Focal Persons Research Articles

Quality Assurance Practices Of Higher Education Institutions In China: Case Analysis

This case study described the quality assurance practices andthe challenges faced by Higher Education Institutions inGuangxi Province, China. The study was carried out withtwelve (12) quality assurance focal persons from each publicUniversity in Guangxi, China. These focal persons have beeninvolved in the practice of quality assurance for at least threeyears. Moreover, findings reveal that the Teaching QualityMonitoring Department takes charge of the planning of theprograms, assisting colleges, and assessing and monitoring ofprograms subjected for accreditation and teaching qualityassurance. However, part of its challenges are limitedinvolvement of other professional institutions in the qualityassurance evaluation, overlapping duties, lack of trainingamong quality assurance staff, the development of teachingquality assurance scheme is incomplete, and utilization ofTeaching quality monitoring department is inadequate.Implications and recommendations were established toimprove quality assurance practices from the results.

Intimate partner violence and health system response in Nekemte town, Western Oromia, Ethiopia, 2019: A cross-sectional study.

Objectives:To assess intimate partner violence and health system response among married women.Methods:A mixed method of quantitative and qualitative cross-sectional community-based study was conducted from August to September 2019. Later than ethical clearance, the data were collected using a pretested structured questionnaire adapted from the literature. Study participants were selected using systematic random sampling. Data collected is entered into EpiData and then exported to SPSS version 25 for analysis. The odds ratio with their 95% confidence interval was calculated. Variables with p-value < 0.25 in bivariate analysis were entered into multivariate logistic regression. Statistical significance was declared if the p-value was <0.05.Results:From all 770 sampled participants in Nekemte town, 730 married women participated in this study, yielding a response rate of 94.8%. The prevalence of intimate partner violence was 55.9%. From this study finding, no intimate partner violence screening was done for 678 (92.9%) respondents who visited health facilities. Educational status of women, partner being illiterate, occupational status being merchant, and daily laborer were associated with intimate partner violence with (adjusted odds ratio = 1.73, 95% confidence interval = (1.05–2.83)), (adjusted odds ratio = 5.94, 95% confidence interval = (1.25–12.23)), (adjusted odds ratio = 4.41, 95% confidence interval = (1.49–13.01)), and (adjusted odds ratio = 3.74, 95% confidence interval = (1.33–10.50)), respectively, were factors found to be associated with intimate partner violence Nekemte town. One of the study participants whose age was 36 years responded that, “our culture approves men’s superiority; we accept intimate partner violence as part of our marital life.” There is an assigned focal person and training was given to them, but screening of intimate partner violence has not started yet and it was not integrated into any maternal service in our health center.Conclusion:This study shows that in excess of half of women experience intimate partner violence. Educational status, occupation and violence seen during childhood were the factors that contributed to intimate partner violence. Educating women and partners, integrating, and strengthening a health service are important.

Factors Associated with Uptake of Immunizations for Vaccine-Preventable Childhood Diseases in a Peri-Urban Settlement; A Case Study of Nansana Municipality, Uganda

Immunization uptake for childhood vaccine-preventable diseases remains low in urban areas of Uganda, leading to repeated outbreaks of diseases like measles, despite easy communication and accessibility to services. The objectives of this study were to establish immunization coverage and to identify the factors that affect the uptake of immunization among the children aged 10 – 23 months in Nansana Municipality, Wakiso District, Uganda. This was a cross-sectional mixed methods study, utilizing both qualitative and quantitative approaches. Assessment of immunization uptake was carried out on 344 parents/guardians of children aged 10–23 months, using simple random sampling on pre-tested structured questionnaires. Data was analyzed using SPSS 20.0 software. Additionally, 2 focus group discussions with parents and key informant interviews with immunization focal persons were also conducted. Immunization coverage was found to be 90.4% for BCG, 89.3% for Penta1, 80.7% for Penta2, 72.5% for Penta3 and 73.9% for measles1. Availability of vaccines (AOR= 33, 95% CI, 1.44 – 792, p=0.03), accessibility to immunization services (AOR = 32, 95% CI, 2.0 – 513, p=0.01) and communication between the parents and health workers about the return dates (AOR = 0.03, 95% CI, 0.01 – 0.83, p=0.03), were the factors that were independently associated with immunization uptake. The coverage rates were higher than the national average, with the health care service-related factors identified as being critical for improving immunization uptake. There is a need for improved vaccine supply and communication about immunization services, which should be designed considering the local context in collaboration with slum-dwelling communities.

