Key Informant Interviews Research Articles

Pandemic-induced online internships as situated, bounded, inclusive learning: a Philippine mixed methods study

ABSTRACT The COVID-19 pandemic rattled educational institutions to implement an online internship arrangement with their industry partners. Journalism felt the same experience, at least in the Philippines where the government had mandated online learning given full school closures for 566 schooldays. This mixed methods study documented the case of a Philippine journalism school, its interns and its news media industry partners on how two rounds of online internship arrangements happened. The study integrated quantitative results from an internship evaluation sheet (N = 129) with qualitative findings from key informant interviews (N = 11) with journalist-mentors and from interns' reflection papers (N = 110). The situated learning and boundary theories, plus the inclusive education concept, provided the theoretical lenses for this paper. It was found that the pandemic-tailored online internship became an inclusive education setup that had normalized telework as the situated, bounded learning milieu of the interns. Should future natural and man-made disruptions come, journalism schools can resurface the lessons of conducting crisis-tailored online internships to reduce worrisome negative outcomes that a pandemic like COVID-19 wrought.

The drivers and barriers influencing the commercialization of innovations at research and innovation institutions in Uganda: a systemic, infrastructural, and financial approach

Research and innovation (R&I) institutions must commercialize their innovations to remain competitive in a knowledge-based economy. While R&I institutions in Uganda have the potential to drive socioeconomic development, a clear understanding of the commercialization pathway is lacking. This study aims to bridge this gap by analyzing the systemic, infrastructural, and financial factors that drive and hinder the commercialization of innovations at R&I institutions in Uganda. This study offers the first comprehensive examination of the systemic, infrastructural, and financial dimensions influencing innovation commercialization within Uganda's R&I ecosystem, presenting new empirical evidence on the prioritized barriers and drivers as perceived by key stakeholders. Employing a mixed-method approach, this study uniquely combines quantitative surveys with qualitative case studies and key informant interviews, enabling a nuanced understanding of the multifaceted drivers of and barriers to innovation commercialization in Uganda. The study employed the Delphi technique to identify consensus among key informants. The findings highlight the urgent barriers to address, including fragmented R&I ecosystems, inadequate support infrastructure, such as technology transfer offices, and significant gaps in innovation financing. These issues underscore the urgent need for targeted policy interventions. Based on our findings, we recommend the establishment of a national innovation fund, enhancement of public private partnerships for R&D infrastructure development, and formulation of a cohesive national policy framework to streamline commercialization processes at R&I institutions. This study provides policymakers with a data-driven foundation to craft targeted interventions aimed at removing the identified barriers, thereby catalyzing the commercialization of innovations in Uganda's R&I institutions.

Assessment of gestational diabetes mellitus knowledge, attitudes, and practices and associated factors among pregnant women at a district hospital in Coastal Kenya

BackgroundGestational diabetes mellitus (GDM) is any degree of glucose intolerance first recognized during pregnancy. GDM awareness among pregnant women translates into GDM prevention and early diagnosis.ObjectiveTo establish the underlying factors influencing GDM Knowledge Attitude and Practices (KAP) among pregnant women at Kinango District Hospital.MethodAn explanatory mixed-methods design was implemented by initially assessing GDM KAP quantitatively [QUAN], followed by the qualitative [qual] exploration of contextual factors behind quantitative results. In the [QUAN] strand, 354 pregnant women were interviewed from January to February 2019. Thereafter, in the [qual] strand, key informant interviews were conducted among four pregnant women and three healthcare workers; a focus group discussion was held among nine pregnant women, from May to June 2019. STATA V15 software package was used to analyze the quantitative data. Qualitative data were analyzed manually using thematic analysis.ResultAmong 354 pregnant women, 29.0% were knowledgeable, 46.98% had good attitude and 60.17% had good practice. Attending at least one antenatal clinic visit and having heard about diabetes mellitus were associated with good GDM attitude and practices. Among the knowledgeable pregnant women, one-third (33.33%) obtained GDM information from a health facility. Discussions with pregnant women and the interviews with healthcare workers highlighted that daily health talks during antenatal clinic, included GDM and diabetes mellitus information. Furthermore, attendance of at least one antenatal clinic visit was low (85.88%), among pregnant women (87.86%) who were expected to have attended at least one antenatal clinic visits.ConclusionDespite low GDM knowledge, pregnant women had relatively good GDM attitudes and good GDM practices. Daily health talks conducted during antenatal clinic as well as indigenous knowledge among pregnant women, influenced the latter. Hence, GDM information dissemination needs to be enhanced for the improvement of GDM KAP among pregnant women for GDM prevention.

