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Interactive effects of atmospheric oxidising pollutants and heat waves on the risk of residential mortality. 大气氧化污染物和热浪对居民死亡风险的交互影响。
IF 2.6 3区 医学
Global Health Action Pub Date : 2024-12-31 Epub Date: 2024-02-21 DOI: 10.1080/16549716.2024.2313340
Nan Ren, Huimin Huang, Baoying Liu, Chuancheng Wu, Jianjun Xiang, Quan Zhou, Shuling Kang, Xiaoyang Zhang, Yu Jiang
{"title":"Interactive effects of atmospheric oxidising pollutants and heat waves on the risk of residential mortality.","authors":"Nan Ren, Huimin Huang, Baoying Liu, Chuancheng Wu, Jianjun Xiang, Quan Zhou, Shuling Kang, Xiaoyang Zhang, Yu Jiang","doi":"10.1080/16549716.2024.2313340","DOIUrl":"10.1080/16549716.2024.2313340","url":null,"abstract":"<p><strong>Background: </strong>The impact of heat waves and atmospheric oxidising pollutants on residential mortality within the framework of global climate change has become increasingly important.</p><p><strong>Objective: </strong>In this research, the interactive effects of heat waves and oxidising pollutants on the risk of residential mortality in Fuzhou were examined. Methods We collected environmental, meteorological, and residential mortality data in Fuzhou from 1 January 2016, to 31 December 2021. We then applied a generalised additive model, distributed lagged nonlinear model, and bivariate three-dimensional model to investigate the effects and interactions of various atmospheric oxidising pollutants and heat waves on the risk of residential mortality.</p><p><strong>Results: </strong>Atmospheric oxidising pollutants increased the risk of residential mortality at lower concentrations, and O3 and Ox were positively associated with a maximum risk of 2.19% (95% CI: 0.74-3.66) and 1.29% (95% CI: 0.51-2.08). The risk of residential mortality increased with increasing temperature, with a strong and long-lasting effect and a maximum cumulative lagged effect of 1.11% (95% CI: 1.01, 1.23). Furthermore, an interaction between atmospheric oxidising pollutants and heat waves may have occurred: the larger effects in the longest cumulative lag time on residential mortality per 10 µg/m3 increase in O3, NO2 and Ox during heat waves compared to non-heat waves were [-3.81% (95% CI: -14.82, 8.63)]; [-0.45% (95% CI: -2.67, 1.81)]; [67.90% (95% CI: 11.55, 152.71)]; 16.37% (95% CI: 2.43, 32.20)]; [-3.00% (95% CI: -20.80, 18.79)]; [-0.30% (95% CI: -3.53, 3.04)]. The risk on heat wave days was significantly higher than that on non-heat wave days and higher than the separate effects of oxidising pollutants and heat waves.</p><p><strong>Conclusions: </strong>Overall, we found some evidence suggesting that heat waves increase the impact of oxidising atmospheric pollutants on residential mortality to some extent.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10883108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Methodology for adapting a co-created early childhood development intervention and implementation strategies for use by frontline workers in India and Guatemala: a systematic application of the FRAME-IS framework. 在印度和危地马拉,前线工作者采用共同创造的儿童早期发展干预措施和实施战略的方法:FRAME-IS 框架的系统应用。
IF 2.6 3区 医学
Global Health Action Pub Date : 2024-12-31 Epub Date: 2024-05-10 DOI: 10.1080/16549716.2024.2338324
Amruta Bandal, Sara Hernández, Revan Mustafa, Karyn Choy, Namrata Edwards, Magdalena Guarchaj, Marinés Mejía Alvarez, Anushree Sane, Scott Tschida, Chetna Maliye, Ann Miller, Abhishek Raut, Roopa Srinivasan, Morgan Turner, Bradley H Wagenaar, Ilgi Ertem, Maria Del Pilar Grazioso, Subodh S Gupta, Vibha Krishnamurthy, Peter Rohloff
{"title":"Methodology for adapting a co-created early childhood development intervention and implementation strategies for use by frontline workers in India and Guatemala: a systematic application of the FRAME-IS framework.","authors":"Amruta Bandal, Sara Hernández, Revan Mustafa, Karyn Choy, Namrata Edwards, Magdalena Guarchaj, Marinés Mejía Alvarez, Anushree Sane, Scott Tschida, Chetna Maliye, Ann Miller, Abhishek Raut, Roopa Srinivasan, Morgan Turner, Bradley H Wagenaar, Ilgi Ertem, Maria Del Pilar Grazioso, Subodh S Gupta, Vibha Krishnamurthy, Peter Rohloff","doi":"10.1080/16549716.2024.2338324","DOIUrl":"10.1080/16549716.2024.2338324","url":null,"abstract":"<p><p>There is little evidence on optimizing the effectiveness and implementation of evidence-based early childhood development (ECD) interventions when task-shifted to frontline workers. In this Methods Forum paper, we describe our adaptation of the International Guide for Monitoring Child Development (GMCD) for task-shifting to frontline workers in Guatemala and India. In 2021-2022, implementers, trainers, frontline workers, caregivers, and international GMCD experts collaborated to adapt the GMCD for a task shifted implementation by frontline workers. We