Primary healthcare training in the Democratic Republic of the Congo

Family medicine is a relatively new discipline in the Democratic of the Congo. It was developed under South­South and Churches Collaboration with the aim of responding in a cost-efficient manner to the crisis of health practitioners in mostly Christian and protestant hospitals based in rural areas in the Democratic Republic of the Congo.

Carbohydrate counting in type 1 diabetes mellitus: dietitians' perceptions, training and barriers to use

Objectives A study was undertaken to determine the perceptions, training and barriers regarding the use of carbohydrate counting in the dietary management of type 1 diabetes mellitus (T1DM) among dietitians in KwaZulu-Natal (KZN). Design A cross-sectional, descriptive study was conducted. Setting Dietitians who were registered with the Health Professions Council of South Africa (HPCSA), and working in the province of KZN at the time of the study, were invited to participate. Methods Data were collected using a self-administered electronic questionnaire distributed through SurveyMonkey, an Internet-based survey programme. Results Dietitians agreed that carbohydrate counting was a useful dietary management approach for diabetes (p < 0.05) and that it was essential to manage T1DM (p < 0.05). However, they felt it was a difficult concept for patients with T1DM to understand (p = 0.001) and teaching it to patients was time consuming (p < 0.05). Although dietitians believed that there was a strong evidence base for teaching carbohydrate counting to patients with T1DM (p < 0.05), they indicated a need for further training or education in it (p < 0.05). Barriers to using carbohydrate counting included a lack of training, confidence and experience, financial resources, time, blood glucose records and poor patient motivation and patient illiteracy (p < 0.05). Conclusions Overall, dietitians who participated in the study had a positive perception towards the use of carbohydrate counting in the management of T1DM. However, further training needs to be addressed for carbohydrate counting to be used with confidence by dietitians in KZN to optimize their management of T1DM.

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.

Online teaching and learning: Experiences of students in a nursing college during the onset of COVID-19

Background: The world has entered the Fourth Industrial Revolution. Utilisation of technology is inevitable. For the past years, the coronavirus disease 2019 (COVID-19) pandemic has halted normal operations, including in the physical classroom for nursing students. Students and facilitators had to move to a remote way of teaching and learning, utilising online teaching and learning. However, students and facilitators were not ready to use online teaching and learning. This not only resulted in numerous challenges, but also became an eye-opener for best practices and intervening strategies. Objectives: To explore and describe experiences of students in a nursing college with regard to online teaching and learning during the onset of the COVID-19 pandemic. Method: A qualitative, exploratory, descriptive and contextual research design was adopted. A purposive, nonprobability sampling approach was used to select participants from second year, third year and fourth year. First-year student nurses were excluded because they did not commence with classrooms at that time. Results: Seven themes emerged, namely knowledge, confidence, training, equipment, clinical exposure, course extension and flexibility, and all themes had subthemes. Conclusion: It is evident that students had more negative experiences during online teaching and learning than positive experiences.

Collaborative research to respond to the HIV epidemic: a case of Uganda (Makerere University)-Case Western Reserve University Research Collaboration 1988-2021

Background: Collaborative research between institutions may not yield results to transform communities. Many research collaborations come to the end of their life time without achieving their originally set goals and with a dearth of community transformation to show for it. Objective: To delineate and highlight the achievements of the Uganda (Makerere University)-Case Western Reserve University Research Collaboration Methods: We retrospectively compiled and reviewed the data on research, training and policy impact achievements of the Uganda (Makerere University)-Case Western Reserve University Research Collaboration over a period of 30 years of its existence. Results: Over the last 35 years, the Uganda (Makerere University)-Case Western Reserve University Research Collaboration trained a total of 104 Ugandans with Masters, PhDs and other varied graduate training programs. More than 70 large tuberculosis/TB+HIV studies were conducted with more than 360 manuscripts published including landmark local and global TB/HIV policy impact publications. Conclusion: The Uganda (Makerere University)-Case Western Reserve University Research Collaboration has in the past 35 years built the capacity of Ugandan and international students through conducting landmark research, training and mentoring and contributed to TB HIV management policy changes in Uganda.

Current use and perceived barriers of emergency point-of-care ultrasound by African health care practitioners

