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Wang W, Khelfaoui I, Ahmed D, Xie Y, Hafeez M, Meskher H. Nexus between information and communication technologies and life expectancies of low-income countries: Does technological advancement increase their life span? SSM Popul Health 2024; 25:101600. [PMID: 38304417 PMCID: PMC10832294 DOI: 10.1016/j.ssmph.2023.101600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/29/2023] [Accepted: 12/31/2023] [Indexed: 02/03/2024] Open
Abstract
Access to state-of-the-art infrastructure is inevitable for a higher standard of living for the people of any country. At least, this has been the case for developed countries. This study investigates the link between information and communication technologies (ICT) and life expectancy at birth (LEB) among low-income countries. We use panel data of low-income countries from 2000 to 2017 from the comprehensive World Bank dataset. Our analysis strategy includes employing Driskol and Kraay methodology and feasible generalized least squares to tackle cross-sectional dependence. Furthermore, we also employ the instrumental variable technique to deal with the endogeneity problem. We found that a rise in mobile internet use and Mobile Cellular Subscriptions led to improved LEB among low-income countries. On the contrary, the rise in fixed telephone subscriptions had a negative empirical effect on reducing LEB-however, the magnitude of the effect ranged between 0% and 4%.
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Affiliation(s)
- Wenxin Wang
- School of Public Health, Shantou University/Institute of Local Government Development, Shantou University, Shan-Tou 515063, China
| | - Issam Khelfaoui
- School of Public Health, Shantou University/Institute of Local Government Development, Shantou University, Shan-Tou 515063, China
- Department of Operational Research, Faculty of Mathematics, University of Science and Technology Houari Boumediane, China
| | - Danish Ahmed
- School of Finance and Economics, Jiangsu University, Zhenjiang, Jiangsu 212013, China
- School of Foreign Language, Shanghai Jianqiao University, Shanghai 201315, China
- Department of Business Administration, HANDS—Institute of Development Studies (HANDS-IDS), Karachi 75230, Pakistan
- Center for Islamic Finance, University of Bolton, Bolton BL3 5AB, UK
- International Institute on Governance and Strategy (IIGS), Beijing 100000, China
| | - Yuantao Xie
- School of Insurance and Economics, University of International Business and Economics, Beijing 100029, China
| | - Muhammad Hafeez
- Institute of Business and Management Sciences, University of Agriculture, Faisalabad, Pakistan
- Adnan Kassar School of Business, Lebanese American University, Beirut, Lebanon
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Musa SM, Haruna UA, Manirambona E, Eshun G, Ahmad DM, Dada DA, Gololo AA, Musa SS, Abdulkadir AK, Lucero-Prisno III DE. Paucity of Health Data in Africa: An Obstacle to Digital Health Implementation and Evidence-Based Practice. Public Health Rev 2023; 44:1605821. [PMID: 37705873 PMCID: PMC10495562 DOI: 10.3389/phrs.2023.1605821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/17/2023] [Indexed: 09/15/2023] Open
Abstract
Background: Among the numerous challenges that Africa faces in improving its healthcare systems, the paucity of health data stands out as paramount. This study aims to examine the challenges related to the paucity of health data in Africa and its impact on the implementation of digital health and evidence-based practice. The findings of the study reveal that health data availability in Africa is both limited and frequently of poor quality. Several factors contribute to this concerning situation, encompassing inadequate infrastructure, a shortage of resources, and cultural barriers. Furthermore, the available data, despite its limitations, is often underutilized due to a lack of capacity and expertise in data analysis and interpretation. Policy Options and Recommendations: To improve healthcare delivery in Africa, we recommend implementing novel strategies for data collection. It's important to recognize that effective information technology service is crucial for enhancing healthcare delivery, and a holistic approach is necessary to achieve this. Conclusion: This brief presents information to help policymakers develop long-term solutions to Africa's health data poverty. Taking action based on this evidence can assist in addressing the problem.
