Level of health data quality and information use, and contributing factors in the Benishangul Gumuze Region, west Ethiopia: using social ecological framework

Background: Creating responsibility for quality healthcare data and utilization are among the basic functions of leadership. While the benefits of data quality and use are well known, the evidence around the role of healthcare information systems leadership and governance in sustaining data demand and use is limited. Therefore, this study aimed to investigate the level and contributing factors of health data quality and information use in Assosa district, Benishangule Gumuze Region. Methods: A mixed approach design, using qualitative exploration and a facility-based quantitative cross-sectional approach was used. Seventeen departments from two health facilities were enrolled for the quantitative component, while 28 in-depth interviews were conducted to complete the qualitative part of the study. A phenomenological approach was used to explore factors influencing the quality and use of health data. Quantitative data was analyzed descriptively using tables and graphs, whereas qualitative data was analyzed using content analysis guided by the framework for the social ecological model. Results: The average levels of information use and report accuracy were 38.6 and 119.33, respectively. Three themes emerged, explaining the main factors that influence quality data generation: individual characteristics, facility and environmental factors, and leadership and governance characteristics. Individual characteristics were motivation, capacity building, commitment, and digital literacy, while facility and environmental factors included infrastructure, healthcare information system resources and supportive supervision. Furthermore, among the leadership and governance related factors, healthcare data, assigning the right person, and system regulation were some of the factors which were identified. Conclusions: The level of health data quality and its utilization was low during the Asossa city adminstration. The unfriendly physical and organizational working environments and high staff turnover which negatively affected the leadership and governance of the health system are some of the reasons which were sighted with regards to the poor quality of data and information use. Therefore, interventions that have multifaceted effects on data quality and use, such as improving leadership and governance practices and behavior should be implemented. [Ethiop. J. Health Dev. 2022;36 (SI-1)]

The Quality of Medical RecordsManagementin Public Health Facilities inthe Jimma Zone, Oromia Regional state, Southwest Ethiopia

Background:Comprehensive medical records are the cornerstones forthe quality and efficiency of patient care, as they can provide a complete and accurate chronology of treatments, patient results, and plans for care. The study aimed to assess the quality of medical records in public health facilities in the Jimma Zone.Methods:A facility-based cross-sectional study design supplemented by a qualitative method was employed from May 30 -July 29, 2020. A total of 384 medical records were reviewed from 36 facilities using afacility inventory checklist. EPIData 3.1 software was used to enter the quantitative data, which wasthen analyzed using SPSS 23, and descriptive statistics were used to present the results. A thematic analysis approach was used for qualitative datawhich wasfinally triangulated with the quantitative data.Result:384medical records were reviewed from thirty-six public health facilities in the Jimma Zone with a 100% retrieval rate. Among the 36 health facilities, only one hada printer in the record room and three (8%) hadtracer cards. On completeness of the medical records, mode of arrival and date of birth were the least recoded data elements (17% and 5%), respectively.Conclusion:The majority of health facilities hada shortage of trained and qualified recording personnel in the medical record units. The majority of medical records had poor completeness in terms of administrative, clinical, financial, and legal data. The overall quality of medical records in public health facilities in the Jimma Zone was low as per the standard of health facility requirements. It was recommended to have qualified medical record unitpersonnel and to standardize the unitin order to improve the quality of medical records. [Ethiop. J. Health Dev. 2022;36(SI-1)]

A structured approach to effective mentoring of women health researchers in Africa

