scholarly journals Family Medicine Training in Lesotho: A Strategy of Decentralized Training for Rural Physician Workforce Development

2021 ◽  
Vol 7 ◽  
Author(s):  
Benjamin Bryden ◽  
Mariel Bryden ◽  
Jonathan Steer-Massaro ◽  
Sebaka Malope
Keyword(s):  
Family Medicine ◽  
Training Program ◽  
Health Professionals ◽  
Capital City ◽  
Sub Saharan Africa ◽  
Physician Workforce ◽  
District Hospitals ◽  
Medical Discipline ◽  
Rural Physician ◽  
Health Alliance

Family medicine is a relatively new but rapidly expanding medical discipline in Sub-Saharan Africa. Specialization in family medicine is an effective means for building and retaining a highly skilled rural physician workforce in low- and middle-income countries. The Lesotho Boston Health Alliance Family Medicine Specialty Training Program is the first and only postgraduate family medicine program and the only accredited postgraduate training program in the Kingdom of Lesotho. Lesotho has unique challenges as a small mountainous enclave of South Africa with one of the lowest physician-to-patient ratios in the world. Most health professionals are based in the capital city, and the kingdom faces challenging health problems such as high human immunodeficiency virus prevalence, high maternal mortality, and malnutrition, as well as increasing burdens of non-communicable diseases such as hypertension, diabetes, and obesity. In response to these health crises and the severe shortage of health professionals, Lesotho Boston Health Alliance partnered with the Lesotho Ministry of Health in 2008 to introduce family medicine as a new specialty in order to recruit home and retain Basotho doctors. Family medicine training in Lesotho uses a unique decentralized, non-university-based model with trainees posted at rural district hospitals throughout the country. While family medicine in Lesotho is still in the early stages of development, this model of decentralized training demonstrates an effective strategy to develop the rural health workforce in Lesotho, has the potential to change the physician workforce and health care system of Lesotho, and can be a model for physician training in similar environments.

52. Simulation based training improves resident competence in the performance of critical resuscitation procedures

2007 ◽  
Vol 30 (4) ◽  
pp. 56
Author(s):  
I. Rigby ◽  
I. Walker ◽  
T. Donnon ◽  
D. Howes ◽  
J. Lord
Keyword(s):  
Internal Medicine ◽  
Emergency Medicine ◽  
Medical Education ◽  
Family Medicine ◽  
Training Program ◽  
Correlation Coefficient ◽  
Training Programs ◽  
Self Assessment ◽  
Procedural Skills ◽  
Simulation Based

We sought to assess the impact of procedural skills simulation training on residents’ competence in performing critical resuscitation skills. Our study was a prospective, cross-sectional study of residents from three residency training programs (Family Medicine, Emergency Medicine and Internal Medicine) at the University of Calgary. Participants completed a survey measuring competence in the performance of the procedural skills required to manage hemodynamic instability. The study intervention was an 8 hour simulation based training program focused on resuscitation procedure psychomotor skill acquisition. Competence was criterion validated at the Right Internal Jugular Central Venous Catheter Insertion station by an expert observer using a standardized checklist (Observed Structured Clinical Examination (OSCE) format). At the completion of the simulation course participants repeated the self-assessment survey. Descriptive Statistics, Cronbach’s alpha, Pearson’s correlation coefficient and Paired Sample t-test statistical tools were applied to the analyze the data. Thirty-five of 37 residents (9 FRCPC Emergency Medicine, 4 CCFP-Emergency Medicine, 17 CCFP, and 5 Internal Medicine) completed both survey instruments and the eight hour course. Seventy-two percent of participants were PGY-1 or 2. Mean age was 30.7 years of age. Cronbach’s alpha for the survey instrument was 0.944. Pearson’s Correlation Coefficient was 0.69 (p < 0.001) for relationship between Expert Assessment and Self-Assessment. The mean improvement in competence score pre- to post-intervention was 6.77 (p < 0.01, 95% CI 5.23-8.32). Residents from a variety of training programs (Internal Medicine, Emergency Medicine and Family Medicine) demonstrated a statistically significant improvement in competence with critical resuscitation procedural skills following an intensive simulation based training program. Self-assessment of competence was validated using correlation data based on expert assessments. Dawson S. Procedural simulation: a primer. J Vasc Interv Radiol. 2006; 17(2.1):205-13. Vozenilek J, Huff JS, Reznek M, Gordon JA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004; 11(11):1149-54. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003; 78(8):783-8.

