Assessing determinants of programmatic performance of community management of malaria, pneumonia, and diarrhea in children in Africa: Protocol and data collection for a mixed-methods evaluation of iCCM (Preprint)

2021 ◽  
Author(s):  
Aliya Karim ◽  
Don de Savigny ◽  
Serge Ngaima ◽  
Daniel Mäusezahl ◽  
Daniel Cobos Muñoz ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Child Health ◽  
Data Collection ◽  
Intervention Effectiveness ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Middle Income ◽  
Key Informant ◽  
Low And Middle Income

BACKGROUND Integrated community case management (iCCM) is a child health program designed to provide integrated, community-based care for pneumonia, malaria and diarrhea for children in hard-to-reach areas of low- and middle-income countries (LMICs). The foundation of the intervention is service-delivery by community health workers (CHWs) who depend on reliable provision of drugs and supplies, consistent supervision, comprehensive training, and community acceptance and participation to perform optimally. The effectiveness of the program may also depend on a number of other elements, including an enabling policy environment, financing mechanisms from the national to the local level, data transmission systems, and appropriate monitoring and evaluation. The extent to which these factors act upon each other to influence the effectiveness and viability of iCCM is both variable and challenging to assess, especially across different implementation contexts. OBJECTIVE In this paper, we describe a mixed-methods systems-based study protocol to assess the programmatic components of iCCM which are associated with intervention effectiveness, and report preliminary results of data collection. METHODS This protocol employs a mixed qualitative and quantitative study design based on a Systems Thinking approach within four iCCM programs in Malawi, Democratic Republic of the Congo, Niger State, and Abia State, Nigeria. Routine monitoring data is collected to determine intervention effectiveness, namely testing, treatment and referral outcomes. Surveys with CHWs, supervisors, and caregivers are performed to collect quantitative data on their demographics, activities, and experiences within the program, and how these relate to the areas of intervention effectiveness. Focus group discussions are conducted with these stakeholders as well as local traditional leaders to contextualize this data. Key informant interviews are undertaken with national and district-level program stakeholders and officers knowledgeable in critical program processes. RESULTS We performed 3,836 surveys and 45 focus group discussions with CHWs, supervisors, and caregivers, and traditional leaders; 120 key informant interviews with district and national-level program managers, health officers, and ministry officials. Policy and program documents were additionally collected for review. CONCLUSIONS Evidence from this study will inform child health programs and practice in low- and middle-income settings, and future policy development within the iCCM intervention.

scholarly journals Social and cultural factors perpetuating early marriage in rural Gambia: an exploratory mixed methods study

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 1949
Author(s):  
Mat Lowe ◽  
Mamsamba Joof ◽  
Bomar Mendez Rojas
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Rural Areas ◽  
The Gambia ◽  
Early Marriage ◽  
Rural Settlements ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Cross Sectional ◽  
Key Informant

Background: Over the last two decades, early marriage in the Gambia declined significantly (from 58% to 30%), however this rate is still high. The reasons for the decline but continuing practice of early marriage, despite existing legislation prohibiting child marriage, are not very well understood. Very few studies have been conducted to find out what and how local factors influence decisions about early marriage in the Gambia. More information is therefore needed on underlying reasons for the persistence of early marriage in the Gambia so that program managers can use this information to design strategies to decrease early marriages. Methods: The study was conducted in 24 rural settlements in Lower Baddibu District in the North Bank Region of the Gambia. It was based on a mixed-methods design including a cross-sectional household survey with a sample of 181 female adolescents, focus group discussions with 16 male and female parents, and eight key informant interviews with community-based decision makers. Focus group discussions and key informant interviews were transcribed verbatim and analyzed using thematic content analysis, while survey data were analyzed using Stata. Results: The study finds that ethnicity and the fear that girls may engage in premarital sex are two important factors associated with early marriage in rural Gambia. In addition, lack of meaningful alternatives to marriage including work opportunities in rural areas may also limit the options and resources available to girls, resulting in early wedlock. Conclusions: These findings suggest that in order to decrease early marriages in rural Gambia, future efforts should focus on understanding and addressing the role of ethnicity in determining marriage patterns and allaying the fear around premarital sex.The findings also suggest a need to provide girls with employment-oriented education including vocational skills which may result into more empowerment and a delay in marriage.

scholarly journals Social and cultural factors perpetuating early marriage in rural Gambia: an exploratory mixed methods study

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 1949
Author(s):  
Mat Lowe ◽  
Mamsamba Joof ◽  
Bomar Mendez Rojas
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Rural Areas ◽  
The Gambia ◽  
Early Marriage ◽  
Rural Settlements ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Cross Sectional ◽  
Key Informant