Objectives: To formatively evaluate the HIGHER Women consortium's Mentor Protégée Program (MPP) and derive lessons for successful African women scientist mentorship. Design: Desk review of program documents and cross-sectional surveys of mentors and protégées. Setting: All 10 regions of Cameroon Participants: Women working in health research participating in the MPP. Interventions: Building health research skills and providing support for women to cope within the African psychosocial environment using a holistic approach. Main outcome measures: Formed mentor-protégés duos applying the MPP with measurable accomplishments. Results: The consortium counted 121 members with 103 protégées and 18 mentors. Of 103 protégées, 35 responded to the 2018 survey, while 77 responded to the 2022 survey. Mentioned benefits of the program included an increase in scientific peer-reviewed journal publications and presentations at national and international conferences. In the 2022 survey, a Pearson correlation showed an r of 0.41, which, although not statistically significant (p = .592), suggests a positive correlation between the increased number of peer-reviewed articles and increased number of years as HIGHER Women protégées. Conclusions: Mentorship programs can help over time to bridge the gender gaps within Africa as well as the gaps between African-led research and the rest of the world while making a meaningful contribution to enhancing the quality, diversity, and productivity of researchers. A mentoring program such as the HIGHER Women MPP can be improved by leveraging local and international partners to foster the mentoring program's sustainability, scalability, and expanded reach.

The application of sigma metrics in the laboratory to assess quality control processes in South Africa

Objective: This study aimed to determine the sigma metrics of analytes when using different total allowable error guidelines.Methods: A retrospective analysis was performed on 19 general chemistry analytes at Charlotte Maxeke Johannesburg Academic Hospital in South Africa between January 2017 and December 2017. Sigma metrics were calculated on two identical analysers, using internal quality control data and total allowable error guidelines from the Ricos biological variation database and three alternative sources (the Royal College of Pathologists of Australasia, the Clinical Laboratory Improvements Amendment, and the European Federation of Clinical Chemistry and Laboratory Medicine). Results: The sigma performance was similar on both analysers but varied based on the guideline used, with the Clinical Laboratory Improvements Amendment guidelines resulting in the best sigma metrics (53% of analytes on one analyser and 46% on the other had acceptable sigma metrics) and the Royal College of Pathologists of Australia guidelines being the most stringent (21% and 23%). Sodium and chloride performed poorly across all guidelines (sigma < 3). There were also month-to-month variations that may result in acceptable sigma despite poor performance during certain months.Conclusion: The sigma varies greatly depending on the total allowable error, but could be a valuable tool to save time and decrease costs in high-volume laboratories. Sigma metrics calculations need to be standardised

Testers' compliance to the quality standards of HIV rapid testing services in Primary Health Care Facilities in Makete District, Tanzania

Background: HIV rapid testing services is one among key interventions in the controlling of HIV/AIDS. Despite availability of quality standards, the quality of HIV rapid testing services remains questionable since non-laboratory testers are allowed to conduct testing while they are not specialized in providing testing services. Objective: To evaluate the compliance to the quality standards of HIV rapid testing services provided by non-laboratory testers in Makete District, Tanzania Methods: An explanatory descriptive study employing quantitative approach of data collection was used. An observation of 23 non-laboratory testers performing HIV rapid tests, observation of HIV testing points and documents review was done in 23 testing points to collect data. Data were analyzed using a programmed excel sheet and a three-point scale was used to determine the level of compliance to quality standards. Results: Analysis shows that out of 23 testing points visited, the level of compliance to quality standards was lower for 22 (95.6%) testing points and moderate in 1 (4.4%) testing point. None of the testing point was highly complied to quality standards for HIV rapid testing services. Conclusion: The quality of HIV rapid testing services provided by non-laboratory testers is below the established quality standards for HIV rapid testing services.

Nigeria vaccine policy

Vaccines are recognised globally for their importance in the reduction of vaccines preventable diseases to improve the quality of life of the entire population. The importance of vaccines has been further demonstrated with the COVID-19 outbreak with countries scrambling to produce vaccines to combat the effect of the pandemic amongst their citizens. The purpose of this Vaccine Policy is to address the goal and objectives of achieving availability, self-sufficiency and vaccine security in the country. It is hoped that the development of this Policy will complement the already existing Immunisation Policy and provide the platform for the amelioration of vaccine-preventable diseases in Nigeria. Highlights of the Policy include: its vision, mission, goal, objectives, targets and implementation strategies for achieving local vaccines production and ownership of the vaccines supply chain management processes towards vaccine availability and security in the country. To achieve these, the Policy needs to be implemented and monitored hence the Policy provides for the establishment of appropriate governing structures to oversee the implementation process. The governing council and its various structures will pursue the achievement of the goal and objectives of the Policy. They will mobilise resources from the governments across all levels, individuals, the international communities, donor agencies. Other critical areas include the resuscitation of local production of vaccines, intensification of research and development and strengthening of the legislature and regulatory agencies to support the quality and safety of vaccines in Nigeria. It is recommended that all stakeholders responsible for implementing this policy should work collaboratively to ensure the goal and objectives are met

