scholarly journals Barriers and Facilitators to Nurse Management of Hypertension: A Qualitative Analysis from Western Kenya

2016 ◽  
Vol 26 (3) ◽  
pp. 315 ◽  
Author(s):  
Rajesh Vedanthan ◽  
Nelly Tuikong ◽  
Claire Kofler ◽  
Evan Blank ◽  
Jemima H. Kamano ◽  
...  
Keyword(s):  
Content Analysis ◽  
Focus Group ◽  
Human Resource ◽  
Barriers And Facilitators ◽  
Patient Specific ◽  
Successful Implementation ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Western Kenya ◽  
Key Informant

<p><strong>Background: </strong>Hypertension is the leading global risk for mortality. Poor treatment and control of hypertension in low- and middle-income countries is due to several reasons, including insufficient human resources. Nurse management of hypertension is a novel approach to address the human resource challenge. However, specific barriers and facilitators to this strategy are not known. </p><p><strong>Objective: </strong>To evaluate barriers and facilitators to nurse management of hypertensive patients in rural western Kenya, using a qualitative research approach. </p><p><strong>Methods: </strong>Six key informant interviews (five men, one woman) and seven focus group discussions (24 men, 33 women) were conducted among physicians, clinical officers, nurses, support staff, patients, and community leaders. Content analysis was performed using Atlas.ti 7.0, using deductive and inductive codes that were then grouped into themes representing barriers and facilitators. Ranking of barriers and facilitators was performed using triangulation of density of participant responses from the focus group discussions and key informant interviews, as well as investigator assessments using a two-round Delphi exercise. <strong></strong></p><p><strong>Results: </strong>We identified a total of 23 barriers and nine facilitators to nurse management of hypertension, spanning the following categories of factors: health systems, environmental, nurse-specific, patient-specific, emotional, and community. The Delphi resultswere generally consistent with the findings from the content analysis. <strong></strong></p><p><strong>Conclusion: </strong>Nurse management of hypertension is a potentially feasible strategy to address the human resource challenge of hypertension control in low-resource settings. However, successful implementation will be contingent upon addressing barriers such as access to medications, quality of care, training of nurses, health education, and stigma. <em>Ethn Dis. </em>2016;26(3):315-322; doi:10.18865/ed.26.3.315. </p>

scholarly journals Drivers and barriers to workplace-based HIV self-testing among high-risk men in Uganda: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patience A. Muwanguzi ◽  
Robert C. Bollinger ◽  
Stuart C. Ray ◽  
LaRon E. Nelson ◽  
Noah Kiwanuka ◽  
...  
Keyword(s):  
Focus Group ◽  
Hiv Testing ◽  
Private Security ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Private Security Companies ◽  
Self Testing ◽  
Key Informant ◽  
Hiv Testing Services ◽  
Security Companies

Abstract Background Men in Sub-Saharan Africa are less engaged than women in accessing HIV testing and treatment and, consequently, experience higher HIV-related mortality. Reaching men with HIV testing services is challenging, thus, increasing the need for innovative ways to engage men with low access and those at higher risk. In this study, we explore men’s perceptions of drivers and barriers of workplace-based HIV self-testing in Uganda. Methods An exploratory study involving men working in private security companies employing more than 50 men in two districts, in central and western Uganda. Focus group discussions and key informant interviews were conducted. Data were analyzed using inductive content analysis. Results Forty-eight (48) men from eight private security companies participated in 5 focus group discussions and 17 key informant interviews. Of the 48 men, 14(29.2%) were ages 26–35 years. The majority 31(64.6%) were security guards. The drivers reported for workplace-based HIV self-testing included convenience, autonomy, positive influence from work colleagues, the need for alternative access for HIV testing services, incentives, and involvement of employers. The barriers reported were the prohibitive cost of HIV tests, stigma, lack of testing support, the fear of discrimination and isolation, and concerns around decreased work productivity in the event of a reactive self-test. Conclusions We recommend the involvement of employers in workplace-based HIV self-testing to encourage participation by employees. There is need for HIV self-testing support both during and after the testing process. Both employers and employees recommend the use of non-monetary incentives, and regular training about HIV self-testing to increase the uptake and acceptability of HIV testing services at the workplace.

scholarly journals Study on Potentiality of Biogas Plants and Their Role for the Conservation of Environment