used an eight-step co-creating process: assembling a multidisciplinary team, training on the existing package, working groups to begin modifications, revision of draft modifications, tailoring of visual materials and language, train-the-trainers activities, pilot frontline worker trainings, final review and feedback. Preliminary effectiveness of adaptations was evaluated through narrative notes and group-based qualitative feedback following pilot trainings with 16 frontline workers in India and 6 in Guatemala. Final adaptations included: refining training techniques to match skill levels and learning styles of frontline workers; tailoring all visual materials to local languages and contexts; design of job aids for providing developmental support messages; modification of referral and triage processes for children in need of enhanced support and speciality referral; and creation of post-training support procedures. Feedback from pilot trainings included: (1) group consensus that training improved ECD skills and knowledge across multiple domains; and (2) feedback on ongoing needed adjustments to pacing, use of video-based vs. role-playing materials, and time allocated to small group work. We use the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS) framework to document our adaptations. The co-creating approach we use, as well as systematic documentation of adaptation decisions will be of use to other community-based early childhood interventions and implementation strategies.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating the implementation of person-centred care and simulation-based learning in a midwifery education programme in the Democratic Republic of Congo: a study protocol. 评估刚果民主共和国助产士教育课程中以人为中心的护理和模拟学习的实施情况:研究方案。
IF 2.2 3区 医学
Global Health Action Pub Date : 2024-12-31 Epub Date: 2024-06-25 DOI: 10.1080/16549716.2024.2370097
Frida Temple, Ewa Carlsson Lalloo, Marie Berg, Urban Berg, Alumeti Munyali Désiré, Olivier Nyakio, Aline Mulunda, Malin Bogren
{"title":"Evaluating the implementation of person-centred care and simulation-based learning in a midwifery education programme in the Democratic Republic of Congo: a study protocol.","authors":"Frida Temple, Ewa Carlsson Lalloo, Marie Berg, Urban Berg, Alumeti Munyali Désiré, Olivier Nyakio, Aline Mulunda, Malin Bogren","doi":"10.1080/16549716.2024.2370097","DOIUrl":"10.1080/16549716.2024.2370097","url":null,"abstract":"<p><strong>Background: </strong>Investing in midwives educated according to international standards is crucial for achieving Sustainable Development Goals in maternal and newborn health. Applying a person-centred care approach and using simulation-based learning to improve the learning experience for midwifery students may enhance the quality of childbirth care. This protocol describes a study evaluating the implementation of person-centred approach and simulation-based learning in childbirth as part of a midwifery education programme at the Evangelical University in Africa, DRC.</p><p><strong>Methods: </strong>The research will be exploratory and guided by an implementation research framework. Ethical approval has been obtained. Facilitators working at the programme's five clinical practice sites will be trained in: 1) Introducing person-centred childbirth care using a training programme called'Mutual Meetings'; and 2) integrating simulation-based learning, specifically by using the three courses: Essential Care of Labor, Bleeding after Birth, and Vacuum Extraction. Data will include interviews with midwifery students, facilitators and clinical preceptors, and maternal and neonatal outcomes from birth registers.</p><p><strong>Discussion: </strong>By integrating a validated and culturally adapted person-centred care training programme and simulation-based learning into a midwifery education programme and clinical practice sites, the findings from the study anticipate an improvement in the quality of childbirth care. Training facilitators in these methodologies aim to effectively mitigate maternal and neonatal adverse outcomes. The findings are expected to provide valuable recommendations for governments, policymakers, and healthcare providers in the DRC and beyond, contributing to significant improvements in midwifery education and aligning with global health priorities, including the Sustainable Development Goals.</p><p><strong>Trial registration: </strong>The study was registered retrospectively with the ISRCTN registry on the 23rd of February 2024. The registration number is: ISRCTN10049855.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11207909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Did the COVID-19 quarantine policies applied in Cochabamba, Bolivia mitigated cases successfully? an interrupted time series analysis. 在玻利维亚科恰班巴实施的 COVID-19 检疫政策是否成功缓解了病例?