Community perception of quality of health care received and client satisfaction in Lagos, Nigeria

Background: Quality of health care and client satisfaction are key elements in improving the performance of health systems. A community-based assessment was conducted to determine the level of client satisfaction and the perception of the quality of services received by citizens of Lagos State.Methods: A descriptive cross-sectional study using both quantitative and qualitative methods, was conducted in four local government areas of Lagos State. Respondents were selected by multi-stage sampling technique. The survey instruments included an interviewer-administered, pre-tested questionnaire and a 10-itemed focus group discussion guide.Results: Two thousand respondents with a mean age of 37.6±10.21 years were recruited. Almost all respondents (98%) rated the health facilities to be clean, 96% felt they received effective treatment from their providers. Six out of ten respondents rated the waiting time to be short and 60% felt that most drugs were available. Eight-five percent opined that the quality of care received was good and 95% were satisfied with the services received. There was a significant correlation between quality of care and client satisfaction (ρ=0.145, p=0.001). Short waiting time was predictive of client satisfaction (OR=13.9, 95%CI, 5.68-33.33, p<0.001) and confidence in health care providers was predictive of both client satisfaction (OR=3.489, 95%CI, 1.554-7.835, p<0.001) and perception of good service quality (OR=2.234, 95%CI, 1.509-3.308, p<0.001)

Assessment of the Quality of Nursing Care in Ahmadu Bello University Teaching Hospital Zaria: Patients' Perspective

This survey attempted to assess the quality of nursing care in Ahmadu Bello University Teaching Hospital based on the patients' opinion. The population of study included patients who were 18 years and above and have spent at least 3 nights in the hospital. A total of one hundred and eight (108) patients were selected for the survey. The results revealed that 81.5of the respondent had attended at least primary school; 44.5had spent 15 days and more in the hospital. Some areas specifically assessed by respondents among others include care and treatment received from Nurses; Nurses knowledge and ability. The patients overall assessment of nursing care reveals that 82.7were satisfied and feels that nursing care was good. The need to continually measure; monitor and improve nursing care as well as encouraging professional specialization and organizing orientation programs/update courses; workshop etc on a regular basis among others were made; as recommendations

Patient Satisfaction with the Quality of Care in a Primary Health Care Setting in Botswana

Primary health care involves a sustained partnership between patients and providers that addresses the majority of a population's health needs over time. Patients' perception of satisfaction is an aspect of healthcare quality that is being increasingly recognised for its importance. The objective of this study was to investigate the factors contributing to patients' satisfaction with and their rating of the quality of care in Extension II Clinic in Gaborone; Botswana. of them were displeased with this aspect. A total of 36.9 Method: This was a cross-sectional study in which 360 systematically selected participants completed five-point Likert scale self-administered questionnaires. Results: Overall; participants were quite satisfied (mean score = 3.75) with the services provided by the different service providers. The participants indicated that overall; the quality of care of the health care facility was good (mean score = 3.45). The pharmacy received the highest satisfaction level with a mean rating of 4.1. Thirty-eight per cent of the participants rated the services provided by the doctors as best despite giving the highest quality ratings with a mean of 3.9 to the pharmacy compared to mean ratings of 3.4 for the doctors. The participants' greatest displeasure was with the time spent at the facility; as 63.9 was most pleased with information given to them as a factor of importance. Conclusion: The participants were quite satisfied with the services provided as well as the quality of care provided by the different service providers of the health care facility. There is; however; a need for interventions in terms of time spent at the facility; which would promote good customer-focused service delivery

Impact of Introducing Integrated Quality Assessment for Tuberculosis and Malaria Microscopy in Kano; Nigeria

