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The Perceived Benefits And Effectiveness Of Patient Feedback Systems In Strengthening Patient-Provider Relationships In Rural Tanzania, Kahabi Isangula, Eunice Pallangyo, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Introduction

Patient feedback system (PFS) forms an important entry point for the medical personnel and healthcare administrators to identify healthcare service delivery gaps and develop responsive interventions. This may foster patient trust consequently increasing healthcare-seeking, engagement in decision, continuity, and satisfaction. However, research on the PFS in rural primary healthcare settings appears limited.

Objective

The paper examines the perceived role and efectiveness of PFS in improving therapeutic relationships building on the recent research on patient-provider relationships in rural Tanzania.

Methods

The paper examines the fndings of qualitative descriptive research conducted in the Shinyanga Region which employed a human-centred design (HCD) …

Interventions Co-Designed By Healthcare Providers And Clients For Improving Therapeutic Relationships In Maternal And Child Healthcare: A Pilot Study Using Human Centered Design In Rural Tanzania, Kahabi Isangula, Eunice Pallangyo, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Background

Research shows that poor provider–client interactions in maternity and child health (MCH) continue to affect health outcomes, service uptake, continuity of care, and trust in formal healthcare systems.

Objective The study’s objective was to jointly create a prototype intervention package for enhancing nurse-client relationships using human centered design (HCD) approach.

Methods A five-step HCD methodology was used: (1) Community-driven discovery through qualitative descriptive research methods using 9 focus groups with nurses and clients and 12 key informant interviews with MCH administrators; (2) consultative ideation and co-creation meetings with 10 nurses, 10 clients, and 10 administrators to co-design a rough …

Improving Nursing Education Curriculum As A Tool For Strengthening The Nurse–Client Relationships In Maternal And Child Healthcare: Insights From A Human-Centered Design Study In Rural Tanzania, Kahabi Isangula, Eunice Pallangyo, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Background. There are growing evidence of poor nurse–client relationships in maternal and child health (MCH). The nursing curriculum forms an important entry point for strengthening such relationships, consequently improving client satisfaction with nurses' competencies, confidence in the formal healthcare system, healthcare-seeking practices, continuity with care, and MCH outcomes.

Objective. MCH nurses and clients were invited to design an intervention package (prototype) to improve nurse–client relationships using a human-centered design (HCD) approach.

Methods. A multi-step HCD approach was employed to first examine the contributors of poor nurse–client relationships using nine focus group discussions with nurses and clients and 12 key informant …

Acceptability And Feasibility Of A Low-Cost Device For Gestational Age Assessment In A Low-Resource Setting: Qualitative Study, Angela Koech, Peris Muoga Musitia, Grace Mwashigadi, Mai-Lei Woo Kinshella, Marianne Vidler, Marleen Temmerman, Rachel Craik, J. Alison Noble, Peter Dadelszen Von Dadelszen, Aris T . Papageorghiou

Obstetrics and Gynaecology, East Africa

Background: Ultrasound for gestational age (GA) assessment is not routinely available in resource-constrained settings, particularly in rural and remote locations. The TraCer device combines a handheld wireless ultrasound probe and a tablet with artificial intelligence (AI)-enabled software that obtains GA from videos of the fetal head by automated measurements of the fetal transcerebellar diameter and head circumference.

Objective: The aim of this study was to assess the perceptions of pregnant women, their families, and health care workers regarding the feasibility and acceptability of the TraCer device in an appropriate setting.

Methods: A descriptive study using qualitative methods was conducted in …

Factors Shaping Good And Poor Nurse-Client Relationships In Maternal And Child Care: A Qualitative Study In Rural Tanzania, Kahabi Isangula, Eunice Pallangyo, Columba Mbekenga, Eunice Ndirangu, Constance Shumba

School of Nursing & Midwifery, East Africa

Background: Evidence indicates that poor nurse‐client relationships within maternal and child health (MCH) continues to impact trust in formal healthcare systems, service uptake, continuity with care and MCH outcomes. This necessitates contextualized innovative solutions that places both nurses and clients at the forefront as agents of change in optimizing intervention designs and implementation. This study explored nurses and clients’ perspectives on the factors shaping nurse‐client relationships in MCH care to generate evidence to guide subsequent steps of human centered design (HCD) that involve designing effective strategies for improving therapeutic relationships in Shinyanga, Tanzania.

Methods: Qualitative descriptive design was …

Healthcare Providers' Experiences With A Clinical Mentorship Intervention To Improve Reproductive, Maternal And Newborn Care In Mwanza, Tanzania, Kahabi Isangula, Columba Mbekenga, Tumbwene Mwansisya, Loveluck Mwasha, Lucy Kisaka, Edna Selestine, David Siso, Thomas Rutachunzibwa, Secilia Mrema, Eunice Pallangyo

School of Nursing & Midwifery, East Africa

Introduction: There is increasing evidence suggesting that clinical mentorship (CM) involving on-the-job training is one of the critical resources—friendly entry points for strengthening the knowledge and skills of healthcare providers (HCPs), which in turn facilitate the delivery of effective reproductive, maternal, and newborn health (RMNH) care. The article explores the experiences of HCPs following participation in the CM program for RMNH in eight districts of Mwanza Region in Tanzania.

