Africa Health Systems Initiative - Research Partnerships / composante recherche - initiative systèmes de santé en Afrique

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Browsing Africa Health Systems Initiative - Research Partnerships / composante recherche - initiative systèmes de santé en Afrique by Title

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    Evaluating a streamlined clinical tool and educational outreach intervention for health care workers in Malawi: the PALM PLUS case study
    (2011-11) Sodhi, Sumeet; Banda, Hastings; Kathyola, Damson; Burciul, Barry; Thompson, Sandy
    The success of PALM PLUS (Practical Approach to Lung Health and HIV/AIDS in Malawi) suggests this intervention is adaptable for use in other resource-limited settings. The PALM PLUS intervention simplifies and integrates existing Malawian national guidelines into a single user-friendly guideline for mid-level health care workers. Training utilizes a peer-to-peer educational outreach approach. The research measures effects of the intervention on staff satisfaction and retention, quality of patient care, and costs. This initiative is an example of South-South knowledge translation between South Africa and Malawi, mediated by a Canadian academic-NGO hybrid. The integration of guidelines requires intensive collaboration.
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    Primary eye care in sub-Saharan African: do we have the evidence needed to scale up training and service delivery?
    (2010) Courtright, P; Seneadza, A; Mathenge, W; Eliah, E; Lewallen, S
    The models for addressing the delivery of an eye-care service in sub-Saharan Africa have seen considerable revision in the last 30 years, and the on-going challenges, as well as the future needs, will probably require many more changes and new systems. There is a need to assess the different models that are currently employed, in order to ensure that all potential contributions to the elimination of avoidable blindness are used; the evolving concept of primary eye care (PEC) requires such assessment. For the current review, the published literature on eye care provided by general front-line healthworkers was screened for articles that provided evidence of the impact of such PEC on the general delivery of eye care in sub-Saharan Africa. Of the 103 relevant articles detected, only three provided evidence of the effectiveness of PEC and the authors of all three of these articles suggested that such eye care was not meeting the needs or expectations of the target populations, the trainers, or programmes of eye care. Among the main problems identified were a lack of a clear definition of the scope of practice for PEC, the need for clarifying the specific skills that a front-line healthworker could perform correctly, and the changing needs and expectations for the delivery of an eye-care service in Africa. If PEC is to become adequately grounded in Africa, the generation of further evidence of the effectiveness and limitations of such care would be a prudent move.
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    Reliability of Community Health Worker Collected Data for Planning and Policy in a Peri-Urban Area of Kisumu, Kenya
    (2012) Otieno, C F; Kaseje, D; Ochieng, B M; Githae, M N
    As reliable and timely health information is essential for public health action and health systems strengthening, the study investigates the validity and reliability of Community Based information towards planning and policy formulation. Evaluation results conclude that community health workers (CHW) accurately and reliably collect household data, especially in resource poor settings. Ten percent of households visited by CHWs for data collection were re-collected by a technically trained team: environmental health and maternal healthcare care presented good correspondence between the two sets of data; this was also true for exclusive breast-feeding indicator. However, measles immunization coverage showed less consistency between sets of results
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    Strengthening health human resources and improving clinical outcomes through an integrated guideline and educational outreach in resource-poor settings: a cluster-randomized trial
    (2010) Schull, Michael J; Banda, Hastings; Kathyola, Damson; Fairall, Lara; Martiniuk, Alexandra
    Background: In low-income countries, only about a third of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) patients eligible for anti-retroviral treatment currently receive it. Providing decentralized treatment close to where patients live is crucial to a faster scale up, however, a key obstacle is limited health system capacity due to a shortage of trained health-care workers and challenges of integrating HIV/ AIDS care with other primary care services (e.g. tuberculosis, malaria, respiratory conditions). This study will test an adapted primary care health care worker training and guideline intervention, Practical Approach to Lung Health and HIV/AIDS Malawi (PALM PLUS), on staff retention and satisfaction, and quality of patient care. Methods/Design: A cluster-randomized trial design is being used to compare usual care with a standardized clinical guideline and training intervention, PALM PLUS. The intervention targets middle-cadre health care workers (nurses, clinical officers, medical assistants) in 30 rural primary care health centres in a single district in Malawi. PALM PLUS is an integrated, symptom-based and user-friendly guideline consistent with Malawian national treatment protocols. Training is standardized and based on an educational outreach approach. Trainers will be front-line peer healthcare workers trained to provide outreach training and support to their fellow front-line healthcare workers during focused (1-2 hours), intermittent, interactive sessions on-site in health centers. Primary outcomes are health care worker retention and satisfaction. Secondary outcomes are clinical outcomes measured at the health centre level for HIV/AIDS, tuberculosis, prevention-of-mother-to-child-transmission of HIV and other primary care conditions. Effect sizes and 95% confidence intervals for outcomes will be presented. Assessment of outcomes will occur at 1 year post- implementation. Discussion: The PALM PLUS trial aims to address a key problem: strengthening middle-cadre health care workers to support the broader scale up of HIV/AIDS services and their integration into primary care. The trial will test whether the PALM PLUS intervention improves staff satisfaction and retention, as well as the quality of patient care, when compared to usual practice.