scholarly journals Improving stroke care in Ghana: a roundtable discussion with communities, healthcare providers, policymakers and civil society organisations

2021 ◽  
Vol 55 (2) ◽  
pp. 147-151
Author(s):  
Olutobi A. Sanuade ◽  
Leonard Baatiemaa ◽  
Kafui Adjaye-Gbewonyo ◽  
Ama De-Graft Aikins

Even though there have been advances in medical research and technology for acute stroke care treatment and management globally, stroke mortality has remained high, with a higher burden in low- and middle-income countries (LMICs) such as Ghana. In Ghana, stroke mortality and disability rates are high, and research on post-stroke survival care is scarce. The available evidence suggests that Ghanaian stroke survivors and their caregivers seek treatment from pluralistic health care providers. However, no previous attempt has been made to bring them together to discuss issues around stroke care and rehabilitation. To address this challenge, researchers from the Institute of Advanced Studies, University College London, in collaboration with researchers from the African Centre of Excellence for Non-communicable diseases (ACE-NCDs), University of Ghana, organised a one-day roundtable to discuss issues around stroke care. The purpose of the roundtable was fourfold. First, to initiate discussion/collaborations among biomedical, ethnomedical and faith-based healthcare providers and stroke patients and their caregivers around stroke care. Second, to facilitate discussion on experiences with stroke care. Third, to understand the healthcare providers’, health systems’, and stroke survivors’ needs to enhance stroke care in Ghana. Finally, to define practical ways to improve stroke care in Ghana.

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Rayetta Johnson

Background and Issues: The burden of stroke in North Carolina is one of the highest in the nation (approximately 28,000 stroke hospitalizations from 2003-2007). The number and high costs of stroke have made it incumbent to improve the numbers of patients receiving effective treatment. There are two major barriers for treatment of acute stroke: time and access. The utilization of telestroke in community hospitals aids in decreasing these barriers by providing immediate access to a stroke neurologist. In order for telestroke to be successful, awareness and education regarding acute stroke care must be provided for health care providers as well as the communities. Thus, the development of a telestroke system requires nursing and medical expertise. The Primary Stroke Center Team at Wake Forest Baptist Medical Center in Winston-Salem, N.C. implemented a telestroke network system (Intouch's Health's RP-7 Robotic system) in January of 2010 to provide 24/7 access to the medical center's acute stroke experts and the latest advancements in stroke interventions. There are eight hospitals in the network at the present time. Methods: Our team identified that many of the network hospital's staff are not experienced in taking care of a stroke patient and that a “roadmap” is useful to guide them in these steps.The stroke nurse specialist developed a quality improvement plan for the network hospitals which included: an evidence-based algorithm for patient care; stroke education, in particular, neurological assessment and tPA administration classes for the ED staff; quarterly meetings to provide outcome and feedback data with each network hospital; stroke awareness events for the community. Mock telestroke consults were also performed prior to “going live” with telestroke for each of the network hospitals. Of utmost importance is the early involvement and education of the EMS system in the respective county of the network hospital. The buy-in of EMS was found to be a key component in the success of the network. Finally, attention to customized quality improvement efforts for each of the facilities are required to accomplish integration into the telestroke network. Results: The data has been analyzed, and thus far, a 24% rate of tPA administration has been seen with our network hospitals (an increase from the 3.6% national average). Comparisons between each of the eight network hospitals' rates of administration of tPA prior to and after joining the network show a trend of increase (10%-40%). The effectiveness of the algorithm has also been explored by analysis of feedback and initial results have shown a positive impact. Conclusion: A combination of improving access to stroke neurologists in conjunction with a focus on improving the level of care via evidenced based stroke care teaching and implementation of algorithms at a network hospital is required for implementing and building a successful telestroke network.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Theresa L Green ◽  
Patrice Lindsay

Introduction: In Canada, approximately 12% of acute stroke patients are admitted to long-term care (LTC; or residential aged care) facilities following an acute stroke event. An additional 20-30% of patients are discharged home from hospital with referral for community-based homecare. Training programs for health care providers in these settings is variable and at times inconsistent with best practices. Internationally, focus is now shifting from a predominant inpatient acute care focus, to one encompassing ongoing care and support in the community for people living with stroke. In 2015, an educational resource called Taking Action for Optimal Community & Long Term Stroke Care (TACLS) was launched across Canada to ensure the appropriate knowledge and skills of front line care providers for stroke survivors in community and LTC facilities; the focus of this resource is on rehabilitation and recovery. Methods: The purpose of this interactive session is to introduce the TACLS resource and to engage health professionals in an examination of current international community based rehabilitation and recovery programs. The discussion/workshop will allow participants to examine, compare and contrast components of the TACLS program with programs being developed or offered elsewhere. Results: As health care providers helping stroke survivors live well and longer means investing in the use of best practice tools and resources that fit the local context and organizational practices. Bringing together international opinions and observations around post-stroke community care will allow cross-collaboration and inter-professional networking opportunities that ultimately will benefit patients living with stroke in community based settings. Discussion: As care shifts from hospital to community based settings, the importance of tools available to support stroke survivors in this area of the care continuum is essential. In Canada, utilizing the HSF education resource (TACLS) provides information to support community based health care providers working with people who have had a stroke in helping them achieve optimal outcomes, regain their best level of functioning, and live meaningful lives.


Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Paula Gilmore ◽  
John Barry ◽  
Jeff Blanchard ◽  
Shannon Howson ◽  
Martha Korzycki

Background: The Southwestern Ontario (SWO) Stroke Network completed community engagement forums with stroke survivors, their loved ones and community service providers to determine barriers to living fully in the community after stroke. One of the priorities identified in the forums was the need for "return to work" services. Currently, 10 % of stroke survivors are people under the age of 50 and in the prime of their working life. Research indicates that return to work rates after stroke are as low as 7%. However, employment is one of the most important social roles that a person fulfills and not working has negative impacts on one’s overall quality of life, health, finances, social isolation and self-efficacy. Stroke survivors and health care professionals need to be aware of how to navigate the process of return to work after stroke. Purpose: A toolkit of resources has been developed to assist stroke survivors and health care professionals navigate the process of return to work after stroke. Methods: A working group comprised of experts in vocational rehabilitation and stroke care developed a toolkit of resources to educate and assist stroke survivors and health care professionals navigate the complex system of return to work. The resources have undergone an external review by health care professionals and stroke survivors. Results: Resources developed include a self assessment guide. It assesses five critical areas to return to work by evaluating the stroke survivor’s current abilities against the demands of the job and is designed to help focus the individual’s recovery efforts. Algorithms on how to navigate the system of return to work, including how to traverse the system of financial benefits and questions to ask employers and information on community financial supports were developed. A literature review and inventories outlining services for persons with stroke, who are preparing to re-enter the workforce, are part of the toolkit. Health care providers and stroke survivors have confirmed the face to face validity of the resources. Conclusions: Research indicates that stroke survivors should be encouraged to evaluate their potential of returning to work and should receive support from knowledgeable professionals regarding return to work as soon as possible after stroke. This toolkit is intended to support stroke survivors and their health care professionals to navigate the system for a successful return to work. Next steps include the development of a website to assist with return to work.


2020 ◽  
Vol 4 (2) ◽  
pp. 80
Author(s):  
Azra Naseem ◽  
Kiran Qasim Ali ◽  
Audrey Juma ◽  
Afroz Sajwani ◽  
Basnama Ayaz Khan ◽  
...  

Afghanistan faces an acute shortage of trained healthcare providers. To build capacity of nurses and midwives, in 2014 a private hospital in Afghanistan initiated an eLearning programme to enhance their knowledge and skills. The study was conducted to identify facilitating and hindering factors for the successful implementation of eLearning. Data collection took place between June and September 2016, when seven Maternal and Child Health (MNCH) related eLearning sessions were conducted. The participants were nurses and midwives working in MNCH wards at the research sites in Bamyan, Faizabad and Kandahar, along with the programme planners and facilitators. Data was collected through pre/post and delayed post-tests, observations and questionnaires, semi-structured interviews and documents analysis. The results highlight four major factors as important for the successful implementation of eLearning, namely: curriculum, context, technology and individual. The needs assessment ensured relevance of the sessions to the needs of the participants. However, pedagogy was lecture-based with limited focus on skills development. Poor connectivity and language of instruction posed challenges. eLearning has shown the potential for developing knowledge and skills of nurses and midwives. Clear communication between teams involved in planning and implementation of the programme, technology infrastructure, design of online pedagogy and facilitator readiness are critical for the success of eLearning in low and middle income countries. Keywords: Health care providers/system, eLearning Programme, Nurses, Midwives, Maternal and child careHow to cite this article:Naseem, A., Ali, K.Q., Juma, A., Sajwani, A., Khan, B.A., Sayani, A. & Abidi, S.S.R. 2020. Factors enabling and hindering an eLearning programme for nurses and midwives in Afghanistan. Scholarship of Teaching and Learning in the South. 4(2): 80-99. https://doi.org/10.36615/sotls.v4i2.106.This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/


2019 ◽  
Author(s):  
Gerardo Luis Dimaguila ◽  
Frances Batchelor ◽  
Mark Merolli ◽  
Kathleen Gray

