scholarly journals Addressing Care Continuity and Quality Challenges in the Management of Chronic Noncommunicable Diseases in a Sub-Saharan Private Healthcare Sector: a Case for Health Information Systems (Preprint)

2020 ◽  
Author(s):  
Aisha Walcott-Bryant ◽  
Sekou Remy ◽  
William Ogallo ◽  
Katherine Tryon ◽  
Winnie Shena ◽  
...  
Keyword(s):  
Health Information ◽  
Digital Health ◽  
Healthcare Systems ◽  
Sub Saharan Africa ◽  
Healthcare Sector ◽  
Noncommunicable Diseases ◽  
Care Providers ◽  
Private Healthcare ◽  
Care Continuity ◽  
Sub Saharan

BACKGROUND The rise of noncommunicable diseases in sub-Saharan Africa places strain on already stretched healthcare systems, that have traditionally focused on infectious diseases. Healthcare provision is fragmented, and there is a dearth of literature on the experiences, challenges, and solutions for improving the management of noncommunicable diseases in sub-Saharan private healthcare sectors. OBJECTIVE We investigated the management of hypertension in the Kenyan private healthcare sector to understand how a health information system could be used to address care continuity and quality challenges in the management of hypertension and other noncommunicable diseases. METHODS We conducted in-depth interviews and direct observations at 18 healthcare institutions in Kenya. We analyzed the data to identify the key challenges and proposed solutions to the challenges. We subsequently used the generated insights to propose the design of a digital health solution for enabling care quality and continuity at the study setting and similar ecosystems. RESULTS The private healthcare sector in Kenya is fragmented and faces challenges such as high cost of care, limited healthcare literacy, lack of self-management support, ineffective referral systems, inadequate care provider training, and inadequate regulation. Care coordination is hindered by suboptimal encounter data collection, limited view of patient histories, and little trust between care providers. Patient health records are siloed in multiple paper and electronic systems that lack integration. The proposed digital health platform system supports care coordination and continuity within fragmented healthcare systems by enabling patient-consented data sharing while ensuring that care providers in separate facilities have holistic views of the patient’s clinical and non-clinical history. CONCLUSIONS Health information systems can play a pivotal role in addressing the care continuity and quality challenges in the management of noncommunicable diseases in sub-Saharan Africa private healthcare sectors. Leveraging technology and processes to support patients managing chronic noncommunicable diseases in disparate clinical and nonclinical settings (e.g. at home and in support groups) is critical.

scholarly journals SAT0640-HPR RHEUMATOLOGY CARE OF MIGRANTS FROM SUB-SAHARAN AFRICA; A QUALITATIVE PILOT STUDY OF PATIENTS’ PERSPECTIVES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1279.1-1279
Author(s):  
Z. Rutter-Locher ◽  
J. Galloway ◽  
H. Lempp
Keyword(s):  
Rheumatoid Arthritis ◽  
Health Care ◽  
Health Care Providers ◽  
Unmet Need ◽  
Primary Care Providers ◽  
Sub Saharan Africa ◽  
Care Providers ◽  
Specialist Care ◽  
Sub Saharan ◽  
The Uk

Background:Rheumatological diseases are common in Sub-Saharan Africa [1] but specialist healthcare is limited and there are less than 150 rheumatologists currently serving 1 billion people in Sub-Saharan Africa [2]. Rheumatologists practising in the UK NHS are likely to be exposed to migrant patients. There is therefore, an unmet need for health care providers to understand the differences in rheumatology healthcare provision between Sub-Saharan Africa and the UK and the barriers which migrants face in their transition of rheumatology care.Objectives:To gain an understanding of the experiences of patients with rheumatological conditions, about their past healthcare in Sub-Saharan Africa and their transition of care to the UK.Methods:A qualitative study using semi-structured interviews was conducted. Participants were recruited from two rheumatology outpatient clinics in London. Thematic analysis was applied to identify key themes.Results:Seven participants were recruited. Five had rheumatoid arthritis, one had ankylosing spondylitis and one had undifferentiated inflammatory arthritis. Participants described the significant impact their rheumatological conditions had on their physical and emotional wellbeing, including their social and financial implications. Compared to the UK, rheumatology healthcare in Sub-Saharan Africa was characterised by higher costs, limited access to specialists, lack of investigations and treatments, the use of traditional medicines and poor communication by clinicians. Barriers to transition of rheumatology care to the UK were: poor understanding of rheumatological conditions by the public and primary care providers, lack of understanding of NHS entitlements by migrants, fear of data sharing with immigration services and delayed referral to specialist care. Patient, doctor and public education were identified by participants as important ways to improve access to healthcare.Conclusion:This study has described, for the first time, patients’ perspectives of rheumatology health care in Sub-Saharan Africa and the transition of their care to the UK. These initial findings allow healthcare providers in the UK to tailor management for this migrant population and suggests that migrants need more information about their NHS entitlements and specific explanations on what non-clinical data will be shared with immigration services. To increase access to appropriate care, a concerted effort by clinicians and public health authorities is necessary to raise awareness and provide better education to patients and migrant populations about rheumatological conditions.References:[1]G. Mody, “Rheumatology in Africa-challenges and opportunities,” Arthritis Res. Ther., vol. 19, no. 1, p. 49, 2017.[2]M. A. M. Elagib et al., “Sudan and Sweden Active Rheumatoid Arthritis in Central Africa: A Comparative Study Between,” J. Rheumatol. J. Rheumatol. January, vol. 43, no. 10, pp. 1777–1786, 2016.Acknowledgments:We are grateful to the patients involved in this study for their time and involvement.Disclosure of Interests:None declared

