Skills Of Healthcare Professionals Research Articles

Healthcare Capacity Building in Northwest Syria: Challenges, Successes, and Lessons Learned

The conflict in Syria has caused significant loss of life and widespread displacement. Northwest Syria (NWS) has been heavily impacted, leading to challenges in providing healthcare services. Attacks on healthcare workers and facilities have worsened the situation. Healthcare students and professionals have been specifically targeted, disrupting their education and resulting in migration and a shortage of skilled healthcare workers. To address these challenges, local and international organizations and institutions have supported long-term projects to improve healthcare facilities and provide a trained healthcare workforce. Collaborations with multiple stakeholders have been established to ensure comprehensive and effective training opportunities, enabling healthcare workers to better serve the population's healthcare needs. A range of undergraduate, postgraduate, and research programs have been developed to enhance healthcare capacity building. These programs aim to strengthen the knowledge and skills of healthcare professionals in NWS. Efforts have been made to strengthen the health system and build the capacity of policy makers in utilizing evidence-based knowledge for informed policy decisions. Global and regional partnerships, along with adequate funding, have played a significant role in the successful enhancement of capacity building activities at all levels.
 Building healthcare and health research capacity in underdeveloped and conflict-affected parts of NWS presents numerous challenges. Underdeveloped infrastructure, inadequate teaching and service delivery tools, gender disparities, and the sustainability of funding create obstacles to effective capacity building. The political context, coupled with security concerns further complicate efforts. The accreditation of education, and the brain drain of skilled healthcare professionals, add to the difficulties in strengthening the healthcare system in NWS. Addressing these challenges requires comprehensive and collaborative approaches that prioritize stability, security, gender equity, sustainable funding, and improved coordination and resources for education and service delivery. The lessons learned from capacity-building efforts in the Syrian conflict have broader implications for other regions facing similar challenges.

Abusive supervisor triggers counterproductive work behaviors in nursing staff: role of psychological contract breach and Islamic work ethics

PurposeAbusive supervision (AS) provides insights into the darker aspects of leadership behavior and its effects on employees. Understanding and addressing AS can contribute to creating healthier work environments and promoting employee well-being. The effect of abusive leadership (AS) on counterproductive work behaviors (CWB) in nursing staff is examined through the theoretical lens of the social exchange theory.Design/methodology/approachData were collected from 302 nursing staff working at public and private hospitals through a self-administered questionnaire. Measurement scales were adapted from the literature and the data were tested for validity and reliability before performing hypotheses testing through structural equation modeling in SmartPLS 4.0.FindingsAS positively affects CWB, and psychological contract breach mediates this relationship. However, employees with high Islamic work ethics (IWE) are less concerned with supervisors' dysfunctional behaviors and pay less attention to them; thus, IWE buffers the effect of AS on CWBs.Originality/valueA positive and supportive organizational climate is crucial for attracting and retaining skilled healthcare professionals. When healthcare professionals are subjected to abusive behaviors, their ability to share knowledge, adopt safety protocols and provide the best patient care may be hampered. Therefore, addressing AS in hospitals is vital to promoting a positive work environment, enhancing employee well-being and improving patient care.

Assessment of Skills of Health Care Professionals Posted in Labour Room and Maternity OTs Based on OSCE (Objective Structured Clinical Examination) Using LaQshya Guidelines

Background: Present study attempts to assess the skills of staff including Doctors and nurses posted in labourroom and maternity OTs based on OSCE (Objective Structured Clinical Examination) as mentioned in LaQshyaguidelines in selected areas of Indore and Ujjain district (M.P) regarding the management of normal labour, theactive management of third stage of labour, Newborn Resuscitation, management of PPH due to atonic uterus andmanagement of eclampsia. Even in these parameters many sub-parameters were studied.Materials and Methods: Pre designed semi structured Observation checklist for Health care providers regardingskill assessment of the staff based on OSCE guideline was used to assess Health care providers including Doctors,Staff nurses/ANMs, who are providing MCH services in LR (Labour room) and maternity OT of the selectedhospitals of Indore and Ujjain district.Results: Most of the manoeuvres were better performed by staff nurses posted in CHCs rather than those postedin PHCs. Breathing assessment of baby was lacking among staff nurses of both CHCs and PHCs and needed to betackled with by a reorientation training of paramedical staff in critical care. Decision to transfer (is usually afterConsultation with the in charge, hence it is usually the Medical officers prerogative) and bimanual compression/aortic compression/condom tamponade to control bleeding was done exclusively by MOs.Conclusion: OSCE helped to assess the skills of the staff of maternity wing in a comprehensive manner and waswell appreciated by the staff. Such OSCE modules should be developed and regularly used and updated to assessthe clinical skill of the staff in the maternity wing of any health centre or hospital.