Barriers to Treatment Compliance of Directly Observed Treatment Shortcourse among Pulmunary Tuberculosis Patients.

Treatment compliance is an important aspect for tuberculosis prevention and control. Poor compliance to treatment can lead to the development of drug-resistant tuberculosis. The aim of this study was to explore the factors affecting treatment compliance for tuberculosis patients. Facility based unmatched case control study was done among the forty non-compliance and eighty compliance pulmonary tuberculosis patients registered at selected directly observed treatment short-course centers of six districts. Data were collected using in-depth interview guideline with the tuberculosis focal person and Focus Group Discussion with tuberculosis patients. A total of 120 respondents, 40 cases and 80 controls were enrolled in the study. About 72.5% of the cases and 56.2% of the controls were male. Five significant independent risk factors for non-compliance to TB treatment were identified. The qualitative session confirmed geographical barriers, inaccessibility to health facility, economic barriers, difficulty in convincing people, knowledge about Directly observed treatment shortcourse program, longer medication period, migration and stigma as a major barrier for treatment compliance. Wider ranges of barriers are prevalent in context of tuberculosis treatment pathway and outcome. Knowledge of the tuberculosis patients and attitude of the family plays a vital role in treatment compliance. Directly observed treatment shortcourse playing tremendous role to ensure treatment adherence has been identified as major barrier to adherence as well. Enablers of adherence need to be emphasized to address the barriers.

Determinants of viral load non-suppression among adolescents in Mbale District, Eastern Rural Uganda

BackgroundAdolescents are lagging behind in the “third 95” objective of the Joint United Nations Program on HIV/AIDS requiring 95% of individuals on antiretroviral therapy (ART) to have viral load (VL) suppression. This study aimed to describe factors associated with viral non-suppression among adolescents in Mbale district, Uganda.MethodsWe conducted a retrospective review of routinely collected HIV programme records. Data such as age, education, ART Regimen, ART duration, WHO Clinical stage, comorbidities, etc., were extracted from medical records for the period January 2018 to December 2018. Descriptive analysis was done for continuous variables using means and frequencies to describe study sample characteristics, and to determine the prevalence of outcome variables. We used logistic regression to assess factors associated with VL non-suppression among adolescents.ResultsThe analysis included 567 HIV-infected adolescents, with 300 (52.9%) aged between 13 to 15 years, 335 (59.1%) female, and mean age of 15.6 years (interquartile range [IQR] 13.5–17.8. VL non-suppression was 31.4% (178/567). Male sex (AOR = 1.78, 95% CI 1.06, 2.99; p < 0.01), age 16–19 years (AOR = 1.78, 95% CI 1.06, 2.99; p < 0.05), No formal education (AOR = 3.67, 95% CI 1.48–9.09; p < 0.01), primary education (AOR = 2.23, 95% CI 1.05–2.32; p < 0.01), ART duration of > 12 months to 5 years (AOR = 3.20, 95% CI 1.31–7.82; p < 0.05), ART duration > 5 years (AOR = 3.47, 95% CI 1.39– 8.66; p < 0.01), WHO Clinical Stage II (AOR = 0.48, 95% CI: 0.28, 0.82; p < 0.01), second-line ART regimen (AOR = 2.38, 95% CI 1.53–3.72; p < 0.001) and comorbidities (AOR = 3.28, 95% CI 1.20–9.00; p < 0.05) were significantly associated with viral non-suppression.ConclusionsVL non-suppression among adolescents was almost comparable to the national average. VL non-suppression was associated with being male, age 16–19 years, education level, duration on ART therapy, WHO Clinical Staging II, second-line ART regimen, and presence of comorbidities. Adolescent-friendly strategies to improve VL suppression e.g. peer involvement, VL focal persons to identify and actively follow-up non-suppressed adolescents, patient education on VL suppression and demand creation for ART are needed, especially for newly-initiated adolescents and adolescents on ART for protracted periods, to foster attainment of the UNAIDS 95–95–95 targets.

