Perceptions des acteurs sur les stratégies de suivi-évaluation des indicateurs de performance de la santé de reproduction de la DGSHP / NA

La performance des projets ou programmes se mesure le plus souvent, par rapport aux dimensions de l'efficacité, de l'efficience, de l'équité, de la recevabilité et de la transparence. Le but de cette étude était de mieux comprendre le processus du S&E de la Direction Générale de la Santé et de l'Hygiène Publique du Mali (DGSHP) et documenter les dysfonctionnements en vue de permettre aux décideurs d'apporter des solutions. Nos résultatsontmontré l'exactitude et la fiabilité des données du S&E de cette structure à travers la disponibilité de mécanismes de contrôle et de traitement des données. Cependant, dans le cadre de la cohérence organisationnelle des différents acteurs, il a été constaté un manque réel de cadre formel de concertation entre les acteurs pour mieux coordonner et harmoniser les activités. Concernant l'efficacité des activités, la majorité des acteurs interrogées pense que le niveau technique du personnel de suivi est faible surtout, au niveau des Directions régionales. En termes de l'adéquation entre les résultats obtenus et les moyens mis à disposition, 57% des répondants ne sont pas satisfaits de l'efficience des activités de S&E de la DGSHP. En conséquence, les autorités doivent envisager des solutions appropriées permettant de comblerces lacunes et d'améliorer la performance du processus de S&Ede la DGSHP.Mots clés: Stratégies, cohérence, performance, suivi et évaluation, santé

The performance of projects or programs is often measured through the dimensions of effectiveness, efficiency, equity, admissibility,and transparency. The purpose of this study was to better understand the monitoring and evaluation (M&E) process and to document dysfunctions toenable decision-makers of the General Direction of Health and Public Hygiene of Mali (DGSHP) to provide solutions. Our results of these surveys have shown the accuracy and reliability of the M&E data of this structure through the availability of control mechanisms and data processing. On the other hand, within the framework of the organizational coherence of the various actors, it was noted a real lack of formal framework of dialogue between the actors to better coordinate and harmonize the activities. Page 41of50RASPVolume 5, Issue1Concerning the effectiveness of the activities, the majority of the interviewed actors think that the technical level of the monitoring staff is low, especially at the level of the regional directions. In terms of the adequacy between the results obtained and the available means, 57% of respondents are not satisfied with the efficiency of the M&E activities of the DGSHP. Consequently, the authorities should consider appropriate solutions to fill the gaps and improve the performance of the M&E process of the DGSHP

Health workers with good self-perceived competency have lower actual competency levels on HIS in Eastern Ethiopia: A cross-sectional study

Introduction: Utilization of health information is critical to meeting service performance goals and for making informed decisions. However, in resource limited countries, health data is rarely used in decisions around program improvements. This study aimed to assess the determinants of competency levels for health workers who utilized data from health information systems in Eastern Ethiopia. Methods:A cross-sectional study was carried out from April -May 2021 at selected public health facilities in the Dire Dawacityand Harar regions. A total of 129 health professionals were included in the study and simple random sampling techniques were used to select health facilities. Data was collected using face-to-face interviews and competency levels were measured using a tool adapted from the Performance of Routine Information Systems Management (PRISM) framework. STATA version 16 was used for data analysis. A linear regression model was applied to determine the linear relationship between self-perceived competency and the actual competency levels of the healthcare workers.Adjusted beta (ß) along with a 95% confidence interval (CI) was used to measure the strength of the association with a p-value < 0.05. Results:The overall mean for the actual competency levels of health workers who utilized data was 20.45 [95% CI: 16.71, 24.19]. Being head of a hospital/health center (ß: 19.24, 95% CI: 4.42, 34.06), perusing HIS training (ß: 14.38, 95% CI: 6.10, 22.67) and good perceived competency to perform RHIS tasks (ß: -12.96, 95% CI: -25.49, -0.43) were significantly associated with actual competency levels.Conclusion:The Health workers with high perceivedcompetency levels were found to have actual competency levels that were low. Health information systemfocused trainings were found to be positively associated with actual competency levels and being a hospital or health center head was found to be associated negatively to the actual competency levels of health workers. This research has found that providing health information system training for health workers could prove to be beneficial. There is also a need for initiatives aimed at enhancing competency in order to improve the health information systems related competency levels and data use.[Ethiop. J. Health Dev. 2022;36(SI-1)]

