scholarly journals Improving Information and Communications Technology (ICT) Knowledge and Skills to Develop Health Research Capacity in Kenya

2019 ◽  
Vol 11 (3) ◽  
Author(s):  
Aliza Monroe-Wise ◽  
John Kinuthia ◽  
Sherrilynne Fuller ◽  
Matthew Dunbar ◽  
David Masuda ◽  
...  
Keyword(s):  
Data Management ◽  
Low Income ◽  
Clinical Care ◽  
Research Capacity ◽  
Information And Communications Technology ◽  
Learning Program ◽  
Knowledge And Skills ◽  
Low Resource Settings ◽  
Low Resource ◽  
Ict Tools

ObjectivesInformation and communication technology (ICT) tools are increasingly important for clinical care, research, data management, international collaborations, and dissemination. Many technologies would be particularly useful for healthcare workers in resource-limited settings; however, these individuals are the least likely to utilize ICT tools, in part because they lack knowledge and skills necessary to use them. Our program aimed to train researchers in low-resource settings on using ICT tools.MethodsWe conducted a tiered, blended learning program for researchers in Kenya on three areas of ICT: geographic information systems, data management, and communication tools. Tiers included didactic online courses for 100-300 students for each topic, skills workshops for 30 students, and mentored projects for 10. Concurrently, a training of trainers course comprised of an online course and a skills workshop to ensure sustainable ongoing training.ResultsCourse ratings were high, particularly when participants engaged in hands-on skill building activities. Teaching that incorporated local examples was most valuable. Discussion boards were sometimes distracting, depending on multiple factors. Mentored projects were most useful when there were clear expectations, pre-existing projects or data, and clear timelines.DiscussionTraining in the use of ICT tools is essential to improve their use among researchers in low-income settings. However, very few training courses have been described. Our students demonstrated acquisition of new skills and felt these skills to be valuable in their workplaces.ConclusionsFurther and ongoing training in ICT skills should be considered in other low-resource settings, and could use our program as a foundational model.

scholarly journals Digitally-enabled approach to improving primary care in a rural and remote low-resource setting

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Ansell
Keyword(s):  
Primary Care ◽  
Public Sector ◽  
Low Income ◽  
Digital Health ◽  
Health Priorities ◽  
Rural And Remote ◽  
Low Resource Settings ◽  
Digital Platform ◽  
Low Resource ◽  
Out Of Pocket Payments

Abstract Introduction An innovative digitally-supported multi-sectoral solution for supporting end-to-end primary care for rural and remote low-income populations in Western Visayas, Philippines was examined to determine its efficacy in supporting health access. This solution brings together multisectoral stakeholders using a digital platform to coordinate the provision of a virtual primary care system. The solution also supports ordering and delivery of low-cost insurance and medicines, with the aim of reducing out-of-pocket payments and complementing public-sector services. Methods Processes and outputs for a novel data-driven digital health solution were documented and analyzed through a mixed methods approach. Researchers conducted interviews with a range of stakeholders, including program beneficiaries and partners. Quantitative data focusing on the project outputs were also examined. Results Through an integrated digital platform to coordinate inputs from the public sector (Department of Health); private sector (pharmaceutical, insurance, and telecom firms); and community (in the form of a peer-worker network), this model offers an example of an innovative approach to primary health delivery in low-resource settings. These inputs are leveraged and informed by a 'big-data' precision approach, based on detailed epidemiological profiles of community residents. This dataset allows for the evidence-based identification of village-specific health priorities and development of corresponding interventions. This approach has contributed to increased access to medicines; affordability of medicines and health services; and community resilience among the target populations. However, barriers involving a local shortage of health human resources and cumbersome eHealth regulations affect program impact. Conclusions This research provides evidence for the scale-up of a multisectoral digital approach to support the implementation of UHC targets in Philippines. Key messages Implementing digital health solutions in low-resource settings is possible. Changes are needed in Philippines health regulations for digital health to properly support UHC implementation.

scholarly journals Building Surgical Research Capacity Globally: Efficacy of a Clinical Research Course for Surgeons in Low-Resource Settings

