Health Systems Research Forum at Oxford
The crossing boundaries III forum on health systems research at the Green Templeton College in Oxford, got off to an exciting start with a good number of guests in attendance. The two - day results dissemination and sharing forum provided useful insights and inputs in ongoing research in low and middle income countries. These studies have the potential impact of improving care for sick newborns and neonates and latest findings from the HSD-N research programme, identified current coverage and gaps in the care of newborns/neonatal services in Kenya.
The project is led by Professor Mike English and Dr Georgina Murphy via the KemriWellcome Trust in Nairobi and from their base at Nuffied Department of Medicine and the University of Oxford. Findings from this meeting focused on and the role of nursing in neonatal care provision, gaps in nursing numbers and potential solutions. Topics discussed were on task shifting, interdisciplinary research methods, antimicrobial resistance, mental health and governance amongst others. The two-day meeting was from the 4-5th of December 2017. More
Congratulations to David Gathara and Jacinta Nzinga
Dr David Gathara and Dr Jacinta Nzinga were successful in their funding application under the HSRI scheme to support new work over the next 2 years. This is great news and a recognition of the interesting new work they are proposing.
The work explores how the nursing profession addresses the nursing workforce deficit in Kenya and will try to understand the effects of this deficit on quality of care and to help support efforts to tackle it.
Data packaging for policymakers is key
Speaking at the Clinical Information Network, CIN meeting this month, Dr Peter Cherutich urged research institutions that work with hospitals to package their research outputs as per global standards. Information and data targeting policymakers should capture in a snapshot, crucial information by creative use of infographics, maps and graphs.
Data should be simplified and packed in a manner that outlines an overview of results, gaps and impact. Dr Cherutich assured KEMRI Wellcome Trust Research Programme of continued support in the area of strengthening data quality and in facilitating research around implementation science. The three day CIN meeting that begun on 15th and ended on the 17th of November 2017 and was attended by hospital paediatricians, nurses and health records officers.
The Nairobi newborn studies report
The Nairobi newborn study provides a detailed landscape of the care being provided for small and sick newborns across Nairobi City County, highlighting important gaps in provision, access, and quality of care for this vulnerable population. Such findings and approaches to service evaluation will be crucial in order for governments to prioritise and plan service improvements to achieve a reduction in neonatal mortality.
The study accessed 1183 patient records from a total of 31 health facilities spanning from public, private and faith based facilities. Thirty three (4 public, 6 mission, and 23 private) facilities providing 24/7 inpatient care in Nairobi City County were identified; 31 were included in this study. Just five facilities accounted for 84% (10,300/12,202) of all annual admissions; the public sector accounted for 71% of admissions in just four facilities. Half of these facilities (15/31), had fewer than 50 annual admissions. Speaking in Nairobi on Monday, October 9th, Dr Georgina Murphy and team who led the studies in Nairobi County from KEMRI-Wellcome Trust Research Programme shared these results and more. HSD-N newsletter Oct-Nov 2017
Interactive feedback meeting at Mbagathi Hospital
Dr. Jacinta Nzinga on the right engages nursing officers at the Mbagathi County hospital. The results dissemination activity took place on May 12th 2017. Discussions were lively and provided useful insights as to the activities surrounding the newborn units at the hospital. Feedback of research findings forms an important component of our work. More (HSD-N newsletter)
Can Paediatricians work collectively to improve health care at local and national levels and guide health policy?
80 percent of newborn admissions in Nairobi county, are shared across 5 health facilities - Mike English, speaking at the annual Kenya Pediatric Association (KPA) meeting on April 29th 2017, at Kisumu. More
Three controversies in health data science
Prof. Niels Peek introduced the three controversies in health data science in a well-attended public lecture at the Strathmore University on Wednesday. The three controversies discussed were; data shall be used only for the purpose for which they were collected, big data and predictive analytics should replace randomised clinical trials and to accelerate research, all medical and healthcare data should made available to data scientists. More
The controversies discussed were within the health context even though they cut across other non-health related fields as was alluded to by Prof Peek. One interesting thing that emerged out of the discussions is that there is plenty of data being generated from a number of sources. This data however, should be of integrity, be verifiable and reliable. In healthcare, those interacting with data at all levels like in health facilities must from the very onset be able to see, understand and to appreciate the value and benefits of this data, including on a personal level. Once these benefits are clear and lead to tangible outcomes like improved health care, evidence to inform policy decisions and develop guidelines, cut costs etc then they appreciate its usefulness.