Digital skills of health care professionals in cancer care: A systematic review.

The digital transformation of healthcare enables new ways of working in cancer care directing attention on the digital skills of healthcare professionals. This systematic review aims to identify existing evidence about digital skills among health care professionals in cancer care to identify the needs for future education and research. Database searches were conducted in PubMed, CINAHL, Web of Science, Scopus, Cochrane and ERIC to identify studies until March 2023. The inclusion criteria were digital skills of health care professionals in cancer care as described by themselves, other health care professionals, patients or significant others. The CASP tool was used for quality assessment of the studies. Data was analysed following inductive content analysis. The search produced 4563 records, of which 24 studies were included (12 qualitative, 10 quantitative, 1 mixed methods design and 1 strategy paper). Four main categories were identified describing HCPs' required skills, existing skills and development areas of digital skills in cancer care: Skills for information technology, Skills for ethical practice, Skills for creating a human-oriented relationship and Skills for digital education and support. In development areas, one more main category, Skills for implementing digital health, was identified. The digital skills of health care professionals in cancer care are multifaceted and fundamental for quality cancer care. The skills need to be assessed to provide education based on actual learning needs. The review findings can be used for education and research in this field.

Institutional drivers for integrating palliative care services in a hospital in a sub-Saharan African military hospital context.

The growing burden of life-threatening illnesses and advancements in care interventions call for the intentional integration of palliative care services into existing care systems. The absence of active, functioning palliative care services in most hospitals in Ghana is a major concern. This study explored the factors influencing the integration of palliative care services in one of such institutions. The aim of the study was to explore the institutional drivers of palliative care integration in a military health facility. Exploratory qualitative study. We employed a qualitative exploratory study design situated within a constructivist paradigm. A purposive sampling method was used to select and interview 11 healthcare professionals. A semistructured interview was used to conduct face-to-face, in-depth interviews with participants between April and May 2022. A thematic data analysis was done based on the Braun and Clarke analysis process with the aid of QSR NVivo-12. The six themes that describe the institutional driving factors for integrating palliative care services were cognitive restructuring, supportive logistics and infrastructure, staffing, healthcare professional skills, institutional policies and priorities, and utilization of focal persons. It was observed that a paradigm shift in the mindset of healthcare professionals and administrators was a major driver that would determine the integration of palliative care services. A cognitive restructuring will facilitate a more aggressive integration of palliative care services because logistics, staffing, and medication access will be prioritized. Institutions have the responsibility of aligning with the WHO policy on palliative care service access and must invest in training, staffing, prioritizing palliative care needs and policies, procurement of essential drugs, and the provision of logistics and supportive infrastructure to scale up the implementation of palliative care services.

Antenatal Care Services in Sudan Before and During the 2023 War: A Review Article.

Antenatal care (ANC) is provided by skilled healthcare professionals to pregnant women to ensure the best health conditions for both mother and baby during pregnancy. It includes risk identification, prevention, management of pregnancy-related diseases, health education, and health promotion. Antenatal care has a great effect on vital health indicators such as maternal and neonatal mortality by identifying and treating pregnancy-related complications. Political instability and armed conflict have seriously affected the health system, which has catastrophic implications for pregnant women's health. This review aimed to summarize the literature on ANC in Sudan before and during political instability and war by highlighting its effect on maternal mortality, coverage, care providers, quality of care, accessibility, and utilization. Other aspects of this review are the ANC components and service provision during the war. In addition, the author tried to identify the gaps and point out the future research needs in Sudan. A total of 58 articles about ANC in Sudan have been reviewed through PubMed, Google Scholar, ResearchGate databases, and other search tools. The keywords used were "antenatal care", "coverage", "service providers", "service quality", "accessibility and utilization", "components", and "ANC during the war". All the keywords were followed by "Sudan" to confine the search. According to the reviewed data, ANC services in Sudan, even during normal political situations, were not sufficient and of poor quality in most of the reviewed regions. The political instability and armed conflicts worsened the situation, and it became catastrophic. To improve the accessibility and quality of ANC services, we will need the collaboration of all stakeholders to address the health needs of vulnerable groups, people in remote rural areas, and nomadic communities towards providing the required health services in general and ANC in particular. On the other hand, an important aspect of this development is the availability of skilled healthcare providers and the adoption, revision, and updating of working procedure guidelines to match the needs of the local communities. The main shareholders are the local communities; they must be empowered and involved by raising their awareness. Then, effective, punctual, and applicable contingency plans should be ready for any unfortunate crises.

