scholarly journals Commitment Levels of Health Care Providers in Using the District Health Information System and the Associated Factors for Decision Making in Resource-Limited Settings: Cross-sectional Survey Study

10.2196/23951 ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. e23951
Author(s):  
Shuma G Kanfe ◽  
Berhanu F Endehabtu ◽  
Mohammedjud H Ahmed ◽  
Nebyu D Mengestie ◽  
Binyam Tilahun
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Providers ◽  
Data Use ◽  
Health Information System ◽  
Evidence Based ◽  
Care Providers ◽  
District Health ◽  
Cross Sectional ◽  
Evidence Based Decision Making

Background Changing the culture of information use, which is one of the transformation agendas of the Ministry of Health of Ethiopia, cannot become real unless health care providers are committed to using locally collected data for evidence-based decision making. The commitment of health care providers has paramount influence on district health information system 2 (DHIS2) data utilization for decision making. Evidence is limited on health care providers’ level of commitment to using DHIS2 data in Ethiopia. Therefore, this study aims to fill this evidence gap. Objective This study aimed to assess the levels of commitment of health care providers and the factors influencing their commitment levels in using DHIS2 data for decision making at public health care facilities in the Ilu Aba Bora zone of the Oromia national regional state, Ethiopia in 2020. Methods The cross-sectional quantitative study supplemented by qualitative methods was conducted from February 26, 2020 to April 17, 2020. A total of 264 participants were approached. SPSS version 20 software was used for data entry and analysis. Descriptive and analytical statistics, including bivariable and multivariable analyses, were performed. Thematic analysis was conducted for the qualitative data. Results Of the 264 respondents, 121 (45.8%, 95% CI 40.0%-52.8%) respondents showed high commitment levels to use DHIS2 data. The variables associated with the level of commitment to use DHIS2 data were found to be provision of feedback for DHIS2 data use (adjusted odds ratio [AOR] 1.85, 95% CI 1.02-3.33), regular supervision and managerial support (AOR 2.84, 95% CI 1.50-5.37), information use culture (AOR 1.92, 95% CI 1.03-3.59), motivation to use DHIS2 data (AOR 1.80, 95% CI 1.00-3.25), health needs (AOR 3.96, 95% CI 2.11-7.41), and competency in DHIS2 tasks (AOR 2.41, 95% CI 1.27-4.55). Conclusions In general, less than half of the study participants showed high commitment levels to use DHIS2 data for decision making in health care. Providing regular supportive supervision and feedback and increasing the motivation and competency of the health care providers in performing DHIS2 data tasks will help in promoting their levels of commitment that can result in the cultural transformation of data use for evidence-based decision making in health care.

scholarly journals Commitment Levels of Health Care Providers in Using the District Health Information System and the Associated Factors for Decision Making in Resource-Limited Settings: Cross-sectional Survey Study (Preprint)

2020 ◽  
Author(s):  
Shuma G Kanfe ◽  
Berhanu F Endehabtu ◽  
Mohammedjud H Ahmed ◽  
Nebyu D Mengestie ◽  
Binyam Tilahun
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Providers ◽  
Data Use ◽  
Health Information System ◽  
Evidence Based ◽  
Care Providers ◽  
District Health ◽  
Cross Sectional ◽  
Evidence Based Decision Making

