Mastering your fellowship: Part 3, 2022

The series, 'Mastering your Fellowship', provides examples of the question formats encountered in the written and clinical examinations, Part A of the Fellowship of the College of Family Physicians of South Africa (FCFP SA) examination. The series is aimed at helping family medicine registrars (and their supervisors) prepare for this examination.Keywords: family physicians; FCFP (SA) examination; family medicine registrars; postgraduate training; national exit examination; infectious diseases.

Routine Health Information System Data Quality and Associated Factors in Selected Public Health Facilitiesof Jigjiga Woreda, Somali Regional State's,Eastern Ethiopia

Background: Health data quality are limited within the health sectors of low-and middle-income countries (LMICs). Although public health decision-making is mainly dependent on the timely availability of quality data, the quality of healthdata is not satisfactory in some countries, including in the Somali Regional State. Therefore, this baseline assessment was aimed at assessing the level of data quality and its determinants in the public health sector of the Somali Regional State, Ethiopia. Methods: A baseline assessment was conducted as part of an implementation research project. The study was conducted in three selected public health facilities of the Jigjiga Woreda, including the Woreda Health Office and the Somali Regional Health Bureau. A total of 179 health care workers participated in the survey. Interviewer guided self-administered, record review, and observation data collection techniques were used for data collection. Data wasanalyzed using descriptive, bivariate, and multivariate logistic models to identify predictors of data quality. A P-value of 0.05 was used as the statistical significance cut-off point. Results:The overall data accuracy and content completeness in the studied facilities was88.12% and 75.75%, respectively. Data accuracy was 92.2% in the Karamara Hospital, 83.1% in Jigjiga Health Center, and 79.8% in the Ayardaga Health Center. Content completeness was 81.6% in the KaramaraHospital, 81.2% in the Jigjiga Health Center, and 69.7% in the Ayardaga health center. Forthe studied variables, the data recording value given by their immediate supervisors was a strong predictor of data accuracy in the study setting. The odds of thosewho felt thatdata recording was notvalued by supervisors had 0.26 times poorer data accuracy than their counterparts (AOR: 0.26, 95%CI: 0.10, 0.66). Conclusion:Both the accuracy and completeness of health data in Eastern Ethiopia were inadequate. As a result, health work force immediate supervisors and Performance Monitoring Teams (PMT) should undertake regular and ongoing supervision and provide timely feedback for corrective action. In addition, specialized training in data recording and documentation would be beneficial in bridging the gap between workers' skill. [Ethiop. J. Health Dev. 2022;36 (SI-1)]

Assessment of Willingness to pay for Community-Based Health Insurance among Artisans in a selected Community of Ekiti State, Southwest Nigeria

Background: Community-based health insurance (CBHI) has emerged as a more efficient and equitable approach to healthcare financing. It was designed to ensure that sufficient resources are made available for members to access effective healthcare. This study assessed the willingness to pay (WTP) for CBHI among artisans in a town in Ekiti State, South West Nigeria. Methods: This was a cross-sectional survey conducted among 416 artisans in a town in Ekiti State. A semi-structured interviewer-administered questionnaire was designed and used for data collection on sociodemographic data and WTP for CBHIS. Data entry and analysis was done using IBM SPSS software version 25.0. Results: The mean age and standard deviation of the respondents was 29.7±10.9 years with male to female ratio of 1:1.4. Most of the respondents were willing to pay (86.3%) and willing to enroll other household members (73.6%) in the CBHI. A large percentage (44.3%) of those willing to pay were ready to pay between ₦1,000-₦5,000 (US$2.63­US$13.16) per year while 39.6% preferred frequency of payment to be annually. Positive predictors of WTP for CBHI were age groups ≥50 years and 40-49 years than <20 years (AOR:13.270, 95%CI: 1.597-110.267; AOR:142.996, 95%CI: 10.689-1913.009). Females than males (AOR:9.155, 95%CI: 3.680-22.775), tertiary level of education than no formal of education (AOR:23.420, 95%CI: 1.648-850.921), no children than ≥5 children (AOR:20.099, 95%CI: 2.705-149.364), earn ≥₦30,000 (US$78.95) than <₦30,000 (AOR:2.248, 95%CI: 1.278-6.499). often and somethings fall ill than seldom fall ill (AOR:6.505, 95%CI: 1.623-26.065; AOR:4.889, 95%CI: 1.674-14.279) Conclusion: WTP for CBHI was high among the artisans, however, there is a variation across the amount and frequency of payment. Therefore, policy that is flexible enough to allow artisans enroll and pay a premium that is affordable, at an acceptable frequency, should be formulated by the Government.

