Assessing the capacity to produce health personnel in Rwanda

2008 ◽  
Vol 21 (4) ◽  
pp. 290-306
Author(s):  
Gilles Dussault ◽  
Laurence Codjia ◽  
Kathy Kantengwga ◽  
Kate Tulenko
Keyword(s):  
Low Income ◽  
Health Personnel ◽  
Health Workers ◽  
Poor Country ◽  
Scale Up ◽  
Qualitative Assessment ◽  
Low Income Countries ◽  
Teaching Staff ◽  
Content Type ◽  
Training Institutions

PurposeThe purpose of this paper is to present the results of a study to assess the capacity of a poor country to scale‐up its production of health workers.Design/methodology/approachThe assessment consisted of a survey of institutions training doctors, nurses and technicians in Rwanda. Data on student intake, teaching staff, infrastructures and equipment were collected directly from the institutions by questionnaire administered in person. Data for the qualitative assessment of current and future capacity of production were collected by interviews.FindingsPhysical capacity in terms of classrooms and dormitories was generally good, except at the Faculty of Medicine. Laboratories and libraries were considered inadequate everywhere. Few national teachers hold a PhD and dependence on foreign trainers is high. Nursing teachers' training is also insufficient, particularly in pedagogy. As trainers are young, providing them with additional training should be easier. All institutions reported insufficient budgets. Managerial competencies are not developed. There is no licensing mechanism to ensure quality maintenance.Research limitations/implicationsThere is no validated data base on training institutions and the research had to rely on self‐reported statistics and other information.Practical implicationsA rapid increase in the production of health personnel would be difficult in the current conditions. Production strengthening should involve stakeholders from training institutions, and include measures to motivate and retain trainers, and to improve the quality of training.Originality/valueThe authors are not aware of similar studies in low income countries. Their methodology can be of interest to researchers and policy‐makers who do not have access to baseline data.

scholarly journals Approaches at Community Level for Care of the Preterm Neonates in Low-Income Countries

2021 ◽  
Author(s):  
Pontius Bayo ◽  
Juliet Ajok
Keyword(s):  
Low Income ◽  
Neonatal Intensive Care ◽  
Health Workers ◽  
Economic Status ◽  
Scale Up ◽  
Survival Rates ◽  
Low Income Countries ◽  
Easy Access ◽  
Preterm Neonates ◽  
Preterm Babies

The survival of preterm babies has significantly improved over the last several decades in the high-income countries because of the availability of Neonatal Intensive Care Units (NICU’s) in both large and small hospitals, presence of specially trained physicians, nurses, and other health care personnel with easy access to sophisticated equipment. However, the bigger public health advances that saw improvements in socio-economic status of the populations, improvements in education and sanitation conditions and reductions in malnutrition and rates of infectious diseases were probably the main reasons for this improved survival rates for preterm neonates. Low in-come countries are currently highest bearers of the burden of preterm morbidity and mortality. The current preventive and care interventions do not reach all the neonates and their mothers, the coverage has remained low, access is poor and the quality of care is low. The aim of this chapter is to propose ideas on how the current preterm neonatal care interventions can be adapted for community scale up through community-based health system structures like community health workers to improve survival of neonates who have been delivered from home or after they have been discharged from hospital.

Foreign capital inflows and economic growth: the experience of low-income countries in Sub Saharan Africa

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Atif Awad
Keyword(s):  
Low Income ◽  
Foreign Capital ◽  
Ordinary Least Squares ◽  
Capital Inflows ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Content Type ◽  
Long Run ◽  
Foreign Capital Inflows ◽  
The Impact

Purpose This paper aims to investigate the long-run impact of selected foreign capital inflows, including aid, remittances, foreign direct investment (FDI), trade and debt, on the economic growth of 21 low-income countries in the Sub Saharan Africa (SSA) region, during the period 1990–2018. Design/methodology/approach To obtain this objective and for robust analysis, a parametric approach, which was dynamic ordinary least squares, and a non-parametric technique, which was fully modified ordinary least squares, were used. Findings The results of both models confirmed that, in the long run, trade and aid affected the growth rate of the per capita income in these countries in a positive way. However, external debt seemed to have an adverse influence on such growth. Originality/value First, this is the initial study that has addressed this matter across a homogenous group of countries in the SSA region. Second, while most of the previous studies regarding capital inflows into the SSA region have focused on the impact of only one or two aspects of such foreign capital inflows on growth, the present study, instead, examined the impact of five types of foreign capital inflows (aid, remittances, FDI, trade and debt).

