scholarly journals FACTORS INFLUENCING CLINICAL MANAGEMENT OF CRYPTOCOCCAL MENINGITIS AMONG HEALTH CARE PROVIDERS AT TWO REFERRAL HOSPITALS IN KISUMU COUNTY, KENYA

2021 ◽  
Vol 7 (1) ◽  
pp. 74-84
Author(s):  
Robina Ogendo
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Cryptococcal Meningitis ◽  
Clinical Management ◽  
Scale Up ◽  
World Health ◽  
Unique Contribution ◽  
Care Providers ◽  
Factors Influencing ◽  
Referral Hospitals

Purpose: Cryptococcal meningitis is one of the most common and lethal opportunistic infections among human immune virus infected clients/patients before initiation of antiretroviral therapy. It is majorly associated to morbidity and early mortality among human immunodeficiency virus infected patients in resource limited countries. The main objective of this study was to investigate the factors influencing clinical management of cryptococcal meningitis in adults among health care providers at two referral hospitals in Kisumu County, Kenya. Methodology: A cross-sectional study using quantitative approach was used targeting 119 health care providers. Collection of data was through pretested self- administered questionnaires to examine factors influencing clinical management of cryptococcal meningitis. Data obtained was analyzed using the statistical package for social science version 25. Descriptive analysis was done using frequencies, percentages and means. Inferential analysis was conducted using bivariate logistic regression to determine relationships among the variables, p-values of at or below 0.05 were considered statistically significant. Results: The major factor associated positively with clinical management of cryptococcal meningitis was the acknowledgement by the health care providers that the world health organization guidelines lead to a better patient outcome (97%, n=113) and inadequate supplies and resources to facilitate management (78%, n=90) was the major factor associated negatively. Health care providers with an experience of five years or less were 40% more likely to agree that the factors were influencing clinical management of cryptococcal meningitis in contrast to those with an experience of six years or more (OR: 0.6; 95%CI: 0.1 – 0.74; p=0.04). Unique contribution to theory, practice and policy:  The clinical management of cryptococcal meningitis in adults in the study area is majorly negatively influenced by inadequate supplies and resources to facilitate the process of management. The study recommends that the policy makers in the County government of Kisumu and the two hospital management teams need to scale up a timely and constant provision of adequate resources, facilities and supplies, which will promote effective clinical management of cryptococcal meningitis in the study area

scholarly journals FACTORS INFLUENCING CONTROL OF BLOOD PRESSURE LEVELS AMONG HYPERTENSIVE ADULT PATIENTS IN SELECTED HOSPITALS, KAKAMEGA COUNTY, KENYA

2021 ◽  
Vol 6 (2) ◽  
pp. 42-71
Author(s):  
Thomas Ong'ondo Ng'ambwa ◽  
Prof. Lt Col (Rtd) John Martin Okoth ◽  
Dr. Tecla Psusma Sum
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Health Care Providers ◽  
Blood Pressure Level ◽  
Adult Patients ◽  
P Value ◽  
Unique Contribution ◽  
Care Providers ◽  
Cross Sectional ◽  
Factors Influencing

Purpose: The study aimed to investigate the factors influencing blood pressure levels in hypertensive adult patients in Kenya's Kakamega County. The specific objectives were as follows: to assess patient factors that influence blood pressure levels among hypertensive adult patients in Kakamega County, examine health-care provider factors that influence blood pressure levels in hypertensive adult patients; determine institutional factors that influence blood pressure levels in hypertensive adult patients in Kakamega County based on the clinical recommendations for cardiovascular disease management from 2018. Methodology: The researcher used a cross-sectional analytical study design. Patients and health care providers were requested to sign a written consent before data was collected using a questionnaire and an observation checklist. Quantitative data were evaluated using descriptive and inferential statistics, statistical package for social sciences version 22, with a statistically significant p-value of 0.05. The strength of the relationship between the variables and the patient's blood pressure level was tested using multiple regression. Findings: The findings showed that the number of years a patient was told he or she had hypertension patient sensitization about the disease (p = 0.04), the patient's BMI (p = 0.01), BP stability at the time of admission (0.0001), having a treatment supporter to advise the patient when to take medications (0.04). The health care provider's age group and knowledge about the disease (p = 0.02) was all separately correlated with blood pressure control. According to the current analysis, in Kakamega County, being a male without adequate patient sensitization about the hypertension disease made patients to be more likely to have uncontrolled blood pressure levels. Unique contribution to theory, practice and policy: The study recommends a model that combines patient and health-care system variables emphasizing on patient sensitization about the hypertension disease, modifiable and modifiable risk factors should be created in attempt to have blood pressure controlled.