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Affiliation(s)
| | - Usman Abubakar Haruna
- Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria
- School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
| | - Emery Manirambona
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Gilbert Eshun
- Seventh-Day Adventist Hospital, Agona-Asamang, Ghana
| | | | - David Adelekan Dada
- Faculty of Pharmaceutical Sciences, Kaduna State University, Kaduna, Nigeria
| | - Ahmed Adamu Gololo
- Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | | | | | - Don Eliseo Lucero-Prisno III
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
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Bahri P, Bowring G, Edwards BD, Anton C, Aronson JK, Caro-Rojas A, Hugman BPJ, Mol PG, Trifirò G, Ilic K, Daghfous R, Fermont I, Furlan G, Gaissmaier W, Geer MI, Hartigan-Go KY, Houÿez F, Neth H, Norgela G, Oppamayun Y, Raynor DKT, Bouhlel M, Santoro F, Sultana J. Communicating for the Safe Use of Medicines: Progress and Directions for the 2020s Promoted by the Special Interest Group of the International Society of Pharmacovigilance. Drug Saf 2023; 46:517-532. [PMID: 37219785 DOI: 10.1007/s40264-023-01285-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2023] [Indexed: 05/24/2023]
Affiliation(s)
- Priya Bahri
- Special Interest Group on Medicinal Product Risk Communication of the International Society of Pharmacovigilance (ISoP CommSIG), Geneva, Switzerland.
- European Medicines Agency (EMA) (Coordinator of the ISoP CommSIG in Her Personal Capacity), Domenico Scarlattilaan 6, 1083 HS, Amsterdam, The Netherlands.
| | - Geoffrey Bowring
- Special Interest Group on Medicinal Product Risk Communication of the International Society of Pharmacovigilance (ISoP CommSIG), Geneva, Switzerland
- Uppsala Monitoring Centre (UMC), Uppsala, Sweden
| | - Brian D Edwards
- Special Interest Group on Medicinal Product Risk Communication of the International Society of Pharmacovigilance (ISoP CommSIG), Geneva, Switzerland
- Husoteria Ltd, Ashtead, UK
| | - Christopher Anton
- Special Interest Group on Medicinal Product Risk Communication of the International Society of Pharmacovigilance (ISoP CommSIG), Geneva, Switzerland
- West Midlands Centre for Adverse Drug Reactions, City Hospital, Birmingham, UK
| | - Jeffrey K Aronson
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Angela Caro-Rojas
- Special Interest Group on Medicinal Product Risk Communication of the International Society of Pharmacovigilance (ISoP CommSIG), Geneva, Switzerland
- Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Peter G Mol
- Special Interest Group on Medicinal Product Risk Communication of the International Society of Pharmacovigilance (ISoP CommSIG), Geneva, Switzerland
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, Groningen, The Netherlands
| | - Gianluca Trifirò
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Katarina Ilic
- Special Interest Group on Medicinal Product Risk Communication of the International Society of Pharmacovigilance (ISoP CommSIG), Geneva, Switzerland
- Takeda, Cambridge, MA, USA
| | - Riadh Daghfous
- Tunisian National Centre of Pharmacovigilance, Tunis, Tunisia
| | - Irene Fermont
- Israel Society for Medication and Vaccine Safety (ERANIM), Jerusalem, Israel
| | - Giovanni Furlan
- Special Interest Group on Medicinal Product Risk Communication of the International Society of Pharmacovigilance (ISoP CommSIG), Geneva, Switzerland
- Pfizer s.r.l., Safety Surveillance and Risk Management, Milan, Italy
| | - Wolfgang Gaissmaier
- Department of Psychology, Social Psychology and Decision Sciences, University of Konstanz, Konstanz, Germany
| | - Mohammad Ishaq Geer
- Department of Pharmaceutical Sciences, University of Kashmir, Srinagar, India
| | - Kenneth Y Hartigan-Go
- Special Interest Group on Medicinal Product Risk Communication of the International Society of Pharmacovigilance (ISoP CommSIG), Geneva, Switzerland
- School of Government, Ateneo De Manila University, Quezon City, Philippines
| | - François Houÿez
- European Organisation for Rare Diseases (EURORDIS), Paris, France
| | - Hansjörg Neth
- Department of Psychology, Social Psychology and Decision Sciences, University of Konstanz, Konstanz, Germany
| | | | - Yaowares Oppamayun
- Thai Food and Drug Administration, Health Product Vigilance Center, Bangkok, Thailand
| | | | - Mehdi Bouhlel
- Tunisian National Centre of Pharmacovigilance, Tunis, Tunisia
- Department of Pharmacology, Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
| | | | - Janet Sultana
- Pharmacy Department, Mater Dei Hospital, Msida, Malta