2015 ◽  
Vol 15 (2) ◽  
pp. 51-56
Author(s):  
Dinesh Ghimire ◽  
Jagannath Shrestha ◽  
Anup K.C
Keyword(s):  
Focus Group ◽  
Science And Technology ◽  
Primary Data ◽  
Household Surveys ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
The People ◽  
Key Informant ◽  
Biogas Plants ◽  
Biogas Technology

This study presents the potentiality of biogas plants and their role for the conservation of environment. It is basedon primary data collected from 84 household surveys, 6 key informant interviews and two focus group discussions. It was observed that more than 95% of the people residing in the VDCs were using firewood as a main source ofenergy. The total amount of firewood consumed was 510.570 ton/year which emits 775.052tCO2e/year. Due to the presence of agriculture based livestock holding population, there is a great potential of biogas technology. Thestudy showed that biogas technology could saved 34.40% of firewood which conserves 5.415 ha of forests area. There is a potentiality of 58 biogas plants of size 6 cu.m which will reduce 440.800 tCO2e/year.DOI: http://dx.doi.org/njst.v15i2.12114Nepal Journal of Science and Technology Vol. 15, No.2 (2014) 51-56

Implementation of ultrasound after central venous catheter insertion: A qualitative study in early adopters

2021 ◽  
pp. 112972982110534
Author(s):  
Enyo A Ablordeppey ◽  
Shannon M Keating ◽  
Katherine M Brown ◽  
Daniel L Theodoro ◽  
Richard T Griffey ◽  
...  
Keyword(s):  
Focus Group ◽  
Central Venous Catheter ◽  
Qualitative Analysis ◽  
Focus Groups ◽  
Venous Catheter ◽  
Barriers And Facilitators ◽  
Central Venous ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Post Procedure

Background: The adoption rate of point of care ultrasound (POCUS) for the confirmation of central venous catheter (CVC) positioning and exclusion of post procedure pneumothorax is low despite advantages in workflow compared to traditional chest X-ray (CXR). To explore why, we convened focus groups to address barriers and facilitators of implementation for POCUS guided CVC confirmation and de-implementation of post-procedure CXR. Methods: We conducted focus groups with emergency medicine and critical care providers to discuss current practices in POCUS for CVC confirmation. The semi-structured focus group interview guide was informed by the Consolidated Framework for Implementation Research (CFIR). We performed qualitative content analysis of the resulting transcripts using a consensual qualitative research approach (NVivo software), aiming to identify priority categories that describe the barriers and facilitators of POCUS guided CVC confirmation. Results: The coding dictionary of barriers and facilitators consisted of 21 codes from the focus group discussions. Our qualitative analysis revealed that 12 codes emerged spontaneously (inductively) within the focus group discussions and aligned directly to CFIR constructs. Common barriers included provider influences (e.g. knowledge and beliefs about POCUS for CVC confirmation), external network (e.g. societal guidelines, ancillary staff, and consultants), and inertia (habit or reflexive processes). Common facilitators included ultrasound protocol advantage and champions. Time and provider outcomes (cognitive offload, ownership, and independence) emerged as early barriers but late facilitators. Conclusion: Our qualitative analysis demonstrates real and perceived barriers against implementation of POCUS for CVC position confirmation and pneumothorax exclusion. Our findings discovered organizational and personal constructs that will inform development of multifaceted strategies toward implementation of POCUS after CVC insertion.

Assessing determinants of programmatic performance of community management of malaria, pneumonia, and diarrhea in children in Africa: Protocol and data collection for a mixed-methods evaluation of iCCM (Preprint)

2021 ◽  
Author(s):  
Aliya Karim ◽  
Don de Savigny ◽  
Serge Ngaima ◽  
Daniel Mäusezahl ◽  
Daniel Cobos Muñoz ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Child Health ◽  
Data Collection ◽  
Intervention Effectiveness ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Middle Income ◽  
Key Informant ◽  
Low And Middle Income