IGF-1 as screening tool for acromegaly and adult-onset growth hormone deficiency in the Netherlands.

Insulin-like growth factor 1 (IGF-1) measurements play a central role in the diagnosis and follow-up of acromegaly and growth hormone deficiency. However, improving health care outcomes for these patients involves an intricate process of laboratory diagnostics and skilled health care professionals. The integrated effects of IGF-1 reports on diagnosis and treatment decisions are yet unknown. Extended quality assessment, distributing the description of five (real) patient cases with accompanying blood samples. Patients suspected or during follow up for acromegaly or adult onset of growth hormone deficiency were included. Laboratory specialists and endocrinologists in the same centre were asked to interpret their centre-specific IGF-1 results by using a laboratory and medical questionnaire. This way, insight could be obtained into the combined effects of different assays, assay harmonisation, reference value sets, and individual physician interpretation in relation to guidelines, thus reviewing the entire diagnostic and management process. Limited variation (CV 13.8 ± 2.8) was found in IGF-1 concentrations despite different use of the harmonization sample and factor among laboratories. This interlaboratory variation increased upon conversion to SD scores (CV 15.7 ± 40.7) as a consequence of the use of different reference value sets. Furthermore, there was a lack of adherence to international guidelines among endocrinologists. Highly variable diagnostic and treatment outcomes in acromegaly and AGHD in the Netherlands can be attributed to increased variability of IGF-1 upon conversion to SD scores and low adherence to clinical guidelines.

The need for a tailored National Dementia Plan in Ethiopia: a call for action

AbstractBackgroundGlobally, a rapid demographic transition is occurring with a significant increment in the proportion of older individuals. For the first time in history, individuals aged 65 and above outnumber that of children under five years of age.MethodA mini review was conducted to assess the burden and types of dementia risk factors in Ethiopia.ResultsIn Ethiopia, the life expectancy has shown dramatic improvements in the past few decades and is expected to reach 74 years by mid‐century. Older age is considered the most important non‐modifiable risk factor for dementia. Likewise, other modifiable diseases such as infectious diseases, non‐communicable diseases, particularly cardiovascular diseases, and traumatic brain injuries are associated with dementia. Despite, the high prevalence of dementia risk factors and impending economic and health impact from dementia, no country in the sub‐Saharan Africa (SSA), including Ethiopia, has developed a standalone national dementia strategic plan to guide the overall effort to improve dementia care in the country. It is vital to design and develop a national dementia plan in line with a framework outlined by the 2017 World Health Organization (WHO) global action plan. The health, social, & economic burden from dementia is expected to be high to the developing countries such as Ethiopia unless clear prevention and management strategies are designed at a national level to cascade the care to the primary care level. The planned strategic policy may focus on improving the knowledge and skills of health care professionals. Translation and cultural adaptation of cognitive, functional, and behavioral assessment batteries is of paramount importance in improving the diagnostic accuracy along with availability of advanced imaging, biomarkers, and dementia treatment.ConclusionIn summary, this call for action paper recommends developing a tailored stand‐alone or an integrated national dementia prevention and care plan which is in congruent with the seven WHO global action plan.

Assessment of Knowledge Regarding Antenatal Care among Men in Selected Rural Areas of Himachal Pradesh

