Prospective evaluation of World Health Organization guidelines for diagnosis of pneumonia in children presenting to an emergency department in a resource-limited setting

Background/Aims The partograph is a tool used to monitor events during labour and was recently modified by the World Health Organization to improve intrapartum care. However, it is unknown how obstetric care providers in Malawi perceive this modified partograph. This study aimed to evaluate the perceived strengths and challenges regarding the World Health Organization's modified partograph design among obstetric care providers in Malawi. Methods For this qualitative study, data were collected from a sample of 34 obstetric care providers from two purposively-selected urban health facilities through in-depth interviews and focus group discussions. The data were subjected to thematic analysis, with the strengths and challenges of using the modified partograph designated as the two major themes. Results The participants reported that there were more challenges than strengths with utilisation of the modified partograph. Two subthemes emerged among the strengths: the partograph is comprehensive and the partograph is clear. Three subthemes emerged from the challenges: 1) unrealistic fetal monitoring intervals, 2) confusing partograph design regarding documentation of caput and moulding and 3) small font. These challenges made partograph use impractical to complete, particularly in the context of chronic understaffing of the labour ward. Conclusions Until staffing levels are improved in Malawi and other resource-limited settings, it is unlikely that the modified partograph design will significantly improve maternal or neonatal outcomes. However, some improvements can be made to the design to help facilitate its use, and more training on its use is needed to prevent confusion.

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Building laboratory capacity to support HIV care in Nigeria: Harvard/APIN PEPFAR, 2004–2012

African Journal of Laboratory Medicine ◽

10.4102/ajlm.v4i1.190 ◽

2015 ◽

Vol 4 (1) ◽

Cited By ~ 7

Author(s):

Donald J. Hamel ◽

Jean-Louis Sankalé ◽

Jay O. Samuels ◽

Abdoulaye D. Sarr ◽

Beth Chaplin ◽

...

Keyword(s):

Viral Load ◽

Scale Up ◽

Hiv Treatment ◽

Resource Limited Setting ◽

World Health ◽

Hiv Care ◽

Future Health ◽

Laboratory Capacity ◽

Resource Limited ◽

Limited Setting

Introduction: From 2004–2012, the Harvard/AIDS Prevention Initiative in Nigeria, funded through the US President’s Emergency Plan for AIDS Relief programme, scaled up HIV care and treatment services in Nigeria. We describe the methodologies and collaborative processes developed to improve laboratory capacity significantly in a resource-limited setting. These methods were implemented at 35 clinic and laboratory locations.Methods: Systems were established and modified to optimise numerous laboratory processes. These included strategies for clinic selection and management, equipment and reagent procurement, supply chains, laboratory renovations, equipment maintenance, electronic data management, quality development programmes and trainings.Results: Over the eight-year programme, laboratories supported 160 000 patients receiving HIV care in Nigeria, delivering over 2.5 million test results, including regular viral load quantitation. External quality assurance systems were established for CD4+ cell count enumeration, blood chemistries and viral load monitoring. Laboratory equipment platforms were improved and standardised and use of point-of-care analysers was expanded. Laboratory training workshops supported laboratories toward increasing staff skills and improving overall quality. Participation in a World Health Organisation-led African laboratory quality improvement system resulted in significant gains in quality measures at five laboratories.Conclusions: Targeted implementation of laboratory development processes, during simultaneous scale-up of HIV treatment programmes in a resource-limited setting, can elicit meaningful gains in laboratory quality and capacity. Systems to improve the physical laboratory environment, develop laboratory staff, create improvements to reduce costs and increase quality are available for future health and laboratory strengthening programmes. We hope that the strategies employed may inform and encourage the development of other laboratories in resource-limited settings.

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Estimating Bed Requirements for Emergency Wards of Qazvin Teaching Hospitals by 2021: Dynamic Systems Modeling

Evidence Based Health Policy Management and Economics ◽

10.18502/jebhpme.v3i4.2063 ◽

2019 ◽

Author(s):

Sima Rafiei ◽

Rafat Mohebbifar ◽

Amir Mohammad Kazemifar ◽

Mahshad Shakuna

Keyword(s):

Emergency Department ◽

World Health Organization ◽

Nursing Staff ◽

Pressure Ratio ◽

World Health ◽

Teaching Hospitals ◽

Working Pressure ◽

Cross Sectional ◽

The World ◽

Health Organization

Background: The provision of manpower is one of the effective factors on the improvement in the coverage of health services and the realization of the highest community health level and a considerable part of the health budget is devoted to the production and update on human resources. Therefore, the current study aimed to estimate the number of nurses required in the Emergency Department (ED) of Imam Ali hospital based on the proposed method of the World Health Organization, in which the manpower is calculated based on the workload Workload Indicators of Staffing Need (WISN). Methods: This was a cross-sectional descriptive study. The study population was all the nurses working in the emergency department of Imam Ali hospital affiliated by Alborz University of Medical Sciences and their duties in the hospital which was performed using the proposed method of the World Health Organization i.e. WISN in 2018. Determination of their duties and the time and number of times for performing them were carried out during the group discussion session through Delphi method. Results: Based on the research findings, 40 standard nurses were calculated. The studied hospital had 4 nursing staff shortages. The working pressure ratio is 0.91in this study. Conclusion: In the current study, the nursing staff shortage is observed and this shortage caused a high working pressure on the nurses working in the study area. Considering the vital role of nurses in the emergency department, it is recommended to employ and distribute the manpower based on the requirement and workload in the department.

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