scholarly journals Professionalisation of International Medical Volunteer Work to Maintain Ethical Standards: A Qualitative Study Exploring the Experience of Volunteer Doctors in Relation to UK Policy

2019 ◽  
Vol 7 (1) ◽  
pp. 9
Author(s):  
Holly Eadsforth
Keyword(s):  
Government Policy ◽  
Policy Development ◽  
Positive Impact ◽  
Critical Evaluation ◽  
International Medical ◽  
Ethical Standards ◽  
Structured Interviews ◽  
Middle Income ◽  
External Governance ◽  
Medical Volunteerism

Doctors from the United Kingdom are increasingly involved in international medical volunteerism in low- and middle-income countries (LMICs). Although supported by government policy this practice lacks infrastructure and coordination. Volunteer activities can have positive impact but also risk causing harm. Without external governance the responsibility lies with volunteers and their organisations to self-evaluate their activities. This study aimed to explore influences affecting volunteer engagement with ethical standards and evaluative practice. Semi-structured interviews were conducted with seven doctors working in the Scottish National Health Service with volunteer experience in LMICs. Findings were analysed thematically to explore this issue in view of ongoing policy development. Although ethical standards were valued by participants they were unaware of relevant government policy. Influences on volunteer development are unstructured and vary in quality. Evaluation lacks structure and framing. Volunteer physicians face a number of barriers to engaging in critical evaluation of their activities in LMICs. Development and professionalization of medical volunteering in LMICs needs to address volunteer preparation and evaluative practice to maximise the benefits of volunteering, reduce the risk of harm and maximise learning and accountability. Further areas of research are suggested to inform professionalisation of this sector.

scholarly journals Experiences and impact of international medical volunteering: a multi-country mixed methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e041599 ◽  
Author(s):  
Mary McCauley ◽  
Joanna Raven ◽  
Nynke van den Broek
Keyword(s):  
Low Income ◽  
Online Survey ◽  
Positive Impact ◽  
Healthcare Providers ◽  
International Medical ◽  
Middle Income ◽  
Use Of Resources ◽  
The Uk ◽  
Medical Volunteers ◽  
The Impact

ObjectiveTo assess the experience and impact of medical volunteers who facilitated training workshops for healthcare providers in maternal and newborn emergency care in 13 countries.SettingsBangladesh, Ghana, India, Kenya, Malawi, Namibia, Nigeria, Pakistan, Sierra Leone, South Africa, Tanzania, UK and Zimbabwe.ParticipantsMedical volunteers from the UK (n=162) and from low-income and middle-income countries (LMIC) (n=138).Outcome measuresExpectations, experience, views, personal and professional impact of the experience of volunteering on medical volunteers based in the UK and in LMIC.ResultsUK-based medical volunteers (n=38) were interviewed using focus group discussions (n=12) and key informant interviews (n=26). 262 volunteers (UK-based n=124 (47.3%), and LMIC-based n=138 (52.7%)) responded to the online survey (62% response rate), covering 506 volunteering episodes. UK-based medical volunteers were motivated by altruism, and perceived volunteering as a valuable opportunity to develop their skills in leadership, teaching and communication, skills reported to be transferable to their home workplace. Medical volunteers based in the UK and in LMIC (n=244) reported increased confidence (98%, n=239); improved teamwork (95%, n=232); strengthened leadership skills (90%, n=220); and reported that volunteering had a positive impact for the host country (96%, n=234) and healthcare providers trained (99%, n=241); formed sustainable partnerships (97%, n=237); promoted multidisciplinary team working (98%, n=239); and was a good use of resources (98%, n=239). Medical volunteers based in LMIC reported higher satisfaction scores than those from the UK with regards to impact on personal and professional development.ConclusionHealthcare providers from the UK and LMIC are highly motivated to volunteer to increase local healthcare providers’ knowledge and skills in low-resource settings. Further research is necessary to understand the experiences of local partners and communities regarding how the impact of international medical volunteering can be mutually beneficial and sustainable with measurable outcomes.