BACKGROUND Integrated community case management (iCCM) is a child health program designed to provide integrated, community-based care for pneumonia, malaria and diarrhea for children in hard-to-reach areas of low- and middle-income countries (LMICs). The foundation of the intervention is service-delivery by community health workers (CHWs) who depend on reliable provision of drugs and supplies, consistent supervision, comprehensive training, and community acceptance and participation to perform optimally. The effectiveness of the program may also depend on a number of other elements, including an enabling policy environment, financing mechanisms from the national to the local level, data transmission systems, and appropriate monitoring and evaluation. The extent to which these factors act upon each other to influence the effectiveness and viability of iCCM is both variable and challenging to assess, especially across different implementation contexts. OBJECTIVE In this paper, we describe a mixed-methods systems-based study protocol to assess the programmatic components of iCCM which are associated with intervention effectiveness, and report preliminary results of data collection. METHODS This protocol employs a mixed qualitative and quantitative study design based on a Systems Thinking approach within four iCCM programs in Malawi, Democratic Republic of the Congo, Niger State, and Abia State, Nigeria. Routine monitoring data is collected to determine intervention effectiveness, namely testing, treatment and referral outcomes. Surveys with CHWs, supervisors, and caregivers are performed to collect quantitative data on their demographics, activities, and experiences within the program, and how these relate to the areas of intervention effectiveness. Focus group discussions are conducted with these stakeholders as well as local traditional leaders to contextualize this data. Key informant interviews are undertaken with national and district-level program stakeholders and officers knowledgeable in critical program processes. RESULTS We performed 3,836 surveys and 45 focus group discussions with CHWs, supervisors, and caregivers, and traditional leaders; 120 key informant interviews with district and national-level program managers, health officers, and ministry officials. Policy and program documents were additionally collected for review. CONCLUSIONS Evidence from this study will inform child health programs and practice in low- and middle-income settings, and future policy development within the iCCM intervention.

scholarly journals Understanding the Livelihood Characteristics of the Migratory and Non-Migratory Fishers of the Padma River, Bangladesh

2018 ◽  
Vol 10 (3) ◽  
pp. 261-273
Author(s):  
M. I. Khan ◽  
M. M. Islam ◽  
G. K. Kundu ◽  
M. S. Akter
Keyword(s):  
Focus Group ◽  
Well Water ◽  
Full Time ◽  
Age Group ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Key Informant ◽  
Part Time ◽  
Tube Well ◽  
Padma River

The Padma is the second longest and one of the trans-boundary rivers of Bangladesh that significantly contributes to fisheries production and supports the fishers’ livelihoods. This study assesses the livelihood characteristics of the Padma river-dependent migratory and non-migratory fishers, employing household interviews, focus group discussions (FGDs), and key informant interviews from July to October, 2015. All migratory fishers were full-time fishers, whereas, non-migratory fishers included full time (88.89%), part-time and occasional fishers (11.11%). Maximum fishers were belonging to the age group of 31 to 50 years of which 94.74% were migratory and 57.4% were non-migratory fishers. Half of the migratory and non-migratory fishers were illiterate. 89.47% migratory fishers used river water for drinking and other purposes, whereas, 94.44% non-migratory fishers used tube-well water. Average annual incomes of both migratory (58%) and non-migratory (65%) fishers ranged from Tk. 30,000 to 60,000, whereas 26% migratory and 5% non-migratory fishers had average annual incomes above Tk. 60,000. The overall livelihood status of the migratory and non-migratory fishers was not satisfactory as they have faced problems like conflicts with elite groups for resources, lack of fish preservation facilities. Effective initiatives and their proper implementations are very crucial to develop the Padma river fisher’s livelihood conditions.

scholarly journals ‘Sometimes you are forced to play God…’: a qualitative study of healthcare worker experiences of using continuous positive airway pressure in newborn care in Kenya

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e034668
Author(s):  
Helen M Nabwera ◽  
Jemma L Wright ◽  
Manasi Patil ◽  
Fiona Dickinson ◽  
Pamela Godia ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Focus Group ◽  
Airway Pressure ◽  
Healthcare Workers ◽  
Positive Airway Pressure ◽  
Scale Up ◽  
Newborn Care ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Key Informant

​ObjectiveTo explore the experiences of using continuous positive airway pressure (CPAP) in newborn care among healthcare workers in Kenya, and to identify factors that would promote successful scale-up.​Design and settingA qualitative study using key informant interviews and focus group discussions, based at secondary and tertiary level hospitals in Kenya.​ParticipantsHealthcare workers in the newborn units providing CPAP.​Primary and secondary outcome measureFacilitators and barriers of CPAP use in newborn care in Kenya.​Results16 key informant interviews and 15 focus group discussions were conducted across 19 hospitals from September 2017 to February 2018. Main barriers reported were: (1) inadequate infrastructure to support the effective delivery of CPAP, (2) shortage of skilled staff rendering it difficult for the available staff to initiate or monitor infants on CPAP and (3) inadequate knowledge and training of staff that inhibited the safe care of infants on CPAP. Key facilitators reported were positive patient outcomes after CPAP use that increased staff confidence and partnership with caregivers in the management of newborns on CPAP. Healthcare workers in private/mission hospitals had more positive experiences of using CPAP in newborn care as the relevant support and infrastructure were available.​ConclusionCPAP use in newborn care is valued by healthcare workers in Kenya. However, we identified key challenges that threaten its safe use and sustainability. Further scale-up of CPAP in newborn care should ensure that staff members have ready access to optimal training on CPAP and that there are enough resources and infrastructure to support its use.EthicsThis study was approved through the appropriate ethics committees in Kenya and the UK (see in text) with written informed consent for each participant.

