scholarly journals The views of key stakeholders in Zimbabwe on the introduction of postgraduate family medicine training: A qualitative study

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Cherifa Sururu ◽  
Robert Mash
Keyword(s):  
Family Medicine ◽  
Private Sector ◽  
Government Support ◽  
Economic Conditions ◽  
Successful Implementation ◽  
Structured Interviews ◽  
African Countries ◽  
District Health ◽  
Primary Health ◽  
Key Stakeholders

Background: Strengthening primary health care (PHC) is a priority for all effective health systems, and family physicians are seen as a key member of the PHC team. Zimbabwe has joined a number of African countries that are seriously considering the introduction of postgraduate family medicine training. Implementation of training, however, has not yet happened.Aim: To explore the views of key stakeholders on the introduction of postgraduate family medicine training.Setting: Key academic, governmental and professional stakeholders in Zimbabwean health and higher education systems.Method: Twelve semi-structured interviews were conducted with purposively selected key stakeholders. Data were recorded, transcribed and analysed using the framework method.Results: Anticipated benefits: More effective functioning of PHC and district health services with reduced referrals, improved access to more comprehensive services and improved clinical outcomes. Opportunities: International trend towards family medicine training, government support, availability of a small group of local trainers, need to revise PHC policy. Anticipated barriers: Family medicine is unattractive as a career choice because it is largely unknown to newly qualified doctors and may not be recognised in private sector. There is concern that advocacy is mainly coming from the private sector. Threats: Economic conditions, poor remuneration, lack of funding for resources and new initiatives, resistance from other specialists in private sector.Conclusion: Stakeholders anticipated significant benefits from the introduction of family medicine training and identified a number of opportunities that support this, but also recognised the existence of major barriers and threats to successful implementation.

scholarly journals European influence in ITU-R: the end of an era of dominance?

Info ◽  
2014 ◽  
Vol 16 (4) ◽  
pp. 1-17 ◽  
Author(s):  
Mohamed Ali El-Moghazi ◽  
Jason Whalley ◽  
James Irvine
Keyword(s):  
European Countries ◽  
Current Debate ◽  
Structured Interviews ◽  
Allocation Mechanism ◽  
African Countries ◽  
Content Type ◽  
Key Stakeholders ◽  
The World ◽  
Spectrum Policy

Purpose – The purpose of this paper is to examine the influence of the European countries in Region 1 of the Radio Sector of the International Telecommunications Union (ITU-R). More specifically, the focus is on the World Radiocommunication Conference 2012 meeting to explore whether European influence is in decline. Design/methodology/approach – This article adopts in-depth case study of the 700-MHz issue. Qualitative data are drawn from semi-structured interviews with key stakeholders who participated at the World Radiocommunication Conference 2012 meeting. Findings – This article concludes that the influence of European countries in the ITU-R in Region 1 has changed. The influence of Arab and African countries has increased, with that of European countries declining. However, European countries remain more influential than their African and Arab counterparts. Research limitations/implications – This article sheds light on an often overlooked but pivotal element of the international spectrum allocation mechanism. Originality/value – This article sheds light on important developments in the international spectrum policy that are largely overlooked in the current debate.

scholarly journals Development of Family Medicine training in Botswana: Views of key stakeholders in Ngamiland

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Radiance M. Ogundipe ◽  
Robert Mash
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Healthcare Delivery ◽  
Family Physicians ◽  
Training Programme ◽  
Holistic Health ◽  
District Health ◽  
Key Stakeholders ◽  
Quality Of Primary Care ◽  
Personal Welfare

Background: Family Medicine training commenced in Botswana in 2011, and Maun was one of the two sites chosen as a training complex. If it is to be successful there has to be investment in the training programme by all stakeholders in healthcare delivery in the district.Aim: The aim of the study was to explore the attitudes of stakeholders to initiation of Family Medicine training and their perspectives on the future roles of family physicians in Ngami district, Botswana.Setting: Maun and the surrounding Ngami subdistrict of Botswana.Methods: Thirteen in-depth interviews were conducted with purposively selected key stakeholders in the district health services. Data were recorded, transcribed and analysed using the framework method.Results: Participants welcomed the development of Family Medicine training in Maun and expect that this will result in improved quality of primary care. Participants expect the registrars and family physicians to provide holistic health care that is of higher quality and expertise than currently experienced, relevant research into the health needs of the community, and reduced need for referrals. Inadequate personal welfare facilities, erratic ancillary support services and an inadequate complement of mentors and supervisors for the programme were some of the gaps and challenges highlighted by participants.Conclusion: Family Medicine training is welcomed by stakeholders in Ngamiland. With proper planning introduction of the family physician in the district is expected to result in improvement of primary care. 