Background: WHO defined health as the state of complete physical, mental, and social well-being and not merely an absence of disease or infirmity, but it includes ability to lead socially and economically productive life.1 Being a man or women has a significant impact on health, as a result of both biological as well as gender related differences. Antenatal care (ANC) is most important aspect of women‘s reproductive health. The antenatal care is the care provided by skilled health care professionals to pregnant women and adolescent girls to ensure best health conditions for mother and baby during pregnancy. It reduces maternal and perinatal morbidity and mortality both directly, through detections and indirectly, through the identification of women and girls at increased risk of developing complications during labour, delivery and ensuring appropriate level of care.1 As per NFHS- 4, the 21% of pregnant women utilised full ANC, ranging from 2.3–65.9% across states. Overall, 51.6% had 4 or more ANC visits, 30.8% consumed IFA for at least 100 days and 91.1% had one or more doses of tetanus toxoid. Full ANC utilisation was inequitable across place of residence, caste, and maternal education. Registration of pregnancy, utilisation of government‘s Integrated Child Development Services (ICDS) and health insurance coverage were associated with higher odds of full ANC utilisation. Lower maternal education, lower wealth quintile, lack of father‘s participation during antenatal visits, higher birth order, teenage and unintended pregnancy were associated with lower odds of full ANC utilisation. This study assesses the knowledge about the antenatal care among married and unmarried men of 18-35 years age in selected rural areas of Himachal Pradesh. Methods: The study was an unmatched case and control design where married men were considered as a case and unmarried men as comparator group. This study was a part of large study for which sample size of 268 men in each group was calculated assuming prevalence of female contraceptives 70% in unmarried men and 85% in married men. This was carried out by cluster-based sampling in villages of Nagrota Bagwan and Shahpur health blocks of DRPGMC Tanda at Kangra. Results: The 93.3% participants among case group are aware of anaemia in pregnancy while only 64.9% among control group are aware of anaemia in pregnancy. The knowledge about all three causes of anaemia was statistically more in case group (61.9%) as compared to control group (38.8%). Assessment about high-risk pregnancy, about 72.4% participants among case group were aware about the risk factors in pregnancy as compared to 43.3% in control group with statistically significant differences (P=0.000). All the causes of high-risk pregnancy were reported by the participants of case group (44.0% vs 29.9%) with statistically significant differences. Conclusions: Married men had significantly more knowledge about various components of antenatal care. The awareness approach for unmarried men needs to be designed regarding antenatal care.

Projected Global Trends in Hematological Malignancies: Incidence, Mortality, and Disability-Adjusted Life Years from 2020 to 2030

Introduction: Hematological malignancies encompass a diverse group of conditions affecting the blood and its components, including anemia, bleeding disorders, hematologic malignancies, and inherited blood disorders. These disorders have a substantial impact on global health, posing challenges for health care systems worldwide. Understanding the future trends in the incidence, mortality, and disability-adjusted life years (DALYs) associated with hematological malignancies is crucial for effective health care planning and resource allocation. This study was designed to project the global trends in hematological malignancies from 2020 to 2030 and provide insights into the anticipated burden of these conditions. Methods: Estimated annual percentage changes (EAPCs) were utilized to forecast trends in the incidence, deaths, and DALYs associated with hematological malignancies between 2020 and 2030. EAPCs were derived using generalized additive models and data from the Global Burden of Disease study spanning from 1990 to 2019. The analysis involved utilizing a comprehensive and systematic approach, incorporating data from multiple sources, including population-based surveys, disease registries, health care databases, and vital statistics. Age-specific and sex-specific incidence rates, mortality rates, and DALYs were calculated for each specific hematological disorder. Advanced statistical modeling techniques, including time series analysis and predictive modeling, were employed to estimate future trends. The projections took into account demographic changes, epidemiological transitions, and advancements in medical technology. Results: The projections for the next decade indicate a varied trend in the age-standardized incidence, mortality, and disability-adjusted life year (DALY) rates of hematological malignancies globally. By 2030, the incidence rates per 100,000 individuals are expected to rise to 0.045 for multiple myeloma (EAPC = 1.70%), 0.016 for leukemia (EAPC = 0.79%), 0.012 for non-Hodgkin lymphoma (EAPC = 1.65%), and 0.002 for Hodgkin lymphoma (EAPC = 0.55%). The global age-standardized mortality rates associated with hematological malignancies show a differential trend. The mortality rates per 100,000 population are projected to increase to 0.016 for multiple myeloma (EAPC = 1.68%) and 0.008 for leukemia (EAPC = 0.40%). On the other hand, a decrease in mortality rate is expected for Hodgkin lymphoma (EAPC = -0.13%), while non-Hodgkin lymphoma exhibits a rise in mortality rate to 0.007 (EAPC = 1.31%). Similarly, the DALY rates per 100,000 population are expected to increase to 0.242 for multiple myeloma (EAPC = 1.54%) and 0.174 for non-Hodgkin lymphoma (EAPC = 0.90%). In contrast, the DALY rates for leukemia and Hodgkin lymphoma are projected to decrease to 0.248 (EAPC = -0.62%) and 0.023 (EAPC = -0.50%), respectively. In terms of geographical distribution, China is expected to face a considerable surge in the total number of hematological malignancy cases, with an estimate of approximately 859,692 cases by 2030. Globally, the total number of hematological malignancy cases is projected to reach approximately 4,634,937. The projected total number of hematological malignancy cases by 2030 across different levels of SDI are as follows: 1,113,313 cases in high-SDI areas, 1,004,403 cases in high-middle SDI areas, 475,496 cases in low-SDI areas, 795,475 cases in low-middle SDI areas, and 1,244,424 cases in middle-SDI areas. Conclusions: The projected global trends in hematological malignancies highlight the urgent need for comprehensive strategies to address this growing burden. Prevention and early detection programs should be strengthened to mitigate the increasing incidence of these malignancies . Accurate diagnosis, appropriate management, and access to affordable treatments are crucial for improving patient outcomes. Health care systems must allocate adequate resources, including health care infrastructure, skilled health care professionals, and specialized services, to effectively manage the growing impact of hematological malignancies . Furthermore, collaboration among health care providers, researchers, policy-makers, and patient advocacy groups is essential to develop and implement evidence-based strategies that can alleviate the future challenges posed by hematological malignancies.