Background: Over the last two decades, early marriage in the Gambia declined significantly (from 58% to 30%), however this rate is still high. The reasons for the decline but continuing practice of early marriage, despite existing legislation prohibiting child marriage, are not very well understood. Very few studies have been conducted to find out what and how local factors influence decisions about early marriage in the Gambia. More information is therefore needed on underlying reasons for the persistence of early marriage in the Gambia so that program managers can use this information to design strategies to decrease early marriages. Methods: The study was conducted in 24 rural settlements in Lower Baddibu District in the North Bank Region of the Gambia. It was based on a mixed-methods design including a cross-sectional household survey with a sample of 181 female adolescents, focus group discussions with 16 male and female parents, and eight key informant interviews with community-based decision makers. Focus group discussions and key informant interviews were transcribed verbatim and analyzed using thematic content analysis, while survey data were analyzed using Stata. Results: The study finds that ethnicity and the fear that girls may engage in premarital sex are two important factors associated with early marriage in rural Gambia. In addition, lack of meaningful alternatives to marriage including work opportunities in rural areas may also limit the options and resources available to girls, resulting in early wedlock. Conclusions: These findings suggest that in order to decrease early marriages in rural Gambia, future efforts should focus on understanding and addressing the role of ethnicity in determining marriage patterns and allaying the fear around premarital sex.The findings also suggest a need to provide girls with employment-oriented education including vocational skills which may result into more empowerment and a delay in marriage.

scholarly journals Opportunities for improving patient experiences among medical travellers from Canada’s far north: a mixed-methods study

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e030885 ◽  
Author(s):  
Kate Kerber ◽  
Fariba Kolahdooz ◽  
Meeka Otway ◽  
Melinda Laboucan ◽  
Se Lim Jang ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Cultural Awareness ◽  
Health Workers ◽  
Patient Experiences ◽  
Access To Healthcare ◽  
Community Advisory Board ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Key Informant

ObjectivesThis paper explores patient experiences and identifies barriers and opportunities for improving access to healthcare for patients from the Canadian north who travel to receive medical care in a Southern province.DesignA mixed-methods, cross-sectional study involved one-on-one interviews, focus group discussions and key informant interviews.Participants52 one-on-one interviews with Northwest Territories (NWT) patients and patient escorts and two focus group discussions (n=10). Fourteen key informant interviews were conducted with health workers, programme managers and staff of community organisations providing services for out-of-province patients. A Community Advisory Board guided the development of the questionnaires and interpretation of results.ResultsRespondents were satisfied with the care received overall, but described unnecessary burdens and bureaucratic challenges throughout the travel process. Themes relating to access to healthcare included: plans and logistics for travel; level of communication between services; clarity around jurisdiction and responsibility for care; indirect costs of travel and direct costs of uninsured services; and having a patient escort or advocate available to assist with appointments and navigate the system. Three themes related to healthcare experiences included: cultural awareness, respect and caring, and medical translation. Respondents provided suggestions to improve access to care.ConclusionsPatients from NWT need more information and support before and during travel. Ensuring that medical travellers and escorts are prepared before departing, that healthcare providers engage in culturally appropriate communication and connecting travellers to support services on arrival have the potential to improve medical travel experiences.

scholarly journals Nairobi Early Childcare in Slums (NECS) Study Protocol: a mixed-methods exploration of paid early childcare in Mukuru slum, Nairobi

2020 ◽  
Vol 4 (1) ◽  
pp. e000822
Author(s):  
Robert C Hughes ◽  
Patricia Kitsao-Wekulo ◽  
Sunil Bhopal ◽  
Elizabeth W Kimani-Murage ◽  
Zelee Hill ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Early Years ◽  
Epidemiological Methods ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Early Childcare ◽  
Depth Interviews ◽  
Childcare Providers

IntroductionThe early years are critical. Early nurturing care can lay the foundation for human capital accumulation with lifelong benefits. Conversely, early adversity undermines brain development, learning and future earning.Slums are among the most challenging places to spend those early years and are difficult places to care for a child. Shifting family and work structures mean that paid, largely informal, childcare seems to be becoming the ‘new normal’ for many preschool children growing up in rapidly urbanising Africa. However, little is known about the quality of this childcare.AimsTo build a rigorous understanding what childcare strategies are used and why in a typical Nairobi slum, with a particular focus on provision and quality of paid childcare. Through this, to inform evaluation of quality and design and implementation of interventions with the potential to reach some of the most vulnerable children at the most critical time in the life course.Methods and analysisMixed methods will be employed. Qualitative research (in-depth interviews and focus group discussions) with parents/carers will explore need for and decision-making about childcare. A household survey (of 480 households) will estimate the use of different childcare strategies by parents/carers and associated parent/carer characteristics. Subsequently, childcare providers will be mapped and surveyed to document and assess quality of current paid childcare. Semistructured observations will augment self-reported quality with observable characteristics/practices. Finally, in-depth interviews and focus group discussions with childcare providers will explore their behaviours and motivations. Qualitative data will be analysed through thematic analysis and triangulation across methods. Quantitative and spatial data will be analysed through epidemiological methods (random effects regression modelling and spatial statistics).Ethics and disseminationEthical approval has been granted in the UK and Kenya. Findings will be disseminated through journal publications, community and government stakeholder workshops, policy briefs and social media content.