BACKGROUND Changing the culture of information use, which is one of the transformation agendas of the Ministry of Health of Ethiopia, cannot become real unless health care providers are committed to using locally collected data for evidence-based decision making. The commitment of health care providers has paramount influence on district health information system 2 (DHIS2) data utilization for decision making. Evidence is limited on health care providers’ level of commitment to using DHIS2 data in Ethiopia. Therefore, this study aims to fill this evidence gap. OBJECTIVE This study aimed to assess the levels of commitment of health care providers and the factors influencing their commitment levels in using DHIS2 data for decision making at public health care facilities in the Ilu Aba Bora zone of the Oromia national regional state, Ethiopia in 2020. METHODS The cross-sectional quantitative study supplemented by qualitative methods was conducted from February 26, 2020 to April 17, 2020. A total of 264 participants were approached. SPSS version 20 software was used for data entry and analysis. Descriptive and analytical statistics, including bivariable and multivariable analyses, were performed. Thematic analysis was conducted for the qualitative data. RESULTS Of the 264 respondents, 121 (45.8%, 95% CI 40.0%-52.8%) respondents showed high commitment levels to use DHIS2 data. The variables associated with the level of commitment to use DHIS2 data were found to be provision of feedback for DHIS2 data use (adjusted odds ratio [AOR] 1.85, 95% CI 1.02-3.33), regular supervision and managerial support (AOR 2.84, 95% CI 1.50-5.37), information use culture (AOR 1.92, 95% CI 1.03-3.59), motivation to use DHIS2 data (AOR 1.80, 95% CI 1.00-3.25), health needs (AOR 3.96, 95% CI 2.11-7.41), and competency in DHIS2 tasks (AOR 2.41, 95% CI 1.27-4.55). CONCLUSIONS In general, less than half of the study participants showed high commitment levels to use DHIS2 data for decision making in health care. Providing regular supportive supervision and feedback and increasing the motivation and competency of the health care providers in performing DHIS2 data tasks will help in promoting their levels of commitment that can result in the cultural transformation of data use for evidence-based decision making in health care.

scholarly journals Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—a cross-sectional study from Ujjain, India

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Isaac Gikandi Mungai ◽  
Sumit Singh Baghel ◽  
Shuchi Soni ◽  
Shailja Vagela ◽  
Megha Sharma ◽  
...  
Keyword(s):  
Health Care ◽  
Quantile Regression ◽  
Health Care Providers ◽  
Knowledge Score ◽  
Neonatal Care ◽  
Evidence Based ◽  
Care Providers ◽  
Cross Sectional ◽  
Evidence Based Practices ◽  
Multivariate Quantile

Abstract Background More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge. Methods A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The total score of the IHCPs was calculated. Multivariate quantile regression model was used to look for association of IHCPs knowledge score with: the practitioners’ age, years of experience, number of patients treated per day, and whether they attended children in their practice. Results Of the 945 IHCPs approached, 830 (88%) participated in the study. The mean ± SD score achieved was 22.3 ± 7.7, with a median score of 21 out of maximum score of 48. Although IHCPs could identify key tenets of enhancing survival chances of neonates, they scored low on the specifics of cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and identification and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations. Results of quantile regression analysis showed that more than 5 years of practice experience and treating more than 20 patients per day had a statistically significant positive association with the knowledge score at higher quantiles (q75th and q90th) only. IHCPs treating children had significantly better scores across quantiles accept at the highest quantile (90th). Conclusions The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that some IHCPs do possess knowledge in basic evidence-based practices in neonatal care, which could be built upon by future educational interventions. Targeting IHCPs can be an innovative way to reach a large rural population in the study setting and to improve neonatal care services.

scholarly journals Kajian Praktik Kefarmasian Apoteker pada Tatanan Rumah Sakit

2013 ◽  
Vol 7 (8) ◽  
pp. 365 ◽  
Author(s):  
Max Joseph Herman ◽  
Rini Sasanti Handayani ◽  
Selma Arsit Siahaan
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Government Regulation ◽  
Hospital Pharmacist ◽  
Standard Operating Procedure ◽  
Care Providers ◽  
District Health ◽  
Cross Sectional ◽  
The Government