Impact Assessment of Forest Degradation on Peoples Livelihood: The Case of Harena Buluq Woreda Bale Eco Region, Southeast Ethiopia

In developing countries like Ethiopia, forest degradation, characterized by the decline in forest cover and diminished capacity to provide essential goods and services, presents significant environmental, social, and economic challenges. The purpose of this study is to assess the effects of forest degradation on the way of life for the people living in the southeast Ethiopian woreda of Harena Buluq. Examining how forest degradation affects local livelihoods with a particular emphasis on livelihood strategies and the degree of reliance on forest resources is the main goal. In order to obtain qualitative insights, data was gathered by means of a combination of secondary sources and key informant interviews, which were complemented by on-site observations of the consequences of forest degradation. After gathering, the data was examined and shown. The findings underscore the multifaceted impact of forest degradation on the socio-economic fabric of communities in Harena Buluq, highlighting the urgent need for targeted interventions to mitigate its adverse effects and promote sustainable livelihood practices.

Civil Society and the Struggle Against Media Freedom Violations in Ghana

ABSTRACT Per the recent rankings of Reporters Without Borders, media freedom in Ghana has been declining as a result of consistent and systematic harassment, physical abuses and even murder of journalists. For years, the literature has been aloof on the question of whether the civil society has been playing its constitutionally assigned duties of protecting the fourth estate. Using data from key informant interviews and within the lens of the libertarian theory of civil society, this study concludes that years of advocacy, activism and legal support for media personnel have cemented the role of civil society in Ghana not just as a protector of media freedom but also as an important vanguard against harassment, unfair prosecution and detention, physical assaults and even murder of journalists. Despite all the efforts from civil society organizations, violations of media freedom still occur frequently while civil society itself faces obstacles ranging from financial problems to media partisanship. This calls for financial and moral support from citizens and other independent organizations and more escalatory actions from the media and civil society such as the recent media blackout of politicians and public officials deemed as perpetrators.

Factors influencing vaccination up-take among nomadic population in four regions of Ghana: a qualitative study

BackgroundVaccination has contributed to the reduction in vaccine preventable diseases. Despite, improved global coverage, vaccination among nomadic populations is still low especially in Africa. This study explored factors influencing vaccination uptake among pastoralist nomads in Ghana.MethodsWe conducted key informant interviews (KII) in 11 districts across four regions of Ghana, using grounded theory qualitative research approach. One hundred and eighty-two KII were conducted among pastoralist nomads, community opinion leaders, community health volunteers, security services personnel, local government personnel and health workers. Guided by the WHO health systems building blocks, data was coded using Nvivo 12 and analysed thematically. Results were presented as narratives with excerpts to support the findings.ResultsCommunity leaders support vaccination among pastoralist nomads as part of their leadership and governance responsibilities. Language barrier between health workers and pastoralist nomads affects service delivery. Also, healthcare providers fear being attacked by pastoralist nomads hence are hesitant to visit their settlements for vaccination. With regards to health workforce, healthcare providers’ perceived use of derogatory words and discrimination against pastoralist nomads influence their vaccination uptake. On medical product, the lack of knowledge about diseases, severity and perceived negative effects about vaccines influence vaccination uptake. Inadequate funds and logistics at the district health directorates affects outreach to nomads during vaccinations. Leveraging existing partnership between the health services and community leaders, information centers, volunteers and butchers to send health information to pastoralist nomads influence vaccination uptake.ConclusionCommunity leaders support vaccination among pastoralist nomads. Nomadic pastoralist miss vaccination dues to language barrier, feel discriminated against, and lack information about diseases and vaccinations. Strengthening Ghana Health Service collaboration with leaders of pastoralist nomads could build trust, create awareness and overcome language barrier between healthcare providers and pastoralist nomads.