Private school vouchers for expanding secondary school access? The case of Tanzania

2018 ◽  
Vol 32 (7) ◽  
pp. 1307-1318
Author(s):  
Donald R. Baum ◽  
Jacobus Cilliers
Keyword(s):  
Secondary Education ◽  
Secondary School ◽  
Low Income ◽  
Private School ◽  
Systems Approach ◽  
Financial Burden ◽  
Low Income Countries ◽  
Urban District ◽  
Content Type ◽  
School Voucher

Purpose The purpose of this paper is to provide insight into the current contributions of private schools to education provision in Tanzania, and to consider the feasibility of a school voucher program to contribute to the expansion of the secondary school system, compared to the alternative expansion of public secondary education. Design/methodology/approach The study offers an analysis of current educational circumstances and educational goals in Tanzania, and projects differential costs and outcomes associated with various options for expanding secondary education. Data come from two sources: a census of the private schooling market in the Morogoro Urban district, conducted as part of the World Bank’s Systems Approach for Better Education Results initiative; and Tanzania’s National Panel Survey 2010–2011. Findings For those students unable to cover the full cost of secondary education, findings suggest that a targeted private school voucher would be an efficient and equitable policy mechanism for secondary school expansion. Such an approach would ease the financial burden on government for constructing all new schools, yet assure access for the most vulnerable. Originality/value The implementation of school voucher programs is increasing in low-income countries. It is important for policy makers to carefully consider the appropriateness of this type of policy intervention for their particular educational contexts. This paper models an approach by which researchers and policymakers can assess the educational circumstances of a particular location, and determine the potential effectiveness of a private school voucher policy.

Cross-cultural metacognition as a prior for humanitarian knowledge: when cultures collide in global health emergencies

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Tachia Chin ◽  
Jianwei Meng ◽  
Shouyang Wang ◽  
Yi Shi ◽  
Jianxin Zhang
Keyword(s):  
Low Income ◽  
A Priori ◽  
Normative Theory ◽  
Cross Cultural ◽  
Warning Signs ◽  
Low Income Countries ◽  
Global Public Health ◽  
Business World ◽  
Content Type ◽  
Cultural Conflicts

Purpose A serious global public health emergency (GPHE) like the COVID-19 aggravates the inequilibrium of medical care and other critical resources between wealthy and poor nations, which, coupled with the collision of cultures, indicates the vital need for developing humanitarian knowledge transcending cultures. Given the scarcity of literature addressing such unprecedent issues, this paper thus proposes new, unconventional viewpoints and future themes at the intersection of knowledge management (KM) and humanitarian inquiry. Design/methodology/approach This paper is conceptual in nature. The data of the World Bank and the Office for the Coordination of Humanitarian Affairs are analysed to introduce some emerging real impact topics regarding cross-cultural conflicts and humanitarian knowledge in the post-COVID business world. The theoretical foundation was built upon a critical literature review. Findings This paper synthesizes the perspectives of culture, KM and the humanistic philosophy to distil the core component of cultural intelligence and comparatively and thereby illuminating why cross-cultural metacognition acts as a priori for achieving cosmopolitan humanitarian knowledge. Research limitations/implications This paper provides profound implications to academics by highlighting the importance to formulating new, inter-disciplinary themes or unorthodox, phenomenon-driven assumptions beyond the traditional KM domain. This paper also offers practitioners and policymakers valuable insights into coping with the growing disparity between high- and low-income countries by showing warning signs of a looming humanitarian crisis associated with a GPHE context. Originality/value This paper does not aim to claim the birth of a new domain but call for more research on developing a normative theory of humanitarian knowledge as transcendence of cultures. It implies uncharted territories of great interest and potential for the real impact KM community.

scholarly journals Global e-government development: besides the relative wealth of countries, do policies matter?

2020 ◽  
Vol 14 (3) ◽  
pp. 381-400 ◽  
Author(s):  
Gonçalo Paiva Dias
Keyword(s):  
Low Income ◽  
Public Policies ◽  
Low Income Countries ◽  
Political Commitment ◽  
Content Type ◽  
Secondary Sources ◽  
Relative Wealth ◽  
Innovative Thinking ◽  
High Level ◽  
Government Development

Purpose This study aims to investigate whether, discounting the effect of the relative wealth of countries, it is possible to observe the relevance of policies for e-government development. Design/methodology/approach The deviations of countries' results from what could be expected, considering their relative wealth is calculated by using the residuals of a linear regression using the Gross Domestic Product per capita as the independent variable and the UN E-Government Development Index as the dependent variable. The countries that achieve better and worse results than expected are then identified and their cases are analyzed by resorting to secondary sources, namely, published research referring to their cases. Those research documents were identified by successively searching the Scopus database, the Google Scholar database and the Web of Science. Findings The existence of formal e-government strategies and plans and the capacity to implement them can make a difference, allowing countries to achieve better results than expected or, in their absence, to perform worse than expected. Research limitations/implications The proposed methodology can be useful to e-government researchers, particularly as a basis for deeper and more detailed studies. Practical implications Countries should invest in well-developed and focused strategies and continuity of public policies and their capacity to deliver results. For that purpose, political commitment and high-level coordination are key factors. For low-income countries, long-lasting cooperation with external experienced partners is crucial. For high-income countries, innovative thinking is a key enabler. Originality/value This study uses an innovative method to look beyond the effect of the relative wealth of countries and investigate the relevance of public policies for e-government development.

