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Health Systems Collaborative Research Highlights

Tools for measuring medical internship experience: a scoping review

Posted 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’ experience of training.

First do no harm: practitioners’ ability to ‘diagnose’ system weaknesses and improve safety is a critical initial step in improving care quality

Posted 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

The paediatrician workforce and its role in addressing neonatal, child and adolescent healthcare in Kenya

Posted 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.

Collective strategies to cope with work related stress among nurses in resource constrained settings

Posted 10/01/2020. Our ethnography aimed to describe Nairobi’s 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’ 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.

Missed nursing care in newborn units: a cross-sectional direct observational study

Posted 14/06/2019. Insufficient nurses caring for sick babies on hospitals’ neonatal units in Kenya seriously undermine efforts to deliver high quality, safe care and make reducing neonatal mortality rates very difficult. Led by David Gathara, the Kenyan and Oxford team conducted the first ever direct observational study of which tasks nurses were able to perform and quantified how much care is missed. Previous work on missed nursing care largely conducted in rich countries has relied on questionnaires so this new work is an important advance.

LIFE, a new smartphone app to train healthworkers to save lives

The Life-saving Instruction for Emergencies (LIFE) is a 3D simulation training app for smartphones that teaches healthcare workers how to manage medical emergencies. LIFE is a scenario-based mobile and virtual reality (VR) gaming platform that teaches healthcare workers to identify and manage medical emergencies using game-like training techniques to reinforce the key steps that need to be performed in order to save lives.

Exploring the space for task shifting to support nursing on neonatal wards in Kenyan public hospitals

Posted 09/04/2019. An ethnography work on neonatal nursing, led by Jacinta Nzinga in Nairobi, shows that to cope with incredibly high workloads, informal task shifting is already happening where non-clinical tasks are delegated to students, mothers and support staff. However, nurses are anxious about professional boundaries and the added responsibilities of supervising a potential new cadre.

Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities

Posted 22/05/2018. A new Case Study by Naomi Muinga from the Global Health Informatics Group reports on the challenges faced implementing an Open Source Electronic Health Record system in Kenya and the strategies employed by the Ministry of Health and development teams for increasing user adoption as the system is scaled up.

How can we implement paediatric care practices in Kenyan hospitals?

Posted 08/09/2017. Changing the practices of health care workers in multiple hospitals in low-income settings is a major contemporary challenge that requires people to think about the complex set of influences that affect clinicians’ behaviour. In this report, Professor Mike English describes a multi-layered strategy utilising a new implementation typology linked to overarching theories of change.

Developing guidelines in low-income and middle-income countries: lessons from Kenya

Posted 01/08/2017. For more than a decade, Professor Mike English and his team have worked with the Kenyan Ministry of Health and professionals to develop national clinical guidelines. This paper describes how this approach has become both more rigorous and more collaborative while offering lessons to other LMIC on how to develop high quality guidelines with limited resources.