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Sep 2024 DOI 10.14302/issn.2693-1176.ijgh-24-5215
Fiona AtimCorresponding author
Background The understanding of older persons with non-communicable diseases (NCDs) regarding health well-being is paramount and can translate to increased self-efficiency, independence, and enhanced well-being. However, little is known about older persons' understanding of the concept of health-related quality of life (HRQoL) in Uganda. The study explored perceptions and unveiled understanding of older persons with NCDs on HRQoL in central Uganda. Methods This exploratory qualitative study design involved 23 participants recruited from selected Primary healthcare facilities in Central Uganda. Thematic analysis using an inductive approach generated themes that informed the study's qualitative findings. Results The study highlighted the physical domain as a key component of HRQoL, encompassing holistic well-being, lifestyle modification, and financial stability. To promote well-being and support a healthy aging journey, it is essential to adopt a person-centered approach that aligns with the perceptions of older adults on HRQoL.
Feb 2024 DOI 10.14302/issn.2641-4538.jphi-23-4871
Mba-Oduwusi NnennaCorresponding author
Background This study evaluates the effectiveness of quality improvement (QI) strategies in mid-level private healthcare facilities in Lagos State, with a focus on the structural components, healthcare processes, and healthcare outcomes. Employing the Donabedian model, the research aims to comprehensively assess and enhance healthcare service quality in these facilities. Methods A before-and-after study design was employed, involving a baseline assessment of 321 health facilities and endline assessment of 239 healthcare facilities, and a subsequent 10 - 12-month quality improvement intervention. Data were collected using facility assessments, client exit interviews, and interviews with key stakeholders. The analysis included a before and after analysis of the structural components, healthcare processes, and healthcare outcomes. Results The study demonstrates positive outcomes in mid-level private healthcare facilities in Lagos State following quality improvement (QI) interventions. Structural components, including, improved equipment availability, and enhanced compliance with standards, showcased significant improvements. Renovations and heightened registration compliance further underscored commitment to regulatory standards. Challenges in service availability, particularly in family planning and laboratory services, were identified. Importantly, the implementation of a QI scoring system revealed an overall positive impact, with the average score rising from 69% to 74%, signifying enhanced quality across diverse priority areas. Implications These findings highlight the success of QI interventions in transforming healthcare processes and structural components. Despite notable progress, persistent challenges in specific services call for targeted interventions. The substantial increase in patient satisfaction and overall QI scores underscores the transformative potential of sustained efforts and tailored interventions in mid-level private healthcare facilities in Lagos State. Conclusions This research comprehensively evaluates the effectiveness of quality improvement strategies implemented in mid-level private healthcare facilities in Lagos State, Nigeria, utilizing the Donabedian Model as a guiding framework. The findings provide valuable insights for policy recommendations, with the aim of aligning healthcare services with the Donabedian model to ensure the provision of high-quality care in mid-level private healthcare facilities in Lagos State. This study contributes to the ongoing efforts to improve healthcare quality in Lagos State. Contribution to Knowledge The research provides empirical insights into the effectiveness of quality improvement strategies in mid-level private healthcare facilities, particularly within the context of Lagos State, Nigeria. It highlights the significance of addressing structural components, optimizing healthcare processes, and monitoring healthcare outcomes to enhance the quality of care provided, aligning with the Donabedian model. These findings offer a valuable basis for policy recommendations and further research efforts aimed at improving healthcare quality in similar settings.
Sep 2021 DOI 10.14302/issn.2690-4837.ijip-20-3944
Ababio Bannor PhilipCorresponding author
Health Facilities and Regulatory Agency, Ghana
Background Infection prevention and control system in healthcare facilities is essential in dealing with the spread of infectious diseases, especially during an outbreak period such as the COVID-19 pandemic. Objectives The study assessed the infection prevention and control (IPC) situation in selected healthcare facilities in the Greater Accra and Ashanti Regions of Ghana during the Covid-19 pandemic. Methods This was a multi-facility based cross-sectional study that used a monitoring tool of the Health Facilities Regulatory Agency (HeFRA) of Ghana to collect information on the IPC practices at the peak of the Covid-19 pandemic. Data was gathered from 501 healthcare facilities in the Greater Accra (335) and Ashanti (151) Regions. Descriptive, Chi-square, and multiple logistic regression were performed. All statistical analyses were considered significant at an alpha level of 0.05. Results 50.6% of health facilities were assessed as having good IPC systems in the overall assessment. The majority of the health facilities were evaluated as good on governance/leadership. Similarly, the majority (54.3 %)of the facilities had effective infectious waste management. The assessment levels of governance/leadership, management, quality assurance system, human resource, IPC equipment, and water management were all significantly associated with the adherence to good IPC systems. Conclusion IPC systems in most facilities were assessed as good, but some areas require critical attention to help prevent the spread of infections in healthcare facilities in Ghana. Support systems such as revised policy on IPC, governance/leadership, and infectious waste management infrastructure are needed to strengthen facilities with weak or poor IPC systems.