scholarly journals Adaptation and validation for Colombia of the WHO safe childbirth checklist

2018 ◽  
Vol 49 (3) ◽  
pp. 201-212
Author(s):  
Ana Carolina Amaya Arias ◽  
Óscar Zuluaga ◽  
Douglas Idárraga ◽  
Javier Hernando Eslava Schmalbach
Keyword(s):  
Low Income ◽  
Health Workers ◽  
Low Cost ◽  
Neonatal Morbidity ◽  
Neonatal Care ◽  
World Health ◽  
Low Income Countries ◽  
Safe Childbirth Checklist ◽  
Health Organization ◽  
Safe Childbirth

Introduction: Most maternal deaths that occur in developing countries are considered unfair and can be avoided. In 2008, The World Health Organization (WHO) proposed a checklist for childbirth care, in order to assess whether a simple, low-cost intervention had an impact on maternal and neonatal mortality in low-income countries. Objective: To translate, adapt and validate the content of the WHO Safe Childbirth Checklist (SCC) for its use in Colombia Methods: The checklist was translated and adapted to the Colombian context. It was subsequently validated by a panel of experts composed of 17 health workers with experience in maternal and neonatal care and safety. Reliability among judges was estimated (Rwg) and items were modified or added to each section of the list according to the results. Results: Modifications were made to 28 items, while 19 new items were added, and none was removed. The most important modifications were made to the management guidelines included in each item, and the items added refer to risks inherent to our environment. Conclusion: The Colombian version of the SCC will be a useful tool to improve maternal and neonatal care and thereby contribute to reducing maternal and neonatal morbidity and mortality in our country.

scholarly journals Establishing Global School Feeding Program Targets: How Many Poor Children Globally Should Be Prioritized, and What Would Be the Cost of Implementation?

2020 ◽  
Vol 8 ◽  
Author(s):  
Lesley J. Drake ◽  
Nail Lazrak ◽  
Meena Fernandes ◽  
Kim Chu ◽  
Samrat Singh ◽  
...  
Keyword(s):  
Low Income ◽  
School Health ◽  
Scale Up ◽  
Good Health ◽  
Global Strategy ◽  
Low Income Countries ◽  
School Age Children ◽  
Middle Income ◽  
Middle Income Countries ◽  
School Feeding

The creation of Human Capital is dependent upon good health and education throughout the first 8,000 days of life, but there is currently under-investment in health and nutrition after the first 1,000 days. Working with governments and partners, the UN World Food Program is leading a global scale up of investment in school health, and has undertaken a strategic analysis to explore the scale and cost of meeting the needs of the most disadvantaged school age children and adolescents in low and middle-income countries globally. Of the 663 million school children enrolled in school, 328 million live where the current coverage of school meals is inadequate (<80%), of these, 251 million live in countries where there are significant nutrition deficits (>20% anemia and stunting), and of these an estimated 73 million children in 60 countries are also living in extreme poverty (<USD 1.97 per day). 62.7 million of these children are in Africa, and more than 66% live in low income countries, with a substantial minority in pockets of poverty in middle-income countries. The estimated overall financial requirement for school feeding is USD 4.7 billion, increasing to USD 5.8 billion annually if other essential school health interventions are included in the package. The DCP3 (Vol 8) school feeding edition and the global coverage numbers were launched in Tunis, 2018 by the WFP Executive Director, David Beasley. These estimates continue to inform the development of WFP's global strategy for school feeding.

‘It makes you someone who changes with the times’: health worker and client perspectives on a smartphone-based counselling application deployed in rural Tanzania

2019 ◽  
Vol 34 (4) ◽  
pp. 307-315 ◽  
Author(s):  
Kristy Hackett ◽  
Mina Kazemi ◽  
Curtis Lafleur ◽  
Peter Nyella ◽  
Lawelu Godfrey ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health System ◽  
Data Management ◽  
Low Income ◽  
Community Intervention ◽  
Health Workers ◽  
Low Income Countries ◽  
Maternal And Newborn Health ◽  
Pregnancy And Childbirth