scholarly journals Drivers and barriers to workplace-based HIV self-testing among high-risk men in Uganda: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patience A. Muwanguzi ◽  
Robert C. Bollinger ◽  
Stuart C. Ray ◽  
LaRon E. Nelson ◽  
Noah Kiwanuka ◽  
...  
Keyword(s):  
Focus Group ◽  
Hiv Testing ◽  
Private Security ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Private Security Companies ◽  
Self Testing ◽  
Key Informant ◽  
Hiv Testing Services ◽  
Security Companies

Abstract Background Men in Sub-Saharan Africa are less engaged than women in accessing HIV testing and treatment and, consequently, experience higher HIV-related mortality. Reaching men with HIV testing services is challenging, thus, increasing the need for innovative ways to engage men with low access and those at higher risk. In this study, we explore men’s perceptions of drivers and barriers of workplace-based HIV self-testing in Uganda. Methods An exploratory study involving men working in private security companies employing more than 50 men in two districts, in central and western Uganda. Focus group discussions and key informant interviews were conducted. Data were analyzed using inductive content analysis. Results Forty-eight (48) men from eight private security companies participated in 5 focus group discussions and 17 key informant interviews. Of the 48 men, 14(29.2%) were ages 26–35 years. The majority 31(64.6%) were security guards. The drivers reported for workplace-based HIV self-testing included convenience, autonomy, positive influence from work colleagues, the need for alternative access for HIV testing services, incentives, and involvement of employers. The barriers reported were the prohibitive cost of HIV tests, stigma, lack of testing support, the fear of discrimination and isolation, and concerns around decreased work productivity in the event of a reactive self-test. Conclusions We recommend the involvement of employers in workplace-based HIV self-testing to encourage participation by employees. There is need for HIV self-testing support both during and after the testing process. Both employers and employees recommend the use of non-monetary incentives, and regular training about HIV self-testing to increase the uptake and acceptability of HIV testing services at the workplace.

scholarly journals A mixed methods approach to determine the climate of interprofessional education among medical and health sciences students

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nabil Sulaiman ◽  
Youssef Rishmawy ◽  
Amal Hussein ◽  
Maha Saber-Ayad ◽  
Hamzah Alzubaidi ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Patient Care ◽  
Interprofessional Education ◽  
Health Sciences ◽  
Study Cohort ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Positive Attitudes ◽  
Health Sciences Students

Abstract Background High-quality patient care is a complex phenomenon that requires collaboration among healthcare professionals. Research has shown that Interprofessional Education (IPE) carries promise to improve collaborative work and patient care. So far, collaboration among various health professionals remains a challenge. Very few focus group discussions to determine the medical students’ readiness and positive attitudes towards IPE have been reported from the Arabian context. Methods A two-staged sequential mixed methods study was conducted among medical, dental, pharmacy, and health sciences students of the University of Sharjah United Arab Emirates. The perspectives of students toward IPE and collaborative practice were first gathered by administering a validated instrument, Readiness for Interprofessional Learning Scale (RIPLS). This was followed by focused group discussions. A quantitative as well as a qualitative data analysis was performed. Results This study cohort included 282 students. All respondents showed readiness to adopt IPE as all statements of the RIPLS inventory scored high median scores. All participants showed positive attitudes and readiness towards IPE. Three main domains of themes were generated from focus group discussions; prior knowledge, need for IPE framework and its implementation. Information workload, lack of clarity and less focused teaching pedagogies of IPE were considered as perceived barriers. Conclusion This study demonstrated a substantial agreement of medical and health sciences students towards readiness and perceived effectiveness of IPE. Educators are urged to embed new IPE programs into existing curricular frameworks, which can potentially enhance collaborative learning and improve quality of patient care.

scholarly journals America in Pakistani Print Media: A Semiotic Discourse Analysis based Study of Pak-Us Relationship

2020 ◽  
Vol 9 (4) ◽  
pp. 71
Author(s):  
Muhammad Akber Sajid ◽  
Muhammad Riaz Khan
Keyword(s):  
Qualitative Research ◽  
Focus Group ◽  
Data Collection ◽  
Print Media ◽  
Time Span ◽  
Research Model ◽  
Semiotic Analysis ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Qualitative Research Design