The Ability for Teaching Self-Efficacy by Clinical Preceptors in Diagnostic Medical Sonography

Objective: This study was designed to explore the teaching self-efficacy, by clinical preceptors instructing sonography students, in bachelor’s degree-accredited sonography programs. Materials and Methods: A survey was provided to sonography clinical preceptors, to gauge their level of teaching self-efficacy. The survey instrument, Sonography Preceptor Teaching Self-Efficacy Inventory (SPTSEI) was used. The intent of the survey was to gauge, holistically, sonography preceptors’ perceptions of influencing student learning, in a clinical setting. Results: The survey respondents suggested that they had a high level of confidence in their skill to transmit knowledge and abilities to students. However, it was found that preceptors who had received some type of professional development, as preceptor, had a statistically significant higher level of teaching self-efficacy than those who had not received any type of training. Conclusion: Clinical preceptors are skilled health care professionals in their chosen discipline but may have little to no teaching experience. If preceptors do not fully understand their role in the educational process, both they and their students may not attain educational goals. It is therefore critically important that proper training and education, to support clinical preceptors, be provided for them. This survey would suggest that clinical preceptors, with training, can better perform their educational roles and better handle any challenges that might arise, as a part of providing clinical education.

Managing diabetes in the psychiatric in-patient setting: knowledge, attitudes and skills of healthcare professionals.

There is currently a lack of monitoring and standardisation of diabetes care in the National Health Service (NHS) psychiatric in-patient setting. We surveyed healthcare professionals in psychiatric in-patient units across England to understand current diabetes care. A 13-item questionnaire was piloted via think-aloud interviews. The survey was completed by healthcare professionals across 19 wards in 11 NHS mental health trusts. Results were analysed via descriptive statistics and thematic analysis. Of 150 respondents, 98% agreed that addressing physical health needs was an important part of the mental health team's role; 68% agreed that they had adequate skills and knowledge to manage diabetes safely. Thematic analysis identified themes relating to individual, organisational and patient-level factors. Psychiatric admission could be used opportunistically to improve the healthcare disparities for people with comorbid diabetes and severe mental illness. This national survey highlights areas that need to be addressed to optimise diabetes care in this setting.

Health sciences lifelong learning and professional development in the era of artificial intelligence