Inferência baseada em magnitude: um olhar para análise individual / Magnitude-based inference: looking at the individual analysis

Os testes de hipótese são amplamente empregados para análise de dados na área de ciência do esporte. Porém, existe um questionamento em relação a utilização desse método e a comunidade científica ainda procura soluções mais adequadas para a análise dos dados. De fato, esse tipo de análise não permite uma interpretação prática das mudanças observadas ao longo do tempo. Por conta disso, o cálculo da "in ferência baseada em magnitude" (IBM) vem sendo cada vez mais utilizado por pesquisadores e analistas de desempenho. Em uma perspectiva aplicada, a IBM permite avaliar a probabilidade de se encontrar diferenças relevantes (i.e., meaningful differences) nas variáveis investigadas. Da mesma forma, a IBM permite examinar com precisão as variações individuais e importantes no desempenho esportivo. O objetivo desse ponto de vista é apresentar e discutir a aplicação da IBM a partir das análises individuais. Para tanto o trabalho aborda os seguintes temas: 1) utilização da análise de dados no "mundo real"; 2) inferência baseada em magnitude: conceitos básicos; 3) aplicando a IBM no contexto do esporte; 4) classificações qualitativas com base nas mudanças observadas; 5) formas de se obter a mínima mudança válida importante e o erro típico; 6) análise e interpretação dos dados. Esperamos que o conteúdo apresentado encoraje pesquisadores e profissionais do esporte a implementar esse novo método de análise em suas rotinas diárias e, ao mesmo tempo, lhes auxilie na interpretação dos dados provenientes das avaliações e testes de desempenho.(AU)

Null hypothesis tests are widely used for data analysis in sport science. However, the scientific community has been questioning this method and is still looking for alternative approaches for data analyses. In fact, this type of analysis does not allow practical interpretation of the changes observed in athletic performance over time. Therefore, the magnitude-based inference (MBI) method has been increasingly used by researchers and performance analysts. From an applied perspective, this method allows examining the probability of finding meaningful differences in assessed variables. In addition, the MBI enables precise assessment of individual changes, which may be releva nt to sport performance. The aim of this article is to present and discuss the application of the individual MBI analysis. Based on this purpose, the manuscript covers the following topics: 1) utilization of data analysis in real world settings; 2) basic concepts of the MBI; 3) applying the MBI approach in sport science; 4) qualitative classifications based on observed changes; 5) different methods to determine the smallest worthwhile change and the typical error; 6) data analysis and interpretation. We hope that this study will encourage practitioners and r esearchers to implement this novel statistical approach in their daily routines, for analysis and interpretation of data collected during physical performance measurements.(AU)

The necessity of detection for insulating property of electrosurgical instrument / 中国医学装备

Objective: To explore the importance and necessity that central sterile supply department (CSSD) carried out detection for insulating property of electrosurgical instrument so as to guarantee the safety of surgery for patients. Methods: 50 monopole instruments and 30 bipolar instruments were collected, and specific insulation tester was adopted to detect the insulation property of these instruments. Besides, the detection methods of electrosurgical instrument between home and abroad were compared so as to avoid and reduce the adverse events caused by the breakage of insulating layer of electrosurgical instrument. Results: The breakages of insulating layer of 5 monopole instruments and 2 bipolar instruments were found through detection and all of them were replaced. The same problem did not be found again after 2 months. The insulation tester was used to detect the insulation property of electrosurgical instruments could effectively found these instruments with damages of insulating layer. Conclusion:The damage of the insulation layer of the electrosurgical instruments may cause serious consequences and even threat safety of patients. Periodic detection for insulation property can effectively reduce and avoid the occurrence of same problems and guarantee the safety of patient. Therefore, it is very necessary measurement.