Gender Role of Household Decision Making (A case study Namobudda Kavre)

Gender roles in household decision making refer to the traditional division of responsibilities and decision-making power between men and women within a family or household. Historically, many societies have adhered to traditional gender roles, where men are often considered the primary decision-makers, particularly in matters related to finances and major family decisions. Women, on the other hand, have often been assigned the roles of managing the household, taking care of children, and dealing with domestic matters. However, it's important to recognize that gender roles are not fixed and vary significantly across cultures, regions, and individual households. Moreover, over time, many societies have witnessed a shift in traditional gender roles, with more emphasis on gender equality and shared decision making. The main purpose of this research was to understand the perception of people regarding the evolvement of gender roles in any household decision making. A Descriptive Cross Sectional study method was used. Altogether, 40 respondents were selected through purposive sampling method, questionnaires, Face to face interview, Informal focused group discussion; Key informant interview method was used using Structured Questionnaire to collect data from respondents. Data analysis was done through MS Excel. It is revealed from the research Gender roles in household decision making refer to the traditional division of responsibilities and decision-making power between men and women within a family or household. Historically, many societies have adhered to traditional gender roles, where men are often considered the primary decision-makers, particularly in matters related to finances and major family decisions. Women, on the other hand, have often been assigned the roles of managing the household, taking care of children, and dealing with domestic matters. However, it's important to recognize that gender roles are not fixed and vary significantly across cultures, regions, and individual households. Moreover, over time, many societies have witnessed a shift in traditional gender roles, with more emphasis on gender equality and shared decision making

An Integrated Framework for Scientific and Ethical Review of Research Proposals

Research proposals must adhere to both scientific and ethical standards to ensure the integrity and impact of research endeavours. However, existing guidelines often fall short in providing comprehensive guidance for non-medical disciplines, requiring separate documents for scientific and ethical reviews, and lacking detailed instructions for specific steps such as risk-benefit analysis and the use of secondary data. This study addresses these challenges by developing a detailed, step-by-step guideline for preparing research proposals that seamlessly integrate scientific and ethical reviews. Through a qualitative research design, involving focus group discussions with ethics review committee members and key informant interviews with experts, combined with a comprehensive literature review, this study identified best practices and challenges in the current review process. The proposed guideline offers a structured approach to preparing research proposals, emphasizing clarity in research objectives, methodology, data analysis, and expected outcomes for scientific review. For ethical review, it provides detailed instructions on risk-benefit analysis, informed consent processes, privacy and confidentiality measures, and the ethical use of secondary or archival data. The guidelines were pilot-tested with researchers to ensure their usability and effectiveness, resulting in a refined tool that can standardize the proposal preparation process and improve the quality and integrity of research across various disciplines.

Towards 'Formalising' WhatsApp Teledermatology Practice in KZ-N District Hospitals: Key Informant Interviews.