IntroductionIn the field of healthcare, lifelong learning is considered a quality indicator due to its potential to enhance healthcare services and the knowledge and skills of healthcare professionals. The purpose of this research is to investigate and document the attitudes and behavior of healthcare professionals from different healthcare institutions toward lifelong learning using artificial intelligence. The study achieves two objectivesIdentifying healthcare professionals' interest in formal lifelong learning and determining how they engage in lifelong learning. Additionally, this study aims to develop a dynamic web platform with several key features including an introduction page, navigation menu, document download form, document table, and download, delete, and resume buttons. MethodologyThe study was conducted from 07/04/2022 to 19/05/2022 and involved a sample of 114 healthcare professionals from various locations in Morocco. A questionnaire comprising three sections (personal information, lifelong learning for personal development, and lifelong learning for professional development) was used as the research instrument. ResultsThe average age of the participants was 43 years, and 76.8% had more than 11 years of experience in the field. The results indicate a correlation between professional development and lifelong learning among healthcare professionals. The two most important factors driving lifelong learning were identified as the advancement of the healthcare profession and the need to elevate the quality of care. Also, this research objective is to develop a dynamic online platform featuring an introduction page, navigation menu, document download form, document table, and download, delete, and resume buttons. ConclusionsAccording to the findings, healthcare professionals consider lifelong learning an ongoing and continuous process essential to their work.

Designing a wholly online, multidisciplinary Master of Cancer Sciences degree

BackgroundImproving oncology-specific knowledge and skills of healthcare professionals is critical for improving the outcomes of people with cancer. Many current postgraduate education offerings may be inaccessible to busy professionals, contain minimal consumer input or do not focus on the multidisciplinary nature of cancer care. In response to these needs, a Master of Cancer Sciences degree was developed. Our aim is to describe the development of the Master of Cancer Sciences.MethodsWe describe the development of the Master of Cancer Sciences, including its theoretical and its pedagogical underpinnings.ResultsOur approach to curriculum design was guided by Kern’s Six-Step Approach to Medical Curriculum and underpinned by the Seven Principles of Online Learning. These approaches were further underpinned by the Cognitive Theory of Multimedia Learning which informed our approach to audio and visual information design. The pedagogy is interactive, experiential, interprofessional and importantly, includes consumers as educators. In practice, learning activities include peer feedback, multidisciplinary team meeting simulations, group work and clinical role plays. The online environment was visually shaped through infographics, high-quality educational videos and gamification.ConclusionWe have designed a Master of Cancer Sciences that is one of the first wholly online, cancer-specific Masters’ programs. Its industry-led curriculum using evidence-based pedagogical choices utilises a range of novel digital formats and integrates the consumer perspective to provide a holistic overview of the field. Quantitative and qualitative evaluation of learning outcomes is ongoing.

Enabling Adults With Severe Asthma to Exercise: A Qualitative Examination of the Challenges for Patients and Health Care Professionals

Adults living with severe asthma have lower physical activity levels, particularly high intensity physical activity, compared to their healthy peers. Physical inactivity is associated with increased morbidity and mortality. We aimed to understand patient and healthcare professional attitudes to exercise to inform future strategies for the improvement of healthy lifestyle behaviours, including exercise. Participants recruited from a specialist Difficult Asthma Service were interviewed individually, and healthcare professionals (HCPs) from primary care, secondary care and a tertiary centre were invited to attend focus groups. Interviews and focus groups were transcribed verbatim. Thematic analysis was performed on interviews and focus groups separately, followed by an adapted framework analysis to analyse datasets together. Twenty-nine people with severe asthma participated in a semi-structured interview. 51 HCPs took part in 8 focus groups across the East Midlands, UK. Final analysis resulted in 3 major themes: Barriers to exercise and exercise counselling whereby patients and HCPs identified disease and non-disease factors impacting on those living with severe asthma; Attitudes towards HCPsupportfor exercise highlighting education needs for HCPs and preference for supervised exercise programmes; Areas for system improvement insupportingHCPs describing the challenges existing across services that limit patient support. The important role of HCPs in supporting and advising on lifestyle change was identified by patients. Despite a preference for supervised exercise programmes, both patient and HCP barriers existed. To meet patients' varied support needs, improved integration of services is required and HCP skills need extending.