2017 ◽  
Vol 2 ◽  
Author(s):  
Theodore A. Miclau ◽  
Kathryn Chomsky-Higgins ◽  
Alfredo Ceballos ◽  
Roberto Balmaseda ◽  
Saam Morshed ◽  
...  
Keyword(s):  
Clinical Research ◽  
Research Capacity ◽  
Surgical Research ◽  
Low Resource Settings ◽  
Low Resource

Telemedicine in Low Resource Settings

2017 ◽  
pp. 129-148 ◽  
Author(s):  
Kagiso Ndlovu ◽  
Kabelo Leonard Mauco ◽  
Ryan Littman-Quinn
Keyword(s):  
Healthcare Delivery ◽  
Mitigation Strategies ◽  
Current Status ◽  
Successful Implementation ◽  
Telecommunication Services ◽  
Low Resource Settings ◽  
Implementation Challenges ◽  
Low Resource ◽  
Information And Communication ◽  
Ict Tools

Telemedicine is a means to support health-care provision utilizing information and communication technology (ICT) tools and telecommunication services. This chapter focuses on telemedicine practices in low resource settings, referencing key telemedicine initiatives in Botswana. Telemedicine is highly practiced in the developed world, and recently there is an increasing interest in the developing world. Current literature suggests telemedicine as an important tool for improving healthcare delivery for low resource settings. Hence the authors' interest in exploring the current status of telemedicine practices with reference to telemedicine projects from low resource settings such as Botswana. The chapter reveals that telemedicine in such settings is mainly implemented through mobile phones, also known as mobile health (mHealth). In this chapter, the authors discuss factors influencing successful implementation of telemedicine solutions in Botswana. Furthermore, the chapter discusses telemedicine implementation challenges in each of the projects and presents possible mitigation strategies. The chapter concludes by affirming the feasibility of successfully practicing telemedicine in low resource settings; notwithstanding challenges such as lack of legal and eHealth frameworks in most developing countries.

scholarly journals The good and the bad: using C reactive protein to distinguish bacterial from non-bacterial infection among febrile patients in low-resource settings

2020 ◽  
Vol 5 (5) ◽  
pp. e002396 ◽  
Author(s):  
Camille Escadafal ◽  
Sandra Incardona ◽  
B Leticia Fernandez-Carballo ◽  
Sabine Dittrich
Keyword(s):  
Antimicrobial Resistance ◽  
Low Income ◽  
Bacterial Infections ◽  
Laboratory Diagnostics ◽  
Antibiotic Prescribing ◽  
Health Coverage ◽  
C Reactive Protein ◽  
Low Resource Settings ◽  
Low Resource ◽  
Reactive Protein

C reactive protein (CRP), a marker for the presence of an inflammatory process, is the most extensively studied marker for distinguishing bacterial from non-bacterial infections in febrile patients. A point-of-care test for bacterial infections would be of particular use in low-resource settings where other laboratory diagnostics are not always available, antimicrobial resistance rates are high and bacterial infections such as pneumonia are a leading cause of death. This document summarises evidence on CRP testing for bacterial infections in low-income and middle-income countries (LMICs). With a push for universal health coverage and prevention of antimicrobial resistance, it is important to understand if CRP might be able to do the job. The use of CRP polarised the global health community and the aim of this document is to summarise the ‘good and the bad’ of CRP in multiple settings in LMICs. In brief, the literature that was reviewed suggests that CRP testing may be beneficial in low-resource settings to improve rational antibiotic use for febrile patients, but the positive predictive value is insufficient to allow it to be used alone as a single tool. CRP testing may be best used as part of a panel of diagnostic tests and algorithms. Further studies in low-resource settings, particularly with regard to impact on antibiotic prescribing and cost-effectiveness of CRP testing, are warranted.

scholarly journals International Neurotrauma Training Based on North-South Collaborations: Results of an Inter-institutional Program in the Era of Global Neurosurgery

