Nursing Partnership Activities, Components, and Outcomes: Health Volunteers Overseas in Uganda 2001-2016.
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ABSTRACT:
SUBMITTER: Mbalinda SN
PROVIDER: S-EPMC5509790 | biostudies-other | 2017
REPOSITORIES: biostudies-other
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Project description:The World Health Organization estimates a global deficit of about 12.9 million skilled health professionals (midwives, nurses, and physicians) by 2035. These shortages limit the ability of countries, particularly resource-constrained countries, to deliver basic health care, to respond to emerging and more complex needs, and to teach, graduate, and retain their future health professionals-a vicious cycle that is perpetuated and has profound implications for health security. The Global Health Service Partnership (GHSP) is a unique collaboration between the Peace Corps, President's Emergency Plan for AIDS Relief, Seed and host-country institutions, which aims to strengthen the breadth and quality of medical and nursing education and care delivery in places with dire shortages of health professionals. Nurse and physician educators are seconded to host institutions to serve as visiting faculty alongside their local colleagues. They serve for 1 year with many staying longer. Educational and clinical best practices are shared, emphasis is placed on integration of theory and practice across the academic-clinical domains and the teaching and learning environment is expanded to include implementation science and dissemination of locally tailored and sustainable practice innovations. In the first 3 years (2013-2016) GHSP placed 97 nurse and physician educators in three countries (Malawi, Tanzania, and Uganda). These educators have taught 454 courses and workshops to 8,321 trainees, faculty members, and practicing health professionals across the curriculum and in myriad specialties. Mixed-methods evaluation included key stakeholder interviews with host institution faculty and students who indicate that the addition of GHSP enhanced clinical teaching (quality and breadth) resulting in improved clinical skills, confidence, and ability to connect theory to practice and critical thinking. The outputs and outcomes from four exemplars which focus on the translation of evidence to practice through implementation science are included. Findings from the first 3 years of GHSP suggest that an innovative, locally tailored and culturally appropriate multi-country academic-clinical partnership program that addresses national health priorities is feasible and generated new knowledge and best practices relevant to capacity building for nursing and medical education. This in turn has implications for improving the health of populations who suffer a disproportionate burden of global disease.
| S-EPMC5522849 | biostudies-other
Project description:Effective management of marine systems requires quantitative tools that can assess the state of the marine social-ecological system and are responsive to management actions and pressures. We applied the Ocean Health Index (OHI) framework to retrospectively assess ocean health in British Columbia annually from 2001 to 2016 for eight goals that represent the values of British Columbia's coastal communities. We found overall ocean health improved over the study period, from 75 (out of 100) in 2001 to 83 in 2016, with scores for inhabited regions ranging from 68 (North Coast, 2002) to 87 (West Vancouver Island, 2011). Highest-scoring goals were Tourism & Recreation (average 94 over the period) and Habitat Services (100); lowest-scoring goals were Sense of Place (61) and Food Provision (64). Significant increases in scores over the time period occurred for Food Provision (+1.7 per year), Sense of Place (+1.4 per year), and Coastal Livelihoods (+0.6 per year), while Habitat Services (-0.01 per year) and Biodiversity (-0.09 per year) showed modest but statistically significant declines. From the results of our time-series analysis, we used the OHI framework to evaluate impacts of a range of management actions. Despite challenges in data availability, we found evidence for the ability of management to reduce pressures on several goals, suggesting the potential of OHI as a tool for assessing the effectiveness of marine resource management to improve ocean health. Our OHI assessment provides an important comprehensive evaluation of ocean health in British Columbia, and our open and transparent process highlights opportunities for improving accessibility of social and ecological data to inform future assessment and management of ocean health.