Health Care Providers in War and Armed Conflict: Operational and Educational Challenges in International Humanitarian Law and the Geneva Conventions, Part I. Historical Perspective

2018 ◽  
Vol 13 (02) ◽  
pp. 109-115 ◽  
Author(s):  
Frederick M. Burkle ◽  
Adam L. Kushner ◽  
Christos Giannou ◽  
Mary A. Paterson ◽  
Sherry M. Wren ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Armed Conflict ◽  
Historical Perspective ◽  
Geneva Convention ◽  
World Health ◽  
International Humanitarian Law ◽  
Humanitarian Law ◽  
Care Providers ◽  
The Impact

AbstractSince 1945, the reason for humanitarian crises and the way in which the world responds to them has dramatically changed every 10 to 15 years or less. Planning, response, and recovery for these tragic events have often been ad hoc, inconsistent, and insufficient, largely because of the complexity of global humanitarian demands and their corresponding response system capabilities. This historical perspective chronicles the transformation of war and armed conflicts from the Cold War to today, emphasizing the impact these events have had on humanitarian professionals and their struggle to adapt to increasing humanitarian, operational, and political challenges. An unprecedented independent United Nations–World Health Organization decision in the Battle for Mosul in Iraq to deploy to combat zones emergency medical teams unprepared in the skills of decades-tested war and armed conflict preparation and response afforded to health care providers and dictated by International Humanitarian Law and Geneva Convention protections has abruptly challenged future decision-making and deployments. (Disaster Med Public Health Preparedness. 2019;13:109–115)

Training health workers to provide person-centred maternal and newborn health care in Burkina Faso

2013 ◽  
Vol 3 (2) ◽  
pp. 154-159
Author(s):  
Janet Perkins ◽  
Aminata Bargo ◽  
Cecilia Capello ◽  
Carlo Santarelli
Keyword(s):  
Health Care ◽  
Burkina Faso ◽  
Health Care Providers ◽  
Health Workers ◽  
Healthcare Providers ◽  
Newborn Health ◽  
World Health ◽  
Maternal And Newborn Health ◽  
Care Providers ◽  
Maternal And Newborn

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.

Adherence to treatment in psychiatry

2020 ◽  
pp. 193-204
Author(s):  
Amy Chan ◽  
Rob Horne
Keyword(s):  
Health Care ◽  
Treatment Adherence ◽  
Health Care Providers ◽  
Patient Perspective ◽  
Good Health ◽  
Active Role ◽  
Care Providers ◽  
Adherence To Treatment ◽  
Factors Influencing ◽  
Adherence Support

Adherence to treatment in psychiatry is pivotal for achieving and maintaining good health outcomes. Yet, despite the vast amount of research into adherence, treatment adherence remains suboptimal. There is a need for everyone to take an active role in addressing non-adherence if we are to realize the full benefits of available treatments. This chapter introduces the concept of adherence and discusses the factors influencing adherence in psychiatry. The adherence literature is then reviewed, and results from past adherence interventions summarized to explain why non-adherence occurs from an individual patient perspective. A perceptions and practicalities approach to adherence is then presented to help guide the design and delivery of patient-centred adherence support. This chapter serves as a practical guide to adherence for health care providers and others interested in supporting adherence to treatment in psychiatry.

scholarly journals General practitioner perceptions of clinical medication reviews undertaken by community pharmacists

2010 ◽  
Vol 2 (3) ◽  
pp. 225 ◽  
Author(s):  
Linda Bryant ◽  
Gregor Coster ◽  
Ross McCormick
Keyword(s):  
Health Care ◽  
General Practitioner ◽  
Patient Outcomes ◽  
Health Care Providers ◽  
Community Pharmacists ◽  
Resource Utilisation ◽  
Utilization Review ◽  
Care Providers ◽  
Factors Influencing ◽  
Medication Reviews