District hospitals in KwaZulu-Natal Province, South Africa, do not have onsite specialist dermatology services. Doctors at these hospitals use WhatsApp instant messaging to informally seek advice from dermatologists and colleagues before possible referral. They have expressed the need to formalise WhatsApp teledermatology. To determine the views and perspectives of clinicians on the feasibility and practicality of formalising the current WhatsApp-based teledermatology activities within the KwaZulu-Natal Department of Health Dermatology Service. Key informant interviews with 12 purposively selected doctors at district hospitals and all 14 dermatologists in the KwaZulu-Natal dermatology service. Their views and perspectives on formalising the current informal use of WhatsApp for teledermatology were recorded, transcribed, and thematically analysed. Five primary themes (communication, usability, utility, process, and poor understanding of legal, regulatory, and ethical issues) and 22 sub-themes were identified. Clinicians wanted WhatsApp teledermatology to continue, be formalised, and be incorporated within the KwaZulu-Natal Department of Health, facilitated by the provision of practical guidelines addressing legal, regulatory, and ethical issues. These findings will be used to develop a policy brief, providing recommendations and proposed guidelines for formalising the teledermatology service. The findings and methods will be relevant to similar circumstances in other countries.

Contribution of Janata Awash Grant for Poverty Reduction in Makwanpur, Nepal

This research paper deals with the Janata Awash Grant, a program resembling Universal Basic Income (UBI), implemented in Raksirang Rural Municipality of Makawanpur District in Nepal, which specifically focuses on poverty reduction, social justice, and inclusion for impoverished families. The main aim of this paper is to examine the effectiveness of the Janata Awash Grant (JAG) in reducing poverty and promoting social justice among the designated families. The research uses a mixed-method approach, employing an explanatory sequential research design, and utilizes both primary and secondary data sources. Forty households out of 200 grant recipients were randomly chosen for primary data collection. Additionally, key informant interviews were conducted with selected representatives and informed beneficiaries to gather qualitative insights. The results indicate significant improvements in the economic status of recipient families, leading to a decrease in poverty rates and an overall enhancement in quality of life. Qualitative analysis highlights the broader societal and ethical impacts of receiving a guaranteed income, emphasizing the transformative potential of UBI beyond its monetary benefits.

Changes in healthcare seeking behaviors among caretakers of children in the previously occupied ISIS territory: Hadeetha, Anbar, Iraq: a cross-sectional survey of 415 households.

The western province of Anbar, and the district of Hadeetha, have suffered direct impacts from the second United States led invasion (2003) through the ISIS invasion (2014-2017). With the primary health care centers being closed or inaccessible, the remaining population experienced changes in health seeking. The area of Anbar, Iraq remains largely remote from the discourse of health system recovery post-conflict. The objective of this study was to describe changes in health seeking behaviors of caregivers of children ages 12-72months of age in Hadeetha, Anbar, Iraq from the conflict period of ISIS (Islamic State of Syria and Iraq), 2014-2017, to the post-conflict period, 2021. This was a mixed-methods study composed of a cross-sectional 415 household survey and focus groups in Hadeetha, Anbar, Iraq. Caretakers of children were interviewed from February to April 2021. Children were sampled from a list of children who missed at least one vaccination appointment without a return for follow-up from the birth cohorts of 2014 to 2020. Healthcare workers focus groups and key informant interviews occurred from 2019 to 2021 centered around experiences from the 2014 to 2021 period. In the post-conflict period, there were no differences in health seeking based upon provider type between respondents. Physicians were primary healthcare providers in the post-conflict period for 79% of respondents versus only 47% in the conflict period. Healthcare workers described major barriers to delivering services in Hadeetha during the ISIS occupation due to infrastructure damage, threats of violence, decreased medical personnel, lack of compensation and disruptions in medical supplies from 2014 to 2017. This study provides insight into health seeking challenges among the many individuals who remained in Hadeetha during the ISIS occupation. Health use patterns by provider type mirror the concerns the healthcare providers shared: limited availability, efflux of professional workers, limited resources and security challenges to providing care. Positive trends toward increased access to physicians during periods of peace are an encouraging marker for continued population resilience during the post-conflict period. Recovery efforts continue to be hampered by internal sectarian discord within Iraq as well as insufficient resources to maintain health services as well as provide catch-up health services, such as immunizations.

