scholarly journals Providing Measurement, Evaluation, Accountability, and Leadership Support for NCDs Prevention in Ghana: Adapting the INFORMAS Approach  

2020 ◽  
Author(s):  
Amos Laar ◽  
Bridget Kelly ◽  
Michelle Holdsworth ◽  
Wilhemina Quarpong ◽  
Richmond Aryeetey ◽  
...  
Keyword(s):  
Local Community ◽  
Food Environments ◽  
Programme Implementation ◽  
Middle Income ◽  
Measurement Evaluation ◽  
Community Readiness Model ◽  
Leadership Support ◽  
African Context ◽  
Food Provision ◽  
Implementation Gaps

Abstract BackgroundLike most other countries, Ghana is experiencing an increase in obesity and nutrition-related non-communicable diseases (NR-NCDs). The need to adopt effective and comprehensive interventions/approaches to address this burden at global, regional, and national levels has been recognized. However, there is limited contextualized evidence on the implementation, and efficacy of approaches that can address NCDs in Ghana. In an earlier study, we assessed food environment priorities, and programme implementation gaps in Ghana. Building on that, this paper describes the rationale, adaptation and final protocol of a project developed to address this: The Measurement, Evaluation, Accountability, and Leadership Support for NCDs (MEALS4NCDs) project. The MEALS4NCDs project aims to measure and support public sector actions that create healthy food marketing, retail and provisioning environments for Ghanaian children, using adapted methods from the International Network for Food and Obesity/NCDs Research Monitoring and Action Support (INFORMAS). The research will facilitate understanding of the processes through which the INFORMAS approach is contextualized to a lower-middle income African context. MethodsThe protocol for this observational study draws substantially from the INFORMAS’ Food Promotion and Food Provision Modules. However, to appraise the readiness of local communities to implement interventions with strong potential to improve Ghanaian children’s food environments, the MEALS4NCDs protocol has innovatively integrated a local community participatory approach based on the Community Readiness Model (CRM) into the INFORMAS approaches. DiscussionThe study establishes a standardised approach to providing implementation science evidence for NCDs prevention in Ghana. It aims to demonstrate feasibility and innovative application of the INFORMAS expanded Food promotion and Food provision modules, together with the integration of the CRM in a lower-middle income setting. The protocol could be adapted for similar country settings to monitor relevant aspects of children’s food environments. Trial registrationNot applicable

scholarly journals Providing Measurement, Evaluation, Accountability, and Leadership Support (MEALS) for Non-communicable Diseases Prevention in Ghana: Project Implementation Protocol

2021 ◽  
Vol 8 ◽  
Author(s):  
Amos Laar ◽  
Bridget Kelly ◽  
Michelle Holdsworth ◽  
Wilhemina Quarpong ◽  
Richmond Aryeetey ◽  
...  
Keyword(s):  
Local Community ◽  
Service Providers ◽  
Food Service ◽  
Communicable Diseases ◽  
Food Environments ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Measurement Evaluation ◽  
Leadership Support ◽  
Food Provision

Background: This study describes the rationale, adaptation, and final protocol of a project developed to address the increase in obesity and nutrition-related non-communicable diseases (NR-NCDs) in Ghana. Code-named the Measurement, Evaluation, Accountability, and Leadership Support for NCDs (MEALS4NCDs) project, it aims to measure and support public sector actions that create healthy food marketing, retail, and provisioning environments for Ghanaian children using adapted methods from the International Network for Food and Obesity/NCDs Research Monitoring and Action Support (INFORMAS).Methods: The protocol for this observational study draws substantially from the INFORMAS' Food Promotion and Food Provision Modules. However, to appraise the readiness of local communities to implement interventions with strong potential to improve food environments of Ghanaian children, the MEALS4NCDs protocol has innovatively integrated a local community participatory approach based on the community readiness model (CRM) into the INFORMAS approaches. The setting is Ghana, and the participants include health and nutrition policy-makers, nutrition and food service providers, consumers, school authorities, and pupils of Ghanaian basic schools.Results: The study establishes a standardized approach to providing implementation science evidence for the prevention of non-communicable diseases (NCDs) in Ghana. It demonstrates feasibility and the innovative application of the INFORMAS expanded food promotion and food provision modules, together with the integration of the CRM in a lower-middle income setting.Conclusion: The research will facilitate the understanding of the processes through which the INFORMAS approach is contextualized to a lower-middle income African context. The protocol could be adapted for similar country settings to monitor relevant aspects of food environments of children.