Unsuppressed viral load after intensive adherence counselling in rural eastern Uganda; a case of Kamuli district, Uganda

BackgroundThe East Central (EC) region of Uganda has the least viral suppression rate despite having a relatively low prevalence of human immunodeficiency virus (HIV). Although the viral suppression rate in Kamuli district is higher than that observed in some of the districts in the region, the district has one of the largest populations of people living with HIV (PLHIV). We sought to examine the factors associated with viral suppression after the provision of intensive adherence counselling (IAC) among PLHIV in the district.MethodsWe reviewed records of PLHIV and used them to construct a retrospective cohort of patients that started and completed IAC during January – December 2019 at three high volume HIV treatment facilities in Kamuli district. We also conducted key informant interviews of focal persons at the study sites. We summarized the data descriptively, tested differences in the outcome (viral suppression after IAC) using chi-square and t-tests, and established independently associated factors using log-binomial regression analysis with robust standard errors at 5% statistical significance level using STATA version 15.ResultsWe reviewed 283 records of PLHIV. The mean age of the participants was 35.06 (SD 18.36) years. The majority of the participants were female (56.89%, 161/283). The viral suppression rate after IAC was 74.20% (210/283). The most frequent barriers to ART adherence reported were forgetfulness 166 (58.66%) and changes in the daily routine 130 (45.94). At multivariable analysis, participants that had a pre-IAC viral load that was greater than 2000 copies/ml [adjusted Prevalence Risk Ratio (aPRR)= 0.81 (0.70 - 0.93), p=0.002] and those that had a previous history of viral load un-suppression [aPRR= 0.79 (0.66 - 0.94), p=0.007] were less likely to achieve a suppressed viral load after IAC. ART drug shortages were rare, ART clinic working hours were convenient for clients and ART clinic staff received training in IAC.ConclusionDespite the consistency in drug availability, counselling training, flexible and frequent ART clinic days, the viral suppression rate after IAC did not meet recommended targets. A high viral load before IAC and a viral rebound were independently associated with having an unsuppressed viral load after IAC. IAC alone may not be enough to achieve viral suppression among PLHIV. To improve viral suppression rates after IAC, other complementary services should be paired with IAC.

“Those who eat from one pot”: Constructing household as a social category in a cash transfer programme in Ghana

AbstractSocial categorisation is situated at the core of any modern attempt to govern or intervene in the social world. This paper investigates the construction of the concept of household in Ghana's official social statistics and its implications when implemented in the internationally co‐organised cash transfer programme, the Livelihood Empowerment Against Poverty (LEAP) programme. The study is based on various literature, conceptual analysis and interviews with key stakeholders, including the LEAP programme authorities and focal persons in a local community. The findings indicate discrepancies between the category of household and the cultural setting it is meant to represent in the Ghanaian context.

OH MY GAD! A CASE STUDY ON THE IMPLEMENTATION OF GENDER AND DEVELOPMENT AMONG PRIVATE HIGHER EDUCATION INSTITUTIONS (HEIS)

The advancement towards gender equality had been made clear through the insertion of Gender and Development among the UNDP Goals. At the school level, certain measures had been implemented to answer the call for gender and development. This case study will examine the status of implementation of Gender and Development among private Higher Education Institutions (HEIs) in Tacloban City, Philippines, based on the mandated CHED Memorandum No. 1 s. 2015 on the Implementation of GAD among Higher Learning Institutions. With GAD focal persons as the primary participants, exhaustive data was gathered and analyzed. GAD programs, activities, and projects, program planning, implementation, and evaluation, problems encountered in the implementation, differing school policies were the emerging themes from the data. The study concluded that private HEIs must recognize a sustainable and meaningful GAD program, activities, and projects to be implemented in their respective schools. Keywords: Gender and development; Program implementation; Private HEIs; Philippines

