scholarly journals Performance, Acceptability, and Usability of Respiratory Rate Timers and Pulse Oximeters When Used by Frontline Health Workers to Detect Symptoms of Pneumonia in Sub-Saharan Africa and Southeast Asia: Protocol for a Two-Phase, Multisite, Mixed-Methods Trial (Preprint)

2018 ◽  
Author(s):  
Kevin Baker ◽  
Mucunguzi Akasiima ◽  
Alexandra Wharton-Smith ◽  
Tedila Habte ◽  
Lena Matata ◽  
...  
Keyword(s):  
Southeast Asia ◽  
Respiratory Rate ◽  
Health Facility ◽  
Large Scale ◽  
Health Workers ◽  
Sub Saharan Africa ◽  
Routine Practice ◽  
Frontline Health Workers ◽  
Sub Saharan ◽  
Pulse Oximeters

BACKGROUND Pneumonia is one of the leading causes of death in children aged under 5 years in both sub-Saharan Africa and Southeast Asia. The current diagnostic criterion for pneumonia is based on the increased respiratory rate (RR) in children with cough or difficulty breathing. Low oxygen saturation, measured using pulse oximeters, is indicative of severe pneumonia. Health workers often find it difficult to accurately count the number of breaths, and the current RR counting devices are often difficult to use or unavailable. Nonetheless, improved counting devices and low-cost pulse oximeters are now available on the market. OBJECTIVE The objective of our study was to identify the most accurate, usable, and acceptable devices for the diagnosis of pneumonia symptoms by community health workers and first-level health facility workers or frontline health workers in resource-poor settings. METHODS This was a multicenter, prospective, two-stage, observational study to assess the performance and usability or acceptability of 9 potential diagnostic devices when used to detect symptoms of pneumonia in the hands of frontline health workers. Notably, 188 possible devices were ranked and scored, tested for suitability in a laboratory, and 5 pulse oximeters and 4 RR timers were evaluated for usability and performance by frontline health workers in hospital, health facility, and community settings. The performance was evaluated against 2 references over 3 months in Cambodia, Ethiopia, South Sudan, and Uganda. Furthermore, acceptability and usability was subsequently evaluated using both qualitative and quantitative methodologies in routine practice, over 3 months, in the 4 countries. RESULTS This project was funded in 2014, and data collection has been completed. Data analysis is currently under way, and the first results are expected to be submitted for publication in 2018. CONCLUSIONS This is the first large-scale evaluation of tools to detect symptoms of pneumonia at the community level. In addition, selecting an appropriate reference standard against which the devices were measured was challenging given the lack of existing standards and differences of opinions among experts. The findings from this study will help create a standardized and validated protocol for future studies and support further comparative testing of diagnostic devices in these settings. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12615000348550; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367306&isReview=true (Archived by Website at http://www.webcitation.org/72OcvgBcf) INTERNATIONAL REGISTERED REPOR RR1-10.2196/10191

Reducing Geographical Imbalances of Health Workers in Sub-Saharan Africa

2010 ◽  
Author(s):  
Christophe Lemiere ◽  
Christopher Herbst ◽  
Negda Jahanshahi ◽  
Ellen Smith ◽  
Agnest Souca
Keyword(s):  
Health Workers ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Precision Agriculture for Resource Use Efficiency in Smallholder Farming Systems in Sub-Saharan Africa: A Systematic Review

2021 ◽  
Vol 13 (3) ◽  
pp. 1158
Author(s):  
Cecilia M. Onyango ◽  
Justine M. Nyaga ◽  
Johanna Wetterlind ◽  
Mats Söderström ◽  
Kristin Piikki
Keyword(s):  
Resource Use ◽  
Precision Agriculture ◽  
Large Scale ◽  
English Language ◽  
Management Practices ◽  
Smallholder Farmers ◽  
Management Strategies ◽  
Sub Saharan Africa ◽  
Smallholder Farming ◽  
Sub Saharan