Introduction: The African Federation of Emergency Medicine (AFEM) recommends the use of emergency point-of-care ultrasound (ePOCUS) as a core skill for health care practitioners in Africa. The study explored the use of ePOCUS by health care practitioners among AFEM members who work across Africa. Methods: An anonymous online survey was distributed to individual members of AFEM and affiliated organisa-tions. The questionnaire was tested by the AFEM Scientific Committee for potential content modifications priorto distribution. Summary statistics are presented. Results: Of the 220 participants that were analysed, 148 (67.3%) were using ePOCUS. The mean age was 36 years;146 (66%) were male; and 198 (90%) obtained their primary medical qualification in Africa. In total, 168 (76%) were doctors, and most participants (n = 204, 93%) have worked in Africa during the last 5 years. Reasons for not using ePOCUS mainly related to lack of training and problems with ultrasound machines or consumables. Most ePOCUS users (116/148, 78%) attended courses with hands-on training, but only 65 (44%) participants were credentialed (by 18 different organizations). The median score for self-perceived level of ePOCUS skills was 75 in credentialed users versus 50 in those that were not credentialed. Ultrasound in trauma was the most frequently used module (n = 141, 99%), followed by focused cardiac assessment (n = 128, 90%) and thoracic (including lung) assessment (n = 128, 90.1%). The FASH-module (Focused Assessment with Sonography for HIV/TB) was the least used (n = 69, 49%). Conclusion: Access barriers to ePOCUS training, mentorship, equipment and consumables are still relevant in Africa. The low credentialing rate and the potential discordance between local burden of disease and ePOCUStraining requires further investigation.

Perceptions of community health workers on their training, teamwork and practice: a cross-sectional study in Tshwane district, Gauteng, South Africa

Background: In 2011, South Africa established ward-based outreach teams (WBOTs) comprising Community Health Workers as part of strategies to strengthen primary healthcare. The new community health workers (CHWs) lacked experience of the programme. This study aimed at assessing perceptions of community health workers on their training, teamwork and practice.Methods: This was a cross-sectional study conducted among CHWs in the seven regions of Tshwane health district between October and November 2015. Data were collected from 431 CHWs in eight Community Health Centres and 11 clinics using a pre-tested, self-administered questionnaire. Outcome measures were CHWs' perceptions on training, teamwork and practice regarding WBOT programme.Results: A total of 431 CHWs formed the study sample. Participants had a mean age of 36 years (SD ± 9.46). The majority (88.2%) were female. Some 77% had completed secondary school. Overall, most CHWs perceived their training (86.4%), teamwork (87.6%) and practices (67.7%) to be good (p = 0.001). The majority were able to provide efficient health care despite the challenges experienced, which were lack of equipment, walking long distances, and safety on the streets and in households with patients who had mental health problems among others. Fisher's exact test showed a significant association between training and work challenges (p = 0.006).Conclusion: The study findings showed that most CHWs had good perceptions regarding their training, teamwork and practice. Several concerns raised by CHWs suggest the need for stakeholders to ensure availability of resources for optimal functioning of CHWs

Building consensus on identifying research mentoring gaps and finding ways of addressing the gap in a Kenyan college of health sciences

Background: The concept of mentoring in clinical practice has traditionally focused on moving graduates from novice to more respectable positions within the clinical practice hierarchy. With the growing emphasis on evidence-based practice, the role of research in generating evidence for practice cannot be overemphasised. Mentoring in clinical operational research for both students and junior members of academic staff in health professionals' training colleges is as important as mentoring for clinical skills. Aim: This study aimed at building consensus on possible ways of enhancing research mentoring for graduate students and members of academic staff in a college of health sciences. Setting: The study was conducted within Moi University College of Health Sciences (MUCHS) in Eldoret, Kenya. Methods: The study population was composed of academic staff members and registered graduate students by the end of 2015. All academic staff and graduate students were eligible to participate. The Delphi technique was used to not only collect individual opinions but also build consensus. During the first iteration, questions were sent for which open-ended responses were needed. Responses from the first round were grouped into patterns and themes that guided the writing of questions for the subsequent rounds.Results: The response rate was 78%. There was consensus in appreciating that mentoring was fundamental for career growth in clinical practice and research and needed for improving and developing formal structure for effective mentoring. It was crucial to establish training programmes for mentors and for accrediting them. Conclusion: Enhancing of current research mentoring in MUCHS was needed and expected by graduate students and academic staff

Preferred approach to performance improvement among stakeholders in the health insurance industry in Southwest Region of Nigeria: Implications for Universal Health Coverage

Background: Population coverage of the National Health Insurance Scheme (NHIS) of Nigeria is low. This study aimed to assess the capacity gaps of personnel in the health insurance industry in southwest Nigeria as well determined the approach to improvement. Methods: This was a cross-sectional survey conducted in the health insurance industry in southwest Nigeria. Survey tool adapted was the World Health Organization adopted Hennessy-Hicks Training Needs Analysis Questionnaire with a set of 30 tasks which are important to the job performance of personnel in the health insurance industry. From the register made available by stakeholders, there were a total of 275 personnel in the industry in the zone. A total population of all available personnel in all the organizations were recruited into the study. Data analysis was done using the guideline provided in the Hennessy-Hicks Training Needs Analysis Questionnaire. Results: Only 32 (13.7%) reported having a training background in health-related degrees, 119 (50.9%) had work-related (actuarial science) training while 148 (63.3%) has had a form of on-the-job actuarial science and related training. The training course approach was generally preferred to organisational change in all items. Conclusion: This study showed that there were gaps in the capacity of personnel in the health insurance industry. Training course was the preferred approach to addressing these. While not neglecting organizational change, stakeholders in Nigeria and in similar settings are advised to pay more attention to personnel training to improve performance