Materials and Methods: A qualitative descriptive design employing data from midterm project review meetings and Key Informant Interviews (KIIs) with purposefully selected HCPs (mentors and mentees) and District Medical Officers (DMOs) …

An Epidemiological, Strategic And Response Analysis Of The Covid-19 Pandemic In South Asia: A Population-Based Observational Study, Hafiz Muhammad Salman, Javaria Syed, Atif Riaz, Zouina Sarfraz, Azza Sarfraz, Syed Hashim Abbas Ali Bokhari, Ivan Cherrez Ojeda

Department of Paediatrics and Child Health

Introduction: South Asia has had a dynamic response to the ongoing COVID-19 pandemic. The overall burden and response have remained comparable across highly-burdened countries within the South Asian Region.
Methodology: Using a population-based observational design, all eight South Asian countries were analyzed using a step-wise approach. Data were obtained from government websites and publicly-available repositories for population dynamics and key variables.
Results: South Asian countries have a younger average age of their population. Inequitable distribution of resources centered in urban metropolitan cities within South Asia is present. Certain densely populated regions in these countries have better testing and healthcare facilities …

Overcoming The Challenges Of Community-Engaged Emergency Referrals In A Rural District Of Pakistan, Imran Naeem Abbasi, Sameen Siddiqi

Community Health Sciences

A functional referral system for addressing health emergencies requires coordinated efforts by health system's stakeholders and the community. Using the Rural Health Programme (RHP) Thatta as a platform provided by an academic institution, district health system stakeholders and the community of Mirpur Sakro, taluka of Thatta, were engaged to strengthen the referral system for health emergencies through active community engagement. Through consultations with stakeholders, a referral system plan was developed with community volunteers from each village as focal persons for transportation, referring patients to health facilities and maintaining referral documentation. The stakeholders' experience and perceptions about the referral system were …

Determinants Of Preconception Care Among Pregnant Women In An Urban And A Rural Health Facility In Kenya: A Qualitative Study, Joan Okemo, Dorothy Kamya, Mukaindo Mwaniki, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Preconception care (PCC) is a form of preventive health care that is offered to women and couples before conception, with the aim of improving their health status and mitigating various risk factors that could con- tribute to poor maternal and child health outcomes. The levels of PCC utilization are still low globally, especially in developing countries and in rural areas. Little is known regarding PCC use in Kenya that could help in addressing this shortfall. This study aimed to qualitatively assess the determinants of PCC in urban and rural settings in Kenya.

Methods: A qualitative approach was …

Use Of Artificial Intelligence On Electroencephalogram (Eeg) Waveforms To Predict Failure In Early School Grades In Children From A Rural Cohort In Pakistan, Muneera A. Rasheed, Prem Chand, Saad Ahmed, Hamza Sharif, Zahra Hoodbhoy, Ayat Siddiqui, Babar S. Hasan

Department of Paediatrics and Child Health

Universal primary education is critical for individual academic growth and overall adult productivity of nations. Estimates indicate that 25% of 59 million primary age out of school children drop out and early grade failure is one of the factors. An objective and feasible screening measure to identify at-risk children in the early grades can help to design appropriate interventions. The objective of this study was to use a Machine Learning algorithm to evaluate the power of Electroencephalogram (EEG) data collected at age 4 in predicting academic achievement at age 8 among rural children in Pakistan. Demographic and EEG data from …

Adolescent Food Insecurity In Rural Sindh, Pakistan: A Cross-Sectional Survey, Sana Sheikh, Romaina Iqbal, Rahat Qureshi, Iqbal Azam Syed, Rubina Barolia

Department of Obstetrics & Gynaecology

Background: Food insecurity (FI) is alarmingly high in developing countries including Pakistan. A quarter of Pakistan's population consists of adolescents yet there is no information on their experience of FI. FI at adolescent age have long term effect on mental and physical health hence we aimed to determine the prevalence of food insecurity (FI) among adolescents and compare it with household FI, and assess social determinants of adolescent FI.
Methods: A cross-sectional survey on 799 households with unmarried adolescents was conducted from September 2015 to June 2016 in three union councils of Hyderabad, Pakistan. Unmarried 10-19 years old girls and …

What Influences Family Planning In Rural Pakistan: Franchised Service Provider And Community Health Worker Perspective, Waqas Hameed, Junaid-Ur-Rehman Siddiqui, Muhammad Ishaque, Sharmeen Hussain, Xaher Gul, Hina Najmi, Shehla Noorani, Ghulam Mustafa, Asma Balal

