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Opportunities and barriers for genetic service delivery in Kenya from a health personnel perspective.

ABSTRACT: Genetic counselling and testing are essential health services for the management of heritable diseases. However, in low-and-middle income countries like Kenya, genetic counsellors are not yet a licenced profession, and there is limited availability of and access to genetic testing. This study aimed to uncover opportunities and barriers for genetic service delivery in the Kenyan healthcare system from the perspectives of those who provide genetic testing and/or genetic counselling. Participants included Kenyan health personnel who deliver genetic services. This was a qualitative study that collected data via semi-structured one-on-one interviews and analyzed it using inductive thematic analysis. Participant demographics and characteristics of clinical genetic service provision were collected using a survey and results summarized using descriptive statistics. Themes revealed during analysis were compared to the clinical characteristics of genetic service provision to inform the opportunities and barriers. Fifteen interviews were conducted in total. Thematic analysis indicated that participants believed that the barriers facing genetic service delivery were linked to three themes: (1) education and training, (2) costs, and (3) counselling challenges. The opportunities for genetic service delivery were linked to four themes: (1) demand, (2) education and training, (3) encouraging a multidisciplinary approach to care, and (4) enhancing laboratory infrastructure. These findings are crucial for the development of a national evidence-informed and culturally appropriate model for genetic service delivery.

SUBMITTER: Zhong A

PROVIDER: S-EPMC8257851 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:IntroductionHealthcare delivery systems across the world have been shown to fall short of the ideals of being cost-effective and meeting pre-established standards of quality but the problem is more pronounced in Africa. Cloud computing emerges as a platform healthcare institutions could leverage to address these shortfalls. The aim of this study was to establish the extent of cloud computing adoption and its influence on health service delivery by public health facilities in Kisumu County.MethodsThe study employed a cross-sectional study design in one-time data collection among facility in-charges and health records officers from 57 public health facilities. The target population was 114 healthcare personnel and the sample size (n = 88) was computed using Yamane formula and drawn using stratified random sampling. Poisson regression was used to determine the influence of cloud computing adoption on the number of realized benefits to health service delivery.ResultsAmong 80 respondents, Cloud computing had been adopted by 42 (53%) while Software-as-a-Service, Platform-as-a-Service and Infrastructure-as-a-Service implementations were at 100%, 0% and 5% among adopters, respectively. Overall, those who had adopted cloud computing realized a significantly higher number of benefits to health service delivery compared to those who had not (Incident-rate ratio (IRR) =1.93, 95% confidence interval (95% CI) [1.36-2.72]). A significantly higher number of benefits was realized by those who had implemented Infrastructure-as-a-Service alongside Software-as-a-Service (IRR = 2.22, 95% CI [1.15-4.29]) and those who had implemented Software-as-a-Service only (IRR = 1.89, 95% CI [1.33-2.70]) compared to non-adopters. We observed similar results in the stratified analysis looking at economic, operational, and functional benefits to health service delivery.ConclusionCloud computing resulted in improved health service delivery with these benefits still being realized irrespective of the service implementation model deployed. The findings buttress the need for healthcare institutions to adopt cloud computing and integrate it in their operations in order to improve health service delivery.

Project description:IntroductionPublic safety personnel (PSP; e.g., communications officials [e.g., 911 call center operators/dispatchers], correctional service employees, firefighters, paramedics, police officers) experience an elevated risk for mental disorders due to inherent work-related stress. Several programs have been designed to increase mental health knowledge, intending to reduce stigma, and increase mental health service help-seeking (e.g., resilience training); however, extant programs have not demonstrated sustained improvements for PSP mental health. The current study assessed levels of mental health knowledge, stigma, and service use intentions in a sample of Canadian PSP and compared trends to published estimates of mental health symptoms across PSP categories to inform future programming.MethodsPSP completed questionnaires assessing mental health knowledge, stigma against coworkers with mental illness, and professional service use intentions. Correlations among variables and one-way analyses of variance were conducted to assess differences among categories. PSP were categorized into six categories for comparison: communication officials, correctional workers, firefighters, municipal/provincial police, paramedics, and Royal Canadian Mounted Police (RCMP).ResultsThere were significant differences between categories for each variable. Correctional workers reported the most mental health knowledge, least stigma, and highest intentions to use mental health services, and the highest positive screens for mental disorders. Conversely, firefighters reported the lowest mental health knowledge, highest stigma, and lowest willingness to seek professional help, and the lowest prevalence of positive screens for mental disorders.DiscussionThe results contrast previously hypothesized associations among mental health variables where education, stigma reduction, and help-seeking have been expected to improve mental health. The discrepant results offer potentially critical information for organizational policies to better support PSP. Individuals reporting mental health symptoms may be a more appropriate target audience for intervention strategies, given the possible, crucial role personal experience plays in increasing mental health knowledge, and ultimately, encouraging help-seeking.

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Opportunities and barriers for genetic service delivery in Kenya from a health personnel perspective.

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