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\n \n \n \nPosted 31/03/2021. Patient safety is a key goal of WHO but identifying harms and developing strategies to deliver safe care has been given little attention. Mike English and colleague describe a \u2018portfolio\u2019 approach to safety improvement in four broad categories: prioritising critical processes, improving the organisation of care, control of risks and enhancing responses to hazardous situations that we believe is relevant to low resource settings. We focus attention on the possible roles of practitioner groups and professional associations as key to advancing patient safety through collaboration and skill development in this field
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\n \n \n \nPosted 18/06/2021. Grace Irimu and colleagues show that newborns account for 46% of admissions and 66% of deaths among children 0-13years in Kenyan hospitals. Most deaths are caused by preventable and treatable causes. The authors call for need to prioritize newborn care for Kenya to achieve the SDGs target.
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\n \n \n \nPosted 12/02/2021. The majority of digital health projects have failed to translate into scaled, routine services, leaving many health leaders cautious and uncertain of how to proceed. Chris Paton and colleagues identify factors that can influence successful and sustainable integration of digital health within local health systems in low resource settings.
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\n \n \n \nPosted 11/05/2022. Yingxi Zhao and colleagues used data from a national health facility assessment to understand the capacity of Kenya internship hospital to provide internship training for medical doctors. They highlight the major gaps in staffing, equipment and service availability in those hospitals and call for more stringent and regular review and re-accreditation of internship hospitals to provide appropriate and well-resourced training.
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\n \n \n \nPosted 08/01/2021. Patient safety is much less well studied in low-resource settings than in higher income settings. Mike English and colleagues suggest how concepts being employed to advance patient safety thinking in higher income settings could be usefully applied by practitioners in low-resource settings. The ability to diagnose system weaknesses should become a core skill for those leading teams, wards, departments or facilities in low-resource settings
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\n \n \n \nPosted 07/07/2020. In a country with 25 million newborns, children and adolescents, how many paediatricians are there and where are they? This paper by Mike English and colleagues seeks to start a debate on how to deliver paediatric services in LMIC in the future.
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\n \n \n \nPosted 03/08/2022. Naomi Muinga and colleagues report on a process of implementing a co-designed, paper-based newborn monitoring chart in a network of hospitals in Kenya. While the chart was well-received, challenges with full uptake persist and offer opportunities to strengthen the process as well as future implementations.
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\n \n \n \nPosted 27/08/2021. Demographic and epidemiological changes have prompted thinking on the need to broaden the child health agenda to include care for paediatric complex and chronic conditions, however such expansion is threatened by workforce shortages. Yingxi Zhao and colleagues reviewed how task sharing could support expanded paediatrics services provision in LMICs, especially beyond acute infectious diseases and malnutrition that are widely and historically shifted.
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\n \n \n \nPosted 22/02/2022. In many sub-Saharan African countries, including Kenya, the use of mortality and morbidity audits in maternal and perinatal/neonatal care as an avenue for learning and improving care delivery is sub-optimal due to structural, organizational, and human barriers. In this exploratory qualitative study, Joyline Jepkosgei and colleagues examined process-related factors that generally influence M&M audits including health workers\u2019 interactions and their experiences, institutional cultures, and broader health system contextual influences, which remain inadequately explored.
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\n \n \n \nPosted 10/01/2020. Our ethnography aimed to describe Nairobi\u2019s inpatient newborn wards and the busy lives of the nurses who work there. They work long hours with little supervision in ill-designed wards, staffed by far too few nurses given the pressing need. Under these difficult conditions, the collective model of nursing that develops reduces nurses\u2019 exposure to stress and anxiety. Jacob McKnight and colleagues describe how these coping methods have implications for the quality of care and limit the potential for a patient-centred approach.
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\n \n \n \nPosted 22/02/2021. Paper continues to be an important medium for recording inpatient care in low\u2010 and middle\u2010income countries. Naomi Muinga and colleagues synthesise evidence on how paper\u2010based nursing records have been developed within inpatient settings to support documentation of nursing care, and that a human\u2010centred design approach might better meet users' needs
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\n \n \n \nPosted 25/03/2022. Alun Davies and colleagues used Participatory Video (PV) to explore how engagement with researchers influenced Kenyan school students\u2019 perceptions of research and aspirations. PV highlighted the complex context in which engagement is situated where students\u2019 time and attention is competed for against curricular, extracurricular, and social-cultural factors. We emphasise the importance of ensuring that engagement benefits students.
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\n \n \n \nPosted 11/11/2022. In this study, Timothy Tuti and colleagues discuss the characteristics of a neonatal inpatient dataset from a network of Kenyan hospitals that allows for exploration of trends in performance and could support better impact evaluation, exploration of links between health system inputs and outcomes, and scrutiny of variation in quality of hospital care.
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\n \n \n \nPosted 26/01/2021. Appropriate and well-resourced medical internship training is important to ensure psychological health and well-being of doctors in training and also to recruit and retain these doctors. Yingxi Zhao and colleagues identified and described a large number of tools designed for measuring medical internship experience, to help medical educators and human resource managers make an evidence-based decision on designing surveys to understand interns\u2019 experience of training.
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\n \n \n \nPosted 19/01/2022. Rita Njeru, Sassy Molyneux and colleagues examine the role of community health workers in supporting post-discharge recovery in young undernourished children. The authors argue that a targeted and multi-pronged approach initiated before or on discharge is needed, supported by clear guidance and training. The ways in which any new tasks or personnel are incorporated into hospital and broader health system hierarchies and systems need careful planning and tracking.
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\n \n \n \nPosted 23/07/2021. Effective management and leadership are essential for everyday health system resilience, but health managers are often under-prepared and under-supported in these roles. Particular challenges have been observed in communication skills, emotional competence and supportive oversight. Jacinta Nzinga and colleagues share their learning from implementing a package of leadership development interventions in Kenya
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\n \n \n \nPosted 28/04/2021. While Health and Demographic Surveillance Systems (HDSS) involving verbal autopsy provide essential data on deaths, births and other health-related events in LMICs where alternative sources are limited, Vicki Marsh and colleagues argue that current regulatory frameworks do not sufficiently recognise their nature as a form of non-traditional epidemiological research. Ethical challenges include risks of uncompensated burdens that alternative regulatory approaches may more successfully identify.
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\n \n \n \nPosted 03/09/2020. Cian Wade, Mike English and colleagues brought together a large body of evidence to inform recommendations for Kenya on neonatal analgesic guidelines for routine procedures. They describe the process by which a group of local experts translated systematic review and meta-analysis findings into context-specific clinical guidelines. The work emphasises the value of breastfeeding or breast milk as an important and feasible therapeutic strategy for alleviating neonatal pain.
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\n \n \n \nPosted 17/05/2022. In this study, leveraging a Kenyan Clinical Information Network, Timothy Tuti, Mike English and colleagues set out to evaluate at the clinical team level, if and how a comprehensive healthcare-specific feedback theory used to design and implement pharmacists-championed feedback strategies could help improve medication prescribing accuracy during inpatient neonatal care.
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\n \n \n \nPosted 05/08/2022. During a rapidly unfolding catastrophic pandemic, research is most needed to inform on nature, containment and prevention of the pandemic. Ethics review and regulatory authorities are important gatekeepers for research, and can facilitate scientifically rigorous and ethically sound relevant research. Alex Hinga, Dorcas Kamuya and colleagues examined how research review was undertaken during COVID19 in one of the review systems in Kenya, factors that enabled and/or hindered accelerated review including the political landscape, and make some recommendations for review systems in LMICs.
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