scholarly journals Climate Change and Health Preparedness in Africa: Analysing Trends in Six African Countries

2021 ◽  
Vol 18 (9) ◽  
pp. 4672
Author(s):  
Samuel Kwasi Opoku ◽  
Walter Leal Filho ◽  
Fudjumdjum Hubert ◽  
Oluwabunmi Adejumo
Keyword(s):  
Public Health ◽  
Climate Change ◽  
South Africa ◽  
Human Health ◽  
Health Systems ◽  
Health Professionals ◽  
Health Problems ◽  
Sub Saharan Africa ◽  
Basic Knowledge ◽  
African Countries

Climate change is a global problem, which affects the various geographical regions at different levels. It is also associated with a wide range of human health problems, which pose a burden to health systems, especially in regions such as Africa. Indeed, across the African continent public health systems are under severe pressure, partly due to their fragile socioeconomic conditions. This paper reports on a cross-sectional study in six African countries (Ghana, Nigeria, South Africa, Namibia, Ethiopia, and Kenya) aimed at assessing their vulnerabilities to climate change, focusing on its impacts on human health. The study evaluated the levels of information, knowledge, and perceptions of public health professionals. It also examined the health systems’ preparedness to cope with these health hazards, the available resources, and those needed to build resilience to the country’s vulnerable population, as perceived by health professionals. The results revealed that 63.1% of the total respondents reported that climate change had been extensively experienced in the past years, while 32% claimed that the sampled countries had experienced them to some extent. Nigerian respondents recorded the highest levels (67.7%), followed by Kenya with 66.6%. South Africa had the lowest level of impact as perceived by the respondents (50.0%) when compared with the other sampled countries. All respondents from Ghana and Namibia reported that health problems caused by climate change are common in the two countries. As perceived by the health professionals, the inadequate resources reiterate the need for infrastructural resources, medical equipment, emergency response resources, and technical support. The study’s recommendations include the need to improve current policies at all levels (i.e., national, regional, and local) on climate change and public health and to strengthen health professionals’ skills. Improving the basic knowledge of health institutions to better respond to a changing climate is also recommended. The study provides valuable insights which may be helpful to other nations in Sub-Saharan Africa.

scholarly journals Surgical ambulance referrals in sub-Saharan Africa – financial costs and coping strategies at district hospitals in Tanzania, Malawi and Zambia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Martilord Ifeanyichi ◽  
Henk Broekhuizen ◽  
Mweene Cheelo ◽  
Adinan Juma ◽  
Gerald Mwapasa ◽  
...  
Keyword(s):  
Coping Strategies ◽  
Surgical Care ◽  
Sub Saharan Africa ◽  
Financial Reports ◽  
Study Approach ◽  
Hospital Managers ◽  
District Hospitals ◽  
Sub Saharan ◽  
Microsoft Office ◽  
Patient Referrals