Informed consent: Towards improved lay-friendliness of patient information sheets

2014 ◽  
Vol 10 (3) ◽  
pp. 201-211
Author(s):  
Morten Pilegaard ◽  
Hanne Berg Ravn
Keyword(s):  
Informed Consent ◽  
Information Structure ◽  
Language Use ◽  
Ethical Standards ◽  
Structured Interviews ◽  
Explorative Study ◽  
Microsoft Word ◽  
Text Production ◽  
Linguistic Intervention ◽  
Set Up

Regional research ethics committee (REC) members have voiced a need for the linguistic improvement of informed consent documents to ensure duly informed consent and to ease committee deliberation. We have little knowledge of what elements of language use hamper comprehension, or of the extent of medical researchers’ appreciation of this problem and their willingness to accept intervention. This qualitative, explorative study proposes an intervention design and tests its feasibility and acceptability. Semi-structured interviews with potential REC applicants informed a linguistic intervention benchmarked against existing guidelines, mandated locally and nationally, and then evaluated quantitatively in a semi-controlled set-up and qualitatively via questionnaires. Potential applicants professed the psychological acceptability of linguistic intervention. The intervention comprised a downloadable Microsoft Word template outlining information structure, a detailed guideline offering advice for each move and self-selected linguistic screening. It was used by 14 applicants and had a measurable effect on REC deliberation time and approval rates. The intervention instruments overall made it easier for applicants to produce informed consent documents meeting prescribed ethical standards concerning lay-friendliness. In conclusion, it was found that linguistic intervention is relevant, feasible and psychologically acceptable to REC applicants; it aids their text production process and seems to enhance the lay-friendliness of these texts.

The European Union’s Policy towards its Eastern Neighbours: The Crisis in Ukraine

2018 ◽  
Author(s):  
Tatsiana Shaban
Keyword(s):  
Crisis Management ◽  
Policy Development ◽  
Interesting Case ◽  
European Neighbourhood Policy ◽  
Significant Progress ◽  
Challenges And Opportunities ◽  
External Governance ◽  
Institutional Challenges ◽  
The Relationship ◽  
The Eu

The European Union’s neighbourhood is complex and still far from being stable. In Ukraine, significant progress has occurred in many areas of transition; however, much work remains to be done, especially in the field of regional development and governance where many legacies of the Soviet model remain. At the crossroads between East and West, Ukraine presents an interesting case of policy development as an expression of European Union (EU) external governance. This paper asks the question: why was the relationship between the EU and Ukraine fairly unsuccessful at promoting stability in the region and in Ukraine? What was missing in the European Neighbourhood Policy (ENP) in Ukraine that rendered the EU unable to prevent a conflict on the ground? By identifying security, territorial, and institutional challenges and opportunities the EU has faced in Ukraine, this paper underlines the most important factors accounting for the performance of its external governance and crisis management in Ukraine.   Full text available at: https://doi.org/10.22215/rera.v12i2.1310

scholarly journals Improving the experience of facility-based delivery for vulnerable women through obstetric care navigation: a qualitative evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kirsten Austad ◽  
Michel Juarez ◽  
Hannah Shryer ◽  
Patricia L. Hibberd ◽  
Mari-Lynn Drainoni ◽  
...  
Keyword(s):  
Health Workers ◽  
Positive Impact ◽  
Qualitative Evaluation ◽  
Obstetric Care ◽  
Hospital Staff ◽  
Public Hospitals ◽  
Future Research ◽  
Care Seeking ◽  
Structured Interviews ◽  
The Impact