BACKGROUND Person-generated health data (PGHD) are produced by people when they use health information technologies. People who use PGHD may have changes in their engagement with their own health care, their relationship with their healthcare providers, and their sense of social support and connectedness. Research into evaluating those reported effects however, has not kept up; thus a method for developing patient-reported outcome measures (PROMs) of utilising PGHD, called the PROM-PGHD Development Method, was previously designed and applied to the exemplar case of Kinect-based stroke rehabilitation systems (K-SRS). A key step of the method ensures that the patient’s voice is included. Allowing stroke survivors to participate in the development and evaluation of health services and treatment can inform health care providers on decisions about stroke care, and thereby improve health outcomes. Moreover, eliciting the input of stroke survivors is important because there could be differences in their perspectives and that of their care providers, regarding treatment and management. OBJECTIVE This paper presents the perspectives of stroke survivors and clinicians on the anticipated effects of stroke survivors’ use of PGHD from a poststroke simulated rehabilitation technology. METHODS This study gathered the perspectives of six stroke survivors and five clinicians through three focus groups and three interviews, recruited for convenience. In the stroke survivors’ focus groups, participants were asked to give their perspectives on how using the PGHD from Jintronix may affect their outcomes; while in the clinicians’ focus group, clinicians were asked for their perspectives on how PGHD use may affect the outcomes of stroke survivors. Participants were also asked questions intended to encourage them to comment on the initial items of the PROM-PGHD. Deductive thematic analysis was performed. RESULTS Survivors and clinicians had varying perspectives in three of the six themes presented, and puts emphasis on the importance of allowing stroke survivors to participate in the evaluation of digital health services. However, the potential for tensions to occur between the needs and preferences of patients and their care providers could be reduced through a similar understanding of health treatment goals. This paper has further demonstrated that outcomes of utilising PGHD can be measured. For instance, stroke survivors described that using PGHD could result in positive, negative, and nil effects on their health behaviours. CONCLUSIONS This study is the first to gather and compare the perspectives of stroke survivors and clinicians, in order to develop a PROM-PGHD for a simulated rehabilitation system. The reported PGHD utilisation outcomes would directly inform the development of a PROM-PGHD for K-SRS, of which this paper is a key step. Additionally, they could help inform health care providers on decisions about stroke care. This is particularly relevant in the area of poststroke simulated rehabilitation technologies.


2019 ◽  
Vol 31 (2) ◽  
pp. 131

In Myanmar, the main challenge to provide quality healthcare by Universal Health Care approach is documented as low health services coverage with substantial wealth-based inequality. To achieve the effective health care system, strong medical care system is essential. Understanding on challenges and needs in provision of medical services among patients and health care providers is critical to provide quality care with desirable outcomes. The aim of the study was to explore the patients’ and health care providers’ perceptions on the challenges in provision of medical services at the Mandalay General Hospital. This was a qualitative study conducted at the tertiary level hospital (Mandalay General Hospital). The data was collected by using focus group discussions and in-depth interviews with hospitalized patients or attendants, healthcare providers such as medical doctors, nurses, laboratory scientists and hospital administrators in March 2017. The qualitative data was analyzed using themes by themes matrix analysis. Most patients were satisfied with the care provided by the doctors because they believed that they received quality care. However, some patients complained about long waiting time for elective operation, congested conditions in the ward, burden for investigations outside the hospital for urgent needs and impolite manners of general workers. Healthcare providers reported that they had heavy workload due to limited human and financial resources in the hospital, poor compliances with hospital rules and regulation among patients and attendants, and inefficient referral practices from other health facilities. Other challenges experienced by healthcare providers were lack of ongoing training to improve knowledge and skills, limited health infrastructure and inadequate medicinal supplies. The findings highlighted the areas needed to be improved to provide quality health care at the tertiary level hospital. The challenges and problems encountered in this hospital can be improved by allocating adequate financial and human resources. The systematic referral system and hospital management guidelines are needed to reduce workload of health staff.


2020 ◽  
Author(s):  
Emad Aborajooh ◽  
Mohammed Qussay Al-Sabbagh ◽  
Baraa Mafrachi ◽  
Muhammad Yassin ◽  
Rami Dwairi ◽  
...  

UNSTRUCTURED We aimed to measure levels of knowledge, awareness, and stress about COVID-19 among health care providers (HCP) in Jordan. This was a cross-sectional study on 397 HCPs that utilized an internet-based questionnaire to evaluate knowledge about COVID-19, availability of personal protective equipment (PEE), future perception, and psychological distress. Ordinal logistic regression analysis was used to evaluate factors associated with knowledge and psychological stress. Overall, 24.4% and 21.2% of the participants showed excellent knowledge and poor knowledge, respectively. Social media (61.7%) was the most commonly used source of information. Being female (β= 0.521, 95% CI 0.049 to 0.992), physician (β=1.421, 95% CI 0.849 to 1.992), or using literature to gain knowledge (β= 1.161, 95% CI 0.657 to 1.664) were positive predictors of higher knowledge. While having higher stress (β= -0.854, 95% CI -1.488 to -0.221) and using social media (β= -0.434, 95% CI -0.865 to -0.003) or conventional media (β= -0.884, 95% CI -1.358 to -0.409) for information were negative predictors of knowledge levels. HCPs are advised to use the literature as a source of information about the virus, its transmission, and the best practice. PPEs should be secured for HCPs to the psychological stress associated with treating COVID-19 patients.