scholarly journals Challenges in the implementation of primary health care reforms: a qualitative analysis of stakeholders’ views in Turkey

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e027492 ◽  
Author(s):  
Ana Belén Espinosa-González ◽  
Charles Normand
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Family Medicine ◽  
Care Quality ◽  
Market Model ◽  
Structured Interviews ◽  
Health Care Reforms ◽  
Delivery Of Care ◽  
Primary Health ◽  
Comprehensive Primary Health Care

ObjectivesThis study aims to assess the implementation of the Family Medicine Programme (FMP), which has taken place in Turkey from 2005 to 2010 as a set of comprehensive primary health care (PHC) reforms and involved changes in professional organisation (eg, family medicine specialisation) and service provision (eg, patients’ registration list). Our particular interest is to identify the challenges and limitations that PHC physicians and academicians have encountered in the implementation of the FMP which could have influenced the delivery of care and utilisation of services.DesignWe applied the framework method to analyse data obtained through semi-structured interviews conducted in the field. This qualitative approach involved the categorisation of raw data into a predefined framework, which comprised challenges and limitations identified in the literature, and the emergence of a new framework, whose categories corresponded to challenges and limitations identified through thematic analysis of our data.SettingPHC centres and academic departments from five Turkish provinces.ParticipantsPHC physicians and academicians involved in training and/or research were invited to participate. 20 participants agreed to take part and, due to schedule limitations, 15 participants (seven PHC physicians and eight academicians) completed the interviews.ResultsShortcomings in the planning of the reforms, inadequate commitment to integration of PHC in the system and collateral effects of a market model in healthcare emerged as limitations to successful FMP implementation. Uncertainty about care quality and physicians’ ethical values as well as perceptions of organisational injustice among healthcare workers were contributing challenges.ConclusionsA systems thinking approach in the FMP design and implementation could help foresee and address these limitations. In decentralisation processes, such as FMP, shared governance by including PHC stakeholders in policy-making and planning could alleviate misalignment of interests and positively affect PHC performance, for example, by removing barriers to gatekeeping implementation.

scholarly journals Context-acceptability theories: example of family planning interventions in five African countries

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jayne Webster ◽  
Shari Krishnaratne ◽  
Jenna Hoyt ◽  
Shiferaw Dechasa Demissie ◽  
Nathaly Spilotros ◽  
...  
Keyword(s):  
Family Planning ◽  
Low Birthweight ◽  
Analytical Framework ◽  
Modern Contraceptive ◽  
Structured Interviews ◽  
African Countries ◽  
Group Discussions ◽  
Effective Interventions ◽  
Key Stakeholders ◽  
Values And Beliefs

Abstract Background Family planning (FP) can lengthen birth intervals and potentially reduce the risk of foetal death, low birthweight, prematurity, and being small for gestational age. Effective FP is most easily achieved through access to and acceptability of modern contraceptive methods (MCMs). This study aimed to identify mechanisms of acceptability and the contexts in which they are triggered and to generate theories to improve the selection and implementation of effective interventions by studying an intervention integrating FP with childhood immunisation services. Methods Qualitative interpretative synthesis of findings from realist evaluations of FP interventions in five African countries was guided by an analytical framework. Empirical mechanisms of acceptability were identified from semi-structured interviews and focus group discussions with key stakeholders (N = 253). The context in which these mechanisms were triggered was also defined. Empirical mechanisms of acceptability were matched to constructs of a theoretical framework of acceptability. Context-acceptability theories (CATs) were developed, which summarised constructs of acceptability triggered for specific actors in specified contexts. Examples of interventions that may be used to trigger acceptability for these actors were described. Results Seven CATs were developed for contexts with strong beliefs in religious values and with powerful religious leaders, a traditional desire for large families, stigmatisation of MCM use, male partners who are non-accepting of FP, and rumours or experiences of MCM side effects. Acceptability mechanisms included alignment with values and beliefs without requiring compromise, actors’ certainty about their ability to avoid harm and make the intervention work, and understanding the intervention and how it works. Additionally, acceptability by one group of actors was found to alter the context, triggering acceptability mechanisms amongst others. Conclusions This study demonstrated the value of embedding realist approaches within implementation research. CATs are transferable theories that answer the question: given the context, what construct of acceptability does an intervention need to trigger, or more simply, what intervention do we need to apply here to achieve our outcomes? CATs facilitate transfer of interventions across geographies within defined contexts.

