ABSTRACT
This paper describes the software design/development process leading to an improved computerized clinical/management solution-RSIPA (2016 version)-integrating care pathways (CPs) specifically designed to meet the needs of frail and disabled older adults in home care. The development methodology used Soft Systems Methodology (SSM) for the initial system design and participatory design (PD) to involve stakeholders and end users, along with AGILE SCRUM methodology to provide rapid iterations in adapting to new requests. Given scarce project resources, we opted to combine methodologies to efficiently deliver a fully functional system for three of the five CP clinical phases. The development methodology aggregated assessment-based data to identify risk factors and assist in needs prioritization leading to care plans and addressed in the current system. The new Quebec RSIPA solution incorporating CCPs is a promising example of technologies that support person-centered care, clinical and management processes, and proactive care in home-care settings.
Subject(s)
Clinical Protocols/standards , Disabled Persons , Home Care Services/organization & administration , Patient-Centered Care/organization & administration , Software Design , HumansABSTRACT
We question the positive effect of intimate partner violence on women's modern contraceptive use in sub-Saharan Africa found in previous studies. The explanations offered for this counter-intuitive result are either that women make greater efforts to avoid childbearing in conflictual relationships, or that endogeneity bias exists. Endogeneity bias stems from the inability of researchers to attribute a specific cause to one variable when they are unable to control for related missing covariates. Demographic and Health Survey data from 13 countries in sub-Saharan Africa provide evidence for the latter but not the former. Indeed, using simple probit regression models, we observe a positive relationship between intimate partner violence and modern contraceptive use in Burkina Faso, Mali, Nigeria, Tanzania, and Zimbabwe. This effect remains unchanged when controlling for various measures of women's autonomy in the household, showing that these two variables interact with contraceptive use independently. However, the use of recursive bivariate probit and Rosenbaum bounds sensitivity analysis to control for endogeneity biases erodes the initial positive effect in the five countries, although only partially in Burkina Faso. Our research shows that the previously reported findings arise from poor model specification and highlights the need for more appropriate data to assess the effect of intimate partner violence on modern contraceptive use in sub-Saharan Africa.
Subject(s)
Contraception Behavior/statistics & numerical data , Contraceptive Agents, Female/therapeutic use , Models, Statistical , Spouse Abuse/statistics & numerical data , Adolescent , Adult , Africa South of the Sahara , Female , Humans , Middle Aged , Personal Autonomy , Regression Analysis , Young AdultABSTRACT
Who are the young people reached by peer education programs and/or by youth centers? The present study intends to better know about the activities of the peer educators who are involved in organizations that promote reproductive health information and services in three West African countries. A special research tool was created to collect data to evaluate the composition and characteristics of the populations that such programs reach; therefore, to evaluate the populations left behind. We found that the typical profile of individuals in contact with peer educators or attending youth centers tended to be males aged 15 and more, schooled or highly educated, never married, and living in urban areas. We also found a relationship between peer educators' and peers' socio-demographic characteristics in rural Burkina Faso and urban Guinea Bissau. Finally, the main topics discussed included HIV/AIDS and Sexually Transmitted Infections, but omitting other aspects of sexual and reproductive health.
