scholarly journals Evaluation of diabetic peer support in Malawi

2021 ◽  
Vol 33 (2) ◽  
pp. 108-113
Author(s):  
Henry T Mwakalinga ◽  
Yamikani M Nuka ◽  
Patrick C Banda ◽  
Thuy D Bui
Keyword(s):  
Health Care ◽  
Peer Support ◽  
Health Care Providers ◽  
Low Income ◽  
Self Efficacy ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Health Concern ◽  
Diabetic Patients ◽  
Care Providers

BackgroundType 2 diabetes is a major health concern worldwide and requires urgent attention from health care providers and policy makers. Due to shortage of health care workers in low-income countries, peer support programs have been viewed as a viable option in management of diabetes and have shown to be effective in sub-Saharan Africa. ObjectiveThe aim of this study is to assess and evaluate the Kamuzu Central Hospital (KCH) diabetic peer support program’s (DPSP) impact 4 years after its establishment by assessing knowledge, self-efficacy and behaviours of DPSP members compared to non-members.Methodology This is a cross-sectional study done among diabetic patients attending clinics between 12th August and 25th September 2018 at KCH. Self and interviewer-administered questionnaires (designed based on validated survey instruments) were used. The participants (n=176) were recruited consecutively after consenting. Results Results showed DPSP members were more knowledgeable regarding the effects of skipping meals and sweet juice on blood glucose and conditions not associated with diabetes. In terms of self-efficacy and behaviour changes, DPSP members believe that they are more able to correct hypoglycaemia, to communicate their concerns to health workers and to perform daily foot exam compared to non-members.Conclusion The KCH (Lilongwe) Diabetes Peer Support program has positively impacted its members and should be scaled up to engage all diabetic patients in Malawi. Ongoing training for peer supporters is necessary to update and reinforce management, knowledge and skills, and to ensure fidelity in program implementation.

scholarly journals Developing nephrology services in low income countries: a case of Tanzania

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Francis F. Furia ◽  
Jacqueline Shoo ◽  
Paschal J. Ruggajo ◽  
Kajiru Kilonzo ◽  
Gopal Basu ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Low Income ◽  
Kidney Diseases ◽  
Developed Countries ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Care Providers ◽  
African Countries ◽  
Middle Income ◽  
Sub Saharan

Abstract Background The burden of kidney diseases is reported to be higher in lower- and middle-income countries as compared to developed countries, and countries in sub-Saharan Africa are reported to be most affected. Health systems in most sub-Sahara African countries have limited capacity in the form of trained and skilled health care providers, diagnostic support, equipment and policies to provide nephrology services. Several initiatives have been implemented to support establishment of these services. Methods This is a situation analysis to examine the nephrology services in Tanzania. It was conducted by interviewing key personnel in institutions providing nephrology services aiming at describing available services and international collaborators supporting nephrology services. Results Tanzania is a low-income country in Sub-Saharan Africa with a population of more than 55 million that has seen remarkable improvement in the provision of nephrology services and these include increase in the number of nephrologists to 14 in 2018 from one in 2006, increase in number of dialysis units from one unit (0.03 unit per million) before 2007 to 28 units (0.5 units per million) in 2018 and improved diagnostic services with introduction of nephropathology services. Government of Tanzania has been providing kidney transplantation services by funding referral of donor and recipients abroad and has now introduced local transplantation services in two hospitals. There have been strong international collaborators who have supported nephrology services and establishment of nephrology training in Tanzania. Conclusion Tanzania has seen remarkable achievement in provision of nephrology services and provides an interesting model to be used in supporting nephrology services in low income countries.

scholarly journals Women who have sex with women’s experiences with healthcare system in low-income countries: qualitative findings from Dar-es-Salaam, Tanzania

2021 ◽  
Vol 2 (3) ◽  
pp. 142-145
Author(s):  
Happiness P. Saronga ◽  
Jackline V. Mbishi ◽  
Saidah S. Bakar ◽  
Switbert R. Kamazima
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Health Care Providers ◽  
Low Income ◽  
Dar Es Salaam ◽  
Health Facilities ◽  
Low Income Countries ◽  
Care Providers ◽  
Public Health Facilities

