scholarly journals Sustainability of ‘mHealth’ interventions in sub-Saharan Africa: a stakeholder analysis of an electronic community case management project in Malawi

2019 ◽  
Vol 31 (3) ◽  
pp. 177-183 ◽  
Author(s):  
Kanika I Dharmayat
Keyword(s):  
Global Health ◽  
Case Management ◽  
Information And Communication Technologies ◽  
Scale Up ◽  
Healthcare Delivery ◽  
Sub Saharan Africa ◽  
Healthcare Sector ◽  
Training Methods ◽  
Community Case Management ◽  
Local Capacity

BackgroundThe global health community and funding agencies are currently engaged in ensuring that worthwhile research-based programmes are sustainable. Despite its importance, few studies have analysed the sustainability of global health interventions. In this paper, we aim to explore barriers and facilitators for the wider implementation and sustainability of a mobile health (mHealth) intervention (Supporting LIFE Community Case Management programme) in Malawi, Africa.MethodsBetween January and March 2017, a qualitative approach was used to carry out and analyse 13 in-depth semi-structured interviews with key stakeholders across all levels of healthcare provision in Malawi to explore their perceptions with regards to the implementation and sustainability of the mHealth programme. Data were analysed thematically by two reviewers. ResultsOverall, our analysis found that the programme was successful in achieving its goals. However, there are many challenges to the wider implementation and sustainability of this programme, including the absence of monetary resources, limited visibility outside the healthcare sector, the lack of integration with community-based and nationwide programmes, services and information and communication technologies, and the limited local capacity in relation to the maintenance, further development, and management.ConclusionsFuture developments should be aligned with the strategic goals and interests of the Ministry of Health and engage with national and international stakeholders to develop shared goals and strategies for nationwide scale-up. These developments should also focus on building local capacity by educating trainers and ensuring that training methods and guidelines are appropriately accredited based on national policies. Our findings provide a framework for a variety of stakeholders who are engaged in sustaining mHealth programmes in resource-poor settings and can be used to develop an evidence-based policy for the utilization of technology for healthcare delivery across developing countries.

scholarly journals Adding proactive and reactive case detection into the integrated community case management system to optimise diagnosis and treatment of malaria in a high transmission setting of Cameroon: an observational quality improvement study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026678 ◽  
Author(s):  
Cavin Epie Bekolo ◽  
Thomas D’Arcy Williams
Keyword(s):  
Quality Improvement ◽  
Case Management ◽  
Diagnostic Testing ◽  
Sub Saharan Africa ◽  
Secondary Outcome ◽  
Case Detection ◽  
Community Case Management ◽  
Reactive Case Detection ◽  
Integrated Community Case Management ◽  
Index Cases

ObjectiveIntegrated community case management (iCCM) of childhood illness is a powerful intervention to reduce mortality. Yet, only 29% and 59% of children with fever in sub-Saharan Africa had access to malaria testing and treatment between 2015 and 2017. We report how iCCM+ based on incorporating active case detection of malaria into iCCM could help improve testing and treatment.DesignA community-led observational quality improvement study.SettingThe rural community of Bare-Bakem in Cameroon.ParticipantsChildren and adults with fever between April and June 2018.InterventionA modified iCCM programme (iCCM+) comprising a proactive screening of febrile children <5 years old for malaria using rapid diagnostic testing to identify index cases and a reactive screening triggered by these index cases to detect secondary cases in the community.Primary and secondary outcome measuresThe proportion of additional malaria cases detected by iCCM+ over iCCM.ResultsWe screened 501 febrile patients of whomPlasmodiuminfection was confirmed in 425 (84.8%) cases. Of these cases, 102 (24.0%) were index cases identified in the community during routine iCCM activity and 36 (8.5%) cases detected passively in health facilities; 38 (8.9%) were index cases identified proactively in schools and 249 (58.6%) were additional cases detected by reactive case detection—computing to a total of 287 (67.5%) additional cases found by iCCM+ over iCCM. The likelihood of finding additional cases increased with increasing family size (adjusted odd ratio (aOR)=1.2, 95% CI: 1.1 to 1.3) and with increasing age (aOR=1.7, 95% CI: 1.5 to 1.9).ConclusionMost symptomatic cases of malaria remain undetected in the community despite the introduction of CCM of malaria. iCCM+ can be adopted to diagnose and treat more of these undiagnosed cases especially when targeted to schools, older children and larger households.