Inclusion of people with psychosocial disability in low and middle income contexts: a practice review

2017 ◽  
Vol 4 (3) ◽  
pp. 72-81 ◽  
Author(s):  
Helen Lea Fernandes ◽  
Stephanie Cantrill ◽  
Raj Kamal ◽  
Ram Lal Shrestha
Keyword(s):  
Mental Health ◽  
Local Community ◽  
Global Mental Health ◽  
Economic Life ◽  
Health Programs ◽  
Middle Income ◽  
Psychosocial Disability ◽  
Practice Review ◽  
Mental Health Programs ◽  
Low And Middle Income

Much of the literature about mental illness in low and middle income countries (LMICs) focuses on prevalence rates, the treatment gap, and scaling up access to medical expertise and treatment. As a cause and consequence of this, global mental health programs have focused heavily on service delivery without due exploration of how programs fit into a broader picture of culture and community. There is a need for research which highlights approaches to broader inclusion, considering historical, cultural, social, and economic life contexts and recognises the community as a determinant of mental health — in prevention, recovery, resilience, and support of holistic wellness. The purpose of this practice review is to explore the experiences of three local organisations working with people with psychosocial disability living in LMICs: Afghanistan, India, and Nepal. All three organisations have a wealth of experience in implementing mental health programs, and the review brings together evidence of this experience from interviews, reports, and evaluations. Learnings from these organisations highlight both successful approaches to strengthening inclusion and the challenges faced by people with psychosocial disability, their families, and communities.  The findings can largely be summarised in two categories, although both are very much intertwined: first, a broad advocacy, public health, and policy approach to inclusion; and second, more local, community-based initiatives. The evidence draws attention to the need to acknowledge the complexities surrounding mental health and inclusion, such as additional stigmatisation due to multidimensional poverty, gender inequality, security issues, natural disasters, and additional stressors associated with access. Organisational experiences also highlight the need to work with communities’ strengths to increase capacity around inclusion and to apply community development approaches where space is created for communities to generate holistic solutions. Most significantly, approaches at all levels require efforts to ensure that people with psychosocial disability are given a voice and are included in shaping programs, policies, and appropriate responses.

scholarly journals Spiritual care practices in hospices in the Western cape, South Africa: the challenge of diversity

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Ronita Mahilall ◽  
Leslie Swartz
Keyword(s):  
South Africa ◽  
Spiritual Care ◽  
Resource Constraints ◽  
Care Service ◽  
Western Cape ◽  
Group Discussions ◽  
Middle Income ◽  
Care Services ◽  
African Context ◽  
Care Practices

Abstract Background South Africa is a very diverse middle-income country, still deeply divided by the legacy of its colonial and apartheid past. As part of a larger study, this article explored the experiences and views of representatives of hospices in the Western Cape province of South Africa on the provision of appropriate spiritual care, given local issues and constraints. Methods Two sets of focus group discussions, with 23 hospice participants, were conducted with 11 of the 12 Hospice Palliative Care Association registered hospices in the Western Cape, South Africa, to understand what spiritual care practices existed in their hospices against the backdrop of multifaceted diversities. The discussions were analysed using thematic analysis. Results Two prominent themes emerged: the challenges of providing relevant spiritual care services in a religiously, culturally, linguistically and racially diverse setting, and the organisational context impacting such a spiritual care service. Participants agreed that spiritual care is an important service and that it plays a significant role within the inter-disciplinary team. Participants recognised the need for spiritual care training and skills development, alongside the financial costs of employing dedicated spiritual care workers. In spite of the diversities and resource constraints, the approach of individual hospices to providing spiritual care remained robust. Discussion Given the diversities that are largely unique to South Africa, shaped essentially by past injustices, the hospices have to navigate considerable hurdles such as cultural differences, religious diversity, and language barriers to provide spiritual care services, within significant resource constraints. Conclusions While each of the hospices have established spiritual care services to varying degrees, there was an expressed need for training in spiritual care to develop a baseline guide that was bespoke to the complexities of the South African context. Part of this training needs to focus on the complexity of providing culturally appropriate services.