Undang-undang Republik Indonesia No. 36 tahun 2009 tentang kesehatan dan peraturan pemerintah No. 51 tahun 2009 menyatakan bahwa tenaga kesehatan harus mempunyai kualifikasi minimum yang ditetapkan oleh pemerintah. Studi kualitatif secara potong lintang pada tahun 2010 untuk mengidentifikasi kualifikasi apoteker rumah sakit dalam memenuhi persyaratan tersebut di Bandung, Yogyakarta dan Surabaya. Data dikumpulkan dengan wawancara mendalam terhadap 10 orang apoteker dari enam rumah sakit dan empat orang direktur/wakil direktur rumah sakit, masing-masing satu orang apoteker dari enam perguruan tinggi farmasi, tiga pengurus Ikatan Apoteker Indonesia, tiga dinas kesehatan provinsi dan kabupaten/kota. Observasi praktek kefarmasian dengan menggunakan daftar tilik dilakukan pada tiap rumah sakit dan data sekunder terkait dokumentasi pemantauan dan evaluasi obat, kepuasan pasien, standar operasional prosedur dan kurikulum perguruan tinggi farmasi juga dikumpulkan. Analisis dilakukan dengan metode triangulasi dan hasil menunjukkan bahwa pengelolaan obat dalam hal pengadaan, distribusi dan penyimpanan dilaksanakan dengan baik oleh apoteker rumah sakit. Praktek farmasi klinik dan keselamatan pasien masih sangat terbatas karena alasan sumber daya manusia dan dokumentasi yang memadai. Informasi obat dan konseling kadang dilakukan tanpa fasilitas yang cukup dan apoteker juga terlibat dalam berbagai tim di rumah sakit seperti penanggulangan infeksi nosokomial dan komite farmasi dan terapi.The Indonesian Health Law No. 36 in 2009 and the Government Regulation No. 51 in 2009 state that health-care providers, including pharmacist, shall have minimum qualification set by the government. A qualitative cross sectional was conducted to to identify hospital pharmacist qualification as health care professionals in meeting the requirements was done in 2010 in Bandung, Yogyakarta and Surabaya. Data were collected through indepth interviews with pharmacists involving ten hospital pharmacists and four hos- pital directors/vice directors, six pharmacy colleges, three regional pharmacist associations, three provincial health offices and district health offices and observation of pharmacy practices using check list in each hospital was also conducted. Secondary data concerning documentation of drug monitoring and evaluation, patient satisfaction, standard operating procedure and pharmacy college curricula were collected too. Qualitative analysis was done descriptively using triangulation method. The study shows that drug procurement, distribution and storage, was well-managed by pharmacist. Practice in clinical pharmacy and patient safety was still limited for the reason of human resources and appropriate documentation. Drug information and counseling was sometimes conducted without adequate facilities and pharmacist was involved in various hospital teams like nosocomial infection control and pharmacy and therapy committee.

scholarly journals Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—A cross-sectional study from Ujjain, India

2020 ◽  
Author(s):  
Isaac Gikandi Mungai ◽  
Sumit Singh Baghel ◽  
Suchi Soni ◽  
Shailja Vagela ◽  
Megha Sharma ◽  
...  
Keyword(s):  
Health Care ◽  
Quantile Regression ◽  
Health Care Providers ◽  
Knowledge Score ◽  
Neonatal Care ◽  
Evidence Based ◽  
Care Providers ◽  
Cross Sectional ◽  
Evidence Based Practices ◽  
Multivariate Quantile

Abstract Background: More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge. Methods: A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The total score of the IHCPs was calculated. Multivariate quantile regression model was used to study association of IHCPs knowledge score with: the practitioners’ age, years of experience, number of patients treated per day, and whether they attended children in their practice. Results: Of the 945 IHCPs approached, 830 (88%) participated in the study. The mean±SD score achieved was 22.3±7.7, with a median score of 21 out of maximum score of 48. Although IHCPs could identify key tenets of enhancing survival chances of neonates, they scored low on the cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations. Results of quantile regression analysis showed that more than 5 years of practice experience and treating more than 20 patients per day had a statistically significant positive association with the knowledge score at higher quantiles (q75 th and q90 th ) only. IHCPs treating children had significantly better scores across quantiles accept at the highest quantile (90 th ). Conclusions: The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that some IHCPs do possess knowledge in basic evidence-based practices in neonatal care, which could be built upon in future educational interventions. Targeting IHCPs can be an innovative way to reach a large rural population and to improve neonatal care services.

