected households according to the WHO-recommended protocol; (ii) develop a score to predict severe complications of COVID-19 in persons infected with SARS-CoV-2 using retrospective and prospective data; (iii) perform semi-structured interviews and direct observation on site, to describe and analyze the healthcare pathways and experiences of patients with COVID-19 attending reference care centers, and to identify the perceptions, acceptability and application of preventive strategies among the population. Discussion: This study will generate comprehensive data that will contribute to improve COVID-19 response strategies in Burkina Faso. The lessons learned from the management of the epidemic may serve as examples to the country authorities to better design preventive strategies in the case of future epidemics or pandemics.Ethics and disseminationThis project was approved by the Ministry for Health (N° 2020 - 00952/MS/CAB/INSP/CM) and the Ethics Committee for Health Research of Burkina Faso (N° 2020-8-140).

scholarly journals COVID-19 epidemiological, sociological and anthropological investigation: study protocol for a multidisciplinary mixed methods research in Burkina Faso

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Isidore Tiandiogo Traoré ◽  
Samiratou Ouedraogo ◽  
Dramane Kania ◽  
Firmin Nongodo Kaboré ◽  
Blahima Konaté ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Burkina Faso ◽  
Health Care Professionals ◽  
Mixed Methods Research ◽  
Lessons Learned ◽  
Preventive Strategies ◽  
Structured Interviews ◽  
Middle Income ◽  
Hygiene Measures ◽  
Bobo Dioulasso

Abstract Background The world has high hopes of vaccination against COVID-19 to protect the population, boost economies and return to normal life. Vaccination programmes are being rolled out in high income countries, but the pandemic continues to progress in many low-and middle-income countries (LMICs) despite implementation of strict hygiene measures. We aim to present a comprehensive research protocol that will generate epidemiological, sociological and anthropological data about the COVID-19 epidemic in Burkina Faso, a landlocked country in West Africa with scarce resources. Methods We will perform a multidisciplinary research using mixed methods in the two main cities in Burkina Faso (Ouagadougou and Bobo-Dioulasso). Data will be collected in the general population and in COVID-19 patients, caregivers and health care professionals in reference care centers: (i) to determine cumulative incidence of SARS-CoV-2 infection in the Burkinabe population using blood samples collected from randomly selected households according to the WHO-recommended protocol; (ii) develop a score to predict severe complications of COVID-19 in persons infected with SARS-CoV-2 using retrospective and prospective data; (iii) perform semi-structured interviews and direct observation on site, to describe and analyze the healthcare pathways and experiences of patients with COVID-19 attending reference care centers, and to identify the perceptions, acceptability and application of preventive strategies among the population. Discussion This study will generate comprehensive data that will contribute to improving COVID-19 response strategies in Burkina Faso. The lessons learned from the management of this epidemic may serve as examples to the country authorities to better design preventive strategies in the case of future epidemics or pandemics. The protocol was approved by the Ministry for Health (N° 2020-00952/MS/CAB/INSP/CM) and the Health Research Ethics Committee in Burkina Faso (N° 2020-8-140).

scholarly journals An Exploration of the Unintended Consequences of Performance-Based Financing in 6 Primary Healthcare Facilities in Burkina Faso

2020 ◽  
Author(s):  
Anne-Marie Turcotte-Tremblay ◽  
Idriss Ali Gali Gali ◽  
Valéry Ridde
Keyword(s):  
Burkina Faso ◽  
Low Income ◽  
Diffusion Of Innovations ◽  
Secondary Data ◽  
Healthcare Services ◽  
Unintended Consequences ◽  
Low Income Countries ◽  
Structured Interviews ◽  
Healthcare Facilities ◽  
Performance Based Financing