Background: The World Health Organization (WHO) has recommended the integration of malaria microscopy quality assessment (QA) with that of other microscopically diagnosed diseases; but there is no evidence that it has been attempted. We assessed the feasibility of linking malaria microscopy into the existing tuberculosis (TB) microscopy QA system in Kano; Nigeria. Methodology: Five TB microscopy centres were selected for implementing the integrated TB and malaria microscopy QA scheme in the state. A model system was designed for selecting and blinded rechecking of TB and malaria slides from these laboratories. Supervision and evaluation was conducted at 3-month intervals for 24 months. Results: TB microscopy QA was strengthened in four laboratories. Full integration of the QA for TB and malaria microscopy was achieved in two laboratories; and partial malaria microscopy results. At the final assessment; 100specificity was achieved for TB microscopy results in four laboratories. There was an increased concordance rate and decreased false positivity and false negativity rates of TB microscopy results in all five laboratories. Conclusions: It is feasible to integrate the QA system and training for TB and malaria microscopy for assessing and improving quality of both services. However; the integrated system needs testing in different settings in order to be able to develop sound recommendations to guide the complex scaling-up process

Improving the use of patient-held records in the Emtshezi Subdistrict

"Background The aim of this interventional study was to assess; document and improve the Patient-held Record (PHR) System in the Emtshezi Subdistrict. The study began in 1998 and was conducted using a Quality Assurance (QA) Cycle; which focuses on systems and processes and encourages a team approach to problem solving and quality improvement. The keeping of good; accurate health records; as well as the communication of this clinical information between health practitioners; is essential for good quality practice in primary care. In Emtshezi; many patients eceive care from different health facilities and practitioners. Historically; the health services in the Subdistrict; as in much of KwaZulu-Natal; were fragmented. Clinics; hospitals and private practitioners in the Subdistrict used a variety of different health records systems; which did not integrate with each other. There was very little communication between these health providers; ossibly because no overall plan for health records was worked out for the Subdistrict or the Province at that stage. The Emtshezi Subdistrict forms part of the uThukela Health District of KwaZulu-Natal and lies 120 km northwest of Pietermaritzburg. The population is mostly rural. The major towns are Estcourt; Weenen and Winterton. In the Subdistrict; there is one district hospital of 300 beds; 10 residential clinics and four mobile clinics. There are more than 20 private practitioners; the majority of whom practice in Estcourt. The term ""ambulatory records"" refers to records that are used by outpatients as opposed to records used for admission to a hospital ward. Two basic types of ambulatory medical records are used throughout KwaZulu-Natal - the A4-sized Facilityheld Record (FHR) and the small PHR (see Photograph 1). They are both called ""Outpatient Record"". The FHRs are used only at that facility and are filed at the facility. The PHR is kept by the patient nd can thus be used at any health facility. Method The method used for this study was the Quality Assurance Cycle. Focus group discussions were the main research tool utilised. This research was conducted with ethical approval as the dissertation towards an MFamMed degree at MEDUNSA. Results The following problems were identified: poor communication of clinical information between health facilities. There were problems with the records system in the hospital; poor design of ambulatory records and the use of multiple PHRs by patients. The following solutions were proposed: A single; common PHR to be the definitive ambulatory health record for every patient at district level. The design of the PHR has been improved and meets the legal requirements for a health record.Conclusions PHRs have a valuable role to play within the District Health System in South Africa. They are especially useful in improving the standard of health care; as well as the continuity of care between the district hospital and the clinics and community health centres that the hospital supports. PHRs form a vital link; not only between facilities; but as a link through time: patients need a definitive personal health record for themselves; a record that is problem-orientated and tracks their health and illnesses throughout life. We need to move away from episodic care. Hospital doctors need to be more seriouslycommitted to communicating with the PHC clinics and private practitioners who refer to that hospital. Senior managers and policy planners need to be more aware of the potential of PHRs as a means of transformation towards a better district health system."