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Addotey-Delove M, Scott RE, Mars M. Healthcare Workers' Perspectives of mHealth Adoption Factors in the Developing World: Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1244. [PMID: 36673995 PMCID: PMC9858911 DOI: 10.3390/ijerph20021244] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/22/2022] [Accepted: 12/29/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND mHealth applications provide health practitioners with platforms that enable disease management, facilitate drug adherence, facilitate drug adherence, speed up diagnosis, monitor outbreaks, take and transfer medical images, and provide advice. Many developing economies are investing more in mobile telecommunication infrastructure than in road transport and electric power generation. Despite this, mHealth has not seen widespread adoption by healthcare workers in the developing world. This study reports a scoping review of factors that impact the adoption of mHealth by healthcare workers in the developing world, and based on these findings, a framework is developed for enhancing mHealth adoption by healthcare workers in the developing world. METHODS A structured literature search was performed using PubMed and Scopus, supplemented by hand searching. The searches were restricted to articles in English during the period January 2009 to December 2019 and relevant to the developing world that addressed: mobile phone use by healthcare workers and identified factors impacting the adoption of mHealth implementations. All authors reviewed selected papers, with final inclusion by consensus. Data abstraction was performed by all authors. The results were used to develop the conceptual framework using inductive iterative content analysis. RESULTS AND DISCUSSION Of 919 articles, 181 met the inclusion criteria and, following a review of full papers, 85 reported factors that impact (promote or impede) healthcare worker adoption of mHealth applications. These factors were categorised into 18 themes and, after continued iterative review and discussion were reduced to 7 primary categories (engagement/funding, infrastructure, training/technical support, healthcare workers' mobile-cost/ownership, system utility, motivation/staffing, patients' mobile-cost/ownership), with 17 sub-categories. These were used to design the proposed framework. CONCLUSIONS Successful adoption of mHealth by healthcare workers in the developing world will depend on addressing the factors identified in the proposed framework. They must be assessed in each specific setting prior to mHealth implementation. Application of the proposed framework will help shape future policy and practice of mHealth implementation in the developing world and increase adoption by health workers.
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Affiliation(s)
- Michael Addotey-Delove
- Department of TeleHealth, School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Richard E. Scott
- Department of TeleHealth, School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Maurice Mars
- Department of TeleHealth, School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia
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Saeed G, Kohler JC, Cuomo RE, Mackey TK. A systematic review of digital technology and innovation and its potential to address anti-corruption, transparency, and accountability in the pharmaceutical supply chain. Expert Opin Drug Saf 2022; 21:1061-1088. [PMID: 35714366 DOI: 10.1080/14740338.2022.2091543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The urgent need to acquire medical supplies amidst the COVID-19 pandemic has led to bypassing of controls that govern the global pharmaceutical supply chain, increasing the risk of corruption. Hence, promoting anti-corruption, transparency, and accountability (ACTA) in supply chain and procurement has never been more important. The adoption of digital tools, if designed and implemented appropriately, can reduce the risks of corruption. AREAS COVERED Following PRISMA guidelines, we conducted an interdisciplinary systematic review of health/medicine, humanities/social sciences, engineering, and computer science literature, with the aims of identifying technologies used for pharmaceutical supply chain and procurement optimization and reviewing whether they address ACTA mechanisms to strengthen pharmaceutical governance. Our review identified four distinct categories of digital solutions: e-procurement and open contracting; track-and-trace technology; anti-counterfeiting technology; and blockchain technology. EXPERT OPINION Findings demonstrate an increase in research of technologies to improve pharmaceutical supply chain and procurement functions; however, most technologies are not being leveraged to directly address ACTA or global health outcomes. Some blockchain and RFID technologies incorporated ACTA mechanisms and mentioned specific policy/governance frameworks, but more purposeful linkage is needed. Findings point to the need for targeted policy development and governance to activate these innovative technologies to improve global health .