scholarly journals Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—A cross-sectional study from Ujjain, India

2020 ◽  
Author(s):  
Isaac Gikandi Mungai ◽  
Sumit Singh Baghel ◽  
Suchi Soni ◽  
Shailja Vagela ◽  
Megha Sharma ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Service Providers ◽  
Neonatal Resuscitation ◽  
Neonatal Care ◽  
Evidence Based ◽  
Care Providers ◽  
Cross Sectional ◽  
Evidence Based Practices ◽  
Number Of Patients

Abstract Background More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge. Methods A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The collective score per question among the respondents was calculated. The score achieved by each respondent was calculated, grouped into either “fair” or “low”, and then checked for association with the practitioners’ age and years of experience, number of patients examined per day, and whether they attended children in their practice. Results Of the 945 IHCPs approached, 830 (88%) participated in the study. Of the potential 39,840 points, only an average of 18,483 (46%) were achieved, indicating a knowledge gap. Although these providers could identify key tenets of enhancing survival chances of neonates, they scored low on the specifics of cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and identification and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations in children they attended. Fair knowledge of IHCPs was significantly associated with attending more than 10 but less than 50 patients per day and of being aged between 35 and 45 years. Offering pediatric consultations was not significantly associated with achieving a fair score. Conclusions The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that educational interventions targeting IHCPs can improve neonatal care services and is an innovative way to reach a large rural population in the study setting.

scholarly journals Conditional Recommendations for Specific Dietary Ingredients as an Approach to Chronic Musculoskeletal Pain: Evidence-Based Decision Aid for Health Care Providers, Participants, and Policy Makers

Pain Medicine ◽  
2019 ◽  
Vol 20 (7) ◽  
pp. 1430-1448 ◽  
Author(s):  
Courtney Boyd ◽  
Cindy Crawford ◽  
Kevin Berry ◽  
Patricia Deuster ◽  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Musculoskeletal Pain ◽  
Health Care Providers ◽  
Self Care ◽  
Chronic Musculoskeletal Pain ◽  
Sufficient Evidence ◽  
Evidence Based ◽  
Minimal Risk ◽  
Care Providers

Abstract Objective Approximately 55–76% of Service members use dietary supplements for various reasons; although such use has become popular for a wide range of pain conditions, decisions to use supplements are often driven by information that is not evidence-based. This work evaluates whether the current research on dietary ingredients for chronic musculoskeletal pain provides sufficient evidence to inform decisions for practice and self-care, specifically for Special Operations Forces personnel. Methods A steering committee convened to develop research questions and factors required for decision-making. Key databases were searched through August 2016. Eligible systematic reviews and randomized controlled trials were assessed for methodological quality. Meta-analysis was applied where feasible. GRADE was used to determine confidence in the effect estimates. A decision table was constructed to make evidence-informed judgments across factors required for decision-making, and recommendations were made for practice and self-care use. Results Nineteen dietary ingredients were included. Conditional evidence-based recommendations were made for the use of avocado soybean unsaponifiables, capsaicin, curcuma, ginger, glucosamine, melatonin, polyunsaturated fatty acids, and vitamin D. In these cases, desirable effects outweighed undesirable effects, but there was uncertainty about the trade-offs, either because the evidence was low quality or because benefits and downsides were closely balanced. Conclusions The evidence showed that certain dietary ingredients, when taken as part of a balanced diet and/or as a supplement (e.g., pill, tablet, capsule, cream), may alleviate musculoskeletal pain with no to minimal risk of harm. This finding emphasizes and reinforces the critical importance of shared decision-making between Operators and their health care providers.