Abstract Background An estimated nine out of ten persons in sub-Saharan Africa (SSA) are unable to access timely, safe and affordable surgery. District hospitals (DHs) which are strategically located to provide basic (non-specialist) surgical care for rural populations have in many instances been compromised by resource inadequacies, resulting in unduly frequent patient referrals to specialist hospitals. This study aimed to quantify the financial burdens of surgical ambulance referrals on DHs and explore the coping strategies employed by these facilities in navigating the challenges. Methods We employed a multi-methods descriptive case study approach, across a total of 14 purposively selected DHs; seven, three, and four in Tanzania, Malawi and Zambia, respectively. Three recurrent cost elements were identified: fuel, ambulance maintenance and staff allowances. Qualitative data related to coping mechanisms were obtained through in-depth interviews of hospital managers while quantitative data related to costs of surgical referrals were obtained from existing records (such as referral registers, ward registers, annual financial reports, and other administrative records) and expert estimates. Interview notes were analysed by manual thematic coding while referral statistics and finance data were processed and analysed using Microsoft Office Excel 2016. Results At all but one of the hospitals, respondents reported inadequacies in numbers and functional states of the ambulances: four centres indicated employing non-ambulance vehicles to convey patients occassionally. No statistically significant correlation was found between referral trip distances and total annual numbers of referral trips, but hospital managers reported considering costs in referral practices. For instance, ten of the study hospitals reported combining patients to minimize trip frequencies. The total cost of ambulance use for patient transportation ranged from I$2 k to I$58 k per year. Between 34% and 79% of all patient referrals were surgical, with total costs ranging from I$1 k to I$32 k per year. Conclusion Cost considerations strongly influence referral decisions and practices, indicating a need for increases in budgetary allocations for referral services. High volumes of potentially avoidable surgical referrals provide an economic case – besides equitable access to healthcare – for scaling up surgery capacity at the district level as savings from decreased referrals could be reinvested in referral systems strengthening.

scholarly journals Knowledge, utilization and barriers of cervical cancer screening among women attending selected district hospitals in Kigali - Rwanda

2021 ◽  
Vol 31 (3) ◽  
pp. 266-274
Author(s):  
Gaudence Niyonsenga ◽  
Darius Gishoma ◽  
Ruth Sego ◽  
Marie Goretti Uwayezu ◽  
Bellancille Nikuze ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Knowledge Utilization ◽  
Sub Saharan Africa ◽  
Eastern Africa ◽  
Screening Rate ◽  
Effective Prevention ◽  
District Hospitals ◽  
Screening Services

Background: Cervical cancer is the third most common cancer attacking women globally, and the second in Eastern Africa where Rwanda is located. Regular screening is an effective prevention approach for cervical cancer. Despite that, the screening rate for cervical cancer in Africa is estimated between 10% and 70%, with a number of barriers. This is especially the case in sub-Saharan Africa. In Rwanda, there is limited literature on the rate of use of screening services or the barriers to cervical screening. Objective: To assess knowledge, utilization, and barriers of cervical cancer screening among women attending selected district hospitals in Kigali, Rwanda. Methods: A descriptive cross-sectional study with a structured questionnaire was used to collect data. Nominal ‘yes’ or ‘no’ questions were used to gather data on knowledge and utilisation of cervical cancer and its screening. Likert-type scale questions were used to identify different barriers to screening services. Data were analysed using descriptive and inferential statistics. Respondents were selected by systematic random sampling from the database of women attending gynaecology services at three district hospitals in Kigali, Rwanda. Results: Three hundred and twenty-nine women responded to the survey. Half of the respondents (n = 165) had high knowledge level scores on cervical cancer screening. The cervical cancer screening rate was 28.3%. Utilization of screening was associated with knowledge (P = 0.000, r = -0.392) and selected demographic factors (P = 0.000). Individual barriers included poor knowledge on availability of screening services, community barriers included living in a rural area, and health provider and systems barriers included lack of awareness campaigns, negative attitudes of healthcare providers toward clients, and long waiting times; all barriers limit the access to screening services. Conclusion: A low rate of cervical cancer screening was identified for women attending selected district hospitals in Kigali-Rwanda due to various barriers. On-going education on cervical cancer and its screening is highly recommended. It is important that trained health providers encourage their clients to have cervical cancer screening and work to reduce related barriers.