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Affiliation(s)
- Gul Saeed
- Accountability and Transparency in the Pharmaceutical Sector, WHO Collaborating Centre for Governance, Toronto, ON, Canada
| | - Jillian C Kohler
- Accountability and Transparency in the Pharmaceutical Sector, WHO Collaborating Centre for Governance, Toronto, ON, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Raphael E Cuomo
- Global Health Policy and Data Institute, San Diego, CA, USA.,Department of Anesthesiology, University of California, San Diego - School of Medicine, La Jolla, CA, USA
| | - Tim K Mackey
- Accountability and Transparency in the Pharmaceutical Sector, WHO Collaborating Centre for Governance, Toronto, ON, Canada.,Global Health Policy and Data Institute, San Diego, CA, USA.,Global Health Program, Department of Anthropology, University of California, San Diego, La Jolla, CA, USA
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Information Communication Technology and Infant Mortality in Low-Income Countries: Empirical Study Using Panel Data Models. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127338. [PMID: 35742591 PMCID: PMC9224393 DOI: 10.3390/ijerph19127338] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/05/2022] [Accepted: 06/08/2022] [Indexed: 01/27/2023]
Abstract
According to the World Health Organization, lower-income countries suffer from adverse health issues more than higher-income countries. Information and communication technologies (ICT) have the potential to resolve these issues. Previous research has analyzed the theoretical and empirical causal effects of ICT on infant mortality at country-specific and global levels for a short period of time. However, the causes and results could be different in low-income countries. The objective of this paper was to examine the deficiencies through the use of panel data from 27 low-income countries from 2000–2017. We applied the predictive mean matching technique to supplement the missing data and then used panel data techniques (i.e., fixed effects (FE) and pooled common correlated effects (PCCE)), and system-GMM to estimate the causal effects. We compared the consistency and the possible heterogeneity of previous results using a set of robust techniques and empirical tests. We found that internet access and, to a lesser extent, cellular mobile subscriptions, two of the three ICT variables used in our research, had a significant positive effect on reducing infant mortality in low-income countries. In conclusion, governments and policymakers of low-income countries should consider the availability of internet-related ICT innovations and make them nationally accessible to reduce health crises such as the infant mortality rate.
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Sharif Z, Peiravian F, Salamzadeh J, Mohammadi NK, Jalalimanesh A. Irrational use of antibiotics in Iran from the perspective of complex adaptive systems: redefining the challenge. BMC Public Health 2021; 21:778. [PMID: 33892681 PMCID: PMC8063475 DOI: 10.1186/s12889-021-10619-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 03/14/2021] [Indexed: 11/12/2022] Open
Abstract
Background Irrational use of antibiotics is proving to be a major concern to the health systems globally. This results in antibiotics resistance and increases health care costs. In Iran, despite many years of research, appreciable efforts, and policymaking to avoid irrational use of antibiotics, yet indicators show suboptimal use of antibiotics, pointing to an urgent need for adopting alternative approaches to further understand the problem and to offer new solutions. Applying the Complex Adaptive Systems (CAS) theory, to explore and research health systems and their challenges has become popular. Therefore, this study aimed to better understand the complexity of the irrational use of antibiotics in Iran and to propose potential solutions. Method This research utilized a CAS observatory tool to qualitatively collect and analyse data. Twenty interviews and two Focus Group discussions were conducted. The data was enriched with policy document reviews to fully understand the system. MAXQDA software was used to organize and analyze the data. Result We could identify several diverse and heterogeneous, yet highly interdependent agents operating at different levels in the antibiotics use system in Iran. The network structure and its adaptive emergent behavior, information flow, governing rules, feedback and values of the system, and the way they interact were identified. The findings described antibiotics use as emergent behavior that is formed by an interplay of many factors and agents over time. According to this study, insufficient and ineffective interaction and information flow regarding antibiotics between agents are among key causes of irrational antibiotics use in Iran. Results showed that effective rules to minimize irrational use of antibiotics are missing or can be easily disobeyed. The gaps and weaknesses of the system which need redesigning or modification were recognized as well. Conclusion The study suggests re-engineering the system by implementing several system-level changes including establishing strong, timely, and effective interactions between identified stakeholders, which facilitate information flow and provision of on-time feedback, and create win-win rules in a participatory manner with stakeholders and the distributed control system.