Abstract Background Global disparities in maternal mortality could be reduced by universal facility delivery. Yet, deficiencies in the quality of care prevent some mothers from seeking facility-based obstetric care. Obstetric care navigators (OCNs) are a new form of lay health workers that combine elements of continuous labor support and care navigation to promote obstetric referrals. Here we report qualitative results from the pilot OCN project implemented in Indigenous villages in the Guatemalan central highlands. Methods We conducted semi-structured interviews with 17 mothers who received OCN accompaniment and 13 staff—namely physicians, nurses, and social workers—of the main public hospital in the pilot’s catchment area (Chimaltenango). Interviews queried OCN’s impact on patient and hospital staff experience and understanding of intended OCN roles. Audiorecorded interviews were transcribed, coded, and underwent content analysis. Results Maternal fear of surgical intervention, disrespectful and abusive treatment, and linguistic barriers were principal deterrents of care seeking. Physicians and nurses reported cultural barriers, opposition from family, and inadequate hospital resources as challenges to providing care to Indigenous mothers. Patient and hospital staff identified four valuable services offered by OCNs: emotional support, patient advocacy, facilitation of patient-provider communication, and care coordination. While patients and most physicians felt that OCNs had an overwhelmingly positive impact, nurses felt their effort would be better directed toward traditional nursing tasks. Conclusions Many barriers to maternity care exist for Indigenous mothers in Guatemala. OCNs can improve mothers’ experiences in public hospitals and reduce limitations faced by providers. However, broader buy-in from hospital staff—especially nurses—appears critical to program success. Future research should focus on measuring the impact of obstetric care navigation on key clinical outcomes (cesarean delivery) and mothers’ future care seeking behavior.

scholarly journals Barriers and facilitators to online medical and nursing education during the COVID-19 pandemic: perspectives from international students from low- and middle-income countries and their teaching staff

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Wen Li ◽  
Robyn Gillies ◽  
Mingyu He ◽  
Changhao Wu ◽  
Shenjun Liu ◽  
...  
Keyword(s):  
Nursing Students ◽  
Online Education ◽  
Response Rate ◽  
International Medical ◽  
Teaching Staff ◽  
Middle Income ◽  
Middle Income Countries ◽  
Education Satisfaction ◽  
Education In China ◽  
Low And Middle Income

Abstract Background The COVID-19 pandemic posed a huge challenge to the education systems worldwide, forcing many countries to provisionally close educational institutions and deliver courses fully online. The aim of this study was to explore the quality of the online education in China for international medical and nursing students from low- and middle-income countries (LMICs) as well as the factors that influenced their satisfaction with online education during the COVID-19 pandemic. Methods Questionnaires were developed and administered to 316 international medical and nursing students and 120 teachers at a university in China. The Chi-square test was used to detect the influence of participants’ personal characteristics on their satisfaction with online education. The Kruskal–Wallis rank-sum test was employed to identify the negative and positive factors influencing the online education satisfaction. A binary logistic regression model was performed for multiple-factor analysis to determine the association of the different categories of influential factors—crisis-, learner-, instructor-, and course-related categories, with the online education satisfaction. Results Overall, 230 students (response rate 72.8%) and 95 teachers (response rate 79.2%) completed the survey. It was found that 36.5% of students and 61.1% of teachers were satisfied with the online education. Teachers’ professional title, students’ year of study, continent of origin and location of current residence significantly influenced the online education satisfaction. The most influential barrier for students was the severity of the COVID-19 situation and for teachers it was the sense of distance. The most influential facilitating factor for students was a well-accomplished course assignment and for teachers it was the successful administration of the online courses. Conclusions Several key factors have been identified that affected the attitudes of international health science students from LMICs and their teachers towards online education in China during the COVID-19 pandemic. To improve the online education outcome, medical schools are advised to promote the facilitating factors and cope with the barriers, by providing support for students and teaching faculties to deal with the anxiety caused by the pandemic, caring for the state of mind of in-China students away from home, maintaining the engagement of out-China students studying from afar and enhancing collaborations with overseas institutions to create practice opportunities at students’ local places.

scholarly journals Health workers’ perspectives on informed consent for caesarean section in Southern Malawi

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Wouter Bakker ◽  
Siem Zethof ◽  
Felix Nansongole ◽  
Kelvin Kilowe ◽  
Jos van Roosmalen ◽  
...  
Keyword(s):  
Informed Consent ◽  
Caesarean Section ◽  
Health Workers ◽  
Group Discussion ◽  
Legal Protection ◽  
Analytical Framework ◽  
Structured Interviews ◽  
Middle Income ◽  
Partial Disclosure ◽  
Labour Pains