INTRODUCTION: Delivery of current health care services focuses on interdisciplinary teams and greater involvement of health care providers such as nurses and pharmacists. This requires a change in role perception and acceptance, usually with some resistance to changes. There are few studies investigating the perceptions of general practitioners (GPs) towards community pharmacists increasing their participation in roles such as clinical medication reviews. There is an expectation that these roles may be perceived as crossing a clinical boundary between the work of the GP and that of a pharmacist. METHODS: Thirty-eight GPs who participated in the General Practitioner–Pharmacists Collaboration (GPPC) study in New Zealand were interviewed at the study conclusion. The GPPC study investigated outcomes of a community pharmacist undertaking a clinical medication review in collaboration with a GP, and potential barriers. The GPs were exposed to one of 20 study pharmacists. The semi-structured interviews were recorded and transcribed verbatim then analysed using a general inductive thematic approach. FINDINGS: The GP balanced two themes, patient outcomes and resource utilisation, which determined the over-arching theme, value. This concept was a continuum, depending on the balance. Factors influencing the theme of patient outcomes included the clinical versus theoretical nature of the pharmacist recommendations. Factors influencing resource utilisation for general practice were primarily time and funding. CONCLUSION: GPs attributed different values to community pharmacists undertaking clinical medication reviews, but this value usually balanced the quality and usefulness of the pharmacist’s recommendations with the efficiency of the system in terms of workload and funding. KEYWORDS: Family physicians; community pharmacy services; drug utilization review; primary healthcare; health plan implementation; qualitative research; interprofessional relations

scholarly journals Health care professionals’ adherence to partograph use in Ethiopia: analysis of 2016 national emergency obstetric and newborn care survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Solomon Weldemariam Gebrehiwot ◽  
Mulugeta Woldu Abrha ◽  
Haftom Gebrehiwot Weldearegay
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Multivariable Analysis ◽  
Newborn Care ◽  
Health Facilities ◽  
World Health ◽  
Outcome Variable ◽  
Care Providers ◽  
Care Survey ◽  
National Emergency

Abstract Background The period around childbirth and the first 24 hours postpartum remains a perilous time for both mother and newborn. Health care providers’ compliance to the World Health Organization modified partogram across the active first stage of labor is a graphic representation of a mother’s condition that is used as a guide in providing quality obstetrics care. However, little evidence is documented on the health providers’ adherence to the use of the partograph in Ethiopia, which limits health care providers’ ability to improve quality care services. Therefore, this study assessed the adherence of partograph use and associated factors in Ethiopia. Methods Data from the Ethiopian 2016 National Emergency Obstetric and Newborn Care survey of 3,804 health facilities that provided maternity services were used. We extracted 2611 partograph charts over a 12 months period prior to the survey to review the proper recording of each component. Data analyses were performed using SPSS version 22.0 software. A logistic regression analyses was used to identify the association of explanatory variables with the outcome variable. A p-value of <0.05 was considered as cut off point to declare the significance association in the multivariable analysis. Results Of the total 2611 partographs reviewed, 561(21.5%) of them were fully recorded as per the WHO guideline. Particularly, molding in 50%, color of liquor in 70.5%, fetal heart beat in 93.3%, cervical dilation in 89.6%, descent in 63.2%, uterine contraction in 94.5%, blood pressure in 80.5%, pulse rate in 70.5%, and temperature in 53% were accurately recorded. The odds of adherence to partograph use were 1.4 in rural health facilities when compared to their counterparts (AOR=1.44; 95% CI: 1.15, 1.80, P- 0.002). Conclusion This study revealed a poor level of adherence in partograph use in Ethiopia. Molding, maternal temperature and decent were the least recorded parameters of the partograph. The odds of completion of partograph were high in rural facilities. Strong supporting supervision and mentoring the health workers to better record and use of partograph are needed mainly in urban health facilities. Moreover in the future, interventional research should be conducted to improve the current rate of adherence.

scholarly journals Pathways to psychiatric care in Ethiopia

2008 ◽  
Vol 39 (3) ◽  
pp. 475-483 ◽  
Author(s):  
Y. Y. Bekele ◽  
A. J. Flisher ◽  
A. Alem ◽  
Y. Baheretebeb
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Service Delivery ◽  
Psychiatric Hospital ◽  
Health Care Providers ◽  
Mental Hospital ◽  
Psychiatric Care ◽  
Addis Ababa ◽  
World Health ◽  
Care Providers