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Affiliation(s)
- Zahra Sharif
- School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Peiravian
- School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jamshid Salamzadeh
- School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nastaran Keshavarz Mohammadi
- Health Promotion School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Scientific Committee of UNESCO global Chair on Health and Education Associate Editor, Health Promotion International, UZH, Zurich, Switzerland.
| | - Ammar Jalalimanesh
- Iranian Research Institute for Information Science and Technology (IRANDOC), Tehran, Iran
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Ogunleye OO, Fadare JO, Eriksen J, Oaiya O, Massele A, Truter I, Taylor SJE, Godman B, Gustafsson LL. Reported needs of information resources, research tools, connectivity and infrastructure among African Pharmacological Scientists to improve future patient care and health. Expert Rev Clin Pharmacol 2019; 12:481-489. [PMID: 30961406 DOI: 10.1080/17512433.2019.1605903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The potentials of Africa for growth and economic transformation through science remains challenging because of existing gaps in knowledge and infrastructure. The Africa Pharmacological Science Gateway project and the Medicines Utilization Research in Africa Group seek to meet the research needs of African pharmacologists. This study aimed at identifying priority needs that might be met by access to information and tools through e-infrastructure. METHODS A web-based cross-sectional study among 472 members of pharmacological societies in Africa to obtain information on their research interests and skills, available resources, needs, and knowledge gaps. Descriptive analyses were done. RESULTS A total of 118 responses from 13 countries were received, mostly from Nigeria (48.3%) and South Africa (21.3%). Respondents had wide ranges of research interests predominantly in drug utilization research. The desired resources included drug utilization research training and tools, pharmacokinetics and pharmacometrics modeling training and tools, drug-drug interaction and medicine prices resources, statistical analysis resources, access to journals, training in specific laboratory techniques, equipment and funding for research-related activities. CONCLUSIONS Key areas of needs not currently provided by the African Pharmacological Science Gateway e-infrastructure were identified to guide the further provision of resources on the e-infrastructure and potentially enhance research capacity within the continent.
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Affiliation(s)
- Olayinka O Ogunleye
- a Department of Pharmacology, Therapeutics and Toxicology , Lagos State University College of Medicine , Lagos , Nigeria.,b Department of Medicine , Lagos State University Teaching Hospital , Lagos , Nigeria
| | - Joseph O Fadare
- c Department of Pharmacology and Therapeutics , College of Medicine, Ekiti State University , Ado-Ekiti , Nigeria
| | - Jaran Eriksen
- d Division of Clinical Pharmacology, Department of Laboratory Medicine , Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden.,e Department of Public Health Sciences , Karolinska Institutet , Stockholm , Sweden
| | - Omo Oaiya
- f West and Central Africa Research and Education Network , Accra , Ghana
| | - Amos Massele
- g Department of Biomedical Sciences, Faculty of Medicine , University of Botswana , Gaborone , Botswana
| | - Ilse Truter
- h Drug Utilization Research Unit (DURU), Department of Pharmacy , Nelson Mandela Metropolitan University , Port Elizabeth , South Africa
| | - Simon J E Taylor
- i Department of Computer Science , Brunel University , London , U.K
| | - Brian Godman
- d Division of Clinical Pharmacology, Department of Laboratory Medicine , Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden.,j Strathclyde Institute of Pharmacy and Biomedical Sciences , University of Strathclyde , Glasgow , U.K .,k Department of Health Economics , Liverpool Management School, Liverpool University , Liverpool , U.K .,l School of Pharmacy , Sefako Makgatho Health Sciences University , Pretoria , South Africa
| | - Lars L Gustafsson
- d Division of Clinical Pharmacology, Department of Laboratory Medicine , Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden
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Khan NN, Puthussery S. Stakeholder perspectives on public-private partnership in health service delivery in Sindh province of Pakistan: a qualitative study. Public Health 2019; 170:1-9. [PMID: 30884348 DOI: 10.1016/j.puhe.2019.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 01/16/2019] [Accepted: 02/04/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to explore the perspectives of stakeholders on public-private partnership (PPP) in healthcare service delivery in Sindh province of Pakistan including the reasons for adopting such policies and the barriers for its implementation. STUDY DESIGN This was a qualitative primary study. METHODS Semistructured in-depth interviews were conducted with 13 stakeholders, including officials from provincial government and district administration (legislators, district managers, deputy commissioners and assistant commissioners) and representatives from private sector organisations with direct or indirect role in implementation of PPP policy, selected using purposive sampling methods. Data were analysed using a thematic approach. RESULTS Participants had very limited in-depth understanding about the concept of PPP. They considered multifaceted corruption in the health system and the success of existing PPP initiatives as the main reasons for the PPP policy adoption. Resistance from healthcare staff was perceived as the main barrier for implementation of PPP. There was a common perception that better monitoring capacity in the private sector management can be a cause of concern for public sector employees who may have become used to less efficient working. A common theme found in the narratives was the possible apprehensions from healthcare staff about the loss of their jobs. CONCLUSION Our findings indicated lack of effective engagement with key stakeholders and the resistance from healthcare staff as the key barriers for PPP implementation in Sindh, Pakistan. These findings provide useful insights for the successful implementation of such initiatives in Pakistan as well as in other similar settings.