Background: Performance-based financing (PBF) is promoted to improve the quality and quantity of healthcare services in low-income countries. Despite the complexity of the intervention, little attention has been given to studying its unintended consequences. Our objective is to increase evidence on the unintended consequences of PBF in Burkina Faso. Methods: Using the diffusion of innovations theory, we conducted a multiple case study. The cases were 6 healthcare facilities in two districts. Between April 2015 and 2016, we collected data through 101 semi-structured interviews, discussions, observations, and documents. We conducted thematic analysis using a hybrid deductive-inductive approach. Secondary data was used to illustrate the evolution of reported services. We conducted a cross-case synthesis to identify the results arising independently from more than 1 case. Results: A desirable unintended consequence of PBF was that 3 facilities limited the sale of non-prescribed medication to encourage patients to consult. Undesirable unintended consequences were found in the majority of facilities including fixation on measures rather than on underlying objectives, the pursuit of narrow and less relevant performance indicators, gaming, and teaching trainees improper practices. Providers in all facilities deliberately manipulated medical registers and documents, such that the reported quantity and quality of care differed from what was actually delivered. While most participants indicated that PBF was more advantageous than previous practices, the long payment delays were a source of dissatisfaction and demotivation across all facilities. Dissatisfaction also emerged in relation to the distribution of subsidies and the non-attribution of quality points for services delivered by certain staff considered "unqualified" in guidelines. Results in many facilities revealed suboptimal planning, a perception of the intervention as "budgetivorous," as well as tensions related to the principle of managerial autonomy. Conclusion: PBF led to numerous unintended consequences that could undermine the intervention’s effectiveness. The findings contribute to a more comprehensive picture of the consequences of implementing PBF. Policy-makers can use the results of this study to devise effective strategies before, during and after the implementation of the intervention to minimize undesirable unintended consequences and promote desirable ones.

A Theoretical Framework for Mixed Methods Research with Canadian Families Living with Low Income

2019 ◽  
Vol 11 (3) ◽  
pp. 255-276 ◽  
Author(s):  
Carla Ginn ◽  
◽  
Karen Benzies ◽  
Leslie-Anne Keown ◽  
Shelley Raffin Bouchal ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Low Income ◽  
Mixed Methods Research ◽  
Theoretical Framework

scholarly journals Birth companionship in a government health system: a pilot study in Kigoma, Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paul Chaote ◽  
Nguke Mwakatundu ◽  
Sunday Dominico ◽  
Alex Mputa ◽  
Agnes Mbanza ◽  
...  
Keyword(s):  
Low Income ◽  
Pilot Project ◽  
Low Income Countries ◽  
Respectful Maternity Care ◽  
Health Providers ◽  
Structured Interviews ◽  
Government Officials ◽  
Government Health ◽  
Project Data ◽  
Birth Companion

Abstract Background Having a companion of choice throughout childbirth is an important component of good quality and respectful maternity care for women and has become standard in many countries. However, there are only a few examples of birth companionship being implemented in government health systems in low-income countries. To learn if birth companionship was feasible, acceptable and led to improved quality of care in these settings, we implemented a pilot project using 9 intervention and 6 comparison sites (all government health facilities) in a rural region of Tanzania. Methods The pilot was developed and implemented in Kigoma, Tanzania between July 2016 and December 2018. Women delivering at intervention sites were given the choice of having a birth companion with them during childbirth. We evaluated the pilot with: (a) project data; (b) focus group discussions; (c) structured and semi-structured interviews; and (d) service statistics. Results More than 80% of women delivering at intervention sites had a birth companion who provided support during childbirth, including comforting women and staying by their side. Most women interviewed at intervention sites were very satisfied with having a companion during childbirth (96–99%). Most women at the intervention sites also reported that the presence of a companion improved their labor, delivery and postpartum experience (82–97%). Health providers also found companions very helpful because they assisted with their workload, alerted the provider about changes in the woman’s status, and provided emotional support to the woman. When comparing intervention and comparison sites, providers at intervention sites were significantly more likely to: respond to women who called for help (p = 0.003), interact in a friendly way (p < 0.001), greet women respectfully (p < 0.001), and try to make them more comfortable (p = 0.003). Higher proportions of women who gave birth at intervention sites reported being “very satisfied” with the care they received (p < 0.001), and that the staff were “very kind” (p < 0.001) and “very encouraging” (p < 0.001). Conclusion Birth companionship was feasible and well accepted by health providers, government officials and most importantly, women who delivered at intervention facilities. The introduction of birth companionship improved women’s experience of birth and the maternity ward environment overall.