scholarly journals Spatial Information Gaps on Deprived Urban Areas (Slums) in Low-and-Middle-Income-Countries: A User-Centered Approach

Urban Science ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 72
Author(s):  
Monika Kuffer ◽  
Jon Wang ◽  
Dana R. Thomson ◽  
Stefanos Georganos ◽  
Angela Abascal ◽  
...  
Keyword(s):  
Information System ◽  
Urban Areas ◽  
Online Survey ◽  
Local Community ◽  
Spatial Information ◽  
Spatial Dynamics ◽  
Middle Income ◽  
Urban Deprivation ◽  
Deprived Areas ◽  
User Centered

Routine and accurate data on deprivation are needed for urban planning and decision support at various scales (i.e., from community to international). However, analyzing information requirements of diverse users on urban deprivation, we found that data are often not available or inaccessible. To bridge this data gap, Earth Observation (EO) data can support access to frequently updated spatial information. However, a user-centered approach is urgently required for the production of EO-based mapping products. Combining an online survey and several forms of user interactions, we defined five system specifications (derived from user requirements) for designing an open-access spatial information system for deprived urban areas. First, gridded maps represent the optimal spatial granularity to deal with high uncertainties of boundaries of deprived areas and to protect privacy. Second, a high temporal granularity of 1–2 years is important to respond to the high spatial dynamics of urban areas. Third, detailed local-scale information should be part of a city-to-global information system. Fourth, both aspects, community assets and risks, need to be part of an information system, and such data need to be combined with local community-based information. Fifth, in particular, civil society and government users should have fair access to data that bridges the digital barriers. A data ecosystem on urban deprivation meeting these requirements will be able to support community-level action for improving living conditions in deprived areas, local science-based policymaking, and tracking progress towards global targets such as the SDGs.

Best practice relief supply for emergency services in a developed economy

2018 ◽  
Vol 8 (1) ◽  
pp. 107-132 ◽  
Author(s):  
Mark M.J. Wilson ◽  
Peter Tatham ◽  
John Payne ◽  
Cécile L’Hermitte ◽  
Michael Shapland
Keyword(s):  
Disaster Response ◽  
Best Practice ◽  
Local Community ◽  
Emergency Services ◽  
Developed Country ◽  
Middle Income ◽  
Emergency Relief ◽  
Content Type ◽  
Emergency Logistics ◽  
Community Outcomes

Purpose The purpose of this paper is to discuss the challenges inherent in planning and responding to disaster events in a multi-agency context where numerous governmental and non-governmental actors and agencies are involved in the planning and response phases. In particular, the authors examine a situation where a lead agency has recently been delegated the responsibility for emergency relief logistics and how it might determine and implement best practice. Design/methodology/approach Adopting an iterative inductive approach, the authors gather data and insights from academic literature, emergency management policies, frameworks and documents and exploratory in-depth interviews with 12 key informants who have considerable experience with the challenges of logistic preparation and response to disasters in a developed country context. The data and context are limited to developed counties, especially the state of Queensland, Australia. Findings The authors discuss the challenge of achieving coordinated supply chain management where mandated/lead response agencies are required to meet stakeholder and local community expectations and outcomes. From these findings, the authors offer 11 practical recommendations to assist the delivery of best practice in emergency logistics. Originality/value Humanitarian logistics is usually examined from a low/middle-income country perspective, yet an efficient and effective disaster response is no less important for developed economies. In this respect, the authors offer a fresh examination of the challenges of delivering best practice for emergency logistics in order to achieve expected community outcomes.

