An Iconic Pillar of Hope in a Rural Township: The Emergence, Growth and Development of AIC Kapsowar Mission Hospital

The article is about the emergence, growth and development of AIC Kapsowar Mission Hospital, the hospital that was central to the development of Kapsowar town since its establishment in 1934. The hospital was so iconic in the sense that it opened Marakwet District to the rest of the world. The hospital created employment opportunities for Kenyans who flocked the town in their thousands in search of jobs. Kapsowar which was once a frontier town transformed into a medical town making it display many signs of prosperity. However, it was not easy for the Africans living in Kapsowar to let go of their lands. They had to fight back and protect what according to them was given to them by their deity ASIS. Among the Marakwet, land was communally owned and its use was decided by the community elders. Individuals did not own land as the sole owners but the land was in the custody of clans. This factor made it very hard for the missionaries to acquire land to establish the mission hospital when they first arrived at the place. The locals were only convinced after a series of successful surgeries were conducted by the mission doctors and that was when they allowed them to settle in their land. That move marked the beginning of a new civilisation among the Marakwet. Many women began to visit the hospital for child delivery, and child mortality rate reduced drastically owing to the good works of the mission doctors. All the good things brought about by the mission Hospital including the development of the town, employment opportunities, improved infrastructure among others notwithstanding, challenges never seized to hit the Mission hospital and the latest challenge was posed by the outbreak of the novel corona virus in 2020 causing a lot of fear and panic to both the doctors and the patients.

Management of prolonged first stage of labour in a low-resource setting: lessons learnt from rural Malawi

Background Caesarean sections without medical indication cause substantial maternal and perinatal ill-health, particularly in low-income countries where surgery is often less safe. In presence of adequate labour monitoring and by appropriate use of evidence-based interventions for prolonged first stage of labour, unnecessary caesarean sections can be avoided. We aim to describe the incidence of prolonged first stage of labour and the use of amniotomy and augmentation with oxytocin in a low-resource setting in Malawi. Methods Retrospective analysis of medical records and partographs of all women who gave birth in 2015 and 2016 in a rural mission hospital in Malawi. Primary outcomes were incidence of prolonged first stage of labour based on partograph tracings, caesarean section indications and utilization of amniotomy and oxytocin augmentation. Results Out of 3246 women who gave birth in the study period, 178 (5.2%) crossed the action line in the first stage of labour, of whom 21 (11.8%) received oxytocin to augment labour. In total, 645 women gave birth by caesarean section, of whom 241 (37.4%) with an indication ‘prolonged first stage of labour’. Only 113 (46.9%) of them crossed the action line and in 71/241 (29.5%) membranes were still intact at the start of caesarean section. Excluding the 60 women with prior caesarean sections, 14/181 (7.7%) received oxytocin prior to caesarean section for augmentation of labour. Conclusion The diagnosis prolonged first stage of labour was often made without being evident from labour tracings and two basic obstetric interventions to prevent caesarean section, amniotomy and labour augmentation with oxytocin, were underused.

Perhitungan Kebutuhan Tenaga Medis Berdasarkan Workload Indicators of Staffing Need (WISN): Studi Kasus di Rs A, Rs B, Rs C, Rs D

Indicators showing how needs of steam in health facilities based on workload , so that the location / relocation would be easier and rational known as the workload indicators of staffing need ( wisn ) .Meeting the needs of of human resources in hospital was a the tone for hospital management .The management of the hospital have to are able to count needs human resources precisely on demand in each service unitMeeting the needs of excess of human resources in the hospital give a consequence labor costs high and gives rise to one of inefficiency of in financial management at the hospital .Lack of meeting the needs of human resources hospital give the effect of the workloads high to health workers and led the decline in of satisfaction with patient care , increase desire move work and diminishes the quality of patient safety. The number of human resources varied at every hospital in the city of medan.To achieve, vision and mission hospital skill and the ability of human resources needed to solve all problems is.From observation carried out in several hospitals in the city of medan, had shown an imperfection in planning the health workers and have not managed in a professional based on the workloads to the needs of human resources in every hospital. As a result , the available health numbers of workers have not been in accordance with a load of work and the real needs of in the field .The purpose of this research to analyze the needs of paramedics by counting discrepancy between the number of ideal paramedics ( skilled manpower including nurses and energy pharmacy ) by the fact that is said wisn difference and counting the workloads .The results of the study stated that the needs of labor is in accordance with the workloads is in some hospitals.