scholarly journals Global Nursing - A Qualitative Case Study of Tanzanian Nursing Students' Experiences of Student Exchange in Sweden

2020 ◽  
Author(s):  
Tara Alden-Joyce ◽  
Elina Scheers-Andersson ◽  
Jane Rogathi ◽  
Paulo Kidayi ◽  
Jenny Cadstedt ◽  
...  
Keyword(s):  
Nursing Education ◽  
Nursing Students ◽  
Low Income ◽  
Qualitative Content Analysis ◽  
Inductive Reasoning ◽  
Low Income Countries ◽  
Structured Interviews ◽  
Global Perspectives ◽  
Purposeful Sampling ◽  
Student Exchange

Abstract Background: Due to globalization and a shift in population demographics, needs within healthcare are changing and nurses require new skills and knowledge. Nursing education needs to facilitate these new demands and student exchange programmes provide an opportunity to develop necessary skills.Aim: The aim of this study was to explore Tanzanian nursing students' experiences of student exchange in Sweden. Method: A qualitative design was used for this empirical study. Semi-structured interviews were conducted with six Tanzanian nursing students who had participated in student exchange in Sweden. The participants were recruited by purposeful sampling. Inductive reasoning and qualitative content analysis were applied.Results: The findings revealed that the students experienced new approaches in Sweden, allowing them to develop skills and competences. Furthermore, they increased their global perspectives on nursing and interest in working with global health issues. However, they also experienced challenges in the new environment.Conclusion: The present study showed that the Tanzanian nursing students benefitted from their student exchange, both personally, as well as for their future careers as nurses. More research is needed examining nursing students from low-income countries participating in student exchange in high-income countries.

A Systems Approach for Sustainably Reducing Childhood Diarrheal Deaths in Developing Countries

2016 ◽  
pp. 1208-1227
Author(s):  
Monica Gray
Keyword(s):  
Developing Countries ◽  
Low Income ◽  
Systems Approach ◽  
Developed Countries ◽  
Lessons Learned ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Health Crisis ◽  
Industrialized Nations ◽  
Sub Saharan

Diarrhea is the second leading cause of death and is the major cause of malnutrition in children under age 5 worldwide. More than 50 percent of the cases occur in developing countries, particularly in sub-Saharan Africa and Southeast Asia. Open defecation, substandard fecal disposal systems, and contaminated water supplies are the typical causes of diarrheal diseases. This public health crisis in low income countries mirrors the experiences of today's industrialized nations two centuries ago. The lessons learned from their sanitary evolution can be instructive in charting a sustainable path towards saving the lives of almost 2 million children annually. In this chapter a case study of Cuba's sanitary reformation is also presented to showcase successes, similar to those of developed countries, within a developing country and economically challenging context.

Exploring the factors motivating continued Lay First Responder participation in Uganda: a mixed-methods, 3-year follow-up

2020 ◽  
Vol 38 (1) ◽  
pp. 40-46
Author(s):  
Peter G Delaney ◽  
Zachary J Eisner ◽  
T Scott Blackwell ◽  
Ibrahim Ssekalo ◽  
Rauben Kazungu ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Low Income ◽  
First Responders ◽  
Prehospital Emergency Care ◽  
Structured Interviews ◽  
Economic Implications ◽  
Taxi Drivers ◽  
Financial Benefits ◽  
Motorcycle Taxi