May 2026 DOI 10.14302/issn.2690-4837.ijip-26-6169
Ershova JuliaCorresponding author
Introduction The risk of exposure to M. tuberculosis among healthcare workers (HCW) remains a public health concern worldwide. During the COVID-19 pandemic, the Biomedical Research and Training Institute supported the Zimbabwe Ministry of Health and Child Care in strengthening infection prevention and control (IPC) practices in healthcare facilities (HCF), integrating tuberculosis (TB) infection control (TBIC) into the intervention strategy. We describe the impact of this intervention on TBIC practices and HCW screening outcomes. Methods The strategy, implemented from June 2021–September 2022, included IPC mentorship training, competency assessments, and use of a standardized risk assessment tool for progress monitoring. For the training purposes, the project developed eight practical problem-solving IPC modules including an occupational health component. Trained mentors conducted bi-monthly site support visits (SSV), used a checklist to track compliance, and assessed competencies of HCW at the targeted facilities. Facility-based risk assessments were conducted three times during the project implementation. Results During the intervention, 1,865 HCW from 105 facilities were trained. Availability and use of personal protective equipment improved by 49% and 42%, respectively. The proportion of HCF with designated areas for sputum collection increased by 43%. The proportion of HCF that screened HCW for TB increased by 42% with 3,761 HCW screened during the project period. Fourteen were diagnosed with TB and referred for care, resulting in 372 new cases per 100,000. Conclusion The implemented strategy of training, mentorship, and regular SSV strengthened TBIC measures, improved TB screening practices and case finding among HCW. Improving and maintaining practices is critical for effective TBIC.
Jul 2025 DOI 10.14302/issn.2577-137X.ji-25-5581
Muthee Waweru EdmondCorresponding author
Coronavirus Disease 2019 (COVID-19) placed significant pressure on global health systems, necessitating rapid and widespread immunization, especially among healthcare workers (HCWs). Despite being prioritized in immunization programs, variations in vaccine uptake among HCWs have been reported across different settings. This study aimed to investigate the predictors of COVID-19 vaccine uptake among HCWs in Kiambu County, Kenya. An analytical cross-sectional study design was employed, involving 112 HCWs sampled using stratified random sampling from Level 2 to Level 5 healthcare facilities. Data were collected through a pre-tested and validated 18-item questionnaire and analyzed using SPSS version 29.0. Statistical methods included descriptive analysis, chi-square tests, logistic regression, and ANOVA. The overall COVID-19 vaccine uptake was 88.9%. Significant predictors of uptake included age (p = 0.048), cadre (p = 0.015), and facility level (p = 0.031). Knowledge of COVID-19 vaccines emerged as the strongest predictor, with HCWs demonstrating good-to-excellent knowledge being 14.97 times more likely to be vaccinated (p < 0.001). Confidence in vaccine safety and effectiveness was also significantly associated with uptake (p < 0.001). Uptake was highest in Level 5 hospitals and lowest in dispensaries. The study reveals high vaccine uptake among HCWs in Kiambu County, but disparities persist due to individual and systemic factors. Strengthening vaccine education, institutional support, and deploying mobile vaccine education units in lower-level facilities could help close these gaps, offering practical strategies for improving HCW vaccine coverage in Kenya and other low- and middle-income countries.