AbstractMobile health (mHealth) applications have been developed for community health workers (CHW) to help simplify tasks, enhance service delivery and promote healthy behaviours. These strategies hold promise, particularly for support of pregnancy and childbirth in low-income countries (LIC), but their design and implementation must incorporate CHW clients’ perspectives to be effective and sustainable. Few studies examine how mHealth influences client and supervisor perceptions of CHW performance and quality of care in LIC. This study was embedded within a larger cluster-randomized, community intervention trial in Singida, Tanzania. CHW in intervention areas were trained to use a smartphone application designed to improve data management, patient tracking and delivery of health messages during prenatal counselling visits with women clients. Qualitative data collected through focus groups and in-depth interviews illustrated mostly positive perceptions of smartphone-assisted counselling among clients and supervisors including: increased quality of care; and improved communication, efficiency and data management. Clients also associated smartphone-assisted counselling with overall health system improvements even though the functions of the smartphones were not well understood. Smartphones were thought to signify modern, up-to-date biomedical information deemed highly desirable during pregnancy and childbirth in this context. In this rural Tanzanian setting, mHealth tools positively influenced community perceptions of health system services and client expectations of health workers; policymakers and implementers must ensure these expectations are met. Such interventions must be deeply embedded into health systems to have long-term impacts on maternal and newborn health outcomes.

scholarly journals Barriers and facilitators of implementation of a community cardiovascular disease prevention programme in Mukono and Buikwe districts in Uganda using the Consolidated Framework for Implementation Research

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Rawlance Ndejjo ◽  
Rhoda K. Wanyenze ◽  
Fred Nuwaha ◽  
Hilde Bastiaens ◽  
Geofrey Musinguzi
Keyword(s):  
Cardiovascular Disease ◽  
Low Income ◽  
Implementation Research ◽  
Health Workers ◽  
Scale Up ◽  
Barriers And Facilitators ◽  
Prevention Programme ◽  
Intervention Implementation ◽  
Design Quality ◽  
Middle Income

Abstract Background In low- and middle-income countries, there is an increasing attention towards community approaches to deal with the growing burden of cardiovascular disease (CVD). However, few studies have explored the implementation processes of such interventions to inform their scale up and sustainability. Using the consolidated framework for implementation research (CFIR), we examined the barriers and facilitators influencing the implementation of a community CVD programme led by community health workers (CHWs) in Mukono and Buikwe districts in Uganda. Methods This qualitative study is a process evaluation of an ongoing type II hybrid stepped wedge cluster trial guided by the CFIR. Data for this analysis were collected through regular meetings and focus group discussions (FGDs) conducted during the first cycle (6 months) of intervention implementation. A total of 20 CHWs participated in the implementation programme in 20 villages during the first cycle. Meeting reports and FGD transcripts were analysed following inductive thematic analysis with the aid of Nvivo 12.6 to generate emerging themes and sub-themes and thereafter deductive analysis was used to map themes and sub-themes onto the CFIR domains and constructs. Results The barriers to intervention implementation were the complexity of the intervention (complexity), compatibility with community culture (culture), the lack of an enabling environment for behaviour change (patient needs and resources) and mistrust of CHWs by community members (relative priority). In addition, the low community awareness of CVD (tension for change), competing demands (other personal attributes) and unfavourable policies (external policy and incentives) impeded intervention implementation. On the other hand, facilitators of intervention implementation were availability of inputs and protective equipment (design quality and packaging), training of CHWs (Available resources), working with community structures including leaders and groups (process—opinion leaders), frequent support supervision and engagements (process—formally appointed internal implementation leaders) and access to quality health services (process—champions). Conclusion Using the CFIR, we identified drivers of implementation success or failure for a community CVD prevention programme in a low-income context. These findings are key to inform the design of impactful, scalable and sustainable CHW programmes for non-communicable diseases prevention and control.

State fragility and human development: a study with special emphasis on social cohesion

2020 ◽  
Vol 48 (1) ◽  
pp. 39-61
Author(s):  
Belay Seyoum
Keyword(s):  
Human Development ◽  
Social Cohesion ◽  
Low Income ◽  
Ordinary Least Squares ◽  
Low Income Countries ◽  
Least Squares Regression ◽  
Content Type ◽  
State Fragility ◽  
State Legitimacy ◽  
The Impact

PurposeThe purpose of this paper is to examine the effect of state fragility on select indicators of human development and identify aspects of state fragility that have the greatest impact on poverty reduction and sustainable development. The paper also explores the impact of social cohesion on human development as well as the mediating role of state legitimacy in mediating the relationship between social cohesion and human development.Design/methodology/approachThe study is based on data from 180 countries and uses ordinary least squares regression and mediation analysis to explore the effects of social cohesion on human development.FindingsThe findings show a significant relationship between state fragility and human development. It suggests that policies and efforts aimed at enhancing social cohesion would have the most significant impact on human development. The findings also show that social cohesion not only has a direct effect on human development but it also has an indirect effect on human development through state legitimacy (mediator).Practical implicationsEven though state fragility has been largely associated with low income countries, different facets of fragility are manifested in various countries regardless of levels of economic development.Originality/valueThe study is timely in view of the evidence of increasing state fragility in many countries. Furthermore, this is the first scholarly work linking lack of social cohesion, state fragility and human development.

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