| S-EPMC6992189 | biostudies-literature
Project description:ObjectivesTo describe the long-term socioeconomic and reproductive health outcomes of women in Uganda by adolescent birth history.DesignCross-sectional study.SettingUganda.ParticipantsWomen aged 40-49 years at the 2016 Uganda Demographic and Health Survey.Outcome measuresWe compared socioeconomic and reproductive outcomes among those with first birth <18 years versus not. Among those with a first birth <18 years, we compared those with and without repeat adolescent births (another birth <20 years). We used two-sample test for proportions, linear regression and Poisson regression.FindingsAmong the 2814 women aged 40-49 years analysed, 36.2% reported a first birth <18 years and 85.9% of these had a repeat adolescent birth. Compared with women with no birth <18 years, those with first birth <18 years were less likely to have completed primary education (16.3% vs 32.2%, p<0.001), more likely to be illiterate (55.0% vs 44.0%, p<0.001), to report challenges seeking healthcare (67.6% vs 61.8%, p=0.002) and had higher mean number of births by age 40 years (6.6 vs 5.3, p<0.001). Among women married at time of survey, those with birth <18 years had older husbands (p<0.001) who also had lower educational attainment (p<0.001). Educational attainment, household wealth score, total number of births and under-5 mortality among women with one adolescent birth were similar, and sometimes better, than among those with no birth <18 years.ConclusionsResults suggest lifelong adverse socioeconomic and reproductive outcomes among women with adolescent birth, primarily in the category with repeat adolescent birth. While our results might be birth-cohort specific, they underscore the need to support adolescent mothers to have the same possibilities to develop their potentials, by supporting school continuation and prevention of further unwanted pregnancies.
| S-EPMC7878126 | biostudies-literature
Project description:BackgroundLactating mothers are at increased risk of being underweight because of the physiological changes that lead to disproportionately higher energy and nutrient requirements compared to their non-pregnant and non-lactating counterparts.ObjectiveWe aimed to determine the prevalence and factors associated with being underweight among lactating women in Uganda.MethodsWe used the Uganda Demographic and Health Survey (UDHS) 2016 data of 1356 women aged 20 to 49 years. Multistage stratified sampling was used to select study participants. The data were collected using validated questionnaires. We used multivariable logistic regression to determine factors associated with underweight among 20 to 49-year-old lactating women in Uganda.ResultsThe prevalence of underweight was 8.2% (111/1356) (95% confidence interval, [CI]: 7.0-10.0). Women who had no education were 10.21 (adjusted odds ratio, [AOR] = 10.21; 95% CI: 1.61-64.74) times as likely to be underweight as those who had higher (post-secondary) education levels. Women who were not working were 50% (AOR = 0.50; 95% CI: 0.26-0.94) less likely to be underweight compared to those who were working. Women in the Western (AOR = 0.15; 95% CI: 0.07-0.32), Eastern (AOR = 0.34; 95% CI: 0.18-0.66), and Central (AOR = 0.30; 95% CI: 0.12-0.74) regions were 85%, 66% and 70% respectively less likely to be underweight compared to those in the Northern region.ConclusionBased on the findings of this and other studies, it is important for the different stakeholders to design targeted nutrition programs for lactating women particularly those with low levels of education and those from the Northern region.
| S-EPMC8362635 | biostudies-literature
Project description:We report 958 cases of cestodiasis occurring in Japan during 2001-2016. The predominant pathogen was Diphyllobothrium nihonkaiense tapeworm (n = 825), which caused 86.1% of all cases. The other cestode species involved were Taenia spp. (10.3%), Diplogonoporus balaenopterae (3.3%), and Spirometra spp. (0.2%). We estimated D. nihonkaiense diphyllobothriasis incidence as 52 cases/year. We observed a predominance of cases during March-July, coinciding with the cherry salmon and immature chum salmon fishing season, but cases were present year-round, suggesting that other fish could be involved in transmission to humans. Because of increased salmon trade, increased tourism in Japan, and lack of awareness of the risks associated with eating raw fish, cases of D. nihonkaiense diphyllobothriasis are expected to rise. Therefore, information regarding these concerning parasitic infections and warnings of the potential risks associated with these infections must be disseminated to consumers, food producers, restaurant owners, physicians, and travelers.
| S-EPMC6056094 | biostudies-literature
Project description:BackgroundIn the summer of 2016 an international group of biomedical and health informatics faculty and graduate students gathered for the 16th meeting of the International Partnership in Health Informatics Education (IPHIE) masterclass at the University of Utah campus in Salt Lake City, Utah. This international biomedical and health informatics workshop was created to share knowledge and explore issues in biomedical health informatics (BHI).ObjectiveThe goal of this paper is to summarize the discussions of biomedical and health informatics graduate students who were asked to define interoperability, and make critical observations to gather insight on how to improve biomedical education.MethodsStudents were assigned to one of four groups and asked to define interoperability and explore potential solutions to current problems of interoperability in health care.ResultsWe summarize here the student reports on the importance and possible solutions to the "interoperability problem" in biomedical informatics. Reports are provided from each of the four groups of highly qualified graduate students from leading BHI programs in the US, Europe and Asia.ConclusionInternational workshops such as IPHIE provide a unique opportunity for graduate student learning and knowledge sharing. BHI faculty are encouraged to incorporate into their curriculum opportunities to exercise and strengthen student critical thinking to prepare our students for solving health informatics problems in the future.