IF 2.2 3区 医学
Global Health Action Pub Date : 2024-12-31 Epub Date: 2024-07-01 DOI: 10.1080/16549716.2024.2371184
Rodrigo K Arce Cardozo, Osvaldo Fonseca-Rodríguez, Yercin Mamani Ortiz, Miguel San Sebastian, Frida Jonsson
{"title":"Did the COVID-19 quarantine policies applied in Cochabamba, Bolivia mitigated cases successfully? an interrupted time series analysis.","authors":"Rodrigo K Arce Cardozo, Osvaldo Fonseca-Rodríguez, Yercin Mamani Ortiz, Miguel San Sebastian, Frida Jonsson","doi":"10.1080/16549716.2024.2371184","DOIUrl":"10.1080/16549716.2024.2371184","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic prompted varied policy responses globally, with Latin America facing unique challenges. A detailed examination of these policies' impacts on health systems is crucial, particularly in Bolivia, where information about policy implementation and outcomes is limited.</p><p><strong>Objective: </strong>To describe the COVID-19 testing trends and evaluate the effects of quarantine measures on these trends in Cochabamba, Bolivia.</p><p><strong>Methods: </strong>Utilizing COVID-19 testing data from the Cochabamba Department Health Service for the 2020-2022 period. Stratified testing rates in the health system sectors were first estimated followed by an interrupted time series analysis using a quasi-Poisson regression model for assessing the quarantine effects on the mitigation of cases during surge periods.</p><p><strong>Results: </strong>The public sector reported the larger percentage of tests (65%), followed by the private sector (23%) with almost double as many tests as the public-social security sector (11%). In the time series analysis, a correlation between the implementation of quarantine policies and a decrease in the slope of positive rates of COVID-19 cases was observed compared to periods without or with reduced quarantine policies.</p><p><strong>Conclusion: </strong>This research underscores the local health system disparities and the effectiveness of stringent quarantine measures in curbing COVID-19 transmission in the Cochabamba region. The findings stress the importance of the measures' intensity and duration, providing valuable lessons for Bolivia and beyond. As the global community learns from the pandemic, these insights are critical for shaping resilient and effective health policy responses.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11218584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The contextual awareness, response and evaluation (CARE) diabetes project: study design for a quantitative survey of diabetes prevalence and non-communicable disease risk in Ga Mashie, Accra, Ghana. 糖尿病背景认识、应对和评估 (CARE) 项目:加纳阿克拉 Ga Mashie 地区糖尿病患病率和非传染性疾病风险定量调查的研究设计。
IF 2.6 3区 医学
Global Health Action Pub Date : 2024-12-31 Epub Date: 2024-02-07 DOI: 10.1080/16549716.2023.2297513
Swaib Abubaker Lule, Sandra Boatemaa Kushitor, Carlos S Grijalva-Eternod, Kafui Adjaye-Gbewonyo, Olutobi Adekunle Sanuade, Mawuli Komla Kushitor, Lydia Okoibhole, Raphael Awuah, Leonard Baatiema, Irene Akwo Kretchy, Daniel Arhinful, Ama de-Graft Aikins, Kwadwo Koram, Edward Fottrell
{"title":"The contextual awareness, response and evaluation (CARE) diabetes project: study design for a quantitative survey of diabetes prevalence and non-communicable disease risk in Ga Mashie, Accra, Ghana.","authors":"Swaib Abubaker Lule, Sandra Boatemaa Kushitor, Carlos S Grijalva-Eternod, Kafui Adjaye-Gbewonyo, Olutobi Adekunle Sanuade, Mawuli Komla Kushitor, Lydia Okoibhole, Raphael Awuah, Leonard Baatiema, Irene Akwo Kretchy, Daniel Arhinful, Ama de-Graft Aikins, Kwadwo Koram, Edward Fottrell","doi":"10.1080/16549716.2023.2297513","DOIUrl":"10.1080/16549716.2023.2297513","url":null,"abstract":"<p><p>Diabetes is estimated to affect between 3.3% and 8.3% of adults in Ghana, and prevalence is expected to rise. The lack of cost-effective diabetes prevention programmes designed specifically for the Ghanaian population warrants urgent attention. The Contextual Awareness, Response and Evaluation (CARE): Diabetes Project in Ghana is a mixed methods study that aims to understand diabetes in the Ga Mashie area of Accra, identify opportunities for community-based intervention and inform future diabetes prevention and control strategies. This paper presents the study design for the quantitative survey within the CARE project. This survey will take place in the densely populated Ga Mashie area of Accra, Ghana. A household survey will be conducted using simple random sampling to select households from 80 enumeration areas identified in the 2021 Ghana Population and