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Affiliation(s)
- N N Khan
- Centre of Excellence in Women and Child Health, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - S Puthussery
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Putteridge Bury Campus, Hitchin Road, Luton, LU2 8LE, UK.
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Majeed MT, Khan FN. Do information and communication technologies (ICTs) contribute to health outcomes? An empirical analysis. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s11135-018-0741-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Opportunities and obstacles using a clinical decision support system for maternal care in Burkina Faso. Online J Public Health Inform 2017; 9:e188. [PMID: 29026454 DOI: 10.5210/ojphi.v9i2.7905] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Maternal and neonatal mortality is high in sub-Saharan Africa. To support Healthcare Workers (HCWs), a computerized decision support system (CDSS) was piloted at six rural maternal care units in Burkina Faso. During the two years of the study period, it was apparent from reports that the CDSS was not used regularly in clinical practice. This study aimed to explore the reasons why HCWs failed to use the CDSS. METHODS A workshop, organized as group discussions and a plenary session, was performed with 13 participants to understand their experience with the CDSS and suggest improvements if pertinent. Workshop transcripts were analyzed thematically. Socio-demographic and usage patterns of the CDSS were examined by a questionnaire and analyzed descriptively. RESULTS The participants reported that the contextual basic conditions for using the CDSS were not fulfilled. These included unreliable power supply, none user-friendly partograph, the CDSS was not integrated with workflow and staff lacked motivational incentives. Despite these limitations, the HCWs reported learning benefits from guidance and alerts in the CDSS. Using the CDSS enabled them to discover problems earlier as they learned to focus on symptoms to prevent harmful situations. CONCLUSION The CDSS was not tailored to the needs and context of the users. The HCWs, defined their needs and suggested how the CDSS should be re-designed. This suggests that the successful and regular usage of any CDSS in rural settings requires the involvement of users throughout the construction and pilot-testing phases and not only during the early prototype design period.
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Sato M, Maufi D, Mwingira UJ, Leshabari MT, Ohnishi M, Honda S. Measuring three aspects of motivation among health workers at primary level health facilities in rural Tanzania. PLoS One 2017; 12:e0176973. [PMID: 28475644 PMCID: PMC5419572 DOI: 10.1371/journal.pone.0176973] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Accepted: 04/20/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The threshold of 2.3 skilled health workers per 1,000 population, published in the World Health Report in 2006, has galvanized resources and efforts to attain high coverage of skilled birth attendance. With the inception of the Sustainable Development Goals (SDGs), a new threshold of 4.45 doctors, nurses, and midwives per 1,000 population has been identified. This SDG index threshold indicates the minimum density to respond to the needs of health workers to deliver a much broader range of health services, such as management of non-communicable diseases to meet the targets under Goal 3: Ensure healthy lives and promote well-being for all people of all ages. In the United Republic of Tanzania, the density of skilled health workers in 2012 was 0.5 per 1,000 population, which more than doubled from 0.2 per 1,000 in 2002. However, this showed that Tanzania still faced a critical shortage of skilled health workers. While training, deployment, and retention are important, motivation is also necessary for all health workers, particularly those who serve in rural areas. This study measured the motivation of health workers who were posted at government-run rural primary health facilities. OBJECTIVES We sought to measure three aspects of motivation-Management, Performance, and Individual Aspects-among health workers deployed in rural primary level government health facilities. In addition, we also sought to identify the job-related attributes associated with each of these three aspects. Two regions in Tanzania were selected for our research. In each region, we further selected two districts in which we carried out our investigation. The two regions were Lindi, where we carried out our study in the Nachingwea District and the Ruangwa District, and Mbeya, within which the Mbarali and Rungwe Districts were selected for research. All four districts are considered rural. METHODS This cross-sectional study was conducted by administering a two-part questionnaire in the Kiswahili language. The first part was administered by a researcher, and contained questions for gaining socio-demographic and occupational information. The second part was a self-administered questionnaire that contained 45 statements used to measure three aspects of motivation among health workers. For analyzing the data, we performed multivariate regression analysis in order to evaluate the simultaneous effects of factors on the outcomes of the motivation scores in the three areas of Management, Performance, and Individual Aspects. RESULTS Motivation was associated with marital status (p = 0.009), having a job description (p<0.001), and number of years in the current profession (<1 year: p = 0.043, >7 years: p = 0.042) for Management Aspects; having a job description (p<0.001) for Performance Aspects; and salary scale (p = 0.029) for Individual Aspects. CONCLUSION Having a clear job description motivates health workers. The existing Open Performance Review and Appraisal System, of which job descriptions are the foundation, needs to be institutionalized in order to effectively manage the health workforce in resource-limited settings.