scholarly journals Industry Modernization Based on the Principles of Smart Specialization. Part I. Using the Key Enabling Technologies as a Priority of the EU Industrial Policy

2020 ◽  
Vol 87 (4) ◽  
pp. 65-71
Author(s):  
O. B. Salikhova
Keyword(s):  
Economic Growth ◽  
Private Sector ◽  
Government Support ◽  
Technological Innovations ◽  
Successful Implementation ◽  
Project Implementation ◽  
Enabling Technologies ◽  
Smart Specialization ◽  
Key Enabling Technologies ◽  
The Eu

The concept of smart specialization is investigated with emphasis on key components of its successful implementation. Its relation with the concepts of technology, innovation and industrialization is shown through their common goal: to increase the productivity and ensure the sustainable economic growth. An analytical review of the official European documents elaborating the mechanisms for industry modernization and the principles for the new strategy of building the smart, innovative and sustainable industry, to promote competitiveness, creation of hybrid jobs and economic growth, is made. The critical role of key enabling technologies, especially advanced industrial technologies, in modernizing industry and implementing the smart specialization strategy is highlighted. The European Commission initiatives are analyzed, aimed at implementing the programs on competitiveness enhancement in the small and medium business sector, their implementation measures, including ones on constructing statistical tools for monitoring and analysis of generation and use of advanced technologies in the context of technological innovations in the private sector. The methodological approaches to building a new set of statistical indicators are supposed to ensure approvals of political decisions on enhancing competitiveness in the EU industry through launching three specific and related actions: (i) support to the development of cross-regional investment projects in the framework of S3P-Industrial Modernization; (ii) support to the development of European strategic cluster partnerships for cooperating in thematic fields and enhancing the industry’s role; (iii)) support to companies in the manufacturing industry in using advanced industrial technologies, in order to enhance their innovation capacities. It is noted that the program “Government Support to Technological Innovations for Industry Development” has not been launched in Ukraine, in spite of 300,000 UAH appropriated in the Budget – 2018 and the procedure for use of budget funds, created and coordinated with the central executive power bodies, by which the funds had to be allocated in implementing industrial innovation technologies in the private sector, for two purposes: (i) co-funding of project implementation; (ii) partial compensation for interest rates on loans received by manufactures for project implementation. The need to form the Strategy for Smart, Innovative and Sustainable Industry in Ukraine with consideration to directives and best practices of EU and the Ukrainian realities is emphasized.  

scholarly journals Implementation of An Outdoor Smoke-Free Policy at Sports Clubs: Critical Situations and Factors Influencing Implementation

2020 ◽  
Author(s):  
Heike H Garritsen ◽  
Andrea D Rozema ◽  
Ien AM van de Goor ◽  
Anton E Kunst
Keyword(s):  
Social Norm ◽  
Successful Implementation ◽  
Structured Interviews ◽  
Sports Clubs ◽  
Smoke Free Policy ◽  
Sports Club ◽  
Number Of Factors ◽  
Key Stakeholders ◽  
National Organizations ◽  
Critical Situations