Implementation of a colour-coded universal protocol safety initiative in Guatemala

2018 ◽  
Vol 27 (8) ◽  
pp. 593-599 ◽  
Author(s):  
Brad M Taicher ◽  
Shannon Tew ◽  
Ligia Figueroa ◽  
Fausto Hernandez ◽  
Sherry S Ross ◽  
...  
Keyword(s):  
Low Income ◽  
Adverse Outcomes ◽  
Quality Improvement Initiative ◽  
Implementation Barriers ◽  
Clinical Workflow ◽  
Patient Identification ◽  
Programme Implementation ◽  
Middle Income ◽  
Protocol Implementation ◽  
Universal Protocol

BackgroundUniversal protocol implementation can be challenging in low-income or middle-income countries, particularly when providers work together across language barriers. The aim of this quality improvement initiative was to test the implementation of a colour-coded universal protocol in a Guatemalan hospital staffed by US and Guatemalan providers.MethodsFrom 2013 to 2016, a US and Guatemalan team implemented a universal protocol at a Guatemalan surgical centre for children undergoing general surgical or urologic procedures. The protocol was a two-step patient identification and documentation checklist, with the first step of all chart element verification in the preoperative area, after which a blue hat was placed on the patient as a visual cue that this was completed. The second step included checklist confirmation in the operating room prior to the procedure. We tested protocol implementation over three phases, identifying implementation barriers and modifying clinical workflow after each phase. We measured the error rate in documentation or other universal protocol steps at each phase and made modifications based on iterative analysis.ResultsOver the course of programme implementation, we substantially decreased the rate of errors in documentation or other universal protocol elements. After the first phase, 30/51 patients (58.8%) had at least one error. By the third phase, only 2/43 patients (4.6%) had any errors. All errors were corrected prior to surgery with no adverse outcomes.ConclusionsCare teams of providers from different countries pose potential challenges with patient safety. Implementation of a colour-coded universal protocol in this setting can prevent and reduce errors that could potentially lead to patient harm.

scholarly journals Innovative Use of mHealth and Clinical Technology for Oncology Clinical Trials in Africa

2020 ◽  
pp. 948-953
Author(s):  
Miriam Mutebi ◽  
Rohini Bhatia ◽  
Omolola Salako ◽  
Fidel Rubagumya ◽  
Surbhi Grover ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Health Systems ◽  
Middle Income Country ◽  
Disruptive Technology ◽  
Full Potential ◽  
Middle Income ◽  
Oncology Clinical Trials ◽  
Health Related ◽  
African Context

Utilization of clinical technology and mobile health (mHealth) is expanding globally. It is important to reflect on how their usage and application could translate in low- and middle-income country (LMIC) settings. With the exponential growth and advancements of mobile and wireless technologies, LMICs are prime to adapt such technologies to potentially democratize and create solutions to health-related challenges. The role of these technologies in oncology clinical trials continues to expand. The lure of mHealth promises disruptive technology that may change the way clinical trials are designed and conducted in many settings. Its applicability in the African context is currently under consideration. Although potentially of expanding benefit, the role of these technologies requires careful and nuanced evaluation of the context in which they might be applied to harness their full potential, while mitigating possible harms or preventing further deepening of disparities within populations. Moreover, technology and digital innovations are no substitute for poor referral pathways and dysfunctional health systems and can only complement or enhance definite strategies aimed at strengthening these health systems.

scholarly journals The changing patterns of access overtime to the renal replacement therapy programme in Thailand

2019 ◽  
Author(s):  
Noppakun Thammatacharee ◽  
Anne Mills ◽  
Dorothea Nitsch ◽  
Adisorn Lumpaopong
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Transplant ◽  
Cohort Analysis ◽  
Universal Coverage ◽  
Programme Implementation ◽  
Health Security ◽  
Middle Income ◽  
Number Of Patients ◽  
Over Time

