Exploring the mechanisms of collaboration between the Tuberculosis and Diabetes Programs for the control of TB-DM Comorbidity in Ghana

Objectives To explore the mechanisms of collaboration between the stakeholders, including National Tuberculosis Control Program (NTP) and the Non-Communicable Disease Control and Prevention Program (NCDCP) at the national, regional, and local (health facility) levels of the health care system in Ghana. This is one of the objectives in a study on the “Barriers and Facilitators to the Implementation of the Collaborative Framework for the Care and Control of Tuberculosis and Diabetes in Ghana” Results The data analysis revealed 4 key themes. These were (1) Increased support for communicable diseases (CDs) compared to stagnant support for non-communicable diseases (NCDs), (2) Donor support, (3) Poor collaboration between NTP and NCDCP, and (4) Low Tuberculosis-Diabetes Mellitus (TB-DM) case detection.

Point-of-contact Interactive Record Linkage (PIRL): A software tool to prospectively link demographic surveillance and health facility data

Linking a health and demographic surveillance system (HDSS) to data from a health facility that serves the HDSS population generates a research infrastructure for directly observed data on access to and utilization of health facility services. Many HDSS sites, however, are in areas that lack unique national identifiers or suffer from data quality issues, such as incomplete records, spelling errors, and name and residence changes, all of which complicate record linkage approaches when applied retrospectively. We developed Point-of-contact Interactive Record Linkage (PIRL) software that is used to prospectively link health records from a local health facility to an HDSS in rural Tanzania. This prospective approach to record linkage is carried out in the presence of the individual whose records are being linked, which has the advantage that any uncertainty surrounding their identity can be resolved during a brief interaction, whereby extraneous information (e.g., household membership) can be referred to as an additional criterion to adjudicate between multiple potential matches. Our software uses a probabilistic record linkage algorithm based on the Fellegi-Sunter model to search and rank potential matches in the HDSS data source. Key advantages of this software are its ability to perform multiple searches for the same individual and save patient-specific notes that are retrieved during subsequent clinic visits. A search on the HDSS database (n=110,000) takes less than 15 seconds to complete. Excluding time spent obtaining written consent, the median duration of time we spend with each patient is six minutes. In this setting, a purely automated retrospective approach to record linkage would have only correctly identified about half of the true matches and resulted in high linkage errors; therefore highlighting immediate benefit of conducting interactive record linkage using the PIRL software.

Point-of-contact Interactive Record Linkage (PIRL): A software tool to prospectively link demographic surveillance and health facility data

Linking a health and demographic surveillance system (HDSS) to data from a health facility that serves the HDSS population generates a research infrastructure for directly observed data on access to and utilization of health facility services. Many HDSS sites, however, are in areas that lack unique national identifiers or suffer from data quality issues, such as incomplete records, spelling errors, and name and residence changes, all of which complicate record linkage approaches when applied retrospectively. We developed Point-of-contact Interactive Record Linkage (PIRL) software that is used to prospectively link health records from a local health facility to an HDSS in rural Tanzania. This prospective approach to record linkage is carried out in the presence of the individual whose records are being linked, which has the advantage that any uncertainty surrounding their identity can be resolved during a brief interaction, whereby extraneous information (e.g., household membership) can be referred to as an additional criterion to adjudicate between multiple potential matches. Our software uses a probabilistic record linkage algorithm based on the Fellegi-Sunter model to search and rank potential matches in the HDSS data source. Key advantages of this software are its ability to perform multiple searches for the same individual and save patient-specific notes that are retrieved during subsequent clinic visits. A search on the HDSS database (n=110,000) takes less than 15 seconds to complete. Excluding time spent obtaining written consent, the median duration of time we spend with each patient is six minutes. In this setting, a purely automated retrospective approach to record linkage would have only correctly identified about half of the true matches and resulted in high linkage errors; therefore highlighting immediate benefit of conducting interactive record linkage using the PIRL software.

Availability and satisfactoriness of latrines and hand washing stations in health facilities, and role in health seeking behavior of women: evidence from rural Pune district, India

Water, sanitation and hygiene (WASH) installations are indispensable in health care facilities. Their quality might also influence the decision whether to visit a health facility. We investigated the WASH infrastructure in small health facilities in rural Pune, India, and surveyed expectations and satisfactoriness among women. The availability and quality of WASH installations was assessed in 12 facilities using a checklist. Dedicated questions in a household survey provided the community perspective, complemented by qualitative methods. A few public facilities had no latrine or hand washing station. On the contrary, all private facilities offered such installations. The bed/outpatient-to-installation ratio was also lower in private compared to public facilities. While most latrines were functional and well maintained, they often lacked garbage bins. Soap was often missing from hand washing stations. Dedicated latrines for women were rare. Women were generally satisfied with the WASH installations in the local health facility, but considered private facilities as better. WASH installations in health facilities are generally acceptable in private facilities while improvements are needed in some government facilities. Women expect WASH installations in health facilities, and view their quality in a broader framework of ‘cleanliness,’ which they consider when choosing facilities.

Bisogni psicologici e valori nella professione infermieristica

- This paper studies basic need satisfaction of competence, autonomy and relatedness (Deci & Ryan, 2000) and professional values in 232 subjects from the 102 Viterbo local health facility (ASL): 110 nursing students, 102 nurses and 20 nurses executives, assuming both the existence of relationships between need satisfaction and values and the career level had a significant effect on satisfaction and motivations. For this purpose the Basic Psychological Needs Scale (ad. It. Szadejko, 2003) and the Value Based Motivation Assessment Scale (Pallini and Laghi, in press) have been used. Prosociality and security resulted predominant, while competitiveness, autonomy and hedonism were scarcely represented. The growing professionalism of nurses would explain the evaluation of epistemic interest. In a statistically significant way nursing students value safety, belonging, cooperation and prosociality, nurses and nurse executives novelties and nurse executives competition. Student nurses perceive themselves as more satisfied in their psychological needs. Basic need satisfaction resulted to be closely linked with value of prosociality, cooperation and belonging.