scholarly journals UNDERSTANDING LOW UPTAKE OF MASS TREATMENT FOR INTESTINAL SCHISTOSOMIASIS AMONG SCHOOL CHILDREN: A QUALITATIVE STUDY IN JINJA DISTRICT, UGANDA

2014 ◽  
Vol 47 (4) ◽  
pp. 505-520 ◽  
Author(s):  
SIMON MUHUMUZA ◽  
ANNETTE OLSEN ◽  
FRED NUWAHA ◽  
ANNE KATAHOIRE
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
School Children ◽  
Primary Schools ◽  
School Teachers ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
School Feeding ◽  
Intestinal Schistosomiasis ◽  
Key Informant

SummaryDespite attempts to control intestinal schistosomiasis through school-based mass drug administration (MDA) with praziquantel using school teachers in Uganda, less than 30% of the school children take the treatment in some areas. The aim of the study was to understand why the uptake of praziquantel among school children is low and to suggest strategies for improved uptake. This was a cross-sectional qualitative study in which 24 focus group discussions and 15 key informant interviews were conducted 2 months after MDA. The focus group discussions were held with school children in twelve primary schools and the key informant interviews were held with school teachers, sub-county health assistants and the District Vector Control Officer. The study shows that the low uptake of praziquantel among school children is a result of a complex interplay between individual, interpersonal, institutional, community and public policy factors. The individual and interpersonal factors underpinning the low uptake include inadequate information about schistosomiasis prevention, beliefs and attitudes in the community about treatment of schistosomiasis and shared concerns among children and teachers about the side-effects of praziquantel, especially when the drug is taken on an empty stomach. The institutional, policy and community factors include inadequate preparation and facilitation of teachers and the school feeding policy, which requires parents to take responsibility for providing their children with food while at school, yet many parents cannot meet the cost of a daily meal due to the prevailing poverty in the area. It is concluded that strategies to improve uptake of praziquantel among school children need to be multi-pronged addressing not only the preparation and motivation of teachers and health education for children, but also the economic and political aspects of drug distribution, including the school feeding policy.

scholarly journals From chaos to control – experiences of healthcare workers during the early phase of the COVID-19 pandemic: a focus group study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fredrik Rücker ◽  
Maria Hårdstedt ◽  
Sekai Chenai Mathabire Rücker ◽  
Emma Aspelin ◽  
Alexander Smirnoff ◽  
...  
Keyword(s):  
Content Analysis ◽  
Focus Group ◽  
Healthcare Workers ◽  
Qualitative Content Analysis ◽  
Working Environment ◽  
Infection Prevention And Control ◽  
Hospital Inpatient ◽  
Work Situation ◽  
Focus Group Discussions ◽  
Group Discussions

Abstract Background The Coronavirus disease 2019 (COVID-19) pandemic has caused overwhelming challenges to healthcare systems worldwide. Healthcare workers (HCWs) have faced particular challenges: being exposed to the coronavirus SARS-CoV-2 and caring for patients having a new and potentially life-threatening disease. The aim of this study was to explore how HCWs in the Swedish healthcare system perceived their work situation during the first phase of the COVID-19 pandemic in 2020. Methods Focus group discussions and interviews with HCWs were performed from June to October 2020 in one Swedish healthcare region. A purposeful sampling approach was used to select a variety of professions (physicians, nurses, nurse aides and cleaners) and workplaces (hospital inpatient wards, emergency department, nursing home and home care service). Qualitative content analysis was used for data analysis. Results In total, 51 HCWs participated in eight focus group discussions and one HCW participated in an individual interview. The content analysis identified two main categories: ‘Concerns about the risk of infection and transmission of infection to others’, and ‘Transition from chaos to managing in a new and challenging work situation’. The findings revealed how HCWs perceived working conditions, including experiences of fear for personal health, confusion and uncertainty regarding personal protective equipment and infection prevention and control (PPE/IPC), and fear of infecting others. Both fearful and appreciating attitudes were achieved from the surrounding community. Helpful strategies for transition from chaos to control were lifted i.e. present and supportive leadership, and finding comfort and strength in the working team. Both helplessness and meaningfulness were described when caring for COVID-19 patients. Conclusions This study provides unique insights into HCWs experiences of an extremely challenging work situation during the first phase of the COVID-19 pandemic, including feelings of stress and insecurity in a chaotic and hazardous working environment. But there is also mitigation of these challenges and even positive experiences including feelings of safety and meaningfulness. To enhance safety among HCWs in healthcare crises such as the COVID-19 pandemic, the findings highlight the importance of avoiding confusion about PPE/IPC, having a supportive healthcare leadership and ensuring accurate information provision about virus transmission to the public.

