Implementation of a web-based national child health-care programme in a local context: A complex facilitator role

Aim: The aim of this study was to investigate child health-care coordinators’ experiences of being a facilitator for the implementation of a new national child health-care programme in the form of a web-based national guide. Methods: The study was based on eight remote, online focus groups, using Skype for Business. A qualitative content analysis was performed. Results: The analysis generated three categories: adapt to a local context, transition challenges and led by strong incentives. There were eight subcategories. In the latent analysis, the theme ‘Being a facilitator: a complex role’ was formed to express the child health-care coordinators’ experiences. Conclusions: Facilitating a national guideline or decision support in a local context is a complex task that requires an advocating and mediating role. For successful implementation, guidelines and decision support, such as a web-based guide and the new child health-care programme, must match professional consensus and needs and be seen as relevant by all. Participation in the development and a strong bottom-up approach was important, making the web-based guide and the programme relevant to whom it is intended to serve, and for successful implementation. The study contributes valuable knowledge when planning to implement a national web-based decision support and policy programme in a local health-care context.

A home-based health care programme to facilitate coping in survivors of cerebro-vascular accidents and their Caregivers in Oshana Region, Namibia

A cerebro-vascular accident entails the sudden death of brain cells resulting from a problem with the blood supply. The patient is consequently left with varying degrees of disability, and usually requires the assistance of a caregiver. This article describes the development of a home-based health care programme intended to facilitate optimal functioning, which formed the final phase of a qualitative study that explored and described the experiences of survivors of cerebrovascular accidents and their caregivers. The development of this programme was based on the four themes that emerged from the original study and which were conceptualised by applying Dickoff, James and Wiedenbach’s (1968) practice theory. These four themes were restructured as four dynamics, namely, reframing knowledge and skills regarding self-care, modifying the daily routine, assisting with the adjustment to altered social relationships, and reframing negative emotions. The programme was implemented over four days and an evaluation was done after two months. The feedback revealed that the survivors and their caregivers had benefitted with regard to the skills and knowledge gained from the educational programme.