Abstract Background: Outdoor smoke-free policies (SFPs) at sports clubs have significant potential in reducing adolescent smoking. However, the actual occurrence of such effects may be strongly dependent on how these policies are implemented in practice. The aim of this study is to identify to what extent outdoor SFPs at sports clubs are implemented in practice and which factors contribute to successful implementation.Methods: Semi-structured interviews were held with 46 key stakeholders at 8 Dutch sports clubs (i.e., field hockey, soccer, tennis, korfball) with an outdoor SFP. A thematic approach was used for analysis of the transcripts. Results: Overall, the implementation of an outdoor SFP at sports clubs appears to be successful. The SFP is often enforced, smokers react positively when they are approached, the SFP has led to less (visible) smokers at the venue, and a nonsmoking norm is reinforced. However, we identified three ‘critical situations’ in which implementation is less than optimal: 1) when children are not present at the sports club, 2) when alcohol is involved, and 3) when smokers relocate at the entrance of the sports club. Several factors influenced implementation in those critical situations: 1) factors related to individual smokers and club members (i.e., support, communication towards smokers), 2) factors related to the SFP itself (i.e., clarity of the policy), 3) factors related to the sports club (i.e., communication of the policy, characteristics of the sports club), and 4) factors related to the wider community (i.e., change of social norm with regard to smoking, support from local and national organizations).Conclusions: Successful implementation of an outdoor SFP at sports clubs is feasible since support is high and experiences are mainly positive. Nevertheless, some situations represent challenges to compliance and enforcement. We identified a number of factors through which sports clubs may foster effectively implementation of an outdoor SFP at their clubs.

scholarly journals Factors contributing to men’s reluctance to seek HIV counselling and testing at Primary Health Care facilities in Vhembe District of South Africa

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Pfungwa Mambanga ◽  
Robert N. Sirwali ◽  
Takalani Tshitangano
Keyword(s):  
South Africa ◽  
Cultural Practices ◽  
Health Care Facilities ◽  
Sampled Data ◽  
Structured Interviews ◽  
District Health ◽  
Primary Health ◽  
Attitudinal Factors ◽  
The Government ◽  
Vhembe District

Background: Voluntary HIV antibody Counselling and Testing (HCT) is a cornerstone of HIV prevention in South Africa because it has the potential to prevent HIV transmission. The government of South Africa has for a long time been investing heavily in fighting the spread of HIV and/or AIDS. However, men rarely utilise this service. Aim: The aim of this study was to explore the factors contributing to the reluctance of men to seek HCT in the primary health facilities in Vhembe District.Setting: The study was conducted at Vhembe District health offices in Limpopo, South Africa. Methods: A qualitative research design, anchored on semi-structured interviews as a method of data collection, was used. Fifteen men working at Vhembe health offices were purposively sampled. Data were analysed using the TECHS’s 8 steps method. The approval from Polokwane Provincial offices was guaranteed with participants being protected and respected throughout the study.Results: The response rate per question was 100% with all 15 participants willing to answer all the raised questions though with different views and opinions. The majority of the interviewees indicated that they were aware of HCT services. Stigma as a societal reaction to disease, governmental policies, and attitudinal factors made men refrain from seeking counselling and testing from public health facilities.Conclusion: There was a high level of HCT awareness among men in Vhembe District. However, attitudinal and political barriers, stigma, and cultural practices such as circumcision were cited as the reasons for the low level utilisation of HCT services.Keywords: awareness, stigma, cultural practices, governmental politics, attitudinal factors

scholarly journals The provision of mental health care by primary health organisations in the northern region: Barriers and enablers

2009 ◽  
Vol 1 (2) ◽  
pp. 120 ◽  
Author(s):  
Anthony O'Brien ◽  
Fiona Moir ◽  
Katey Thom
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Northern Region ◽  
Structured Interviews ◽  
District Health ◽  
Good Communication ◽  
Barriers And Enablers ◽  
Primary Health

AIM: To identify barriers and enablers to the provision of mental health care by Primary Health Organisations (PHOs) in the northern region. METHODS: Information was generated from structured interviews with 22 of the 25 PHOs and the four District Health Boards (DHBs) in the northern region. RESULTS: Of the 22 PHOs who participated in the study, 17 had at least one specific mental health initiative; others had up to five initiatives. PHOs that were funded to provide one of the 41 Ministry of Health mental health pilot projects had more mental health initiatives in place. Barriers and enablers to providing mental health care occurred in areas such as workforce capacity, funding, infrastructure, and limited interest in transfer of care from secondary to primary care. CONCLUSIONS: Barriers to providing mental health care within the primary sector include stigma, lack of training, communication between sectors, funding and perceptions of sector roles. Factors which enable provision of mental health care are availability of training, good communication between sectors, use of available and new funding mechanisms and community involvement. Further research at the practice and practitioner level is necessary to fully understand development of mental health care within the primary care sector. KEYWORDS: Mental health, primary care, Primary Health Organisations, health policy

scholarly journals Implementing trachoma control programmes in marginalised populations in Tanzania: A qualitative study exploring the experiences and perspectives of key stakeholders