Home-based care practices and experiences influencing health-seeking behaviour among caregivers of children diagnosed with pneumonia in Endebess Sub-County, Kenya

Background Pneumonia continues to be the second leading cause of both morbidity and mortality in children under five years in Kenya. In part, the high burden of the disease arises from delay and inappropriate health-seeking by caregivers. Caregivers delay seeking care at health facilities due to the administration of home-based remedies. Some home remedies may lead to a prolonged hospital stay and, in many cases, result in death. However, little is known about the home-based care practices for pneumonia. This study sought to examine predictors of home-based care practices and pneumonia experiences that influence health-seeking behaviour in Endebess Sub-County, Kenya. Methods A cross-sectional study involving 273 caregivers accompanied by the qualitative study in the 24 health personnel was conducted from May to August, 2019. Questionnaires and key informant interview guides were used to collect data. Simple random sampling was used to select caregivers visiting the seven public health facilities in the sub-county. Quantitative data were analysed using SPSS Version 22 at a statistical significance of P≤ 0.05, whereas qualitative data were analysed by searching for emerging themes on home-based care practices and experiences shared by caregivers. Results Timely health-seeking behaviour was associated with available home care remedies (P=0.035) and knowledge of pneumonia symptoms (P&lt;0.001). Caregivers with pneumonia experience from the house-hold (P&lt;0.001; odds ratio, OR=5.73, 95% confidence interval, CI=2.787-11.799) and from other community members (P&lt;0.001; OR=6.49, 95% CI=3.71-11.34) were more likely to visit the hospital on time relative to those without experience. Conclusions To improve health-seeking behaviour among caregivers, there is a need for health facility focal persons to incorporate health education and behaviour change communication interventions on pneumonia management at the community and hospital visits as caregivers seek antenatal and postnatal care services.

Exploring drivers and barriers to the utilization of community client-led ART delivery model in South-Western Uganda: patients\u2019 and health workers\u2019 experiences

BackgroundIn an effort to accommodate the growing number of HIV clients, improve retention in care and reduce health care burden, the differentiated service delivery (DSD) models were introduced in 2014. One such model, Community Client-Led ART Delivery (CCLAD) was rolled out in Uganda in 2017. The extent of utilization of this model has not been fully studied. The aim of the study was to explore the patients’ and health workers’ experiences on the utilization of CCLAD model at Bwizibwera Health Centre IV, south western Uganda.MethodsThis was a descriptive study employing qualitative methods. The study had 68 purposively selected participants who participated in 10 focus group discussions with HIV clients enrolled in CCLAD; 10 in-depth interviews with HIV clients not enrolled in CCLAD and 6 in-depth interviews with the health workers. Key informant interviews were held with the 2 focal persons for DSD. The discussions and interviews were audio recorded, transcribed verbatim and then translated. Both deductive and inductive approaches were employed to analyse the data using in NVivo software.ResultsPatients’ and health workers’ experiences in this study were categorized as drivers and barriers to the utilization of the CCLAD model. The main drivers for utilization of this model at different levels were: individual (reduced costs, living positively with HIV, improved patient self-management), community (peer support and contextual factors) and health system (reduced patient congestion at the health centre, caring health workers as well as CCLAD sensitization by health workers). However, significant barriers to the utilization of this community-based model were: individual (personal values and preferences, lack of commitment of CCLAD group members), community (stigma, gender bias) and health system (frequent drug stockouts, certain implementation challenges, fluctuating implementing partner priorities, shortage of trained health workers and insufficient health education by health workers).ConclusionBased on our findings the CCLAD model is meeting the objectives set out by Differentiated Service Delivery for HIV care and treatment. Notwithstanding the benefits, challenges remain which call on the Ministry of Health and other implementing partners to address these hindrances to facilitate the scalability, sustainability and the realisation of the full-range of benefits that the model presents.