Opportunities exist for adoption of precision agriculture technologies in all parts of the world. The form of precision agriculture may vary from region to region depending on technologies available, knowledge levels and mindsets. The current review examined research articles in the English language on precision agriculture practices for increased productivity among smallholder farmers in Sub-Saharan Africa. A total of 7715 articles were retrieved and after screening 128 were reviewed. The results indicate that a number of precision agriculture technologies have been tested under SSA conditions and show promising results. The most promising precision agriculture technologies identified were the use of soil and plant sensors for nutrient and water management, as well as use of satellite imagery, GIS and crop-soil simulation models for site-specific management. These technologies have been shown to be crucial in attainment of appropriate management strategies in terms of efficiency and effectiveness of resource use in SSA. These technologies are important in supporting sustainable agricultural development. Most of these technologies are, however, at the experimental stage, with only South Africa having applied them mainly in large-scale commercial farms. It is concluded that increased precision in input and management practices among SSA smallholder farmers can significantly improve productivity even without extra use of inputs.

scholarly journals Neonatal care practices in Buikwe District, Uganda: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marte Bodil Roed ◽  
Ingunn Marie Stadskleiv Engebretsen ◽  
Robert Mangeni
Keyword(s):  
Health Workers ◽  
Post Partum ◽  
Newborn Care ◽  
Neonatal Care ◽  
Sub Saharan Africa ◽  
Cord Clamping ◽  
Care Practices ◽  
Sub Saharan ◽  
Skin To Skin ◽  
User Perspectives

Abstract Background Sub-Saharan Africa is the region with the highest neonatal mortality rate, with Uganda reporting 20 deaths per 1000 live births. The Uganda Clinical Guidelines (UCG) from 2016 have detailed descriptions on care for mothers and their newborns during pregnancy, delivery and the post-partum period. The objective of the study was to identify provider and user perspectives regarding the knowledge of and adherence to the UCG recommendations in aspects of delivery and newborn care, both in cases of normal as well as complicated births. Methods The study used qualitative methods with data collection from participant observations, interviews with key-informants and focus group discussions. Malterud’s Systematic Text Condensation (STC) was used for analysis. Results The study found low knowledge about the UCG among the health workers. Various discrepancies between performed hands-on-procedures and the UCG were found related to neonatal care practices, including low use of partograms, uncertainty around timing for cord clamping, routine oronasopharyngeal suction of newborns and inadequate implementation of skin-to-skin care. Conclusions Continued focus on systemic strategies for further implementation of the UCG is recommended.

scholarly journals Factors influencing access to and utilisation of youth-friendly sexual and reproductive health services in sub-Saharan Africa: a systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Lesley Rose Ninsiima ◽  
Isabel Kazanga Chiumia ◽  
Rawlance Ndejjo
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Health Workers ◽  
Sub Saharan Africa ◽  
Inclusion Criteria ◽  
Reproductive Health Services ◽  
Factors Influencing ◽  
Sub Saharan ◽  
Youth Friendly

Abstract Background Despite the global agreements on adolescents’ sexual and reproductive health and rights, access to and utilisation of these services among the youth/adolescents remain unsatisfactory in low- and middle-income countries which are a significant barrier to progress in this area. This review established factors influencing access and utilisation of youth-friendly sexual and reproductive health services (YFSRHS) among the youth in sub-Saharan Africa to inform programmatic interventions. Methodology A systematic review of studies published between January 2009 and April 2019 using PubMed, Web of Science, EMBASE, Medline, and Cochrane Library, and Google Scholar databases was conducted. Studies were screened based on the inclusion criteria of barriers and facilitators of implementation of YFSRHS, existing national policies on provision of YFSRHS, and youth’s perspectives on these services. Findings A total of 23,400 studies were identified through database search and additional 5 studies from other sources. After the full-text screening, 20 studies from 7 countries met the inclusion criteria and were included in the final review. Structural barriers were the negative attitude of health workers and their being unskilled and individual barriers included lack of knowledge among youth regarding YFSRHS. Facilitators of utilisation of the services were mostly structural in nature which included community outreaches, health education, and policy recommendations to improve implementation of the quality of health services and clinics for adolescents/youth to fit their needs and preferences. Conclusion Stakeholder interventions focusing on implementing YFSRHS should aim at intensive training of health workers and put in place quality implementation standard guidelines in clinics to offer services according to youth’s needs and preferences. In addition, educating the youth through community outreaches and health education programs for those in schools can facilitate utilisation and scale up of the service.