Socioeconomic Determinants of Household Access to HIV/AIDS Healthcare in Kibra Sub-County, Nairobi County, Kenya

This study examined the impact of social and economic factors on the uptake of HIV/AIDS care in Kibra Sub County, Nairobi. The research was grounded in Behavioral theory and focused on how household income, literacy levels, and access to health information influenced the adoption of HIV/AIDS treatment. A descriptive survey design approach was employed, involving a sample of 365 households chosen through simple random and stratified sampling techniques from target population of 61,690 households, as outlined by Krejcie and Morgan's formula. Data collection was carried out using key informant interviews and self-administered questionnaires. Descriptive techniques, such as frequency and median analysis, as well as inferential techniques, such as bivariate correlation analysis, chi-square testing, and binomial logistic regression, were used. The results were displayed using tables, graphs, and percentages. Thematic analysis was also used to examine qualitative data in order to find new topics. The analysis revealed a strong positive relationship between access to health information and the likelihood of seeking treatment. Households with higher income and literacy levels were more likely to pursue HIV/AIDS care. Quantitative results showed that access to HIV-related information increased the likelihood of treatment uptake by 6.666 times. Additionally, increased household income and higher literacy levels were linked to a 7.434-fold and 3.554-fold rise, respectively, in the probability of seeking care. The study concluded that socio-economic factors, particularly income, literacy, and information access, significantly influenced healthcare-seeking behaviors in Kibra. To enhance access to HIV/AIDS treatment, it is recommended that policymakers, NGOs, and other stakeholders implement targeted interventions, including income-generating programs and comprehensive health education, to address the socio-economic barriers that hinder healthcare uptake.

Barriers and Willingness to Continue Using Telehealth Services Beyond the COVID-19 Pandemic from the Perspectives of Oral and Maxillofacial Surgeons in Australia: A Mixed-Method Study.

Patient demand for oral and maxillofacial telehealth services increased during COVID-19. To explore the potential for their continued use post-COVID-19, an assessment was conducted by examining the association between the clinical and socio-demographic characteristics of consultants and the perceived facilitators and barriers influencing their future intent. Practicing oral and maxillofacial consultants were recruited through purposive and snowball sampling methods. Data were collected through surveys and key informant interviews. Chi-square tests were used to determine whether consultants' clinical and socio-demographic characteristics and perceptions were associated with a willingness to use telehealth in the future. Coded interview transcripts were analyzed thematically to identify the main themes influencing their willingness. Among the 42 respondents, 82% expressed a willingness to continue using telehealth services with the majority having at least 2 to 3 years (p = 0.028) of experience utilizing these services. The four main themes impacting consultants willingness include the accessibility of oral and maxillofacial healthcare, challenges addressing patient needs, the uncertainty of diagnostic accuracy and effectiveness as a post-operation observation tool. Most oral and maxillofacial consultants favored the routine use of telehealth services beyond COVID-19. Concern for patients' needs was a key determinant of their continued use. Co-designing strategies to eliminate barriers and unmet needs for consultants and patients may improve oral and maxillofacial telehealth uptake.

The livelihood impacts of eucalypt plantations on rural farm households in Western Gurage Watersheds, Central-south Ethiopia