Combined assessment of tuberculosis case notification rate and infection control at health facilities of Dale districts, Sidama Zone, Southern Ethiopia.

BackgroundMycobacterium tuberculosis (TB) is the deadliest disease that claims millions of deaths globally. Ethiopia is among the countries heavily hit by the disaster. Despite the effective directly observed treatment and TB infection control (TBIC) measures provided by the world health organization (WHO), the rate of new cases increased daily throughout the country. Healthcare workers (HCWs) are at highest risk serving without having the necessary facility in place while overcrowding of patients exacerbated TB transmission. The study aimed to assess TBIC implementation and analyze case notification rate (CNR) of smear-positive pulmonary TB in the selected health facilities at Dale district, Sidama Zone, Southern Ethiopia.MethodsSeven health care facilities have been visited in the study area and smear-positive pulmonary TB notification rate was determined retrospectively during the years 2012 to 2014. Data on smear positive test results and demographic characteristics were collected from the TB unit registries. A structured questionnaire, facility survey, and observation checklists were used to assess the presence of TBIC plans at the health care facilities.ResultsThe overall case notification rate of smear-positive pulmonary tuberculosis was 5.3% among all 7696 TB suspected patients. The odds of being diagnosed with smear-positive TB were 24% more in males than in females (adj OR = 1.24, 95% CI: (1.22, 1.55). Moreover, in the study area, only 28% of the facilities have been practiced TB infection control and 71% of the facilities assigned a focal person for the TBIC plan. The implementation of environmental control measures in the facilities was ranged between 16–83%. N95 particulate respirators were found only in 14% of the facilities.ConclusionTB CNR in Dale district was low. Moreover, implementations of TBIC in Dale district health facilities were poor when the survey was done. Hence, urgent measures should be taken to reverse the burden of TB.

The Potential of Digital Data Collection Tools for Long-lasting Insecticide-Treated Net Mass Campaigns in Nigeria: Formative Study.

BackgroundNigeria has the world’s largest malaria burden, accounting for 27% of the world’s malaria cases and 23% of malaria mortality globally. This formative study describes the operational process of the mass distribution of long-lasting insecticide-treated nets (LLINs) during a campaign program in Nigeria.ObjectiveThis study aims to assess whether and how digital data collection and management tools can change current practices and help resolve major implementation issues.MethodsQualitative data on the technical features and operational processes of paper-based and information and communication technology (ICT)–based systems in the Edo and Kwara states from June 2 to 30, 2017, were collected on the basis of documented operation manuals, field observations, and informant interviews. During the LLIN campaign in Edo State, we recruited 6 local government area focal persons and monitors and documented daily review meetings during household mobilization (9 days) and net distribution (5 days) to understand the major program implementation issues associated with the following three aspects: logistic issues, technical issues, and demand creation. Each issue was categorized according to the expected degree (low, mid, and high) of change by the ICT system.ResultsThe net campaign started with microplanning and training, followed by a month-long implementation process, which included household mobilization, net movement, net distribution, and end process monitoring. The ICT system can improve management and oversight issues related to data reporting and processes through user-centered interface design, built-in data quality control logic flow or algorithms, and workflow automation. These often require more than 50% of staff time and effort in the current paper-based practice. Compared with the current paper-based system, the real-time system is expected to reduce the time to payment compensation for health workers by about 20 days and produce summary campaign statistics for at least 20 to 30 days.ConclusionsThe ICT system can facilitate the measurement of population coverage beyond program coverage during an LLIN campaign with greater data reliability and timeliness, which are often compromised due to the limited workforce capacity in a paper-based system.