Benefits of Investing on Mother and Child Healthcare in Tanzania

Purpose: Maternal and child healthcare play crucial role in reducing global mortality rates, with a significant impact on the overall burden of disease. The Sustainable Development Goal 3 aims to reduce the global maternal mortality ratio to less than 70 per 100,000 live births, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births by 2030. Sub-Saharan Africa, including Tanzania, carries a high burden of mortality rates and experiences a significant share of maternal and child deaths, exacerbating the global figures. The average prevalence of below 5 years mortality in SSA between 2010 and 2018 was 4.10% according to Ahinkorah (2021). Recognizing the severity of this issue, the government of Tanzania through the Development Agenda 2025, Draft health policy 2020 and the current Health Sector strategic plan 2021-2026 plans to reduce infant and maternal mortality rates through mother and child healthcare investment. The Health Sector Strategic Plan focuses on strengthening the health systems in the country and aims to sustain the achievements made in enhancing the health of reproductive, maternal, newborn, children, and adolescent populations. This study sought to assess the benefits of investing on mother and child healthcare in Tanzania. The study was guided by the investment commodity theory developed by the economist John Maynard Keynes in 1936. The study evaluated the current status of mother and child health indicators, the benefits of investing in mother and child health on overall health outcomes and identified the existing gaps and challenges in the provision, access and utilization of mother and child healthcare services in Tanzania.
 Methodology: The study was a desktop review-based study which relied on existing published information, data, and literature.
 Findings: The study found out that there have been improvements in certain areas of mother and child health indicators but maternal and child mortality rates remain high. Health interventions such as vaccination programs, improved access to healthcare services, and the use of maternal and child health insurance cards showed positive effects on reducing child mortality, improving child health outcomes, and enhancing maternal healthcare utilization. The significant gaps and challenges in the provision, access, and utilization of mother and child healthcare services include disparities in access to healthcare services based on factors such as education level and wealth status, inadequate healthcare infrastructure, long distances to health facilities, sociocultural barriers, and financial constraints.
 Unique contribution to theory, practice and policy: The study recommends strengthening of healthcare infrastructure, enhancing access to maternal and child healthcare services, especially for vulnerable populations, promoting health education and raising awareness about maternal and child healthcare practices, addressing the shortage of skilled healthcare professionals, improving data collection and use and monitoring of maternal and child health indicators, addressing socio-cultural barriers that hinder access and utilization of healthcare services and increasing investment in mother and child health care programs through allocate adequate resources.

Cancer Research in Pakistan: Progress, Challenges, and Future Directions

Cancer is a growing public health concern in Pakistan, with rising incidence rates and significant impacts on individuals and communities. In recent years, cancer research in Pakistan has made notable strides in understanding the epidemiology, risk factors, and treatment outcomes of various cancer types. However, numerous challenges persist, hindering progress in cancer control and prevention. Exploring the progress made, acknowledging the challenges faced, and outlining future directions is crucial for advancing cancer research and improving cancer care in Pakistan.
 In terms of progress, cancer research in Pakistan has provided valuable insights into the burden of different cancer types across various regions. Studies have shed light on the prevalence of common cancers such as breast, lung, and gastrointestinal cancers, enabling targeted interventions and screening programs. Furthermore, collaborative efforts between research institutions and healthcare providers have resulted in improved diagnosis and treatment modalities, with advancements in radiotherapy, chemotherapy, and surgical techniques.
 Despite these advancements, several challenges persist. Limited access to quality cancer care, particularly in rural areas, remains a significant barrier. Insufficient infrastructure, shortage of skilled healthcare professionals, and financial constraints impede timely diagnosis, treatment, and follow-up care. Additionally, cultural beliefs and social stigmas surrounding cancer often lead to delayed diagnosis and inadequate support for patients and their families. Overcoming these challenges requires comprehensive strategies, including strengthening healthcare infrastructure, training healthcare professionals, and raising awareness about cancer prevention and early detection.
 Looking ahead, the future of cancer research in Pakistan lies in a multidimensional approach. Enhancing collaboration among researchers, healthcare providers, and policymakers is crucial for effective data collection, research translation, and evidence-based policymaking. Investment in research infrastructure, including molecular and genetic profiling facilities, can facilitate targeted therapies and personalized treatment options. Additionally, fostering international collaborations and partnerships can provide opportunities for knowledge exchange, access to innovative technologies, and clinical trials.
 Cancer research in Pakistan has made significant progress in understanding the burden of cancer and improving treatment outcomes. However, challenges such as limited access to quality care and cultural barriers must be addressed to ensure equitable and comprehensive cancer services across the country. By investing in research infrastructure, fostering collaborations, and promoting awareness, Pakistan can enhance cancer research capabilities and make substantial strides in cancer prevention, early detection, and treatment. A concerted effort by researchers, policymakers, healthcare professionals, and communities is necessary to combat the growing burden of cancer and improve the lives of individuals affected by the disease.

Artificial Intelligence Supporting the Training of Communication Skills in the Education of Health Care Professions: Scoping Review.