Managing technology risks in the healthcare sector: disaster recovery and business continuity planning

2000 ◽  
Vol 9 (4) ◽  
pp. 257-270 ◽  
Author(s):  
Raja K. Iyer ◽  
Kakoli Bandyopadhyay
Keyword(s):  
Information And Communication Technologies ◽  
Disaster Recovery ◽  
Health Management ◽  
Healthcare Delivery ◽  
Communication Technologies ◽  
Healthcare Sector ◽  
Business Continuity ◽  
Healthcare Organizations ◽  
Continuity Planning ◽  
Information And Communication

The relentless onslaught of computers and communications technologies has recently descended on the healthcare industry. Fortunately, however, the utilization of technologies in healthcare delivery and administration could not be timelier because of the need to control escalating health costs. While the proliferation of information and communication technologies in healthcare, referred to as health management information systems (HMIS), is certainly long overdue in healthcare organizations (HCOs), it is important to recognize and be prepared for the vulnerabilities of these technologies to natural, technological, and man‐made disasters. This paper describes how HCOs have justifiably become dependent on HMIS and how these organizations may proactively plan for disasters which can impact on HMIS. A phased approach, referred to as the disaster recovery and business continuity (DRBC) planning model, is presented in the paper as an approach to develop and implement business continuity plans in HCOs.

scholarly journals Malaria Care-Seeking and Treatment Ideation among Gold Miners in Guyana

2021 ◽  
Author(s):  
Bolanle Olapeju ◽  
Camille Adams ◽  
Sean Wilson ◽  
Joann Simpson ◽  
Gabrielle Hunter ◽  
...  
Keyword(s):  
Case Management ◽  
Self Efficacy ◽  
Perceived Risk ◽  
Scale Up ◽  
Care Seeking ◽  
Community Case Management ◽  
Self Medication ◽  
Gold Miners ◽  
The Relationship ◽  
Malaria Knowledge

Abstract Background Although miners are a priority population in malaria elimination in Guyana, scant literature exists on the drivers of malaria-related behaviour. This study explores the relationship between gold miners’ malaria-related ideation and the adoption of malaria care-seeking and treatment behaviours including prompt care-seeking, malaria testing, and self-medication. Methods Data are from a cross-sectional quantitative survey of 1685 adult miners between the ages of 18–59 years who live in mining camps in Regions 1, 7, and 8. The analysis focused on miners who reported an episode of fever in the past year (n = 745). Malaria care-seeking and treatment ideation was defined as a composite additive score consisting of the following variables: general malaria knowledge, perceived severity, perceived susceptibility, beliefs, perceived self-efficacy, perceived norms, interpersonal communication, and perceived response efficacy. Multivariable logistic regressions explored the relationship between ideation on care-seeking/treatment behaviours, controlling for confounding variables. Results Most miners with a recent episode of fever had perceived risk (92%), self-efficacy (67%), susceptibility (53%) and high malaria knowledge (53%). Overall, miners' care-seeking/treatment ideation score ranged from 0 to 8 with a mean of 4.1. Ideation scores were associated with higher odds of care-seeking for fever (aOR:1.19; 95% CI: 1.04–1.36), getting tested for malaria (aOR: 1.22; 95% CI: 1.07–1.38) and lower odds of self-medication (aOR: 0.87; 95% CI: 0.77–0.99). Conclusions A national community case management initiative is using study findings as part of its scale-up, using volunteers to make testing and treatment services more accessible to miners. This is complemented by a multi-channel mass media campaign to improve miners’ ideation. Communication messages focus on increasing miners’ knowledge of malaria transmission and symptoms, encourage positive beliefs about malaria testing and volunteer testers, promote evidence about the effectiveness of testing, and reminders of how quick and easy it is to get a malaria test with the community case management initiative. Study findings also have implications for efforts to eliminate malaria across the Guiana Shield.

scholarly journals Policy Challenges Facing the Scale Up of Integrated Community Case Management (iCCM) in Uganda

2021 ◽  
Author(s):  
Phyllis Awor ◽  
Joan Nakayaga Kalyango ◽  
Cecilia Stålsby Lundborg ◽  
Freddie Ssengooba ◽  
Jaran Eriksen ◽  
...  
Keyword(s):  
Case Management ◽  
Scale Up ◽  
Community Case Management ◽  
Integrated Community Case Management
Sign in / Sign up

Export Citation Format

Share Document