BackgroundThe WHO recommends training lay first responders (LFRs) as the first step towards establishing emergency medical services (EMS) in low-income and middle-income countries. Understanding social and financial benefits associated with responder involvement is essential for LFR programme continuity and may inform sustainable development.MethodsA mixed-methods follow-up study was conducted in July 2019 with 239 motorcycle taxi drivers, including 115 (75%) of 154 initial participants in a Ugandan LFR course from July 2016, to evaluate LFR training on participants. Semi-structured interviews and surveys were administered to samples of initial participants to assess social and economic implications of training, and non-trained motorcycle taxi drivers to gauge interest in LFR training. Themes were determined on a per-question basis and coded by extracting keywords from each response until thematic saturation was achieved.ResultsThree years post-course, initial participants reported new knowledge and skills, the ability to help others, and confidence gain as the main benefits motivating continued programme involvement. Participant outlook was unanimously positive and 96.5% (111/115) of initial participants surveyed used skills since training. Many reported sensing an identity change, now identifying as first responders in addition to motorcycle taxi drivers. Drivers reported they believe this led to greater respect from the Ugandan public and a prevailing belief that they are responsible transportation providers, increasing subsequent customer acquisition. Motorcycle taxi drivers who participated in the course reported a median weekly income value that is 24.39% higher than non-trained motorcycle taxi counterparts (p<0.0001).ConclusionsA simultaneous delivery of sustained social and perceived financial benefits to LFRs are likely to motivate continued voluntary participation. These benefits appear to be a potential mechanism that may be leveraged to contribute to the sustainability of future LFR programmes to deliver basic prehospital emergency care in resource-limited settings.

scholarly journals Exploring Health Literacy in Individuals with Alcohol Addiction: A Mixed Methods Clinical Study

2020 ◽  
Vol 17 (18) ◽  
pp. 6728
Author(s):  
Gabriela Rolova ◽  
Beata Gavurova ◽  
Benjamin Petruzelka
Keyword(s):  
Clinical Practice ◽  
Mixed Methods ◽  
Health Literacy ◽  
Health Information ◽  
Mixed Methods Research ◽  
Addiction Treatment ◽  
Alcohol Addiction ◽  
Structured Interviews ◽  
Literacy Survey ◽  
Health Related

This mixed methods research paper explores health literacy (HL) in individuals with alcohol addiction by using the 47-item version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) and semi-structured interviews concerning health-related competencies (access, understand, appraise, and apply health information), and determines the limitations of the HLS-EU-Q47 when used under specific conditions of clinical practice. The questionnaire survey and the interviews were conducted with individuals of different health literacy levels who were undergoing inpatient alcohol addiction treatment. The findings indicate that individuals with alcohol addiction might require different types of health information according to their health literacy level in terms of quantity and quality of information to recover from alcohol addiction and improve their overall health. The implications for the clinical practice of addiction treatment as well as recommendations for national and regional policy are also discussed.

scholarly journals Access to Controlled Medicines in Low-Income Countries: Listening to Stakeholders in the Field

2020 ◽  
pp. 002073142090674
Author(s):  
Agnes Vitry ◽  
Gilles Forte ◽  
Jason White
Keyword(s):  
Low Income ◽  
Low Income Countries ◽  
Structured Interviews ◽  
African Countries ◽  
Country Level ◽  
Written Information ◽  
Health Authorities ◽  
Psychotropic Medicines ◽  
Republic Of The Congo ◽  
International Conventions

Little is known on current practices and challenges associated with the legal trade of medicines controlled under international conventions in low-income countries. This qualitative survey involved semi-structured interviews of stakeholders engaged in the trade of controlled medicines at a global level or at a country level in 3 African countries (Uganda, Kenya, Democratic Republic of the Congo). Nine interviews were conducted, including 3 international wholesalers, 2 relief organizations, 2 procurement officers, and 2 regulatory officers. Additionally, 4 other participants provided written information. All participants consistently reported that the current process of procuring controlled medicines in compliance with international conventions was long and complex given the number of administrative steps required for obtaining export and import authorizations, which are mandatory for both narcotic and psychotropic medicines. It may be difficult or impossible to obtain import authorizations from some health authorities in low-income countries because of long delays, mistakes in forms, absence or shortage of staff, or when annual national estimates are exceeded. The complexities of the trade of controlled medicines directly contribute to the lack of access to essential controlled medicines, both narcotics and psychotropics, in low-income countries.

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