| S-EPMC6241746 | biostudies-literature
Project description:ObjectiveTo identify and assess the globally available valid, reliable and acceptable tools for assessing health research partnership outcomes and impacts.MethodsWe searched Ovid MEDLINE, Embase, CINAHL Plus and PsycINFO from origin to 2 June 2021, without limits, using an a priori strategy and registered protocol. We screened citations independently and in duplicate, resolving discrepancies by consensus and retaining studies involving health research partnerships, the development, use and/or assessment of tools to evaluate partnership outcomes and impacts, and reporting empirical psychometric evidence. Study, tool, psychometric and pragmatic characteristics were abstracted using a hybrid approach, then synthesized using descriptive statistics and thematic analysis. Study quality was assessed using the quality of survey studies in psychology (Q-SSP) checklist.ResultsFrom 56 123 total citations, we screened 36 027 citations, assessed 2784 full-text papers, abstracted data from 48 studies and one companion report, and identified 58 tools. Most tools comprised surveys, questionnaires and scales. Studies used cross-sectional or mixed-method/embedded survey designs and employed quantitative and mixed methods. Both studies and tools were conceptually well grounded, focusing mainly on outcomes, then process, and less frequently on impact measurement. Multiple forms of empirical validity and reliability evidence was present for most tools; however, psychometric characteristics were inconsistently assessed and reported. We identified a subset of studies (22) and accompanying tools distinguished by their empirical psychometric, pragmatic and study quality characteristics. While our review demonstrated psychometric and pragmatic improvements over previous reviews, challenges related to health research partnership assessment and the nascency of partnership science persist.ConclusionThis systematic review identified multiple tools demonstrating empirical psychometric evidence, pragmatic strength and moderate study quality. Increased attention to psychometric and pragmatic requirements in tool development, testing and reporting is key to advancing health research partnership assessment and partnership science. PROSPERO CRD42021137932.
| S-EPMC9817421 | biostudies-literature
Project description:BACKGROUND:Perinatal mortality is a devastating pregnancy outcome affecting millions of families in many low and middle-income countries including Nepal. This paper examined the more distant factors associated with perinatal mortality in Nepal. METHODS:A sample of 23,335 pregnancies >?28?weeks' gestation from the Nepal Demographic and Health Survey datasets for the period (2001-2016) was analysed. Perinatal Mortality (PM) is defined as the sum of stillbirth (fetal deaths in pregnancies >?28?weeks' gestation) and early neonatal mortality (deaths within the first week of life), while Extended Perinatal Mortality (EPM) is denoted as the sum of stillbirth and neonatal mortality (deaths within the first 28?days of life). Rates of PM and EPM were calculated. Logistic regression generalized linear latent and mixed models (GLLAMM) that adjusted for clustering and sampling weight was used to examine the factor associated with perinatal mortality. RESULTS:Over the study period, the PMR was 42 [95% Confidence Interval (CI): 39, 44] per 1000 births for the five-year before each survey; while corresponding EPMR was 49 (95% CI, 46, 51) per 1000 births. Multivariable analyses revealed that women residing in the mountains, who did not use contraceptives, women aged 15-18?years or 19-24?years, and women having no education were associated with increased PM and EPM. The study also identified households using biomass as cooking fuel, and households who reported unimproved sanitation or open defecation were significantly more likely to experience PM and EPM. CONCLUSIONS:Interventions aimed to improve use of contraceptives, and reduce biomass as a source of cooking fuel are needed to achieve the recommended target of <?12 perinatal deaths per 1000 births by 2030.