2021 ◽  
Vol 8 ◽  
Author(s):  
Andrés M. Rubiano ◽  
Dylan P. Griswold ◽  
P. David Adelson ◽  
Raul A. Echeverri ◽  
Ahsan A. Khan ◽  
...  
Keyword(s):  
Medical Students ◽  
Low Income ◽  
Health Research ◽  
Systems Of Care ◽  
Academic Support ◽  
High Income ◽  
Global Health Research ◽  
Fellowship Program ◽  
Low Resource Settings ◽  
Low Resource

Objective: Shortage of general neurosurgery and specialized neurotrauma care in low resource settings is a critical setback in the national surgical plans of low and middle-income countries (LMIC). Neurotrauma fellowship programs typically exist in high-income countries (HIC), where surgeons who fulfill the requirements for positions regularly stay to practice. Due to this issue, neurosurgery residents and medical students from LMICs do not have regular access to this kind of specialized training and knowledge-hubs. The objective of this paper is to present the results of a recently established neurotrauma fellowship program for neurosurgeons of LMICs in the framework of global neurosurgery collaborations, including the involvement of specialized parallel education for neurosurgery residents and medical students.Methods: The Global Neurotrauma Fellowship (GNTF) program was inaugurated in 2015 by a multi-institutional collaboration between a HIC and an LMIC. The course organizers designed it to be a 12-month program based on adapted neurotrauma international competencies with the academic support of the Barrow Neurological Institute at Phoenix Children's Hospital and Meditech Foundation in Colombia. Since 2018, additional support from the UK, National Institute of Health Research (NIHR) Global Health Research in Neurotrauma Project from the University of Cambridge enhanced the infrastructure of the program, adding a research component in global neurosurgery and system science.Results: Eight fellows from Brazil, Venezuela, Cuba, Pakistan, and Colombia have been trained and certified via the fellowship program. The integration of international competencies and exposure to different systems of care in high-income and low-income environments creates a unique environment for training within a global neurosurgery framework. Additionally, 18 residents (Venezuela, Colombia, Ecuador, Peru, Cuba, Germany, Spain, and the USA), and ten medical students (the United Kingdom, USA, Australia, and Colombia) have also participated in elective rotations of neurotrauma and critical care during the time of the fellowship program, as well as in research projects as part of an established global surgery initiative.Conclusion: We have shown that it is possible to establish a neurotrauma fellowship program in an LMIC based on the structure of HIC formal training programs. Adaptation of the international competencies focusing on neurotrauma care in low resource settings and maintaining international mentoring and academic support will allow the participants to return to practice in their home-based countries.

scholarly journals Medical equipment donation in low-resource settings: a review of the literature and guidelines for surgery and anaesthesia in low-income and middle-income countries

2019 ◽  
Vol 4 (5) ◽  
pp. e001785 ◽  
Author(s):  
Isobel H Marks ◽  
Hannah Thomas ◽  
Marize Bakhet ◽  
Edward Fitzgerald
Keyword(s):  
Low Income ◽  
Medical Equipment ◽  
Grey Literature ◽  
National Guidelines ◽  
Middle Income ◽  
Low Resource Settings ◽  
Low Resource ◽  
User Training ◽  
Biomedical Equipment ◽  
Donation Process

BackgroundMedical equipment donation to low-resource settings is a frequently used strategy to address existing disparities, but there is a paucity of reported experience and evaluation. Challenges such as infrastructure gaps, lack of technological and maintenance capabilities, and non-prioritisation of essential supplies have previously been highlighted. This pragmatic review summarises existing guidelines and literature relevant to surgical and anaesthesia equipment, with recommendations for future initiatives and research.MethodsRetrospective literature review including both academic and grey literature from 1980 to 2018. We conducted a narrative synthesis to identify key factors that were condensed thematically.ResultsThirty-three biomedical equipment donation guidelines were identified from governments, WHO, World Bank, academic colleges and non-governmental organisations, and 36 relevant studies in peer-reviewed literature. These highlighted the need to consider all stages of the donation process, including planning, sourcing, transporting, training, maintaining and evaluating equipment donation. Donors were advised to consult national guidelines to ensure equipment was appropriate, desirable and non-costly to both parties. User training and access to biomechanical engineers were suggested as necessary for long-term sustainability. Finally, equitable partnerships between donors and recipients were integral to reducing inappropriate donations and to improve follow-up and evaluation.ConclusionThere is a paucity of evidence on the causes of success or failure in medical equipment donation, despite its domination of equipment sourcing across many low-resource settings. Equitable partnerships, consultation of policies and guidelines, and careful planning may improve equipment usability and life span. A concerted effort is required to increase awareness of guidelines among health professionals worldwide.