EVALUATION OF DISABILITY MAINSTREAMING STATUS IN SELECTED PUBLIC HIGH SCHOOLS AND EMPLOYMENT INSTITUTIONS IN LIBERIA

Purpose: The purpose of the study sought to evaluate the status of disability mainstreaming policy in education in selected public high schools and public employment institutions in Liberia.&#x0D; Materials and Methods: The research design incorporates both quantitative and qualitative methods. Purposive sampling was used to select 125 respondents from students with disabilities, principals, human resource directors, employees with disabilities from public employment institutions and representatives from Persons with disabilities organizations. Quantitative data was collected through electronic data collection tools (Kobo/ Survey CTO) and transferred in Excel spreadsheets for descriptive analysis and comparison. Qualitative data was collected through key informant interviews and analyzed according to themes.&#x0D; Results: The study established that although there are disability mainstreaming policies at public high schools and employment institutions there is limited awareness and understanding of these policies among students and employees with disabilities. Moreover, there was no defined disability mainstreaming strategies to serve as a benchmark to determine the success or failure of implementation. Findings also showed that persons with disabilities were still finding it difficult to secure employment since the 4% disability quota mandated by the government to enhance the employability of persons with disabilities is not adhered to by government institutions. Further analysis indicated that the perception of principals and human resource officers can reinforce barriers to mainstreaming disability in public high schools and employment institutions. The study also found that limited budgetary allocation for disability mainstreaming activities, limited awareness of disability mainstreaming, lack of coordination among various implementing agencies, lack of teacher training in disability mainstreaming pedagogy and unavailability of training materials for teachers and students for inclusive education were among factors contributing to gaps in disability mainstreaming in public high schools and employment institutions.&#x0D; Unique contribution to theory, practice and policy: The study recommends that the Ministry of Gender, Children and Social Protection (MGCSP) which coordinates all disability mainstreaming activities along with the National Commission on Disability create more public awareness on disability in all public entities. Government should provide funding’s to public high schools and employment institutions to enable them to implement the disability mainstreaming policies. Disability focal persons should also be assigned to these institutions to coordinate and monitor implementation.

The Genesis and Performance of Gender Focal Person Structures in Rwanda and Uganda National Agricultural Organisations: A Critique

Gender Focal Persons (GFPs) are commonly recruited by organisations as part of institutional efforts to mainstream gender. Despite their wide usage, these structures often struggle to achieve the intended goals. The underlying factors that explain their limited success are not well understood; yet, this would inform strategies for institutionalising gender in research institutions. This paper traces the genesis and operationalisation of the gender focal person structures in Rwanda and Uganda national agricultural research organisations, to unearth factors influencing their performance. Results presented are based on document reviews and qualitative interviews with scientists, managers, and GFPs in the two organisations. We found that the GFPs hinged on individuals and donors, and operated in an ad hoc manner without streamlined procedures. The structures were not embedded in institutional frameworks, hence their low visibility within the organisations. They were characterized by informality, voluntarism, unclear terms of reference, and accountability frameworks. We conclude that the ineffective performance of the GFPs in both organisations is explained by the informal approach used to establish, operationalise, and nurture them. Institutionalising the structure would require that the pioneering champions and donors successfully negotiate the embedding of GFPs into the mainstream; eventually, guaranteeing allocation of adequate human and financial resources from national budgets, as well as the establishment of accountability systems.

344Impact of a disease surveillance training program on knowledge of health workers in South-western Nigeria

Abstract Background Poor knowledge of frontline health workers on integrated disease surveillance and response (IDSR) is a cause of poor surveillance reporting performance in Nigeria. To improve the knowledge of frontline health workers, they are trained annually, together with the surveillance focal persons, on IDSR. This study determined the immediate impact of one of such trainings on IDSR knowledge of the trainees. Methods A quasi experimental study, involving a pre- and post-test questionnaire survey, was conducted among 205 surveillance training participants in Ondo State, Nigeria. Data was analysed using descriptive and inferential statistics at 5% statistical level of significance. Results Mean age was 39.4 ± 9.1 years, 77.6% were females and 51.7% were clinicians. Although most (89.3%) were aware of IDSR, only 48.3 % and 43.9% had been involved in IDSR implementation and training respectively. Overall, the mean pre-test IDSR knowledge score was 12.43. This increased significantly to 18.63 in the post-test (p &amp;lt; 0.001). Sex (p = 0.003) and previous involvement in IDSR implementation (p = 0.043) were associated with improved knowledge score. Females were significantly more likely to have an improved knowledge score [β = 1.876 (CI: 0.305-3.447)]. Conclusions IDSR trainings has the capacity to improve surveillance knowledge in the short-term with a possible resultant improvement in disease prevention and control in the long-term. Key messages Training on IDSR should be conducted regularly for all health care workers and special attention should be given to male health workers.