Housing Census. Trained enumerators will interview and collect data from permanent residents aged ≥ 25 years. Pregnant women and those who have given birth in the last six months will be excluded. Data analysis will use a combination of descriptive and inferential statistics, and all analyses will account for the cluster sampling design. Analyses will describe the prevalence of diabetes, other morbidities, and associated risk factors and identify the relationship between diabetes and physical, social, and behavioural parameters. This survey will generate evidence on drivers and consequences of diabetes and facilitate efforts to prevent and control diabetes and other NCDs in urban Ghana, with relevance for other low-income communities.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Financial inclusion for people with disability: a scoping review. 残疾人的金融包容性:范围界定审查。
IF 2.6 3区 医学
Global Health Action Pub Date : 2024-12-31 Epub Date: 2024-05-10 DOI: 10.1080/16549716.2024.2342634
Louise Puli, Natasha Layton, Diane Bell, Abu Zafar Shahriar
{"title":"Financial inclusion for people with disability: a scoping review.","authors":"Louise Puli, Natasha Layton, Diane Bell, Abu Zafar Shahriar","doi":"10.1080/16549716.2024.2342634","DOIUrl":"10.1080/16549716.2024.2342634","url":null,"abstract":"<p><strong>Background: </strong>Financial exclusion is a human rights issue affecting health equity. Evidence demonstrates that financial exclusion is exacerbated for people with disability and those in low- to middle-income countries (LMIC). Barriers to financial access include limited demand for services, banking inadequacies in catering to people with disability, and insufficiently accessible information technologies (ICT) and infrastructure.</p><p><strong>Objectives: </strong>This scoping review sought to identify barriers to and facilitators of financial inclusion for people with disability in LMIC. As a secondary objective, the study explored the potential of financial education and ICT utilisation as viable strategies for enhancing financial inclusion.</p><p><strong>Methods: </strong>This review utilised the Arksey and O'Malley framework and PRISMA Checklist for systematic literature examination and data extraction. The WHO's Environmental Factors guided the analysis to propose potential interventions and to generate recommendations.</p><p><strong>Results: </strong>The review analysed 26 publications from various global regions and fields including finance, business, technology, health and disability policy. It identified consistent financial inclusion barriers for people with disability, resulting in a set of global recommendations across attitudes, environment, technology, services, and policy.</p><p><strong>Conclusions: </strong>Recommendations include using ICT, digital innovation and multi-stakeholder collaboration to address the financial barriers experienced by people with disability. These efforts, rooted in social justice, aim to include people with disability in LMIC as valued financial sector participants, promoting health and equity.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Distances to emergency departments and non-urgent utilization of medical services: a systematic review. 到急诊室的距离与非急诊医疗服务的使用:系统回顾。
IF 2.6 3区 医学
Global Health Action Pub Date : 2024-12-31 Epub Date: 2024-06-03 DOI: 10.1080/16549716.2024.2353994
Uma Kelekar, Debasree Das Gupta, Nicole Theis-Mahon, Emily Fashingbauer, Boyen Huang
{"title":"Distances to emergency departments and non-urgent utilization of medical services: a systematic review.","authors":"Uma Kelekar, Debasree Das Gupta, Nicole Theis-Mahon, Emily Fashingbauer, Boyen Huang","doi":"10.1080/16549716.2024.2353994","DOIUrl":"10.1080/16549716.2024.2353994","url":null,"abstract":"<p><strong>Background: </strong>The use of Emergency Departments (EDs) for non-urgent medical conditions is a global public health concern.</p><p><strong>Objectives: </strong>A systematic review, guided by a registered protocol (PROSPERO: CRD42023398674), was conducted to interpret the association between distance as a measure of healthcare access and the utilization of EDs for non-urgent care in high- and middle-income countries.</p><p><strong>Methods: </strong>The search was conducted on 22 August 2023 across five databases using controlled vocabulary and natural language keywords. Eligibility criteria included studies that examined non-urgent care, and featured concepts of emergency departments, non-urgent health services and distance, reported in English. Articles and abstracts where patients were transported by ambulance/paramedic services, referred/transferred from another hospital to an ED, or those that measured distance to an ED from another health facility were excluded. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework informed the quality of evidence.</p><p><strong>Results: </strong>Fifteen articles met the inclusion criteria. All studies demonstrated satisfactory quality with regard to study design, conduct, analysis and presentation of results. Eight (53.3%) of the studies (1 paediatric, 4 all ages/adult, 3 ecological) found a moderate level of evidence of an inverse association between distance and ED visit volume or utilization for non-urgent medical conditions, while the remaining studies reported very low or low evidence.</p><p><strong>Conclusions: </strong>Half of the studies reported non-urgent ED use to be associated with shortest distance traveled or transportation time. This finding bears implications for healthcare policies aiming to reduce ED use for non-urgent care.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quality and resilience of clinical laboratories in Rwanda: a need for sustainable strategies. 卢旺达临床实验室的质量和复原力:需要可持续战略。
IF 2.6 3区 医学
Global Health Action Pub Date : 2024-12-31 Epub Date: 2024-06-03 DOI: 10.1080/16549716.2024.2358633
Vincent Rusanganwa, Innocent Nzabahimana, Magnus Evander
{"title":"Quality and resilience of clinical laboratories in Rwanda: a need for sustainable strategies.","authors":"Vincent Rusanganwa, Innocent Nzabahimana, Magnus Evander","doi":"10.1080/16549716.2024.2358633","DOIUrl":"10.1080/16549716.2024.2358633","url":null,"abstract":"<p><strong>Background: </strong>Quality healthcare is a global priority, reliant on robust health systems for evidence-based medicine. Clinical laboratories are the backbone of quality healthcare facilitating diagnostics, treatment, patient monitoring, and disease surveillance. Their effectiveness depends on sustainable delivery of accurate test results. Although the Strengthening Laboratory Management Towards Accreditation (SLMTA) programme has enhanced laboratory quality in low-income countries, the long-term sustainability of this improvement remains uncertain.</p><p><strong>Objective: </strong>To explore the sustainability of quality performance in clinical laboratories in Rwanda following the conclusion of SLMTA.</p><p><strong>Methods: </strong>A quasi-experimental design was adopted, involving 47 laboratories divided into three groups with distinct interventions. While one group received continuous mentorship and annual assessments (group two), interventions for the other groups (groups one and three) ceased following the conclusion of SLMTA. SLMTA experts collected data for 10 years through assessments using WHO's StepwiseLaboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. Descriptive and t-test analyses were conducted for statistical evaluation.</p><p><strong>Results: </strong>Improvements in quality were noted between baseline and exit assessments across all laboratory groups (mean baseline: 35.3%, exit: 65.8%, <i>p</i> < 0.001). However, groups one and three experienced performance declines following SLMTA phase-out (mean group one: 64.6% in reference to 85.8%, <i>p</i> = 0.01; mean group three: 57.3% in reference to 64.7%, <i>p</i> < 0.001). In contrast, group two continued to enhance performance even years later (mean: 86.6%compared to 70.6%, <i>p</i> = 0.03).</p><p><strong>Conclusion: </strong>A coordinated implementation of quality improvement plan that enables regular laboratory assessments to pinpoint and address the quality gaps is essential for sustaining quality services in clinical laboratories.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Starting then stopping: a nationwide register-based study on the magnitude, predictors, and urban-rural patterns of under-vaccination variation across health centers in The Gambia. 开始然后停止:关于冈比亚各医疗中心疫苗接种不足的程度、预测因素和城乡差异模式的全国性登记研究。
IF 2.6 3区 医学
Global Health Action Pub Date : 2024-12-31 Epub Date: 2024-06-03 DOI: 10.1080/16549716.2024.2348788
Alieu Sowe, Fredinah Namatovu, Bai Cham, Per E Gustafsson