scholarly journals Practices and Attitudes toward Returning Genomic Research Results to Low-Resource Research Participants

2021 ◽  
pp. 1-12
Author(s):  
Megan B. Raymond ◽  
Kayla E. Cooper ◽  
Lisa S. Parker ◽  
Vence L. Bonham
Keyword(s):  
Low Income ◽  
Clinical Care ◽  
Genomic Research ◽  
Research Results ◽  
Low Resource ◽  
Research Participants ◽  
Research Programs ◽  
Ancillary Care ◽  
Genomic Results ◽  
Resource Research

<b><i>Introduction:</i></b> Many research programs are challenged to accommodate low-resource research participants’ (LRRP) ancillary care needs when returning genomic research results. We define LRRP as those who are low income, uninsured, underinsured, or facing barriers to act upon the results returned. This study evaluates current policies and practices surrounding return of results (RoR) to LRRP, as well as the attitudes of investigators toward providing ancillary care to LRRP. <b><i>Methods:</i></b> A semi-structured interview study was conducted with representatives of 35 genomic research programs nationwide. Eligible programs were returning, or planning to return, medically actionable genomic results to participants. <b><i>Results:</i></b> Three content categories emerged from this study, including: (1) RoR structures, (2) barriers to RoR to LRRP, and (3) solutions to meet community and LRRP needs. Three major structures of RoR emerged: (1) RoR Embedded in Clinical Care, (2) RoR Independent of Clinical Care, and (3) Reliance on Clinical Partnerships to Facilitate RoR. Inadequacy of program resources to address the needs of LRRP was commonly considered a significant obstacle. The attitudes and views of informants regarding responsibility to provide ancillary care for LRRP receiving genomic results were highly varied. Some informants believed that genomic sequencing and testing was not a priority for LRRP because of other pressing issues in their lives, such as housing and food insecurity. Research programs differ regarding whether clinical and social support for LRRP is considered within the purview of the research team. Some programs instituted accommodations for LRRP, including social work referral and insurance enrollment assistance. <b><i>Conclusion:</i></b> Support to access downstream treatment is not readily available for LRRP in many genomic research programs. Development of best practices and policies for managing RoR to LRRP is needed.

Telemedicine in Low Resource Settings

2017 ◽  
pp. 994-1013
Author(s):  
Kagiso Ndlovu ◽  
Kabelo Leonard Mauco ◽  
Ryan Littman-Quinn
Keyword(s):  
Healthcare Delivery ◽  
Mitigation Strategies ◽  
Current Status ◽  
Successful Implementation ◽  
Telecommunication Services ◽  
Low Resource Settings ◽  
Implementation Challenges ◽  
Low Resource ◽  
Information And Communication ◽  
Ict Tools

Telemedicine is a means to support health-care provision utilizing information and communication technology (ICT) tools and telecommunication services. This chapter focuses on telemedicine practices in low resource settings, referencing key telemedicine initiatives in Botswana. Telemedicine is highly practiced in the developed world, and recently there is an increasing interest in the developing world. Current literature suggests telemedicine as an important tool for improving healthcare delivery for low resource settings. Hence the authors' interest in exploring the current status of telemedicine practices with reference to telemedicine projects from low resource settings such as Botswana. The chapter reveals that telemedicine in such settings is mainly implemented through mobile phones, also known as mobile health (mHealth). In this chapter, the authors discuss factors influencing successful implementation of telemedicine solutions in Botswana. Furthermore, the chapter discusses telemedicine implementation challenges in each of the projects and presents possible mitigation strategies. The chapter concludes by affirming the feasibility of successfully practicing telemedicine in low resource settings; notwithstanding challenges such as lack of legal and eHealth frameworks in most developing countries.