2021 ◽  
Vol 15 (9) ◽  
pp. e0009727
Author(s):  
Kaki Tsang ◽  
Gilles de Wildt ◽  
Upendo Mwingira ◽  
Tara B. Mtuy
Keyword(s):  
Comparative Method ◽  
Opportunity To Learn ◽  
Anatomical Location ◽  
Successful Implementation ◽  
Way Of Life ◽  
Structured Interviews ◽  
Community Values ◽  
Community Needs ◽  
Key Stakeholders ◽  
Control Programmes

Background Despite aspects of the SAFE strategy for reducing trachoma in Tanzania have been somewhat successful, the disease still persists in marginalised communities even with repeated trachoma control interventions. This study aims to understand the facilitators and barriers associated with implementing trachoma control programmes in these communities, from the perspective of non-governmental organisations (NGOs). Methods Participants were the representatives of NGOs who had knowledge and experience in the implementation of trachoma control programmes. Data was collected using in-depth, semi-structured interviews guided by a topic guide, which was updated after each interview using a constant comparative method. Interviews were audio-recorded and then transcribed verbatim. Thematic analysis was done inductively. Codes were generated from the transcripts and then clustered into themes. Findings The context within marginalised communities often acted as a perceived barrier to successful implementation of control programmes. This included poor environmental cleanliness, lack of trust, poor disease knowledge and traditional lifestyles. Community values could either be a facilitator or a barrier, depending on the scenario. The anatomical location of the disease and the poor understanding of the disease progression also served as barriers. Considerations affecting decision-making among NGO’s include financial feasibility, community needs and whether the quality of the intervention could be improved. NGOs felt that the collaboration and the opportunity to learn from other organisations were beneficial aspects of having different actors. However, this also resulted in variability in the effectiveness of interventions between districts. Conclusion NGOs should focus on behaviour change and health education that is tailored to marginalised communities and seek innovative ways to implement trachoma intervention programmes whilst being minimally intrusive to the traditional way of life. Partners should also implement ways to ensure high quality programmes are being provided, by increasing staff accountability and compensating volunteers fairly.

scholarly journals Critiquing Collaborative Language Learning: A Qualitative Study of Teachers’ Perceptions

sjesr ◽  
2021 ◽  
Vol 4 (1) ◽  
pp. 448-455
Author(s):  
Dr. Liaqat Iqbal ◽  
Muhammad Sheeraz
Keyword(s):  
Private Sector ◽  
Language Learning ◽  
Teaching And Learning ◽  
Language Education ◽  
Social Aspect ◽  
Successful Implementation ◽  
Structured Interviews ◽  
Public And Private ◽  
Public And Private Sector ◽  
Collaborative Language

Collaborative language learning, followed as a language teaching and learning methodology in many countries, is often critiqued with mixed arguments. To some, while keeping in view its social aspect where learners work on common projects intending to partake in collective decision making and intellectual engagement, collaborative language learning is more productive than the traditional way of teaching and learning a second/foreign language. To others, because of different requirements for its successful implementation, collaborative language learning becomes a difficult practice where the cost exceeds the benefits. To know the problems and prospects of collaborative language learning, in the present study, data were collected through semi-structured interviews from teachers of both public and private sector schools of district Mardan. Through purposive sampling, data were collected from 40 teachers (20 each from public and private sector schools). The findings reveal that besides many positive aspects, there are some negative aspects of collaborative learning where the prominent one is the loss of an individual's authority and creativity, promotion of totalitarian approach, and overlooking of the shy students. It can be a useful tool for language education provided some requirements including teacher training, availability of proper space, and classroom size, etc. are tackled properly.

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