Search results
Found 420 matches for
Oxford Centre for Tropical Medicine and Global Health
Strategies for Deploying Pediatric Death Audit to Improve Quality of Care
NDM-CGHR
Posted 26/04/2024. Pediatric death audits can be used to improve health care quality and outcomes for children. In this report, MOMENTUM Country and Global Leadership examined the use of death audits in Kenya, Nigeria, Sierra Leone, South Africa, and Zambia. These experiences suggested both challenges in the use of death audits for improving pediatric quality care as well as options to begin developing effective systems that incorporate audits, even in low-resource settings. Three HSC researchers are members of the Momentum team.
Effectiveness of a multi-country implementation-focused network on quality of care: Delivery of interventions and processes for improved maternal, newborn and child health outcomes
NDM-CGHR
Posted 12/03/2024. The Network for Improving Quality of Care for Maternal, Newborn and Child Health (QCN) works with healthcare professionals to improve quality of care at global, national and local levels. In this evaluation Mike English and colleagues explore QCN’s effectiveness in Bangladesh, Ethiopia, Malawi and Uganda and provide useful knowledge for future multi-country global health networks.
Breaking the silence on first referral hospitals and universal health coverage
NDM-CGHR
Posted 01/03/2024. First referral hospitals (FRHs) are neglected in the current discourse on universal health coverage (UHC) in low-income and middle-income countries. Mike English and colleagues propose a comprehensive approach that increases the focus on FRHs in the UHC discourse and shows that they are integral to enhancing primary health care (PHC) in low-income and middle-income countries.
First referral hospitals in low- and middle-income countries: the need for a renewed focus
NDM-CGHR
Posted 28/02/2024. First referral hospitals (FRHs) fulfil important functions in health systems in low- and middle-income countries. Through three reviews Rosanna Mazhar and colleagues found confusion around the definition and function of FRHs and called for renewed interest and investment in FRHs from the global health academic and policy-making community.
Individualised, short-course antibiotic treatment versus usual long-course treatment for ventilator-associated pneumonia (REGARD-VAP): a multicentre, individually randomised, open-label, non-inferiority trial
MORU NDM-CGHR
Posted 26/01/2024. Ventilator-associated pneumonia is common amongst critically-ill patients. Mo Yin and colleagues investigated a personalized approach to shorten antibiotic duration, and found it as effective as a longer treatment in terms of death or pneumonia recurrence; it also reduced antibiotic side effects significantly. This study provides crucial evidence to guide antibiotic prescription to reduce resistance emergence.
Scoping review of interventions to improve continuity of postdischarge care for newborns in LMICs
NDM-CGHR
Posted 19/01/2024. Newborn mortality rates post-hospital discharge in low-and-middle-income countries are a growing concern, with most deaths occurring within 30 days of discharge. Gulraj Grewal and colleagues highlight the interventions used to support care continuity post-discharge, assumptions underpinning these interventions, opportunities and challenges, and whether participatory methods were used in intervention development.
Characterising support and care assistants in formal hospital settings: a scoping review
KWTRP NDM-CGHR
Posted 05/12/2023. The adoption of ‘Care Assistants’ in formal hospital settings as a HRH strategy is gaining more traction in the Global North than the Global South. Vincent Kagonya and colleagues highlight their effect on care as well as gaps in the labelling, role assignment, training, clinical governance, and regulation in the clinical environment.
The influence of internship training experience on Kenyan and Ugandan doctors’ career intentions and decisions: a qualitative study
KWTRP NDM-CGHR
Posted 28/11/23. Medical internship is a key period for doctors’ individual career planning and also a transition period for the broader labour market. Daniel Mbuthia and colleagues highlighted how experience during internship shaped medical doctors’ career intentions in Kenya and Uganda, and emphasized the importance of job availability and context in influencing doctors’ career choices.
A systematic review of neglected tropical diseases (NTDs) in Myanmar
LOMWRU MOCRU MORU NDM-CGHR SMRU
Posted 21/11/2023. Neglected tropical diseases (NTDs) are a group of preventable and treatable diseases common in Myanmar, primarily affecting marginalized rural communities. Myo Swe and colleagues provide an overview of reported NTDs in Myanmar over 100 years, indicating gaps in knowledge about certain diseases to inform future research directions related to NTDs in Myanmar.
Development and validation of a new measurement instrument to assess internship experience of medical doctors in low-income and middle-income countries
KWTRP NDM-CGHR
Posted 22/11/2023. Routine surveys are used to understand the training quality and experiences of junior doctors but there are lack of tools designed to evaluate the training experiences of interns in LMICs where working conditions and resource constraints are challenging. Yingxi Zhao and colleagues described their process developing and validating a “medical internship experience scale”.