2020 ◽  
Vol 32 (S1) ◽  
pp. 123-123
Author(s):  
Ken Schwartz ◽  
Robert Madan ◽  
Anna Berall ◽  
Marsha Natadira ◽  
Anna Santiago

Background:Responsive behaviours in dementia are associated with poor outcomes for the person with dementia (PWD) and caregiver burnout. Family caregivers need a variety of tools to manage responsive behaviours. The Baycrest Quick-Response Caregiver Tool was developed to provide caregivers with a tool that can be used in real time. In this study, the feasibility, impact, and effectiveness of this new tool were studied in family caregivers and health care providers (HCP) using quantitative and qualitative measures.Methods:Family caregivers were recruited and were asked to complete a pre-survey before being sent the link to the educational tool. One month after the telephone survey, caregivers were sent an online post-survey to gather their feedback on the tool and the impact of the tool on caregiver well -being. Healthcare providers were also recruited and reviewed the tool through an online feedback survey. The feasibility, impact, and effectiveness of the tool were assessed using quantitative and qualitative measures.Results:Caregivers had a moderate degree of and reported a high level of competence - these scores were maintained throughout the study. Caregivers reported that tool positively impacted their compassion towards the person with dementia (PWD), and that their interactions with improved. 100% of HCP who completed the feedback survey would recommend the tool to other HCP and to caregivers of PWD. The caregivers and HCP provided specific suggestions for improvement.Conclusions:The Baycrest Quick-Response Caregiver Tool was found to be feasible and helpful. It provides caregivers and HCP with an additional approach for responsive behaviours.


Author(s):  
Ariana Kong ◽  
Michelle Dickson ◽  
Lucie Ramjan ◽  
Mariana S. Sousa ◽  
Joanne Goulding ◽  
...  

The aim of this study was to explore whether oral health was an important consideration for Aboriginal and Torres Strait Islander women during pregnancy, whether oral health could be promoted by Aboriginal health staff, and strategies that would be appropriate to use in a new model of care. A qualitative descriptive methodology underpinned the study. All participants in this study identified as Aboriginal, with no Torres Strait Islander participants, and were from New South Wales, Australia. The interviews were analysed using inductive thematic analysis. From the data, two themes were constructed. The first theme identified that oral health was not always the first priority for participants as poor accessibility alongside other competing commitments were challenges to accessing oral health services. The second theme highlighted how relationships with personal networks and healthcare providers were essential and could be used to support maternal oral health during pregnancy. Effective strategies to promote oral health during pregnancy for Aboriginal and Torres Strait Islander women should involve key stakeholders and health care providers, like Aboriginal Health Workers, to facilitate culturally safe support and tailored oral health advice.


2013 ◽  
Vol 3 (2) ◽  
pp. 154-159
Author(s):  
Janet Perkins ◽  
Aminata Bargo ◽  
Cecilia Capello ◽  
Carlo Santarelli

Assuring the provision of person-centred care is critical in maternal and newborn health (MNH). As a component of the national strategy to improve MNH, Burkina Faso Ministry of Health, supported by Enfants du Monde, La Fondation pour le Développement Communautaire/Burkina Faso and UNFPA, is implementing the World Health Organization’s (WHO) framework for Working with Individuals, Families and Communities (IFC) to improve MNH. As a first step in district implementation, participatory community assessments were conducted. These assessments consistently revealed that poor interactions with healthcare providers posed one important barrier preventing women from seeking MNH services. In order to address this barrier, healthcare providers were trained to improve their interpersonal skills and in counselling women. During 2011-12 a total of 175 personnel were trained over a 5-day course developed using a WHO manual. The course was met with enthusiasm as providers expressed their need and desire for such training. Immediate post-test results revealed an impressive increase in knowledge and anecdotal evidence suggests that training has influenced provider’s behaviours in their interactions with women. In addition, health care providers are taking concrete action to build the capabilities of women to experience pregnancy and birth safely by engaging directly with communities.  While early findings are promising, an evaluation will be necessary to measure how the training has influenced practices, whether this translates into a shift of perceptions at community level and ultimately its contribution toward promoting person-centred care in Burkina Faso.


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