Strathmore University hosts e-health meeting
Strathmore this year hosted the Kenya Health Informatics Association (KeHIA), meet up that was rich in content with presentations and discussions from the University of Nairobi, the KEMRI-Wellcome Trust Research Programme, Ministry of Health, University of Oxford, Strathmore University and Philips Health among others. The discussions were on how e-health can be used to deploy and to improve health outcomes in a number of health settings weather for purposes of research, conducting better patient diagnosis or for routine reporting. The theme for the meeting was ‘Digital health assets/investments in Kenya; A look into the past and future’.
The meeting that took place on the 28th of April showed how KEMRI-Wellcome Trust Research Programme together with partners including the Ministry of Health, is utilizing data across hospitals in Kenya, to improve clinical care and service delivery. Over the years, the programme with a host of collaborators including the University of Oxford has steadily improved its capacity to use data available at the health facilities to drive improvement, generate new knowledge and enhance performance monitoring.
Notable speakers at the meeting were: Naomi Muinga of KEMRI-Wellcome Trust Research Programme, Dr Chris Paton, University of Oxford, Dr Philip Ayieko KWTRP and Dr Pratap Kumar of Strathmore University.
Over 90 percent improvement recorded on the documentation of common childhood illnesses
Documentation of patient history & essential key signs, within the Clinical Information Network (CIN), improved to over 90 percent across 14 hospitals. Reports generated indicate a steady improvement in data collection. While the data has been useful and leading to improved quality of care and decisions in the hospitals, it has also contributed to increased knowledge on; monitoring of vital signs in children admitted to hospitals, variation in and risk factors for paediatric inpatient all-cause mortality in a low income setting, improving documentation of clinical care and more, as highlighted in the CIN timeline. more
Speaking at the meeting on 24th April, Prof Grace Irimu and Prof Mike English noted that the success of CIN has largely been driven by hospital teams led by paediatricians who collect data on common childhood illnesses and diseases that lead to child deaths.
The Ministry of Health, the Kenya Paediatric Association and KEMRI-Wellcome Trust seek to get more counties on board in 2017, with an aim of improving data collection leading to quality care and more opportunities to broaden knowledge based on evidence from this data. Hospitals currently in the network are: Machakos, Embu, Kiambu, Kerugoya, Mbagathi, Nyeri, Busia, Kisumu East, Mama Lucy, Kakamega, Mbale, Karatina, Vihiga and Kitale.
Nairobi newborn studies feedback meeting
A feedback dissemination meeting on the just concluded Nairobi newborn study took place on Monday 30th January and was attended by 75 delegates. Discussions were on: routine newborn care in newborn units, infrastructure and services available in health facilities, accessibility of drugs, newborn care in the maternity wards, material and human resource capacity, utilization of inpatient newborn services; and the quality of existing services.
Representatives from 32 health facilities across Nairobi City County from public, private and faith-based hospitals who participated in the study attended. Partners in the study including the Ministry of Health, the Nursing Council of Kenya, the University of Nairobi, UNICEF, the University of Nairobi and Save the Children were also present.
The ongoing study is part of a larger study referred to as Health Services that Deliver for Newborns (HSD-N) and has five phases, which are: exploring the quality of and need for inpatient neonatal care in Nairobi City County; exploring the context of neonatal nursing, how nurses manage the pressures of working in a newborn unit; task analysis, describing tasks missed care, quantifying tasks done and those not done; understanding what influences the ability of nurses to provide quality inpatient care; documenting the roles and perceptions of mothers of hospitalized sick newborns. The last phase of the study is due for completion in the first quarter of 2018.
LINK programme visit to Kenya
On 23-4 January 2017, the LINK programme held its first full team meeting hosted by Professor Bob Snow in Nairobi, Kenya. This was a valuable opportunity for the London and Nairobi-based team members to meet for an update on the programme and to jointly plan activities going forward. In the first quarter of 2017, LINK will be working to develop profiles with National Control Malaria Programmes (NMCPs) in Ghana, Kenya, Mozambique, Nigeria, Sierra Leone, South Sudan and Uganda.
While in Nairobi, the team also presented one of its major project outputs, a national timeline of malaria key events, to the Kenya National Malaria Control Programme (NMCP). The Kenyan timeline illustrates the history of malaria from 1910 to 2015 and the progress that the NMCP has made.
The LINK programme is a 4-year DFID-funded collaboration between London School of Hygiene and Tropical Medicine (LSHTM) and the KEMRI-Wellcome Trust in partnership with the WHO African regional office. Its aim is to develop and support the use of malaria epidemiological profiles in sub-Saharan Africa and to increase the use of data to guide policy and operational decisions. LINK is led by Dr Caroline Lynch (LSHTM) and Professor Bob Snow (KEMRI-Wellcome Trust).
Dr. Ejersa Waqo, Head of the National Malaria Control Programme (NMCP) in Kenya with the LINK programme team.
Group photo with a banner on the Kenyan malaria timeline