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Affiliation(s)
- Miho Sato
- Department of Community-based Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Deogratias Maufi
- President’s Office Regional Administration and Local Goverment, Dodoma, Tanzania
| | - Upendo John Mwingira
- Neglected Tropical Diseases Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania
| | - Melkidezek T. Leshabari
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Mayumi Ohnishi
- Department of Community-based Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Sumihisa Honda
- Department of Community-based Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Abstract
This systematic review describes mHealth interventions directed at healthcare workers in low-resource settings from the PubMed database from March 2009 to May 2015. Thirty-one articles were selected for final review. Four categories emerged from the reviewed articles: data collection during patient visits, communication between health workers and patients, communication between health workers, and public health surveillance. Most studies used a combination of quantitative and qualitative methods to assess acceptability of use, barriers to use, changes in healthcare delivery, and improved health outcomes. Few papers included theory explicitly to guide development and evaluation of their mHealth programs. Overall, evidence indicated that mobile technology tools, such as smartphones and tablets, substantially benefit healthcare workers, their patients, and healthcare delivery. Limitations to mHealth tools included insufficient program use and sustainability, unreliable Internet and electricity, and security issues. Despite these limitations, this systematic review demonstrates the utility of using mHealth in low-resource settings and the potential for widespread health system improvements using technology.
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Olok GT, Yagos WO, Ovuga E. Knowledge and attitudes of doctors towards e-health use in healthcare delivery in government and private hospitals in Northern Uganda: a cross-sectional study. BMC Med Inform Decis Mak 2015; 15:87. [PMID: 26537731 PMCID: PMC4634590 DOI: 10.1186/s12911-015-0209-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 10/12/2015] [Indexed: 11/29/2022] Open
Abstract
Background E-health is an essential information sharing tool in healthcare management and delivery worldwide. However, utilization of e-health may only be possible if healthcare professionals have positive attitudes towards e-health. This study aimed to determine the relationships between healthcare professionals’ attitudes towards e-health, level of ICT skills and e-Health use in healthcare delivery in government and private hospitals in northern Uganda. Methods Cross-sectional survey design was used. Sixty-eight medical doctors in three government hospitals and four private hospitals in Northern Uganda participated in the study. A pretested self-administered questionnaire was used to collect the required data. Data was analysed using SPSS software Version 19. Results Out of the 68 respondents, 39 (57.4 %) reported access to computer and 29 (48.5 %) accessed Internet in the workplace. Majority of healthcare professionals had positive attitudes towards e-health attributes (mean 3.5). The level of skills was moderate (mean 3.66), and was the most important and significant predictor of ICT use among healthcare professionals (r = .522, p < .001); however, attitudes towards e-health attributes did not contribute significantly in predicting e-health use. Conclusions The findings suggest need for hospitals managements to strengthen e-health services in healthcare delivery in Northern Uganda.
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Affiliation(s)
- Geoffrey Tabo Olok
- Department of Computer Science, Faculty of Science Gulu University, P.O. Box 166, Gulu, Uganda
| | - Walter Onen Yagos
- Department of Library and Information Service, Faculty of Medicine Gulu University, P.O. Box 166, Gulu, Uganda.
| | - Emilio Ovuga
- Department of Mental Health, Faculty of Medicine Gulu University, P.O.Box 166, Gulu, Uganda
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Massele A, Godman B, Adorka M, Fadare J, Gray A, Lubbe M, Ogunleye O, Truter I. Initiative to progress research on medicine utilization in Africa: formation of the Medicines Utilization Research in Africa group. Expert Rev Pharmacoecon Outcomes Res 2015; 15:607-10. [DOI: 10.1586/14737167.2015.1065735] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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