Print media semiotic discourses are one of the best sites for ideological investment and their role is very significant in the production and dissemination of certain ideology. The aim of the present study is to critically decode the semiotic discourse(s) of Pakistani English newspaper DAWN (daily) with special reference to the representation of Pak- Us relationship through the analysis of the semiotics discourses. The data for the present research has been collected from the mentioned newspaper. The time span for data collection ranges from October 2018 to December 2018. Out of ten (10) caricatures which represent Pakistan attempting to survive at its own rather than depending on America one was purposively selected for linguistic and semiotic analyses. The study is descriptive and utilizes qualitative research design. For this purpose, the researchers have devised an amended research model by drawing upon Fairclough (1995), Kress (2010) and Kruger’s (2000) research models to analyse linguistic, semiotic and focus group discussions data. The semiotic analysis has also been validated by incorporating the remarks of focus group participants. Based on the analysis of data the study concludes that noting is absolute in politics as far as Pak- Us relations through semiotic discourses are concerned. Additionally, the research reveals that print media semiotic discourses work insidiously to represent socio- political changes by employing linguistic and meta-linguistic devices and techniques.

scholarly journals Study on Potentiality of Biogas Plants and Their Role for the Conservation of Environment

2015 ◽  
Vol 15 (2) ◽  
pp. 51-56
Author(s):  
Dinesh Ghimire ◽  
Jagannath Shrestha ◽  
Anup K.C
Keyword(s):  
Focus Group ◽  
Science And Technology ◽  
Primary Data ◽  
Household Surveys ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
The People ◽  
Key Informant ◽  
Biogas Plants ◽  
Biogas Technology

This study presents the potentiality of biogas plants and their role for the conservation of environment. It is basedon primary data collected from 84 household surveys, 6 key informant interviews and two focus group discussions. It was observed that more than 95% of the people residing in the VDCs were using firewood as a main source ofenergy. The total amount of firewood consumed was 510.570 ton/year which emits 775.052tCO2e/year. Due to the presence of agriculture based livestock holding population, there is a great potential of biogas technology. Thestudy showed that biogas technology could saved 34.40% of firewood which conserves 5.415 ha of forests area. There is a potentiality of 58 biogas plants of size 6 cu.m which will reduce 440.800 tCO2e/year.DOI: http://dx.doi.org/njst.v15i2.12114Nepal Journal of Science and Technology Vol. 15, No.2 (2014) 51-56

scholarly journals Persepsi Ibu Terhadap Iklan Vaksin Measles Rubella (MR)

2019 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Muslimah Muslimah ◽  
Dian Ayubi
Keyword(s):  
Public Health ◽  
Health Promotion ◽  
Focus Group ◽  
Data Collection ◽  
Qualitative Study ◽  
Electronic Media ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Data Collection Process ◽  
Depth Interviews

Measles and Rubella (MR) is a disease that is highly contagious and usually occurs in children aged 9 months until the age of 15 years. One effort that can be done to reduce the incidence of the disease is through health promotion about the importance of immunization. Purpose the promotion was packaged in the form of advertisements on electronic media with the aim of building perceptions that the importance of immunization for public health. Methods this research was a qualitative study with a method of collecting in-depth interviews and focus group discussions. The number of informants in this study was 19 mothers who had children aged 0.9 to 15 years in one of the Puskesmas work areas in Merangin District, Jambi Province. Before the data collection process, all informants were asked to see two MR immunization advertisements. Results that immunization advertisements are interesting and contain humor. Meanwhile, informants who did not give MR immunization to their children tended to be negative towards MR immunization advertisements and tended to ignore the effects that arose if they did not give immunizations to their children. The recommendation that MR immunization advertisements should avoid using the fear arousal method and use the pay off idea method in those ads

scholarly journals Poor Information Literacy Skills and Practices as Barriers to Academic Performance: A Mixed Methods Study of the University of Dar es Salaam

2016 ◽  
Vol 55 (4) ◽  
pp. 293 ◽  
Author(s):  
Tina Klomsri ◽  
Matti Tedre
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Information Literacy ◽  
Literacy Skills ◽  
Focus Group Discussions ◽  
Online Questionnaire ◽  
Group Discussions ◽  
Postgraduate Students ◽  
Knowing How ◽  
The University

Information and Communication Technology (ICT) is increasingly used in Tanzanian education. Knowing how to operate ICT alone is incomplete without knowing how to use it as a tool for organization, communication, research, and problem-solving. In recognition of this challenge, information literacy (IL) has been identified as a key attribute to students as they progress through their learning paths. Based on a mixed methods strategy, using questionnaires and focus group discussions, this study measured the level of IL skills among University of Dar es Salaam’s (UDSM) postgraduate students, to gain insights into the students’ perceptions and experiences with information problems. A total of 102 students from four institutions answered the online questionnaire and 22 students participated in six focus group discussions. The questionnaire scores of the students were poor in the majority of IL categories, suggesting ineffectiveness of the current IL training in imparting IL knowledge and skills. The study ends by discussing recommendations to improve current IL practices at the university.

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