scholarly journals Levels of Equivalence in Interpreter-mediated Sermons from English into Luhya Varieties

2021 ◽  
Vol 3 (5) ◽  
pp. 26-30
Author(s):  
Annet Aromo Khachula ◽  
Lucy Mandillah ◽  
Bernard Angatia Mudogo
Keyword(s):  
Focus Group ◽  
Participant Observation ◽  
Relevance Theory ◽  
Target Language ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Source Language ◽  
Key Informant ◽  
Audio Recorder

Languages have different concepts for conveying meanings; hence there is a problem in finding equivalents between the source language (SL) and the target language (TL) in the process of interpreting. The transfer of meaning is identified as one of the basic problems in interpreting due to the absence of equivalence between two languages. This paper identifies levels of equivalence in the interpretation of selected sermons from English into Luhya varieties. Data was collected through key-informant interviews of interpreters, Focus Group Discussions by the congregants, and the researcher’s non-participant observation during church services. An audio recorder was used to collect the corpus for analysis which was later transcribed and translated for analysis. Relevance Theory by Sperber and Wilson (1986) provided the background for the discussion of the data. The findings revealed the following levels of equivalence in the interpretation of English sermons into Luhya varieties; one to many, one to part-of-one and nil equivalence. Further, it was also revealed that interpreters need to identify these three levels of equivalence in interpreting English sermons into Luhya varieties to determine the appropriate measures to counteract the situation.

scholarly journals Exploring barriers to the adoption and utilization of improved latrine facilities in rural Ethiopia: An Integrated Behavioral Model for Water, Sanitation and Hygiene (IBM-WASH) approach

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245289
Author(s):  
Aiggan Tamene ◽  
Abel Afework
Keyword(s):  
Focus Group ◽  
Data Gathering ◽  
Educational Status ◽  
Behavioral Model ◽  
Focus Group Discussions ◽  
Health Extension Workers ◽  
Group Discussions ◽  
Sanitation And Hygiene ◽  
Key Informant ◽  
Funding Opportunities

Background Even though evidence shows that access to and use of improved latrines is related to healthful families and the public, obstacles to the adoption and use of improved latrine facilities remain. Globally, not many inquiries appear to have been carried out to satisfactorily inform us regarding the multi-level barriers influencing the adoption and utilization of improved latrines facilities. Related studies in Ethiopia are even fewer. Methods Two qualitative data gathering methods, viz., key informant interviews and focus group discussions, were employed to collect data for this study. A total of fifteen focus group discussions were conducted with members of the community in the rural Wonago district of Ethiopia. Similarly, ten key informant interviews were conducted with water, sanitation, and hygiene officers, and health extension workers responsible for coordinating sanitation and hygiene activities. Open code software 4.03 was used for thematic analysis. Result Barriers to adoption and use of improved latrine facilities were categorized into Contextual factors (e.g. Gender, educational status, personal preference for using the field, limited space, population density, the status of land ownership), Psychosocial factors (Culture, beliefs, attitudes, and perceptions of minimal health threat from children's feces), and Technological factors (inconveniences in acquiring materials and cost of constructing a latrine). Conclusion There are a series of multi-leveled barriers to the sustained adoption and use of latrines. Providing funding opportunities for the underprivileged and offering training on the engineering skills of latrine construction at the community level based on the contextual soil circumstances could expand the latrine coverage and use. Similarly, taking into account the variability in motivations for adopting and using latrines among our study in Ethiopia and other studies, we implore public health experts to recognize behaviors and norms in their target communities in advance of implementing sanitation interventions.

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