Emergency medical services (EMS) training in Kenya: Findings and recommendations from an educational assessment

Background.Over the past twenty years, Kenya has been developing many important components of a prehospital emergency medical services (EMS) system. This is due to the ever-increasing demand for emergency medical care across the country. To better inform the next phase of this development, we undertook an assessment of the current state of EMS training in Kenya.Methods.A group of international and Kenyan experts with relevant EMS and educational expertise conducted an observational qualitative assessment of Kenyan EMS training institutions in 2016. Three assessment techniques were utilised: semi-structured interviews, document review, and structured observations. Recommendations were reached through a consensus process amongst the assessment team.Results.Key findings include: (i) No national or state-level policy exists that establishes levels of EMS providers or expected fund of knowledge and skills; (ii) Training institutions have independently created their own individual training standards; (iii) Training materials are not adapted for the local context; (iv) The foundation of basic anatomy and physiology education is weak; (v) Training does not focus on symptom- or syndrome-based complaints; (vi) Students had difficulty applying foundational classroom knowledge in simulations and clinical encounters; (vii) There is limited emphasis on complex critical thinking.Discussion.Standardisation of training is needed in Kenya, including clearly defined levels of providers and expected learning outcomes. A nationally standardised EMS provider scope of practice may also help focus EMS education. Instructors must reinforce basic anatomy and physiology amongst all trainees to establish a robust foundation, then layer on field experience before trainees receive advanced training. Training graduates should be EMS providers who approach patient care with high-order symptom- or syndrome-based critical thinking. While these recommendations are specific to the Kenyan EMS environment, they may have wider applicability to other developing EMS systems in resource-limited settings

Comment réussir l'épreuve de pédiatrie au diplôme d'Etat ? A l'usage des étudiants de 3è année des sciences infirmières

Cet ouvrage regroupe l'essentiel des connaissances que l'étudiant en fin de Cycle des Sciences Infirmières, section Infirmière/Sage-femme, doit savoir en pédiatrie. Il se présente sous forme de situations / problèmes et est centré sur le Plan des soins.

The Role of Educational Strategies to Reverse the Inverse Performance Spiral in Academically Isolated Rural Hospitals

The importance of continuous professional development for health care workers is widely acknowledged; but the identification of optimal implementation strategies remains a challenge; particularly in academically isolated rural areas. We report the results of a qualitative study that evaluated the effect of an educational intervention aimed at rural doctors in the Western Cape Province; South Africa. We also present a conceptual framework for developing best practice educational strategies to reverse the inverse performance spiral in academically isolated rural hospitals. Doctors felt that participation in relevant learning activities improved their competence; increased the levels of job satisfaction they experienced; increased their willingness to stay in a rural environment; and impacted positively on the quality of services provided. However; the success of educational strategies is heavily dependant on the local environment (context); as well as the practical applicability and clinical relevance of the activities (process). Successful educational strategies may help to reverse the inverse performance spiral previously described in academically isolated rural hospitals; however; this requires effective local leadership that creates a positive learning environment and supports clinically relevant learning activities. The study findings also indicate the need for health care providers and institutions of higher education to join forces to improve the quality of rural health care