scholarly journals Pandemics and Burden of Stroke and Epilepsy in Sub-Saharan Africa: Experience from a Longstanding Health Programme

2021 ◽  
Vol 18 (5) ◽  
pp. 2766
Author(s):  
Massimo Leone ◽  
Fausto Ciccacci ◽  
Stefano Orlando ◽  
Sandro Petrolati ◽  
Giovanni Guidotti ◽  
...  
Keyword(s):  
Neurological Disorders ◽  
Combined Treatment ◽  
Cerebrovascular Disorders ◽  
Sub Saharan Africa ◽  
Noncommunicable Diseases ◽  
People Living With Hiv ◽  
Sub Saharan ◽  
Health Programme ◽  
Excess Deaths ◽  
Hiv Aids

Eighty percent of people with stroke live in low- to middle-income nations, particularly in sub-Saharan Africa (SSA) where stroke has increased by more than 100% in the last decades. More than one-third of all epilepsy−related deaths occur in SSA. HIV infection is a risk factor for neurological disorders, including stroke and epilepsy. The vast majority of the 38 million people living with HIV/AIDS are in SSA, and the burden of neurological disorders in SSA parallels that of HIV/AIDS. Local healthcare systems are weak. Many standalone HIV health centres have become a platform with combined treatment for both HIV and noncommunicable diseases (NCDs), as advised by the United Nations. The COVID-19 pandemic is overwhelming the fragile health systems in SSA, and it is feared it will provoke an upsurge of excess deaths due to the disruption of care for chronic diseases such as HIV, TB, hypertension, diabetes, and cerebrovascular disorders. Disease Relief through Excellent and Advanced Means (DREAM) is a health programme active since 2002 to prevent and treat HIV/AIDS and related disorders in 10 SSA countries. DREAM is scaling up management of NCDs, including neurologic disorders such as stroke and epilepsy. We described challenges and solutions to address disruption and excess deaths from these diseases during the ongoing COVID-19 pandemic.

scholarly journals Pregnancy and childbirth in Mozambique: men as decision makers and women as caretakers?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Galle ◽  
H Cossa ◽  
N Osman ◽  
K Roelens ◽  
S Griffin ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Hiv Prevention ◽  
Health Care Providers ◽  
Male Involvement ◽  
Sub Saharan Africa ◽  
Care Providers ◽  
Pregnancy And Childbirth ◽  
Policy Level ◽  
Sub Saharan