Autonomic correlates of Yo-Yo performance in soccer referees / Correlatos autonômicos do desempenho no Yo-Yo em árbitros de futebol

We tested the hypothesis that: basal cardiac autonomic modulation (i.e. heart rate variability, HRV) was associated with the parasympathetic withdrawal during, and overall Yo-Yo IR1 performance; and therefore HRV could be used as a simple tool for specific fitness assessment. Nine sub-elite soccer referees performed the Yo-Yo IR1 until exhaustion with simultaneous recording of heart rate with the autonomic response during exercise calculated as the area under the curve (AUC). In the same week but with at least 48 hrs between days, a night-time HR recording was obtained from participants for determination of basal HRV. Correlation analysis demonstrated strong (r>0.83) relationships among Yo-Yo IR1 performance, AUC and basal HRV. These results indicate that both nocturnal HRV and AUC can be utilised as simple and valid monitoring tools of soccer referees' fitness.

Nós testamos a hipótese de: que a modulação autonômica cardíaca (i.e. variabilidade da freqüência cardíaca, VFC) está associada com a retirada parassimpática durante a execução do Yo-Yo IR1; e que, portanto, a VFC poderia ser usada como uma ferramenta simples para a avaliação do desempenho físico específico. Nove árbitros sub-elite de futebol executaram o Yo-Yo IR1 até a exaustão com registro simultâneo da freqüência cardíaca e VFC para o cálculo da área sob a curva (ASC). Na mesma semana, mas com mínimo de 48 horas entre dias, obteve-se um registro noturno da FC dos participantes para a determinação da VFC basal. As análises de correlação demonstraram elevados coeficientes (r>0,83) entre o desempenho no Yo-Yo IR1, a ASC e a VFC basal. Estes resultados indicam que a VFC noturna e a ASC podem ser empregadas como ferramentas simples e válidas para o monitoramento do desempenho de árbitros de futebol.

Terceirização em cuidados continuados: uma abordagem de gestão de risco / Outsourcing in long-term care: a risk management approach

Este artigo tem como objetivo investigar a decisão de externalização, integrada na gestão da cadeia de suprimentos no setor da saúde, nomeadamente os motivos e condicionantes da decisão, os critérios de escolha das atividades a entregar a terceiros, os tipos de acordos possíveis e o impacto que a decisão tem na organização e na pratica. Através do estudo de caso de uma unidade de saúde prestadora de cuidados continuados de forma inovadora, com grandes níveis de customização e em início de atividade, investigou-se todo o processo de terceirização em contexto do início do ciclo de vida de uma organização (não no contexto comum de mudança organizacional) e construiu-se uma matriz de avaliação de risco para atividades terceirizadas de modo a permitir a definição do processo de monitorização da performance a implementar. Este estudo visa compreender como se avaliam e balizam os riscos da adopção de uma estratégia de terceirização e sugere um modelo de monitorização, com recurso a ferramentas de gestão de risco. Concluiu-se que uma abordagem de Gestão de Risco pode ser uma solução para monitorização de terceirização em atividade que se iniciam. Retiram-se, ainda, conclusões acerca da insatisfação com os resultados da estratégia de externalização adotada.

This article seeks to investigate outsourcing decisions in supply chain management of healthcare organizations, namely the motives and constraints behind the decision, the selection criteria for activities to be outsourced to third parties, the type of possible agreements, and the impact of this decision on the organization per se. A case study of the start-up phase of a Long-term Care unit with an innovative approach and high levels of customization was conducted to understand the outsourcing process in a start-up context (not in the standard context of organizational change) and a risk evaluation matrix was created for outsourcing activities in order to define and implement a performance monitoring process. This study seeks to understand how to evaluate and assess the risks of an outsourcing strategy and proposes a monitoring model using risk management tools. It was shown that the risk management approach can be a solution for monitoring outsourcing in the organizational start-up phase. Conclusions concerning dissatisfaction with the results of outsourcing strategies adopted are also presented.