scholarly journals 120. Antimicrobial Prescribing Guidance and Communication Among Health Care Professionals in Five Guatemalan Hospitals

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S173-S174
Author(s):  
Brooke M Ramay ◽  
Clara I Secaira ◽  
Nuria Chavez ◽  
Mario Augusto Melgar Toledo ◽  
Randall M Lou-Meda ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Multidisciplinary Teams ◽  
Evidence Based ◽  
Antimicrobial Use ◽  
Care Providers ◽  
Research Support ◽  
Cross Sectional ◽  
Antimicrobial Prescribing

Abstract Background Communication among health care professionals during antimicrobial prescribing is critical to ensure appropriate use. This is of concern in Guatemala where physicians seldom consider guidance from other professionals during antimicrobial prescribing activities. Methods We carried out a cross sectional questionnaire and open ended interviews with physicians from five hospitals in Guatemala to describe perceptions of communication between health care providers, and acceptance of antimicrobial guidance during prescribing. Results From January to April 2021 an electronic questionnaire was sent to enrolled physicians of which 74% completed participation (n=107/145). Fifty-five percent participated in open ended interviews (n=79/145). Respondents perceived high levels of communication between physicians and ID specialists (94% of respondents); 52%, and 54% perceived high levels of physician-pharmacist, and physician-nurse communication respectively. Significant differences in the perception of physician-pharmacist communication were detected when comparing responses between hospitals, and between respondent sex (chi2, p< 0.05). Barriers to communication between professionals included lack of local guidelines or protocols, patient overload, COVID-19 pandemic, lack of mentorship, and little room to discuss antimicrobial therapy with higher-ranking physicians. Eighty percent and 45% of physicians were open to receiving antibiotic optimization recommendations from other physicians, and pharmacists respectively. Notable barriers to accepting recommendations from pharmacists included lack of regular communication, lack of clinical experience, and concern about evidence based recommendations. Conclusion Effective communication is perceived between physicians during antimicrobial prescribing activities. Marginal levels of communication and acceptance of prescribing recommendations have been detected between physicians and pharmacists.In this milieu, there is an opportunity to strengthen multidisciplinary teams to optimize antimicrobial use. Disclosures Mario Augusto Melgar Toledo, MD, Merck (Grant/Research Support)Pfizer (Grant/Research Support)

scholarly journals Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—A cross-sectional study from Ujjain, India

2020 ◽  
Author(s):  
Isaac Gikandi Mungai ◽  
Sumit Singh Baghel ◽  
Suchi Soni ◽  
Shailja Vagela ◽  
Megha Sharma ◽  
...  
Keyword(s):  
Health Care ◽  
Quantile Regression ◽  
Health Care Providers ◽  
Knowledge Score ◽  
Neonatal Care ◽  
Evidence Based ◽  
Care Providers ◽  
Cross Sectional ◽  
Evidence Based Practices ◽  
Multivariate Quantile

Abstract Background: More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge.Methods: A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The total score of the IHCPs was calculated. Multivariate quantile regression model was used to look for association of IHCPs knowledge score with: the practitioners’ age, years of experience, number of patients treated per day, and whether they attended children in their practice.Results: Of the 945 IHCPs approached, 830 (88%) participated in the study. The mean±SD score achieved was 22.3±7.7, with a median score of 21 out of maximum score of 48. Although IHCPs could identify key tenets of enhancing survival chances of neonates, they scored low on the specifics of cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and identification and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations. Results of quantile regression analysis showed that more than 5 years of practice experience and treating more than 20 patients per day had a statistically significant positive association with the knowledge score at higher quantiles (q75th and q90th) only. IHCPs treating children had significantly better scores across quantiles accept at the highest quantile (90th). Conclusions: The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that some IHCPs do possess knowledge in basic evidence-based practices in neonatal care, which could be built upon by future educational interventions. Targeting IHCPs can be an innovative way to reach a large rural population in the study setting and to improve neonatal care services.

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