scholarly journals Potential solutions for screening, triage, and severity scoring of suspected COVID-19 positive patients in low-resource settings: a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046130
Author(s):  
Sarah Hirner ◽  
Jennifer Lee Pigoga ◽  
Antoinette Vanessa Naidoo ◽  
Emilie J Calvello Hynes ◽  
Yasein O Omer ◽  
...  
Keyword(s):  
Scoping Review ◽  
Low Income ◽  
The United States ◽  
Validation Data ◽  
Middle Income ◽  
Severity Scoring ◽  
Low Resource Settings ◽  
Low Resource ◽  
Resource Limited ◽  
Scoring Tools

ObjectivesPurposefully designed and validated screening, triage, and severity scoring tools are needed to reduce mortality of COVID-19 in low-resource settings (LRS). This review aimed to identify currently proposed and/or implemented methods of screening, triaging, and severity scoring of patients with suspected COVID-19 on initial presentation to the healthcare system and to evaluate the utility of these tools in LRS.DesignA scoping review was conducted to identify studies describing acute screening, triage, and severity scoring of patients with suspected COVID-19 published between 12 December 2019 and 1 April 2021. Extracted information included clinical features, use of laboratory and imaging studies, and relevant tool validation data.ParticipantThe initial search strategy yielded 15 232 articles; 124 met inclusion criteria.ResultsMost studies were from China (n=41, 33.1%) or the United States (n=23, 18.5%). In total, 57 screening, 23 triage, and 54 severity scoring tools were described. A total of 51 tools−31 screening, 5 triage, and 15 severity scoring—were identified as feasible for use in LRS. A total of 37 studies provided validation data: 4 prospective and 33 retrospective, with none from low-income and lower middle-income countries.ConclusionsThis study identified a number of screening, triage, and severity scoring tools implemented and proposed for patients with suspected COVID-19. No tools were specifically designed and validated in LRS. Tools specific to resource limited contexts is crucial to reducing mortality in the current pandemic.

scholarly journals Knowledge Summaries for Comprehensive Breast Cancer Control

2018 ◽  
pp. 1-7 ◽  
Author(s):  
Jo Anne Zujewski ◽  
Allison L. Dvaladze ◽  
Andre Ilbawi ◽  
Benjamin O. Anderson ◽  
Silvana Luciani ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Care ◽  
Breast Cancer Mortality ◽  
Cancer Control ◽  
Integrated Approach ◽  
Evidence Based ◽  
Low Resource Settings ◽  
Low Resource ◽  
Four Levels ◽  
Breast Cancer Control

Breast cancer is the most common cancer in women worldwide, affecting > 1.6 million women each year, projected to increase to 2.2 million cases annually by 2025. A disproportionate number of the > 500,000 women who die as a result of breast cancer each year reside in low-resource settings. Breast cancer control is an important component of cancer control planning and women’s health programs, and tools are needed across the care continuum to reduce the cancer burden, especially in low-resource settings. Cancer control planning is complex and multifaceted. Evidence shows that outcomes are improved when prevention, early diagnosis, treatment, and palliation are integrated and synchronously developed within a country/region’s health plan. The Knowledge Summaries for Comprehensive Breast Cancer Control are the product of a multiyear collaboration led by the Union for International Cancer Control, Breast Health Global Initiative, Pan American Health Organization, and Center for Global Health of the US National Cancer Institute. Fourteen knowledge summaries distilled from evidence-based, resource-stratified guidelines, and aligned with WHO guidance on breast cancer control, build a framework for resource prioritization pathways and delivery systems for breast cancer control at four levels of available resources: basic, limited, enhanced, and maximal. Each summary contains relevant content to inform breast cancer policy, clinical care, and advocacy, aiding in the development and implementation of policies and programs. These tools provide a common platform for stakeholders, including policymakers, administrators, clinicians, and advocates to engage in decision making appropriate to their local setting. The goal is to facilitate evidence-based policy actions and urgently advance implementation of an integrated approach to reduce breast cancer mortality and improve quality of life.

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