Introduction: Women who have sex with women (WSW) have a right to access health care. Many studies have reported lower access to health services by sexual minorities in many parts of the world. This study explored WSW’s experiences in accessing health care in Tanzania with the intention of determining specific issues facing WSW when accessing health care services. Methods: This study was cross-sectional descriptive, and retrospective conduced in Dar-es-Salaam region, the largest commercial city in Tanzania. Study population included WSW aged 18 years and above who met inclusion criteria. Data was collected using focus group discussions (FGDs), in-depth interviews (IDIs), observation, and life stories. Data analysis applied thematic analysis. Results: Most WSW receive rightful health services from public and private health providers. However, transgender WSW face stigma, discrimination, and disrespect from some public health facilities. Private health care providers offer trust, privacy and confidentiality to WSW, although at a higher cost of services compared to public health facilities. Conclusion: Negative experiences with care may discourage WSW from seeking care or fully disclosing health concerns to providers limiting the extent of services offered.

scholarly journals SAT0640-HPR RHEUMATOLOGY CARE OF MIGRANTS FROM SUB-SAHARAN AFRICA; A QUALITATIVE PILOT STUDY OF PATIENTS’ PERSPECTIVES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1279.1-1279
Author(s):  
Z. Rutter-Locher ◽  
J. Galloway ◽  
H. Lempp
Keyword(s):  
Rheumatoid Arthritis ◽  
Health Care ◽  
Health Care Providers ◽  
Unmet Need ◽  
Primary Care Providers ◽  
Sub Saharan Africa ◽  
Care Providers ◽  
Specialist Care ◽  
Sub Saharan ◽  
The Uk

Background:Rheumatological diseases are common in Sub-Saharan Africa [1] but specialist healthcare is limited and there are less than 150 rheumatologists currently serving 1 billion people in Sub-Saharan Africa [2]. Rheumatologists practising in the UK NHS are likely to be exposed to migrant patients. There is therefore, an unmet need for health care providers to understand the differences in rheumatology healthcare provision between Sub-Saharan Africa and the UK and the barriers which migrants face in their transition of rheumatology care.Objectives:To gain an understanding of the experiences of patients with rheumatological conditions, about their past healthcare in Sub-Saharan Africa and their transition of care to the UK.Methods:A qualitative study using semi-structured interviews was conducted. Participants were recruited from two rheumatology outpatient clinics in London. Thematic analysis was applied to identify key themes.Results:Seven participants were recruited. Five had rheumatoid arthritis, one had ankylosing spondylitis and one had undifferentiated inflammatory arthritis. Participants described the significant impact their rheumatological conditions had on their physical and emotional wellbeing, including their social and financial implications. Compared to the UK, rheumatology healthcare in Sub-Saharan Africa was characterised by higher costs, limited access to specialists, lack of investigations and treatments, the use of traditional medicines and poor communication by clinicians. Barriers to transition of rheumatology care to the UK were: poor understanding of rheumatological conditions by the public and primary care providers, lack of understanding of NHS entitlements by migrants, fear of data sharing with immigration services and delayed referral to specialist care. Patient, doctor and public education were identified by participants as important ways to improve access to healthcare.Conclusion:This study has described, for the first time, patients’ perspectives of rheumatology health care in Sub-Saharan Africa and the transition of their care to the UK. These initial findings allow healthcare providers in the UK to tailor management for this migrant population and suggests that migrants need more information about their NHS entitlements and specific explanations on what non-clinical data will be shared with immigration services. To increase access to appropriate care, a concerted effort by clinicians and public health authorities is necessary to raise awareness and provide better education to patients and migrant populations about rheumatological conditions.References:[1]G. Mody, “Rheumatology in Africa-challenges and opportunities,” Arthritis Res. Ther., vol. 19, no. 1, p. 49, 2017.[2]M. A. M. Elagib et al., “Sudan and Sweden Active Rheumatoid Arthritis in Central Africa: A Comparative Study Between,” J. Rheumatol. J. Rheumatol. January, vol. 43, no. 10, pp. 1777–1786, 2016.Acknowledgments:We are grateful to the patients involved in this study for their time and involvement.Disclosure of Interests:None declared