Abstract Based on projected numbers, approximately only 50% of those requiring renal replacement therapy (RRT) receive it. Many patients who require RRT live in low- and middle-income countries. The objective of this study was to examine the changing pattern over time of entry into the RRT programme in Thailand following RRT’s inclusion in the Universal Coverage Scheme. This study was an ecological study using the age-period-cohort analysis to look at dialysis registration and kidney transplant trends during RRT programme implementation. Data from 2008 to 2016 of patients diagnosed with end-stage renal disease (ESRD) were obtained from the National Health Security Office. The study found that the numbers of new patients with ESRD, aged 20–69, registered with the dialysis programme increased over time. For patients aged 20–40 years, the dialysis programme took up to 400 new patients for every 1000 new ESRD diagnoses. For kidney transplant, the rates increased slowly. The kidney transplant programme could at best treat only around 50 cases for every 1000 new ESRD diagnoses in patients aged 20–30 years. Findings of this study highlighted the importance of promoting strategies to reduce the increasing number of patients with kidney disease, to consider conservative therapy for older/frail patients, and to improve access to kidney transplantation and live-donation.

scholarly journals Tailored support for national NCD policy and programme implementation: an over-looked priority

2020 ◽  
Vol 5 (8) ◽  
pp. e002598 ◽  
Author(s):  
Angela Jackson-Morris ◽  
Rachel Nugent
Keyword(s):  
Low Income ◽  
Technical Support ◽  
Programme Implementation ◽  
Middle Income ◽  
Capacity Enhancement ◽  
Integrative Health ◽  
Effective Strategies ◽  
Middle Income Countries ◽  
Premature Deaths ◽  
National Investment

Many low-income and middle-income countries (LMICs) are unlikely to achieve Sustainable Development Goal 3.4 to reduce premature deaths from non-communicable diseases (NCDs) by one-third by 2030. For some, the prospect is receding: between 2010 and 2020, the decline in premature deaths for the major NCDs slowed compared with the prior decade. Barriers to implementing effective strategies are well known, yet the value of tailored technical support to countries has been overlooked and downplayed. Tailored technical support is specialist guidance for country-specific application of technical tools, and capacity enhancement when needed, that enables an LMIC to advance its NCD priorities and plans. We present a model identifying pivotal junctures where tailored technical support can help surmount implementation obstacles. We draw on our experience preparing NCD investment cases with health ministries, development partners and technical agencies. National investment cases produce evidence based, locally tailored and costed packages of NCD interventions and policies appropriate to national needs and circumstances. They can include analysis of financing needs and point towards sustainable funding mechanisms. Enhancing the NCD-specific knowledge of government and Civil Society Organization leads can capitalise on existing expertise, aid integrative health system developments and unlock capabilities to use global tools and guidance. Investment cases form a platform to develop or review NCD plans and (re)prioritise action, then apply implementation science to trouble-shoot obstacles. Partnering national stakeholders with technical support in this process is critical to develop and implement effective NCD strategies.

scholarly journals Cultural adaptation of two school-based smoking prevention programs in Bogotá, Colombia

2021 ◽  
Author(s):  
Sharon Sánchez-Franco ◽  
Luis Fernando Arias ◽  
Joaquin Jaramillo ◽  
Jennifer M Murray ◽  
Ruth F Hunter ◽  
...  
Keyword(s):  
Program Implementation ◽  
Cultural Adaptation ◽  
Local Community ◽  
Smoking Prevention ◽  
Local Context ◽  
Evidence Based ◽  
Community Members ◽  
Middle Income ◽  
School Based ◽  
Low And Middle Income

Abstract Smoking prevention among adolescents is a public health challenge that is even more significant in low- and middle-income countries where local evidence is limited and smoking rates remain high. Evidence-based interventions could be transferred to low- and middle-income country settings but only after appropriate cultural adaptation. This paper aims to describe the process of the cultural adaptation of two school-based smoking prevention interventions, A Stop Smoking in Schools Trial and Dead Cool, to be implemented in Bogotá, Colombia. A recognized heuristic framework guided the cultural adaptation through five stages. We conducted a concurrent nested mixed-methods study consisting of a qualitative descriptive case study and a quantitative pre- and post quasi-experiment without a control. Contextual, content, training, and implementation modifications were made to the programs to address cultural factors, to maintain the fidelity of implementation, and to increase the pupils’ engagement with the programs. Modifications incorporated the suggestions of stakeholders, the original developers, and local community members, whilst considering the feasibility of delivering the programs. Involving stakeholders, original program developers, and community members in the cultural adaptation of evidence-based interventions is essential to properly adapt them to the local context, and to maintain the fidelity of program implementation.

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