BackgroundRural landscapes, particularly those close to human settlements and main roads throughout the highlands of Ethiopia, appear greener than the outfields because of eucalypt plantations. The most common factors for eucalypt plantations are two: fuel and construction demands and to generate income. ObjectiveThis study tried to investigate the socioeconomic impacts of eucalypt plantations in Western Gurage Watersheds located in Central-south Ethiopia. The specific objectives are: to evaluate the socioeconomic importance of eucalypt plantations on the livelihood of farm households, and to assess perceptions on impacts of eucalypt plantation and copping strategies. MethodsSystematic and purposive sampling method was employed by selecting households with eucalypt woodlots from the list of each Woreda's Kebeles. Close- and open- ended questionnaires were distributed to every fifth households that possessed eucalypt plantations. Three hundred eighty three questionnaires were distributed and collected from households found in three Woredas (districts) namely Cheha, Enemorna Ener, and Eza located in the Watersheds. To supplement the information critical observations, discussions with focus groups and interviews with key informant were employed. The survey data were analyzed using both qualitative and quantitative techniques. To describe data acquired from critical observations, focus group discussions and key informant interviews; critical and logical qualitative data analysis technique were used. Descriptive and dispersive statistics such as frequency, percentage, mean, variance, standard deviation, p- value and correlation were employed using SPSS Version 20. ResultsThe result showed that eucalypt plantation dominated fuel wood and construction consumption and substituted further encroachment to natural forests. From multiple responses given, households prefer planting eucalypts to indigenous trees because it is fast growing (100 %), profitable (100 %), needs lesser labor (100 %), needs lower capital (100 %), can be used for multipurpose (100 %), and coppice itself fatly (93 %). They rated income gained from eucalypt as 2nd next to enset. ConclusionsHouseholds may continue planting the species particularly for fuel wood and construction need since substituting it by other alternative seems not feasible and challenging. To sustain the livelihood and environment; appropriate management like site selection and substitutions by horticultural and cash crops using micro irrigation schemes for market needs are recommended. Conducting in-depth participatory research and specific policy ratification and promulgation on eucalypt plantations will sustain its utilization and curb the drawbacks.

Analysis of Factors Affecting Participation of Smallholder Farmers in Wheat Cluster Farming: The Case of Gasera District, Bale Zone, Oromia Region, Ethiopia

Agriculture is the main means of livelihood in Africa. Wheat is one of the globally produced and marketed cereal crops which cover 15% of the total sowing areas of cereal crops in the world. This study focused on the analysis of factors affecting smallholder farmer’s participation in wheat cluster farming in Gasera District of Bale zone. A multi-stage sampling method was employed for this study. Simple random sampling technique was used to select 259 sample respondents in three selected Kebeles out of 24 total kebeles in the woreda. Primary data sources were generated using an interview schedule, five Focus Group Discussions, and eight key informant interviews. Besides, secondary data were obtained from literature and the Woreda Agricultural Office. Both descriptive statistics and econometric models were employed to analyze the collected data. The descriptive statistics results showed that from the total sampled households, 169 (65.3%) were participant and, 90 (34.7%) were non-participant smallholder farmers of wheat cluster farming technology. According to the probit regression model, education status, wheat land, livestock size, frequency of extension contact, credit access, availability of fair price, market information, agricultural input access, training access and membership in a cooperative had a positive influence on farmers’ decisions to participate in wheat cluster farming. Therefore, the local community, Woreda Agriculture Office and research institutes need to expand cluster farming technology to increase wheat production and policies aiming at increasing farmers’ awareness of producing wheat in cluster to increase yield of farmers.

Partisan Impacts and Determinants for Internationalization of Ethiopian Pharmaceutical Products