BackgroundUnderstanding the pathways to psychiatric care and recognition of delay points are crucial for the development of interventions that aim to improve access to mental health-care services.MethodOver a 2-month period in 2003, a total of 1044 patients at the commencement of new episodes of care at Amanuel Specialized Mental Hospital in Addis Ababa, Ethiopia were interviewed using the encounter form that was developed by the World Health Organization (WHO) for the study of pathways to psychiatric care.ResultsThe mental hospital was contacted directly by 41% of patients. The remaining patients sought care from up to four different caregivers before arriving at the psychiatric hospital. Where the initial service was not received at the psychiatric hospital, 30.9% of patients sought care from priests/holy water/church. The median delay between onset of illness and arrival at the psychiatric hospital was 38 weeks. The longest delays before arriving at the mental hospital were associated with having no formal education, joblessness, and diagnoses of epilepsy and physical conditions.ConclusionsImplementing a robust referral system and establishing a strong working relationship with both traditional and modern health-care providers, as well as designing a service delivery model that targets particular segments of the population, such as those who are uneducated, jobless and/or suffer from epilepsy and somatic conditions, should be the most important strategies towards improving mental health service delivery and shortening of undue delay for patients receiving psychiatric care in Ethiopia.

scholarly journals Hiking

2016 ◽  
Vol 12 (4) ◽  
pp. 302-310 ◽  
Author(s):  
Denise Mitten ◽  
Jillisa R. Overholt ◽  
Francis I. Haynes ◽  
Chiara C. D’Amore ◽  
Janet C. Ady
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Emotional Health ◽  
World Health ◽  
Health Care Practitioner ◽  
Federal State ◽  
Care Providers ◽  
Increased Risk

Research has connected sedentary lifestyles with numerous negative health outcomes, including a significant increased risk for mortality. Many health care professionals seek ways to help clients meet physical activity guidelines recommended by the Office of Disease Prevention and Health Promotion, the World Health Organization, and the American College of Sports Medicine in order to promote active lifestyles and improve overall wellness. Hiking is a cost-effective intervention that encourages people to be physically active while spending time in nature. Time in nature can lead to health benefits through contact with the natural elements, participation in physical activity, restoration of mental and emotional health, and time with social contacts. Benefits may be immediate, such as decreased blood pressure, decreased stress levels, enhanced immune system functioning, and restored attention, or transpire over time, such as weight loss, decreased depression, and overall wellness. Health care providers are ideally positioned to recommend and prescribe hiking to clients. Federal, state, and local natural resource agencies are beginning to partner with health care professionals to promote outdoor nature-related activities. Examples of successful doctor and other health care practitioner partnership programs are described, along with tips for getting started.

scholarly journals Developing an Indonesian fertility preservation questionnaire for health care providers treating patients with cancer: A preliminary pilot study

F1000Research ◽  
2019 ◽  
Vol 7 ◽  
pp. 1890
Author(s):  
Achmad Kemal Harzif ◽  
Raymond Surya ◽  
Mila Maidarti ◽  
Ana Mariana ◽  
Bara Tracy Lovita ◽  
...  
Keyword(s):  
Health Care ◽  
Pilot Study ◽  
Fertility Preservation ◽  
Health Care Providers ◽  
Expert Panel ◽  
World Health ◽  
Cognitive Interviewing ◽  
Care Providers ◽  
Patients With Cancer ◽  
Forward Translation

Background: Early detection and advanced treatment increases the five-year survival rate of patients with cancer. However, long-term cancer therapy, such as chemotherapy and radiotherapy, can have negative effects, such as infertility. This study aimed to develop a standardized Indonesian questionnaire, which would be used to assess the quality of health care providers’ knowledge, attitude, and practice regarding fertility preservation in patients with cancer. Methods: A pilot study was performed in January and February 2018 at Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. An existing questionnaire was translated from English to Indonesian using forward translation, back translation, expert panel, pretesting, and cognitive interviewing. Ten subspecialists in the following departments made up an expert panel, who were involved in pretesting and cognitive interviewing: pediatric hematology-oncology, hematology-oncology/internal medicine, gynecologic oncology, gynecologic immune-endocrinology, radiology-oncology, and surgical oncology. Results: The questionnaire was successfully translated. The ten respondents stated that the maximum age for women’s fertility preservation is 40 years of age (60%), 45 years of age (30%), or had no maximum age (10%). Additionally, the respondents stated that the maximum age for men’s fertility preservation is 40 years of age (30%), 50 years of age (20%), or had no maximum age (50%). The respondents’ knowledge stated that > 50% of them were aware but do not know enough about fertility preservation. The respondents stated that more than 50% of them give feedback agreeing to fertility preservation, and they always give advice about fertility preservation to their patients. Conclusion: The translation of the questionnaire followed translation steps from the World Health Organization and was adjusted based on the expert panel’s comments concerning fertility preservation. This validated questionnaire tool in Indonesian can be used for research purposes and clinical evaluation of fertility preservation among health care providers in Indonesia.

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