Community Health Sciences

Background: Pakistan has a low modern contraceptive prevalence rate, 26%, leading family planning (FP) programmes to explore partnerships with local private providers to improve access to quality FP services. This study aims to understand the socio-cultural and organizational factors that influence delivery of quality family planning services.
Methods: This qualitative study was conducted with private service providers and community health workers (CHW) in Marie Stopes Society's (MSS) social franchise network. A total of 31 providers and 28 CHWs from Sindh, Punjab, and Khyber Pakhtunkhwa provinces of Pakistan were purposively selected for in-depth interviews. The study used thematic content analysis to …

Safe Motherhood Training For Rural Health Care Workers In Odukpani Local Government Area Of Cross River State, Nigeria, Josephine Etowa, Ekaete Asuquo, Ani Etokidem

School of Nursing & Midwifery, East Africa

Maternal mortality remains a challenge in developing countries which bear 99% of global maternal deaths (WHO, 2014). Nigeria, India, Pakistan, Afghanistan and Ethiopia carry more than 50% of the global burden of maternal mortality. According to the UNDP Human Development Report (2014), Nigeria’s maternal mortality ratio of 630 per 100,000 live births ranks among the highest in Africa. Two countries accounted for one third of all global maternal deaths: India at 17% (50 000) and Nigeria at 14% (40 000) (WHO, 2014).. Archibong and Aghan (2010) found that hospital based maternal mortality ratio in Cross River state was 1,513.4per 100,000 …

Development Of A Quantitative Food Frequency Questionnaire For Use Among Rural South Africans In Kwazulu Natal, T. Sheehy, F. Kolahdooz, T. L. Mtshali, Tashmin Khamis, S. Sharma

Faculty of Health Sciences, East Africa

Background: South Africa is experiencing a dietary and lifestyle transition as well as increased rates of noncommunicable chronic diseases. Limited information is available on the diets of rural populations. The present study aimed to characterise the diets of men and women from rural KwaZulu-Natal (KZN) and develop a quantitative food-frequency questionnaire (QFFQ) specific for this population.

Methods: A cross-sectional study was carried out by collecting single 24-h dietary recalls from 81 adults and developing a QFFQ in Empangeni, KZN, South Africa.

Results: The diet of this population was limited in variety, high in plant-based foods (especially cereals and beans), and …

Social Franchising And Vouchers To Promote Long-Term Methods Of Family Planning In Rural Pakistan: A Qualitative Stocktaking With Stakeholders, Syed Khurram Azmat, Ghulam Mustafa, Waqas Hameed, Jamshaid Asghar, Aftab Ahmed, Babar T. Shaikh

Community Health Sciences

Background: The overall use of modern contraception in Pakistan is quite low, especially in rural areas. Several studies have demonstrated the effectiveness of social franchising (SF) approaches in increasing access to modern contraception and improving the quality of healthcare in resource-poor areas in Asia and Africa. Drawing on best practices in SF, the Marie Stopes Society (MSS) implemented an SF model in certain rural areas of Pakistan to increase access to affordable and quality family planning (FP) services. The model was branded as Suraj (sun) and complemented with an innovative voucher scheme for intrauterine contraceptive devices (IUCDs). This paper describes …

Solar Water Disinfection In Household Settings:Hype Or Hope?, Zulfiqar Ahmed Bhutta

Woman and Child Health

No abstract provided.

Factors Influencing Adherence To Referral Advice Following Pre-Referral Treatment With Artesunate Suppositories In Children In Rural Tanzania, Daudi Simba, Marian Warsame, Omari Kimbute, Deodatus Kakoko, Max Petzold, Goran Tomson, Zul Premji, Melba Gomes

Pathology, East Africa

Objective: WHO recommends artemisinin suppository formulations as pre-referral treatment for children who are unable to take oral medication and cannot rapidly reach a facility for parenteral treatment. We investigated factors influencing caretakers’ adherence to referral advice following pre-referral treatment of their children with rectal artesunate suppositories.

Methods: The study was nested within an intervention study that involved pre-referral treatment of all children who came to a community dispenser for treatment because they were unable to take oral medications because of repeated vomiting, lethargy, convulsions or altered consciousness. All patients who did not comply with referral advice were stratified by actions …

Knowledge And Practices Regarding Cigarette Smoking Among Adult Women In A Rural District Of Sindh, Pakistan, Sajid Ali, Naseem Ara, Arif Ali, Beena Ali, Muhammad Masood Kadir

Community Health Sciences

OBJECTIVE: To determine the prevalence of cigarette smoking and to obtain information on socio-demographic factors and attitude regarding cigarette smoking among adult women in a rural district of Sindh Province, Pakistan.

METHODS: A cross sectional community based survey was done in a rural district of Sindh province of Pakistan using a two stage cluster sampling design. A pre tested questionnaire was used to interview 502 adult women (aged 18- 60 years) from the study site. The study was approved by the ethical research committee and informed consent was taken from participants.

RESULTS: A total of 502 women were interviewed for …