{"title":"Starting then stopping: a nationwide register-based study on the magnitude, predictors, and urban-rural patterns of under-vaccination variation across health centers in The Gambia.","authors":"Alieu Sowe, Fredinah Namatovu, Bai Cham, Per E Gustafsson","doi":"10.1080/16549716.2024.2348788","DOIUrl":"10.1080/16549716.2024.2348788","url":null,"abstract":"<p><strong>Objectives: </strong>Six million children were under-vaccinated in 2022. Our study aimed to 1) quantify the magnitude of under-vaccination variation between health facilities, 2) assess to which extent individual and health center level factors contributed to the variation, 3) identify individual and health facility factors associated with under-vaccination, and 4), explore rural vs. urban health facility variations.</p><p><strong>Methods: </strong>We used data from 61,839 children from The Gambia national routine vaccination register. We cross tabulated under-vaccination status across study variables and fitted two-level random intercept multilevel logistic regression models to measure variance, contribution to the variance, and factors associated with the variance and under-vaccination.</p><p><strong>Results: </strong>We found that 7% of the prevalence of under-vaccination was due to variation between health facilities. Thirty-seven percent of the variation was explained by individual and health center variables. The variables explained 36% of the variance in urban and 19% in rural areas. Children who were not vaccinated at 4 months or with delayed history, due for vaccination in the rainy season, and health facilities with very small or large population to health worker ratios had higher under-vaccination odds.</p><p><strong>Conclusion: </strong>Our study indicates that one of the pathways to improving vaccination coverage is addressing factors driving under-vaccination inequities between health facilities through urban-rural differentiated strategies.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of the COVID-19 pandemic on type 2 diabetes care and factors associated with care disruption in Kenya and Tanzania. COVID-19 大流行对肯尼亚和坦桑尼亚 2 型糖尿病护理的影响以及与护理中断相关的因素。
IF 2.6 3区 医学
Global Health Action Pub Date : 2024-12-31 Epub Date: 2024-05-22 DOI: 10.1080/16549716.2024.2345970
Richard E Sanya, Caroline H Karugu, Peter Binyaruka, Shukri F Mohamed, Lyagamula Kisia, Peter Kibe, Irene Mashasi, Grace Mhalu, Christopher Bunn, Manuela Deidda, Frances S Mair, Eleanor Grieve, Cindy M Gray, Sally Mtenga, Gershim Asiki
{"title":"Impact of the COVID-19 pandemic on type 2 diabetes care and factors associated with care disruption in Kenya and Tanzania.","authors":"Richard E Sanya, Caroline H Karugu, Peter Binyaruka, Shukri F Mohamed, Lyagamula Kisia, Peter Kibe, Irene Mashasi, Grace Mhalu, Christopher Bunn, Manuela Deidda, Frances S Mair, Eleanor Grieve, Cindy M Gray, Sally Mtenga, Gershim Asiki","doi":"10.1080/16549716.2024.2345970","DOIUrl":"10.1080/16549716.2024.2345970","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic affected healthcare delivery globally, impacting care access and delivery of essential services.</p><p><strong>Objectives: </strong>We investigated the pandemic's impact on care for patients with type 2 diabetes and factors associated with care disruption in Kenya and Tanzania.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among adults diagnosed with diabetes pre-COVID-19. Data were collected in February-April 2022 reflecting experiences at two time-points, three months before and the three months most affected by the COVID-19 pandemic. A questionnaire captured data on blood glucose testing, changes in medication prescription and access, and healthcare provider access.</p><p><strong>Results: </strong>We recruited 1000 participants (500/country). Diabetes care was disrupted in both countries, with 34.8% and 32.8% of the participants reporting change in place and frequency of testing in Kenya, respectively. In Tanzania, 12.4% and 17.8% reported changes in location and frequency of glucose testing, respectively. The number of health facility visits declined, 14.4% (<i>p</i> < 0.001) in Kenya and 5.6% (<i>p</i> = 0.001) in Tanzania. In Kenya, there was a higher likelihood of severe care disruption among insured patients (adjusted odds ratio [aOR] 1.56, 95% confidence interval [CI][1.05-2.34]; <i>p</i> = 0.029) and a lower likelihood among patients residing in rural areas (aOR, 0.35[95%CI, 0.22-0.58]; <i>p</i> < 0.001). Tanzania had a lower likelihood of severe disruption among insured patients (aOR, 0.51[95%CI, 0.33-0.79]; <i>p</i> = 0.003) but higher likelihood among patients with low economic status (aOR, 1.81[95%CI, 1.14-2.88]; <i>p</i> = 0.011).</p><p><strong>Conclusions: </strong>COVID-19 disrupted diabetes care more in Kenya than Tanzania. Health systems and emergency preparedness should be strengthened to ensure continuity of service provision for patients with diabetes.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11123500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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