Abstract Objective Informed consent is a prerequisite for caesarean section, the commonest surgical procedure in low- and middle-income settings, but not always acquired to an appropriate extent. Exploring perceptions of health care workers may aid in improving clinical practice around informed consent. We aim to explore health workers’ beliefs and experiences related to principles and practice of informed consent. Methods Qualitative study conducted between January and June 2018 in a rural 150-bed mission hospital in Southern Malawi. Clinical observations, semi-structured interviews and a focus group discussion were used to collect data. Participants were 22 clinical officers, nurse-midwives and midwifery students involved in maternity care. Data were analysed to identify themes and construct an analytical framework. Results Definition and purpose of informed consent revolved around providing information, respecting women’s autonomy and achieving legal protection. Due to fear of blame and litigation, health workers preferred written consent. Written consent requires active participation by the consenting individual and was perceived to transfer liability to that person. A woman’s refusal to provide written informed consent may pose a dilemma for the health worker between doing good and respecting autonomy. To prevent such refusal, health workers said to only partially disclose surgical risks in order to minimize women's anxiety. Commonly perceived barriers to obtain a fully informed consent were labour pains, language barriers, women’s lack of education and their dependency on others to make decisions. Conclusions Health workers are familiar with the principles around informed consent and aware of its advantages, but fear of blame and litigation, partial disclosure of risks and barriers to communication hamper the process of obtaining informed consent. Findings can be used to develop interventions to improve the informed consent process.

scholarly journals FAO/WHO GIFT platform - hands on

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Ferreira de Sousa ◽  
V Padula de Quadros ◽  
A Balcerzak ◽  
T Bevere
Keyword(s):  
Food Safety ◽  
Food Consumption ◽  
Policy Development ◽  
Middle Income ◽  
Middle Income Countries ◽  
Consumption Data ◽  
Hands On ◽  
Food Consumption Data ◽  
Inventory Map ◽  
Global Initiatives

Abstract The FAO/WHO Global Individual Food consumption data Tool (FAO/WHO GIFT) is a novel open-access online platform hosted by FAO and supported by WHO. FAO/WHO GIFT is aimed at increasing the quality, availability and use of individual quantitative food consumption (IQFC) data in low- and middle-income countries (LMIC) to enable evidence-based decision-making and policy development for better nutrition and food safety. The platform is developed in synergy with other global initiatives working with food consumption data (e.g. Intake, Global Dietary Database, FAO/WHO FOSCOLLAB). The main objective of the session is to give the opportunity to participants to apply the knowledge gained over the previous sessions. Participants will be divided in small groups to do hands-on exercises using the features of the platform. Participants will learn how to identify existing IQFC surveys worldwide using the FAO/WHO GIFT inventory map. Participants will also explore the potential of the Indicators section of the platform according to the needs of different fields of work (food consumption, food safety and nutrition). Expert users will learn how to download dietary microdata and how to take advantage of other data sources using the same food classification and description system - FoodEx2. The workshop will close with a brainstorm session on how the FAO/WHO GIFT platform can be improved to support participants work.

scholarly journals Economic uncertainty and tourism consumption

2020 ◽  
pp. 135481662098151
Author(s):  
Canh Phuc Nguyen ◽  
Su Dinh Thanh ◽  
Bach Nguyen
Keyword(s):  
Economic Development ◽  
Theory Of Reasoned Action ◽  
Reasoned Action ◽  
Negative Impact ◽  
Positive Impact ◽  
Tourism Development ◽  
Economic Uncertainty ◽  
Middle Income ◽  
Domestic Tourism