Sep 2019 DOI 10.14302/issn.2641-4538.jphi-19-3005
Rutayisire ErigeneCorresponding author
Mount Kenya University, School of Health Sciences, Department of Public Health, P.O. Box 5826, Kigali Campus, Rwanda
Background Globally, about 10 to 25% of the volume of bio-medical waste from hospitals and healthcare institutions presents a serious health risks to patients, healthcare personnel, and anybody who comes in contact with it. The waste management practices in Rwanda healthcare facilities are poor and need improvement. Objectives To assess the knowledge and practices regarding bio-medical waste management among healthcare personnel at Kabgayi district hospital in Southern Province of Rwanda. Materials and Methods A cross-sectional study design was conducted. A total of 200 healthcare personnel were selected randomly out of 400 target population including doctors, nurses, social workers, and cleaners. Structured questionnaire was used to collect data. Descriptive analysis using frequency and proportions were used. Chi-Square test was used to determine the association between the variables and level of significance was set at p ≤ 0.05. Results The study found that about half (49.0%) of healthcare personnel had good knowledge about waste management. We found that the majority of healthcare personel 133(66.5%) had poor practices towards bio-medical waste management. The factors associated with good practice were better knowledge on bio-medical waste management (p=0.013) and older age group (p=0.001). Conclusion/Recommendations The level of in both knowledge and practice towards bio-medical waste management among healthcare personnel was low. Continuing education and training programmes and short courses on bio-medical waste management should be carried out to improve the knowledge and practices towards bio-medical waste management among healthcare personnel.
Feb 2018 DOI 10.14302/issn.2379-7835.ijn-17-1872
Agaba EdgarCorresponding author
FTF Nutrition Innovation Lab, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
Objective: To elaborate on the procedures undertaken to establish blood draws and cold chain for nutrition assessments. Setting: A total of 5,044 birth cohort households were enrolled and assessed using household questionnaires, anthropometry, and blood sampling to assess nutritional issues and exposures to environmental contaminants. The challenge was to obtain, transport, process, store, and analyze tens of thousands of serum samples obtained in sites that were often difficult to reach. Approach: Before enrollment began, 24 healthcare facilities in the North and Southwest of Uganda were assessed for suitability as local nodes for processing and storage. Equipment needs included functional centrifuges, refrigeration, ice machines, and -20oC freezers. Other important physical infrastructure included the presence of backup power (generator or solar generated) in the event of electricity failure. Once samples were obtained, they were transported within 5 hours to the facility laboratories, where serum was separated and aliquoted into properly labelled storage tubes and then frozen. Relevant Changes: At community level, our team visited households or small group of household members close to their homes to reduce on travel time hence contributed to high retention rates. Our immediate testing for anemia and malaria results benefited enrollees and enhanced community acceptance. By using Village Health Teams (VHTs), we could accommodate household preferences for the timing of sample collection. Our engagement with phlebotomists transformed their role from a simple service into active team members. Lessons Learned: Our first lesson was that in our setting, the success of this nutrition biological sampling system required community engagement and acceptance. By combining an immediately actionable set of tests (for anemia and malaria), and visiting cohort households, we greatly enhanced the success of the system.
Jun 2017 DOI 10.14302/issn.2474-7785.jarh-16-1354
Frumence GastoCorresponding author
Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Tanzania.
Tanzania is among the developing countries experiencing rapid growth of an ageing population, which has an implication in healthcare expenditure especially in resource poor settings where majority of elderly people cannot afford to pay for the cost of accessing health services. The country has developed the Tanzania National Health Policy (2007) and National Ageing Policy (2003), which, among other things, recognize the importance of having a healthcare system that provides free basic services to the vulnerable elderly population. This study aimed at exploring health service providers’ and managers’ perspectives on the factors facilitating or prohibiting access to health services among elderly people in Tanzania. The study adopted a qualitative approach and data were collected using semi-structured interviews. A total of 24 in-depth interviews were conducted with district healthcare managers, heads of public healthcare facilities, and health service providers. The data generated were analysed for themes and patterns. The results show that Tanzania’s healthcare system has made some efforts to implement the national exemption policy to ensure better access to health services for the elderly. Some of these efforts include: having in place a system to identify and exempt elderly people from paying for health services and giving them special priority during treatment. However, there are some barriers hindering elderly people’s access to health services. Among others include: lack of specific consultation rooms and doctors for serving the elderly, and lack of sufficient drugs and other medical equipment in most government-owned healthcare facilities. In summary, the healthcare system has created a good environment for the implementation of exemption policy aiming at enhancing accessibility of health services among the elderly population in the country. However, such environment cannot function effectively without addressing the identified barriers. It is recommended that the government should allocate adequate human and non-human resources to the healthcare system to enable it to function effectively, including the provision of health services to the elderly.