Abstract Background Increasing male involvement during pregnancy is considered an important, but often overlooked intervention for improving maternal health in sub-Saharan Africa. This study explores the attitudes and beliefs of health policymakers, health care providers and local communities regarding men's involvement in maternal health in southern Mozambique. Methods Ten key informant interviews with stakeholders were carried out to assess their attitudes and perspectives regarding male involvement in maternal health, followed by 10 days of semi structured observations in health care centers. Subsequently 16 focus group discussions were conducted in the community and at provider level, followed by three in depth couple interviews. Analysis was done by applying a socio-ecological systems theory in thematic analysis. Results Results show a lack of strategy at policy level to stimulate male involvement in maternal health. Invitation cards for men are used as an isolated intervention in health facilities but these have not lead to the expected success. Providers have a rather passive attitude towards male involvement initiatives and women accompanied by a husband are often put in a submissive position. In the community however, male attendance at ANC is considered important and men are willing to take a more participating role. Main barriers are the association of male attendance at ANC with being HIV infected and strong social norms and gender roles. On the one hand men are seen as caretakers of the family by providing money and making the decisions. On the other hand, men supporting their wife by showing interest in their health or sharing household tasks are seen as weak or as a manifestation of HIV seropositivity. Conclusions A clear strategy at policy level and a multi-level approach is needed. Gender-equitable relationships between men and women should be encouraged in all maternal health interventions and health programs should step away from linking male involvement to HIV prevention. Key messages Linking the promotion of gender equality to male involvement is the key for success. Step away from linking HIV prevention to male involvement in maternal health.

Digital Health Engagement in the US Population: Insights From the 2018 Health Information National Trends Survey

2021 ◽  
pp. e1-e4
Author(s):  
Chelsea L. Ratcliff ◽  
Melinda Krakow ◽  
Alexandra Greenberg-Worisek ◽  
Bradford W. Hesse
Keyword(s):  
Public Health ◽  
Health Information ◽  
Health Care Providers ◽  
Digital Health ◽  
Smart Device ◽  
P Value ◽  
Care Providers ◽  
Cross Sectional ◽  
The Us ◽  
National Trends

Objectives. To examine prevalence and predictors of digital health engagement among the US population. Methods. We analyzed nationally representative cross-sectional data on 7 digital health engagement behaviors, as well as demographic and socioeconomic predictors, from the Health Information National Trends Survey (HINTS 5, cycle 2, collected in 2018; n = 2698–3504). We fitted multivariable logistic regression models using weighted survey responses to generate population estimates. Results. Digitally seeking health information (70.14%) was relatively common, whereas using health apps (39.53%) and using a digital device to track health metrics (35.37%) or health goal progress (38.99%) were less common. Digitally communicating with one’s health care providers (35.58%) was moderate, whereas sharing health data with providers (17.20%) and sharing health information on social media (14.02%) were uncommon. Being female, younger than 65 years, a college graduate, and a smart device owner positively predicted several digital health engagement behaviors (odds ratio range = 0.09–4.21; P value range < .001–.03). Conclusions. Many public health goals depend on a digitally engaged populace. These data highlight potential barriers to 7 key digital engagement behaviors that could be targeted for intervention. (Am J Public Health. Published online ahead of print May 20, 2021: e1–e4. https://doi.org/10.2105/AJPH.2021.306282 )

scholarly journals Factoring digital health for improved outcomes in management of Non Communicable Diseases

2016 ◽  
Vol 04 (02) ◽  
pp. 102-107
Author(s):  
Neera Gupta ◽  
Tushar Dixit ◽  
Vikram K.
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Ethical Issues ◽  
Digital Health ◽  
Treatment Compliance ◽  
Security And Privacy ◽  
Noncommunicable Diseases ◽  
The Government

AbstractMake in India is a flagship campaign from the Government of India which is aimed at various sectors. Indian health-care system can take advantages by introducing digital technologies to health care. The possible uses of health information technology as a method to engage with people involving communicable and noncommunicable diseases (NCDs) are wide-ranging. Health information technology can support interventions for prevention, diagnosis, managing surveillance, disease monitoring, and treatment compliance of many conditions. Digital health can offer various technologies such as wearables that are tracked by various mobile or smartphone applications to facilitates patient engagement, self-monitoring, and implementing behavior changes in NCDs such as diabetes. By incorporating the interactive audiovisual items, the digital health tools can create greater interest and engage people from different geographies, age, gender, and culture. Currently, the common digital heath tech issues include hesitancy from doctors to adopt any new product or technology, difficulty in reaching and accessing the needy patients, cultural diversity in population, and inadequate infrastructure. The ethical issues of consent, data security, and privacy of patients need to be addressed as they are highly sensitive in nature.

Digital health and the need to develop centers of expertise in sub-Saharan Africa : two examples in Mali and Cameroon

2017 ◽  
Vol 27 (4) ◽  
pp. 348-353 ◽  
Author(s):  
C.-O. Bagayoko ◽  
G. Bediang ◽  
A. Anne ◽  
M. Niang ◽  
A.-K. Traoré ◽  
...  
Keyword(s):  
Digital Health ◽  
Sub Saharan Africa ◽  
Sub Saharan
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