This study examines the influence of economic uncertainty on tourism. The key hypothesis to test is that while economic uncertainty reduces outbound tourism, it may boost domestic tourism due to the economic-stagnant effects. Utilizing the framework of the theory of reasoned action to analyze a global sample of 124 countries over the period 1996–2017, we find some initial evidence showing that an increase in economic uncertainty encourages domestic tourism while reducing outbound tourism in the global sample. Notably, while these effects are consistent in the upper-middle-income economies, an increase in uncertainty has a positive impact on both domestic and outbound tourism in lower-middle-income economies and a negative impact on both domestic and outbound tourism in higher-income economies. The key implementation of this study is that tourism development is not always associated with economic development and stability; sometimes it could be a signal of economic stagnancy and inactiveness.

scholarly journals Video-Based Intervention for Improving Maternal Retention and Adherence to HIV Treatment: Patient Perspectives and Experiences

2021 ◽  
Vol 18 (4) ◽  
pp. 1737
Author(s):  
Steven Masiano ◽  
Edwin Machine ◽  
Mtisunge Mphande ◽  
Christine Markham ◽  
Tapiwa Tembo ◽  
...  
Keyword(s):  
Positive Impact ◽  
Low Cost ◽  
Hiv Treatment ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Structured Interviews ◽  
Convenience Sample ◽  
Long Term Conditions ◽  
Art Initiation ◽  
Retention In Hiv Care

VITAL Start is a video-based intervention aimed to improve maternal retention in HIV care and adherence to antiretroviral therapy (ART) in Malawi. We explored the experiences of pregnant women living with HIV (PWLHIV) not yet on ART who received VITAL Start before ART initiation to assess the intervention’s acceptability, feasibility, fidelity of delivery, and perceived impact. Between February and September 2019, we conducted semi-structured interviews with a convenience sample of 34 PWLHIV within one month of receiving VITAL Start. The participants reported that VITAL Start was acceptable and feasible and had good fidelity of delivery. They also reported that the video had a positive impact on their lives, encouraging them to disclose their HIV status to their sexual partners who, in turn, supported them to adhere to ART. The participants suggested using a similar intervention to provide health-related education/counseling to people with long term conditions. Our findings suggest that video-based interventions may be an acceptable, feasible approach to optimizing ART retention and adherence amongst PWLHIV, and they can be delivered with high fidelity. Further exploration of the utility of low cost, scalable, video-based interventions to address health counseling gaps in sub-Saharan Africa is warranted.

scholarly journals Music Is Life—Follow-Up Qualitative Study on Parental Experiences of Creative Music Therapy in the Neonatal Period

2021 ◽  
Vol 18 (12) ◽  
pp. 6678
Author(s):  
Friederike Barbara Haslbeck ◽  
Lars Schmidli ◽  
Hans Ulrich Bucher ◽  
Dirk Bassler
Keyword(s):  
Music Therapy ◽  
Positive Reinforcement ◽  
Positive Impact ◽  
Complementary Therapy ◽  
Structured Interviews ◽  
Developmental Problems ◽  
Creative Music ◽  
Modifiable Factors ◽  
Hospitalization Period ◽  
Extremely Preterm

Developmental problems in extremely preterm (EP) infants and the associated longitudinal burden for their families are major health issues worldwide. Approaches to social-emotional support such as family-integrating Creative Music Therapy (CMT) are warranted. We aimed: (1) to explore parental perspectives on the use of CMT with EP infants in the neonatal hospitalization period and (2) to examine the possible longitudinal influence of CMT. A qualitative design was used to examine the perspective of six families from various backgrounds. Semi-structured interviews were carried out when the infants reached school age. We used an inductive–deductive thematic analysis to identify three main themes, each with three sub-themes: (1) the positive impact of CMT on the infants, the parents, and bonding; (2) the attitude toward CMT, from being open-minded to recommending it as complementary therapy; and (3) the experience of overall healthy infant development despite unique developmental delay issues. The findings elucidate the positive and formative impact of CMT on both infants and parents in the stressful NICU setting and beyond. CMT may empower positive transformation in the parents through individualized early nurturing musical interactions, capacity building, and positive reinforcement. Further research may help to identify and implement potentially modifiable factors for improving health care in this vulnerable group through early family-integrating, resource-based approaches such as CMT.

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