<i>Background</i>: The pharmaceutical and related commodities manufacturing industry in Ethiopia is long-lived because the country is well-endowed with basic raw materials and local ownership and to some extent with machinery and technological know-how. The pharmaceutical industry, both globally and in Africa, encounters challenges in internationalizing products. In Ethiopia, challenges like regulatory complexities and limited government support hinder international market access for pharmaceutical products. This aim is to explore the barriers and understand why Ethiopian pharmaceuticals struggle to enter global markets. <i>Method</i>: The study adopted a mixed research approach, integrating qualitative and quantitative methods. It focuses on 15 pharmaceutical industries in Ethiopia, particularly those in Addis Ababa and the Oromia Special Zone, using probability and none probability sampling technique. The total study participants involved in the quantitative and qualitative studies were 373 and 15, respectively. Data collection comprises questionnaires, key informant interviews, and observation checklists, supplemented by secondary data from official and theoretical sources. Ethical considerations underscore obtaining verbal consent and ensuring confidentiality. Analysis entails descriptive statistics and qualitative synthesis, with numerical analysis conducted using STATA 14.1 software. <i>Results</i>: Out of the expected 384 study participants, 373 (97.13%) participated in our study, while the entire group of participants proposed in the qualitative study (15) also participated in this study. Key findings include resource constraints, regulatory issues, and biased perceptions against local products, hindering their global recognition. While strong political commitment and effective policy enforcement at the top government level are crucial, inadequate collaboration across government tiers undermines these efforts. Despite existing policies, inadequate implementation and procedural guidance diminish industry interest. There's uncertainty about government support for local pharmaceutical production, with persistent challenges like resource shortages and policy inconsistencies impeding progress. Perceptions vary on the effectiveness of policies promoting local production, and concerns about taxation issues impact the industry. Nevertheless, most respondents’ express confidence in the quality of domestically produced pharmaceuticals. <i>Conclusion</i>: Despite crucial government commitment, weak collaboration across levels impedes progress. Respondents note deficient policy implementation and doubt government support. Persistent issues like resource shortages persist, along with taxation concerns, despite locally produced products being perceived as equal in quality. To advance, better policy implementation, regulatory harmony, financial support, infrastructure enhancement, increased awareness, and improved collaboration are essential.

Canvassing Taboo: African Sexuality as Post-Cultural Discourse in the Kenyan Disconnect 2 and Nafsi Films

Sexuality narratives in the Kenyan film industry play a crucial role in directly and indirectly shaping narrative interests, addressing stakeholder concerns, and delivering effective messaging. Locally, these narratives are closely monitored, regulated, and classified due to their sensitive nature, compounded by their evolving nature as newer sexuality concepts integrate with traditional paradigms. This study aims to explore the social conceptualization of African Sexuality as a Post-Cultural Discourse in the Kenyan films Disconnect 2 and Nafsi. Utilizing film analysis and key informant interviews with industry professionals, the research reveals that post-cultural sexuality narratives are presented as non-threatening sexual ideals and practices that can coexist harmoniously with traditional sexual paradigms. Recommendations include establishing a structured hierarchy for sexual narratives in film production to depict both traditional and post-cultural themes effectively. By incorporating consequences within the post-cultural discourse, audiences can better engage with and understand the complex sexual ideologies presented in these films.

Verification of Sub-national Claim for ‘TB-free’ Status of Rajsamand District, Rajasthan, India-2020

Background: Tuberculosis (TB) caused by Mycobacterium tuberculosis is an opportunistic infection that affects the lungs in humans. Caseload of TB has been deemed it endemic in various regions of the world and India is on top of that list. The Government of India has set out a goal to eliminate tuberculosis in India by the year 2025 with the help of the National Strategic Plan (NSP) 2017–25. The objective of the index study was to verify the claim of Rajsamand district in Rajasthan, that it witnessed a >20% reduction in TB incidence between 2015 and 2020. Methodology: This was a mixed-methods study. Quantitative component (cross-sectional study): Secondary data review (review of records from Nikshay notification systems and National tuberculosis elimination program (NTEP) reports, utilization of drugs in the public sector, and drug sales in the private sector). Primary data collection through survey. Qualitative component: nominal group technique and key informant interviews. Result: Percentage decline of a ≥ 20% incidence in 2020 compared to baseline 2015 was not seen. The number needed to test (increased by 18.26% in 2020 as compared to the baseline of 2015. TB Score of Rajsamand district for the year 2020 was 68.34 out of 100. Conclusion: Rajsamand district’s claim of ≥20% reduction in TB incidence in the year 2020, was rejected.