Communication is a crucial element of every health care profession, rendering communication skills training in all health care professions as being of great importance. Technological advances such as artificial intelligence (AI) and particularly machine learning (ML) may support this cause: it may provide students with an opportunity for easily accessible and readily available communication training. This scoping review aimed to summarize the status quo regarding the use of AI or ML in the acquisition of communication skills in academic health care professions. We conducted a comprehensive literature search across the PubMed, Scopus, Cochrane Library, Web of Science Core Collection, and CINAHL databases to identify articles that covered the use of AI or ML in communication skills training of undergraduate students pursuing health care profession education. Using an inductive approach, the included studies were organized into distinct categories. The specific characteristics of the studies, methods and techniques used by AI or ML applications, and main outcomes of the studies were evaluated. Furthermore, supporting and hindering factors in the use of AI and ML for communication skills training of health care professionals were outlined. The titles and abstracts of 385 studies were identified, of which 29 (7.5%) underwent full-text review. Of the 29 studies, based on the inclusion and exclusion criteria, 12 (3.1%) were included. The studies were organized into 3 distinct categories: studies using AI and ML for text analysis and information extraction, studies using AI and ML and virtual reality, and studies using AI and ML and the simulation of virtual patients, each within the academic training of the communication skills of health care professionals. Within these thematic domains, AI was also used for the provision of feedback. The motivation of the involved agents played a major role in the implementation process. Reported barriers to the use of AI and ML in communication skills training revolved around the lack of authenticity and limited natural flow of language exhibited by the AI- and ML-based virtual patient systems. Furthermore, the use of educational AI- and ML-based systems in communication skills training for health care professionals is currently limited to only a few cases, topics, and clinical domains. The use of AI and ML in communication skills training for health care professionals is clearly a growing and promising field with a potential to render training more cost-effective and less time-consuming. Furthermore, it may serve learners as an individualized and readily available exercise method. However, in most cases, the outlined applications and technical solutions are limited in terms of access, possible scenarios, the natural flow of a conversation, and authenticity. These issues still stand in the way of any widespread implementation ambitions.

Experiences and perspectives of healthcare professionals implementing advance care planning for people suffering from life-limiting illness: a systematic review and meta-synthesis of qualitative studies

BackgroundLife-limited patients may lose decision-making abilities during disease progression. Advance care planning can be used as a discussion method for healthcare professionals to understand patients’ future care preferences. However, due to many difficulties, the participation rate of healthcare professionals in advance care planning is not high.AimTo explore the facilitators of and barriers to healthcare professionals’ provision of advance care planning to life-limited patients to better implement it for this population.MethodsWe followed ENTREQ and PRISMA to guide this study. We conducted a systematic search of PubMed, Web of Science, Embase, CINAHL, PsycINFO, CNKI, and SinoMed to include qualitative data on the experiences and perspectives of healthcare professionals in different professional fields in providing advance care planning for life-limited patients. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research was used to assess the quality of the included studies.ResultsA total of 11 studies were included. Two themes were identified: unsupported conditions and facilitative actions. Healthcare professionals regarded cultural concepts, limited time, and fragmented record services as obstacles to implementation. They had low confidence and were overly concerned about negative effects. They needed to possess multiple abilities, learn to flexibly initiate topics, and facilitate effective communication based on multidisciplinary collaboration.ConclusionHealthcare professionals need an accepting cultural environment to implement advance care planning, a sound legal system, financial support, and a coordinated and shared system to support them. Healthcare systems need to develop educational training programs to increase the knowledge and skills of healthcare professionals and to promote multidisciplinary collaboration to facilitate effective communication. Future research should compare the differences in the needs of healthcare professionals in different cultures when implementing advance care planning to develop systematic implementation guidelines in different cultures.

Advancing the Cardiovascular Workforce in Africa to Tackle the Epidemic of Cardiovascular Disease: The Time is Now.

The African region is experiencing an epidemic of cardiovascular disease with dire consequences of increasing morbidity and mortality. Compared with high-income countries where older populations are most affected, the burden of CVD in Africa is higher in the younger populations, which hampers regional socioeconomic development. Strategies to increase and advance the cardiovascular workforce are urgently needed to help address this problem. This commentary highlights the critical lack of skilled cardiovascular healthcare professionals, including cardiologists, cardiac surgeons, and cardiovascular nurses in the African region. Multilevel viable solutions to advance the cardiovascular workforce in Africa based on successful models in Africa are also presented.