| S-EPMC6417106 | biostudies-literature
Project description:Child mortality in Nepal has reduced, but the rate is still above the Sustainable Development Goal target of 20 deaths per 1000 live births. This study aimed to identify common factors associated with under-five mortality in Nepal. Survival information of 16,802 most recent singleton live births from the Nepal Demographic and Health Survey for the period (2001⁻2016) were utilized. Survey-based Cox proportional hazard models were used to examine factors associated with under-five mortality. Multivariable analyses revealed the most common factors associated with mortality across all age subgroups included: mothers who reported previous death of a child [adjusted hazard ratio (aHR) 17.33, 95% confidence interval (CI) 11.44, 26.26 for neonatal; aHR 13.05, 95% CI 7.19, 23.67 for post-neonatal; aHR 15.90, 95% CI 11.38, 22.22 for infant; aHR 16.98, 95% CI 6.19, 46.58 for child; and aHR 15.97, 95% CI 11.64, 21.92 for under-five mortality]; nonuse of tetanus toxoids (TT) vaccinations during pregnancy (aHR 2.28, 95% CI 1.68, 3.09 for neonatal; aHR 1.86, 95% CI 1.24, 2.79 for post-neonatal; aHR 2.44, 95% CI 1.89, 3.15 for infant; aHR 2.93, 95% CI 1.51, 5.69 for child; and aHR 2.39, 95% CI 1.89, 3.01 for under-five mortality); and nonuse of contraceptives among mothers (aHR 1.69, 95% CI 1.21, 2.37 for neonatal; aHR 2.69, 95% CI 1.67, 4.32 for post-neonatal; aHR 2.01, 95% CI 1.53, 2.64 for infant; aHR 2.47, 95% CI 1.30, 4.71 for child; and aHR 2.03, 95% CI 1.57, 2.62 for under-five mortality). Family planning intervention as well as promotion of universal coverage of at least two doses of TT vaccine are essential to help achieve child survival Sustainable Development Goal (SDG) targets of <20 under-five deaths and <12 neonatal deaths per 1000 births by the year 2030.
| S-EPMC6479835 | biostudies-literature
Project description:ObjectivesTo explore the association between health literacy and levels of three types of core activities among health promotion volunteers (developing a healthy lifestyle, outreach to family, and outreach to community members).Study designA cross-sectional, anonymous, self-administered postal survey of registered health promotion volunteers in the Konan area in Shiga Prefecture in Japan, conducted in January 2010. The study sample was 575 registered health promotion volunteers.MethodsThe survey collected data on health literacy, gender, age, education, self-rated health, perceptions about the volunteer organization, and perceptions of recognition in the community. The level of engagement in health promotion activities was measured by the extent to which the participants engaged in seven healthy behaviors and promoted them to family members and the community. The authors compared the health literacy level and other characteristics of the participants by core health promotion activities, using a chi-squared test, to examine the associations between demographic and other variables and the three core activities (healthy lifestyle, outreach to family, and outreach to community).Logistic regression analysis was conducted to examine the association between the degree to which the volunteers engaged in core activities ("healthy lifestyle," "outreach to family," "outreach to community") and the levels of health literacy (low, medium, high) among health promotion volunteers, controlling for the effects of age, gender, health condition, education which may also have an impact on volunteers' outreach activities.ResultsFour hundred and fifty-four questionnaires were returned, a 79.0% response rate. Excluding 16 cases with missing values on health literacy or the degree of health promotion activities, 438 research subjects were included in the analysis (valid response rate: 76.2%). Health literacy and a few demographic and other characteristics of the volunteers were associated with the three core health promotion activities. In bivariate analyses, active participation in the core activities was more prevalent among older volunteers (p<0.001 for all three activities). Self-rated health condition was associated with both outreach to family (p = 0.018) and community (p = 0.046). Years of experience as volunteer and perception of being recognized in the community also had statistically significant association with outreach to the community (p<0.001). In multiple logistic regression, those with higher level of health literacy were more likely than others to actively engage in outreach to family (OR = 1.70, 95% CI 1.03 to 2.80; OR = 1.76, 95%CI 1.04 to 3.00 for medium and high, respectively) and outreach to community (OR = 2.26, 95%CI 1.34 to 3.83; OR = 2.61 95%CI 1.49 to 4.58 for medium and high, respectively). Perception of being recognized in the community also had a statistically significant and positive impact on outreach to the community (OR = 1.52, 95%CI 1.17 to 1.99).ConclusionsVolunteers with higher health literacy were more likely to actively engage in outreach to family and outreach to community. Providing educational programs to improve volunteers' health literacy may facilitate their work.
| S-EPMC5063291 | biostudies-literature