Setbacks to the Implementation of the Nationally Appropriate Mitigation Actions: Case Studies of the Namas of Ethiopia, Georgia and Indonesia

Abstract The lack of implementation of the Nationally Appropriate Mitigation Actions (NAMAs) of the non-Annexe I Parties registered in the NAMA Registry of the United Nations Framework Convention on Climate Change (UNFCCC) is a worrying situation in the sense that it is limiting the contributions these NAMA projects would have made towards mitigating global climate change. There is however little research on the reasons behind the lack of implementation of these NAMAs projects and this is the knowledge gap that this paper seeks to fill based on a critical overview of the NAMAs of Ethiopia, Indonesia and Georgia. The source of data for this paper is mainly from the focal persons for the NAMAs of the countries under study, which was obtained via telephone and Skype interviews with the respondents. Our findings show that lack of funding, complicated financial mechanisms, lack of technical expertise, fringe conditions to donor support and policy issues according to the findings of this study are the main hindrances to the implementation of NAMAs. International organisations, donor partners, developed countries and local governments alike are therefore encouraged to channel some of the funds meant for fighting global climate change into sponsoring the NAMAs of poorer countries, as this will see to the successful implementations of these NAMAs and their subsequent impacts on mitigating global climate change. The paper is also timely considering the scarcity of literature on NAMAs related issues.

Assessing the capacity of primary health care centres to provide tuberculosis services in Kaduna State, North-Western Nigeria

Background: Despite earlier successes achieved in combating it, cases of tuberculosis in Nigeria are now on the increase, affecting more people and communities. Primary health care in Nigeria is through ward health system, designed to provide minimum health package to the communities including TB services. This study aimed to ascertain the capacity of PHC centres to provide TB services in Kaduna North senatorial district, Kaduna State, Nigeria.Methods: Four out of eight local Government areas in the district were randomly selected and one PHC per ward was recruited in the study. In each facility, questionnaires developed from the TB tracer items of the WHO service availability and readiness assessment tool were administered to the facility in-charges and TB/DOTS focal persons.Results: Forty four facilities were selected from Zaria, Sabon Gari, Makarfi and Kudan LGAs. Almost all facilities (98%) diagnosed TB clinically and 39 (90%) had anti-TB drugs available. National TB guidelines were lacking in 23 (52%) facilities and only 5 (11%) had additional capacity for sputum microscopy. While 35 (80%) TB/DOTS focal persons had received training on TB diagnosis and treatment, only 24 (55%)received training on TB/HIV co-infection and only 8 (18%) received training on multi-drug resistant TB.Conclusions: While TB services are widely available in the district, urgent need exists for all stakeholders to work together towards equipping those facilities with critical infrastructure that will improve their overall capacity, particularly with regards to comprehensive TB guidelines, laboratory diagnosis and personnel training for effective TB management.