‘We were treated like we are nobody’: a mixed-methods study of medical doctors’ internship experiences in Kenya and Uganda
KWTRP NDM-CGHR
Posted 15/11/2023. Medical interns are an important workforce providing first-line healthcare services in hospitals. Yingxi Zhao and colleagues provided an overview of doctors’ internship experience in Kenya and Uganda, and highlighted challenges experienced by interns spanning from burnout, stress, challenging working environment, inadequate support and poor quality of supervision.
The uncertain role of substandard and falsified medicines in the emergence and spread of antimicrobial resistance
MORU NDM-CGHR
Posted 10/22/2023. Sean Cavany and colleagues publish a new perspective in Nature Communications that describes the possible mechanisms by which substandard and falsified antimicrobials could affect antimicrobial resistance and suggests ways to improve our understanding of this relationship. The article arose from the work of the FORESFA project, funded by a Wellcome Collaborative Award.
Hospital care for critical illness in low-resource settings: lessons learned during the COVID-19 pandemic
KWTRP NDM-CGHR
Posted 07/11/2023. As COVID spread globally support for LMIC focused on skilled, technologically enabled ICU care. This ignored fundamental weaknesses in health systems and the need for basic, effective care to save lives in all clinical settings. Whole of system vigilance and response requires reorientation of priorities and effective change management, by Mike English.
A rapid review of community engagement and informed consent processes for adaptive platform trials and alternative design trials for public health emergencies
KWTRP MORU NDM-CGHR
Posted 30/08/2023. Alternative Design Trials (ADTs) and Adaptive Platform Trials (APTs) have enabled efficient large-scale testing of biomedical interventions during recent Public Health Emergencies (PHEs). Alun Davies and colleagues aimed to rapidly review evidence on engagement and informed consent for ADTs and APTs during PHE to consider what (if any) recommendations can inform practice.
Severe falciparum malaria in pregnancy in Southeast Asia: a multi-centre retrospective cohort study
MORU NDM-CGHR OUCRU SMRU
Posted 30/08/2023. This study by Makoto Saito and colleagues analysing 213 severe malaria cases in pregnancy at SMRU, MORU and OUCRU showed vital organ dysfunction led to high maternal and fetal mortality. In contrast, severe anaemia or hyperparasitaemia alone did not. This marked difference may explain the variation of mortality reported in the literature. Early diagnosis and treatment of malaria and anaemia in antenatal care should be promoted.
Not just surveys and indicators: narratives capture what really matters for health system strengthening
NDM-CGHR
Posted 25/08/2023. Dorothy Oluoch, Lisa Hinton and colleagues in a new Viewpoint explore the rich potential for patient narratives to complement typical epidemiological and health service evidence on the status of health systems in low-income countries. They explain that we have much to learn about the improvements needed to systems and where to intervene from patients’ stories about their experiences of health care, and that doing this is key to developing person-centred care.
Quality of inpatient paediatric and newborn care in district hospitals: WHO indicators, measurement, and improvement
NDM-CGHR
Posted 25/08/2023. Mike English and colleagues outline in their Lancet Global Health Viewpoint the challenges of measuring quality of care and the challenging pathways from measurement to actual improvement in health service delivery. They argue in particular that collecting data for measuring quality is too often the main focus with little attention is paid to the complex work required to actually change health care practices.
Examining the absorption of post-internship medical officers into the public sector at county-level in devolved Kenya: a qualitative case study
NDM-CGHR
Posted 23/08/2023. Kenyan medical schools are now estimated to be training and graduating increasing numbers of doctors, however recent data suggested that only less than half of these trainees are being absorbed by the public sector. Yingxi Zhao and colleagues conducted a qualitative case study to understand how post-internship medical trainees are absorbed into the Kenyan public sector.
Medical device regulation and oversight in African countries: a scoping review of literature and development of a conceptual framework
NDM-CGHR
Posted 22/08/2023. Medical devices are a fundamental component of health systems, but how are these governed to ensure benefits are achieved and harms are minimised? Naima Nasir and collesgues explore governance arrangements for medical devices in African countries and proposes a conceptual framework for the exploration of governance realities across the health system.
Policies and resources for strengthening of emergency and critical care services in the context of the global COVID-19 pandemic in Kenya
KWTRP NDM-CGHR
Posted 26/07/2023. Critical illnesses cause several million deaths annually, many occurring in low-resource settings. Despite great efforts and investments, lower income countries faced constraints in upscaling critical care during the COVID-19 pandemic. Rosanna Mazhar, Jacquie Oliwa and colleagues explore how Kenya’s efforts to do so were operationalised, offering insights into some of the challenges faced.