Quality Assurance - The Key to Improving Health Care

Quality Assurance activities were introduced to the health care system in Uganda many years ago. It started in Uganda as a project in the Ministry of Health but now it is a whole department headed by a Commissioner. The concept of quality of health care has been a major concern of the Minsitry of Health. At Mulago Hospital there is also commitment to provide quality health care. However; the provision of quality health care is a big challenge due to the constraints of available resources. In such environment of limited resources methods are available to ensure that there is quality of health care. This is achieved by adhering to the principles of quality assurance and regularly monitoring; measuring and improving the quality of health care by collecting and analyzing a core set of performance indicators. The activities and the principles of quality assurance provide the groundwork for performance improvement. This paper discusses what quality assurance is; the principles; its activities and how incharges of departments; units; firms or wards and begin to reflect on how to introduce quality assurance activities

A Short Anaesthesia Course: A surgeon's experience

Quality patient care demands competent response by the Clinician to the needs of the patient in a variety of situations. In the same way; Quality Assurance in Surgery requires all practicing Surgeons to be acquainted with the Basic Anaesthetic Principles and Skills as part of the fundamentals of the holistic management of the patient; for the best quality of life after surgery. In this paper; a surgeon had three (3) months Apprenticeship in Anaesthesia and was empowered with the basic Principles and Skills in Safe Anaesthesia. She ultimately got trained and becomes a better and more competent clinical Surgeon. Introduction: Quality patient care demands competent response; by the clinician to the needs of the patient in various situations. Achievement of the best quality of life after surgery requires the surgeon to be conversant with the basic principles and skills of safe anaesthesia which are part of the fundamentals of holistic management of a patient. Unfortunately; training curricula for anaesthesia in Uganda medical Schools give brief exposure in Anaesthesia to both undergraduates and postgraduates. The consequences of this; is some deficiency in the management of the patient. The need to correct this cannot be over emphazed. For this reason; the presenter opted for the Short Course in Anaesthesia

Assessment of chest radiographs for quality assurance and radiation protection

A retrospective study of 1000 chest radiographs randomly selected from various government and private owned hospitals in the southern part of Nigeria covering a period of twenty years was carried out. Accuracy in patient positioning; beam collimation and identification of radiographs were assessed as indicators for quality assurance and radiation protection. The result showed that for male 59 were rotated and 41 were not. For the female; 60 were rotated while 39 were not. 95.30 radiographs were inadequately collimated; and 69.30 were properly identified. This suggests poor quality and exposure of patients to unnecessary radiation though more attention was paid to identification of radiographs

Introducing quality management into primary health care services in Uganda

In 1994; a national quality assurance programme was established in Uganda to strengthen district-level management of primary health care services. Within 18 months both objective and subjective improvements in the quality of services had been observed. In the examples documented here; there was a major reduction in maternal mortality among pregnant women referred to Jinja District Hospital; a reduction in waiting times and increased patient satisfaction at Masaka District Hospital; and a marked reduction in reported cases of measles in Arua District. Beyond these quantitative improvements; increased morale of district health team members; improved satisfaction among patients; and greater involvement of local government in the decisions of district health committees have been observed. At the central level; the increased coordination of activities has led to new guidelines for financial management and the procurement of supplies. District quality of health headquarters have led to a greater uderstanding by central staff of the issues faced at the district level. The quality assurance programme has also fotered improved coordination among national disease-control programmes. Difficulties encountered at the central level have included delays in carrying out district support visits and the failure to provide appropriate support. At the district level; some health teams tackled problems over which they had little control or which were overly complex; others lacked the management capacity for problem solving

Occupational radiation monitoring and quality assurance in hospital X-ray departments

Quality assurance is essential to any programme of diagnostic radiology; to prevent undue exposure of x-ray personnel and patients to radiation. This paper reports observations from a survey of some hospital x-ray facilities in Accra and Kumasi in Ghana; to find out about steps taken by x-ray workers to ensure quality control and administration in diagnostic radiology. The grid point method has been used to do a detailed study of scatter radiation levels of two x-ray departments in Accra. The iso-dose rate contours have been analysed; and results show the importance of good design of x-ray rooms and provision of protective structures