scholarly journals Pregnancy and childbirth in Mozambique: men as decision makers and women as caretakers?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Galle ◽  
H Cossa ◽  
N Osman ◽  
K Roelens ◽  
S Griffin ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Hiv Prevention ◽  
Health Care Providers ◽  
Male Involvement ◽  
Sub Saharan Africa ◽  
Care Providers ◽  
Pregnancy And Childbirth ◽  
Policy Level ◽  
Sub Saharan

Abstract Background Increasing male involvement during pregnancy is considered an important, but often overlooked intervention for improving maternal health in sub-Saharan Africa. This study explores the attitudes and beliefs of health policymakers, health care providers and local communities regarding men's involvement in maternal health in southern Mozambique. Methods Ten key informant interviews with stakeholders were carried out to assess their attitudes and perspectives regarding male involvement in maternal health, followed by 10 days of semi structured observations in health care centers. Subsequently 16 focus group discussions were conducted in the community and at provider level, followed by three in depth couple interviews. Analysis was done by applying a socio-ecological systems theory in thematic analysis. Results Results show a lack of strategy at policy level to stimulate male involvement in maternal health. Invitation cards for men are used as an isolated intervention in health facilities but these have not lead to the expected success. Providers have a rather passive attitude towards male involvement initiatives and women accompanied by a husband are often put in a submissive position. In the community however, male attendance at ANC is considered important and men are willing to take a more participating role. Main barriers are the association of male attendance at ANC with being HIV infected and strong social norms and gender roles. On the one hand men are seen as caretakers of the family by providing money and making the decisions. On the other hand, men supporting their wife by showing interest in their health or sharing household tasks are seen as weak or as a manifestation of HIV seropositivity. Conclusions A clear strategy at policy level and a multi-level approach is needed. Gender-equitable relationships between men and women should be encouraged in all maternal health interventions and health programs should step away from linking male involvement to HIV prevention. Key messages Linking the promotion of gender equality to male involvement is the key for success. Step away from linking HIV prevention to male involvement in maternal health.

Immigrant Communities and COVID-19: Strengthening the Public Health Response

2021 ◽  
Vol 111 (S3) ◽  
pp. S224-S231
Author(s):  
Lan N. Đoàn ◽  
Stella K. Chong ◽  
Supriya Misra ◽  
Simona C. Kwon ◽  
Stella S. Yi
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Immigrant Communities ◽  
Care Providers ◽  
Public Health Response ◽  
The Public ◽  
Public Health Infrastructure ◽  
Health Infrastructure

The COVID-19 pandemic has exposed the many broken fragments of US health care and social service systems, reinforcing extant health and socioeconomic inequities faced by structurally marginalized immigrant communities. Throughout the pandemic, even during the most critical period of rising cases in different epicenters, immigrants continued to work in high-risk-exposure environments while simultaneously having less access to health care and economic relief and facing discrimination. We describe systemic factors that have adversely affected low-income immigrants, including limiting their work opportunities to essential jobs, living in substandard housing conditions that do not allow for social distancing or space to safely isolate from others in the household, and policies that discourage access to public resources that are available to them or that make resources completely inaccessible. We demonstrate that the current public health infrastructure has not improved health care access or linkages to necessary services, treatments, or culturally competent health care providers, and we provide suggestions for how the Public Health 3.0 framework could advance this. We recommend the following strategies to improve the Public Health 3.0 public health infrastructure and mitigate widening disparities: (1) address the social determinants of health, (2) broaden engagement with stakeholders across multiple sectors, and (3) develop appropriate tools and technologies. (Am J Public Health. 2021;111(S3):S224–S231. https://doi.org/10.2105/AJPH.2021.306433 )

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