scholarly journals A Clinician-Researcher Training Program for Family Medicine Residents

2019 ◽  
Vol 42 (3) ◽  
pp. E35-E39
Author(s):  
Gideon Koren ◽  
Linoy Gabay ◽  
Joseph Kuchnir
Keyword(s):  
Family Medicine ◽  
Health Services ◽  
Training Program ◽  
Research Training ◽  
Research Question ◽  
Steering Committee ◽  
Research Proposal ◽  
Community Based ◽  
Community Based Research ◽  
Face To Face

Purpose: Research training for clinicians is becoming relatively common for postdoctoral trainees in academic institutions. In contrast, there are relatively few such training programs for family physician residents. The purpose of this article is to describe a novel program for family medicine trainees in Maccabi Health Services, a large Israeli health fund. Methods: Following organizational approval and budget allocation, a call for family residents resulted in 18 applications, 15 of whom were selected for a two-year research training program. Each trainee submitted a research proposal, dealing with a community- based research question. Each protocol was allocated a budget. The Program, overseen by a steering committee of family physicians and scientists, has a designated clinical epidemiologist who coordinates all activities. The Project runs monthly face-to-face meetings where trainees present their research proposals. The group reviewed the protocols ahead of time, commented on them and criticized them. In parallel, the trainees participate in a detailed discussion of their research proposals face-to-face with the program director and clinical epidemiologist, and the revised research proposal is submitted to the Institution Review Board. Results: The Program received enthusiastic responses from the trainees and from Maccabi Health Services, which has already approved the budget for the second year of the Program with a new stream of trainees. The approved research proposals dealt with original and important community-based clinical questions. Conclusions: With the aim of developing clinician-researchers in the field of family medicine, this novel program will help change the research climate in a large organization, where community-based family practitioners were not typically involved in research.

scholarly journals Online Training Course on COVID-19

BioMedica ◽  
2020 ◽  
Vol 36 (2S) ◽  
pp. 78-80
Author(s):  
Nasir Shah
Keyword(s):  
Risk Factors ◽  
Family Medicine ◽  
Health Professionals ◽  
Clinical Presentation ◽  
Online Courses ◽  
Online Training ◽  
Health Sciences ◽  
Online Course ◽  
Global Trend ◽  
The World

<p>In the wake of COVID-19 pandemic, global trend for launching online courses and trainings regarding risk factors, acquisition, diagnosis, clinical presentation, management and prevention of COVID-19 is cresting. Department of Family Medicine at University of Health Sciences Lahore introduced a 2-hours online course where a total of 39993 health professionals from all over the world were enrolled and 32000 participants completed the course with encouraging feedback.</p>

Envisioning a National e-Medicine Network Architecture in a Developing Country

2011 ◽  
pp. 35-53
Author(s):  
Fikreyohannes Lemma ◽  
Mieso K. Denko ◽  
Joseph K. Tan ◽  
Samuel Kinde Kassegne
Keyword(s):  
Developing Countries ◽  
Developing Country ◽  
Health Professionals ◽  
Network Architecture ◽  
Healthcare Services ◽  
Sub Saharan Africa ◽  
Policy Makers ◽  
Effective Delivery ◽  
Sub Saharan ◽  
Medical And Healthcare

Poor infrastructures in developing countries such as Ethiopia and much of Sub-Saharan Africa have caused these nations to suffer from lack of efficient and effective delivery of basic and extended medical and healthcare services. Often, such limitation is further accompanied by low patient-doctor ratios, resulting in unwarranted rationing of services. Apparently, e-medicine awareness among both governmental policy makers and private health professionals is motivating the gradual adoption of technological innovations in these countries. It is argued, however, that there still is a gap between current e-medicine efforts in developing countries and the existing connectivity infrastructure leading to faulty, inefficient and expensive designs. The particular case of Ethiopia, one such developing country where e-medicine continues to carry significant promises, is investigated and reported in this article.

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