CORPORATE SOCIAL RESPONSIBILITY: ITS ROLES IN THE SUSTAINABLE ENGAGEMENT INITIATIVES OF PRIVATE HIGHER EDUCATION INSTITUTIONS IN REGION II

Corporate Social Responsibility of private universities is a commitment to ethical conduct for economic development contribution as well as improving the quality of academic, spiritual, and material life for related members. Through implementing CSR strategies, higher education institutions are now using this approach as a part of their competitive strategy. However, systematic evidence on best practices and priorities to articulate CSR within formal private academic institutions in the country is still scarce which prompted the researcher is motivated to undertake this study. Thus, there is a need to investigate the CSR initiatives being implemented by the Private Higher Education Institutions and its impact on the institutions’ sustainability to be able to develop interventions to address the scarce corporate social responsibility performance of Private Higher Education Institutions. This study employed Descriptive-survey design since the purpose of this study is to determine the Corporate Social Responsibility programs being implemented by the Private Higher Education Institutions and its role on sustainability. This study made use of a validated survey-questionnaire on the corporate social responsibility implemented by private higher education institutions. This research was carried out in Region 02, which is mainly composed of forty-seven (47) Private Higher Education Institutions. The CSR Focal Persons were purposefully chosen as study respondents because they are the ones who plan, integrate, and implement their respective institutions' corporate social responsibility. As a result, 47 CSR focal persons were asked to participate as research participants in the conduct of this study. Only 42 focal persons, however, responded and returned the questionnaire. Results revealed that the Private Higher Education Institutions in Region II are quite established and have been educating students for a significant period offering varied programs, but are not too keen in accrediting the institution which might be because it is not a mandatory requirement for colleges/universities. They are mostly practicing CSR initiatives through donations and charitable deeds, grounded with moral principles and extends it with the community, exhibits commitment in abiding regulations and standards of the government and responsible in sharing its resources in order to uplift the economic wellbeing of the society through corporate social responsibility. The corporate social responsibility practices of the private higher education institutions in region 2 has roles on the culture of the college/university, when it comes to financial aspect, there has been observed to be Moderately Important of the corporate social responsibility, also it has Greatly Important on social aspect and Corporate Social Responsibility of the private higher education institutions notably contributes in the ability of the PHEIs to be at par with international educational standards. The Private higher educations in region 2 finds that there is a pressing problem encountered in the execution of their institutional corporate social responsibility initiatives, especially in terms of evaluating how the initiatives are yielding outcome on the institution.

Challenges and opportunities of gender mainstreaming strategy implementation in public sectors: The case of Women and Children Affairs Office, Bahir Dar City Administration, Amhara Region, Ethiopia

AbstractGender Mainstreaming is an organizational strategy to bring a gender perspective to all aspects of an institution's policy. This research aimed to investigate the challenges and opportunities of gender mainstreaming implementation by taking women, children, and youth affairs office of Bahir Dar City administration as a case. To do so, a qualitative research method with a case study research design was employed. To select the participants, purposive and availability sampling techniques were employed. Interview, focus group discussion, and document review were used as major data collection instruments. The data were analyzed thematically. The findings revealed that, absence of gender focal person, compartmentalization, lack of commitments, lack of training, lack of theoretical and technical skills about gender, and insufficient budget were the identified challenges. The presence of evaluation among heads at the council, existence of policies, and cooperative leadership were identified as an opportunity. To sum up, there are numerous challenges that hinder its monitoring and evaluation activities to mainstream gender even if there were a few opportunities that facilitate their activities. Based on the findings, the regional government should support and monitor the respective office challenges.

Overcoming the challenges of community-engaged emergency referrals in a rural district of Pakistan.

A functional referral system for addressing health emergencies requires coordinated efforts by health system's stakeholders and the community. Using the Rural Health Programme (RHP) Thatta as a platform provided by an academic institution, district health system stakeholders and the community of Mirpur Sakro, taluka of Thatta, were engaged to strengthen the referral system for health emergencies through active community engagement. Through consultations with stakeholders, a referral system plan was developed with community volunteers from each village as focal persons for transportation, referring patients to health facilities and maintaining referral documentation. The stakeholders' experience and perceptions about the referral system were assessed through qualitative in-depth interviews. Patients' experiences of referral system improved with enhanced transport availability, but they faced structural challenges, including out of pocket transport expenses, weak back-referral links, lack of trust between the community and healthcare providers and poor availability of medicines.