Intraclass Correlation Coefficients for Designing Cluster-Randomized Trials in Sub-Saharan Africa Education

2016 ◽  
Vol 40 (6) ◽  
pp. 500-525 ◽  
Author(s):  
Ben Kelcey ◽  
Zuchao Shen ◽  
Jessaca Spybrook
Keyword(s):  
Large Scale ◽  
Randomized Trials ◽  
Intraclass Correlation ◽  
Educational Interventions ◽  
Sub Saharan Africa ◽  
Design Stage ◽  
Education Outcomes ◽  
Randomized Studies ◽  
Sub Saharan ◽  
Variance Explained

Objective: Over the past two decades, the lack of reliable empirical evidence concerning the effectiveness of educational interventions has motivated a new wave of research in education in sub-Saharan Africa (and across most of the world) that focuses on impact evaluation through rigorous research designs such as experiments. Often these experiments draw on the random assignment of entire clusters, such as schools, to accommodate the multilevel structure of schooling and the theory of action underlying many school-based interventions. Planning effective and efficient school randomized studies, however, requires plausible values of the intraclass correlation coefficient (ICC) and the variance explained by covariates during the design stage. The purpose of this study was to improve the planning of two-level school-randomized studies in sub-Saharan Africa by providing empirical estimates of the ICC and the variance explained by covariates for education outcomes in 15 countries. Method: Our investigation drew on large-scale representative samples of sixth-grade students in 15 countries in sub-Saharan Africa and includes over 60,000 students across 2,500 schools. We examined two core education outcomes: standardized achievement in reading and mathematics. We estimated a series of two-level hierarchical linear models with students nested within schools to inform the design of two-level school-randomized trials. Results: The analyses suggested that outcomes were substantially clustered within schools but that the magnitude of the clustering varied considerably across countries. Similarly, the results indicated that covariance adjustment generally reduced clustering but that the prognostic value of such adjustment varied across countries.

Land conflicts and social differentiation in eastern Uganda

2017 ◽  
Vol 55 (3) ◽  
pp. 395-422 ◽  
Author(s):  
Matt Kandel
Keyword(s):  
Large Scale ◽  
Local Level ◽  
Sub Saharan Africa ◽  
Social Differentiation ◽  
Land Conflicts ◽  
Current Period ◽  
Post Conflict ◽  
Sub Saharan ◽  
Historical Developments ◽  
Eastern Uganda

ABSTRACTRising competition and conflict over land in rural sub-Saharan Africa continues to attract the attention of researchers. Recent work has especially focused on land governance, post-conflict restructuring of tenure relations, and large-scale land acquisitions. A less researched topic as of late, though one deserving of greater consideration, pertains to how social differentiation on the local-level shapes relations to land, and how these processes are rooted in specific historical developments. Drawing on fieldwork conducted in Teso sub-region of eastern Uganda, this paper analyses three specific land conflicts and situates them within a broad historical trajectory. I show how each dispute illuminates changes in class relations in Teso since the early 1990s. I argue that this current period of socioeconomic transformation, which includes the formation of a more clearly defined sub-regional middle class and elite, constitutes the most prominent period of social differentiation in Teso since the early 20th century.

scholarly journals Prospective assessment of the risk of obstructive sleep apnea in patients attending a tertiary health facility in Sub-Saharan Africa

2014 ◽  
Vol 17 ◽  
Author(s):  
Obianuju Beatrice Ozoh ◽  
Njideka Ulunma Okubadejo ◽  
Ayesha Omolara Akinkugbe ◽  
Oluwadamilola Omolara Ojo ◽  
Chinyere Nkiru Asoegwu ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Health Facility ◽  
Sub Saharan Africa ◽  
Obstructive Sleep ◽  
Prospective Assessment ◽  
Sub Saharan
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