Healthcare leadership practice and associated factors among primary healthcare managers in East Gojam Zone, Northwest Ethiopia: a mixed method study

BackgroundLeadership plays a critical role in the delivery of person centered, safe, efficient, and effective healthcare services globally. Poor healthcare leadership contributes to low staff motivation, patient dissatisfaction, and reduced healthcare-seeking behavior. However, there is limited evidence on healthcare leadership practice and associated factors among primary healthcare managers in the study area and at large in Ethiopia. Therefore, the findings of this study will contribute to improved healthcare leadership practices among primary healthcare managers.MethodFacility-based cross-sectional study supplemented with qualitative inquiry was conducted in the East Gojam zone among 532 primary healthcare managers selected by a two-stage stratified random sampling technique. A pre-tested and structured self-administered questionnaire was used to collect the quantitative data. Data were entered into Epi-Data version 4.6 and exported into Stata version 14.0 for analysis. Multiple linear regression analysis was used to identify factors associated with healthcare leadership practice, and statistical significance was declared at a p-value < 0.05 with a 95% CI. Six key informant interviews were conducted, and thematic analysis was used for the qualitative study.ResultThe magnitude of healthcare leadership practice among primary healthcare managers in the East Gojam zone was 45.7% (95% CI: (41.4, 50.0)). Factors associated with healthcare leadership practice were age [β = 0.44, 95% CI: (0.16, 0.71)], training in healthcare leadership practice [β = 1.19, 95% CI: (0.19, 2.20)], experience sharing [β = 1.68, 95% CI: (0.59, 2.76)], organizational communication [β = 0.19, 95% CI: (0.05, 0.33)], managerial working experience [β = 0.94, 95% CI: (0.18, 1.69)] and emotional intelligence [β = 0.35, 95% CI: (0.31, 0.38)].Conclusion and recommendationThe magnitude of healthcare leadership practice among primary healthcare managers in the East Gojam zone was low as compared with a previous study in Ethiopia. It was significantly associated with age, training in leadership, experience sharing, organizational communication, managerial working experience, and emotional intelligence. Thus, human resource managers at primary healthcare level should consider older and more experienced candidates during assigning managers, organize training on healthcare leadership and experience sharing with model managers to improve the leadership practice of primary healthcare managers in the East Gojam zone.

Cross border population movements across three East African states: Implications for disease surveillance and response.

The frequent population movement across the five East African Countries poses risk of disease spread in the region. A clear understanding of population movement patterns is critical for informing cross-border disease control interventions. We assessed population mobility patterns across the borders of the East African states of Kenya, Uganda, and Rwanda. In November 2022, we conducted Focus Group Discussions (FGDs), Key Informant Interviews (KIIs), and participatory mapping. Participants were selected using purposive sampling and a topic guide used during interviews. Key informants included border districts (Uganda and Rwanda) and county health officials (Kenya). FGD participants were identified from border communities and travellers and these included truck drivers, commercial motorcyclists, and businesspersons. During KIIs and FGDs, we conducted participatory mapping using Population Connectivity Across Borders toolkits. Data were analysed using thematic analysis approach using Atlas ti 7 software. Different age groups travelled across borders for various reasons. Younger age groups travelled across the border for education, trade, social reasons, employment opportunities, agriculture and mining. While older age groups mainly travelled for healthcare and social reasons. Other common reasons for crossing the borders included religious and cultural matters. Respondents reported seasonal variations in the volume of travellers. Respondents reported using both official (4 Kenya-Uganda, 5 Rwanda-Uganda borders) and unofficial Points of Entry (PoEs) (14 Kenya-Uganda, 20 Uganda-Rwanda) for exit and entry movements on borders. Unofficial PoEs were preferred because they had fewer restrictions like the absence of health screening, and immigration and customs checks. Key destination points (points of interest) included: markets, health facilities, places of worship, education institutions, recreational facilities and business towns. Twenty-eight health facilities (10- Lwakhakha, Uganda, 10- Lwakhakha, Kenya, and 8- Cyanika, Uganda) along the borders were the most commonly visited by the travellers and border communities. Complex population movement and connectivity patterns were identified along the borders. These were used to guide cross-border disease surveillance and other border health strategies in the three countries. Findings were used to revise district response and preparedness plans by strengthening community-based surveillance in border communities.