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The role of 'mega-foundations' in aid programmes to developing countries.
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DOI: 10.1108/OXAN-DB210952
ISSN: 2633-304X
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Topical
Alexandra Martiniuk, Julia Challinor, Ramandeep S. Arora, Sri Andini Handayani and Catherine Lam
Globally, cancer represents an increasing proportion of child mortality as progress against infectious causes is made. Approximately 400,000 children will develop cancer, each…
Abstract
Purpose
Globally, cancer represents an increasing proportion of child mortality as progress against infectious causes is made. Approximately 400,000 children will develop cancer, each year, around the world. Only about half of these cancers will ever be diagnosed. In high-resource settings, 80% of children will survive, but only about 30% will survive in low-resource settings. Digital solutions have a valuable role in increasing health professional knowledge, skills and empowerment to diagnose, treat and otherwise care for children and adolescents with cancer. This review sought to identify digital resources that support the training and development of the paediatric oncology workforce in resource -poor settings.
Design/methodology/approach
This paper presents a narrative descriptive review of peer-reviewed publications and digital platforms that contribute to health professionals' education and training regarding paediatric oncology, particularly in rural and other low-resource settings.
Findings
Digital solutions were identified for building communities of practice, facilitating access to information and support and providing access to training, education and supervision specifically for paediatric oncology health professionals. A total of 33 resources are discussed in depth. A quality assessment of the digital resources is provided using the Currency, Relevance, Authority, Accuracy and Purpose (CRAAP) tool and suggestions to improve the quality of resources are discussed.
Practical implications
The authors anticipate that this summary of digital resources for the global paediatric oncology professional community will inform digital health investments and design of digital innovations to meet emerging needs and will have an impact on the workforce in the real world. Ultimately, this work will contribute to an improvement in the diagnosis and treatment of children and adolescents with cancer in resource-poor settings.
Originality/value
This is the first discussion and summary of digital education platforms which educate, train and offer support to health professionals with respect to paediatric oncology. These digital platforms are often aimed at, and are essential for, health professionals in rural and other low-resource settings.
Jiawei Liu, Zi Xiong, Yi Jiang, Yongqiang Ma, Wei Lu, Yong Huang and Qikai Cheng
Fine-tuning pre-trained language models (PLMs), e.g. SciBERT, generally require large numbers of annotated data to achieve state-of-the-art performance on a range of NLP tasks in…
Abstract
Purpose
Fine-tuning pre-trained language models (PLMs), e.g. SciBERT, generally require large numbers of annotated data to achieve state-of-the-art performance on a range of NLP tasks in the scientific domain. However, obtaining fine-tuning data for scientific NLP tasks is still challenging and expensive. In this paper, the authors propose the mix prompt tuning (MPT), which is a semi-supervised method aiming to alleviate the dependence on annotated data and improve the performance of multi-granularity academic function recognition tasks.
Design/methodology/approach
Specifically, the proposed method provides multi-perspective representations by combining manually designed prompt templates with automatically learned continuous prompt templates to help the given academic function recognition task take full advantage of knowledge in PLMs. Based on these prompt templates and the fine-tuned PLM, a large number of pseudo labels are assigned to the unlabelled examples. Finally, the authors further fine-tune the PLM using the pseudo training set. The authors evaluate the method on three academic function recognition tasks of different granularity including the citation function, the abstract sentence function and the keyword function, with data sets from the computer science domain and the biomedical domain.
Findings
Extensive experiments demonstrate the effectiveness of the method and statistically significant improvements against strong baselines. In particular, it achieves an average increase of 5% in Macro-F1 score compared with fine-tuning, and 6% in Macro-F1 score compared with other semi-supervised methods under low-resource settings.
Originality/value
In addition, MPT is a general method that can be easily applied to other low-resource scientific classification tasks.
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Those who design and implement teacher professional development (TPD) in international donor-funded, low-resource environments often lack a strong foundation of evidence-based…
Abstract
Those who design and implement teacher professional development (TPD) in international donor-funded, low-resource environments often lack a strong foundation of evidence-based research to guide their work. This lack of a research base raises questions about the efficacy and quality of TPD in low-resource settings. Educational practitioners need, and want, quality research to improve the interventions they offer teachers. However, for reasons specific to academic research, the nature of donor funding, and the on-the-ground conditions in many developing countries, conducting evidence-based research is often fraught with difficulties. This article argues that research in donor-funded, low-resource contexts must be conceptualized, funded, and produced differently than is presently the case. Thus, the article proposes recommendations, from an educational practitioner perspective, to guide researchers in terms of framing their research, the research methods used, and communicating and disseminating findings.
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Augustino Mwogosi and Cesilia Mambile
The study aims to explore the utilisation of Clinical Decision Support (CDS) tools in Tanzanian healthcare facilities by identifying the tools used, the challenges encountered and…
Abstract
Purpose
The study aims to explore the utilisation of Clinical Decision Support (CDS) tools in Tanzanian healthcare facilities by identifying the tools used, the challenges encountered and the adaptive strategies employed by healthcare practitioners. It utilises an Activity Theory (AT) approach to understand the dynamic interactions between healthcare providers, CDS tools and the broader healthcare system.
Design/methodology/approach
The research adopts a qualitative approach in two prominent regions of Tanzania, Dar es Salaam and Dodoma. It involves semi-structured interviews with 26 healthcare professionals and key stakeholders across ten healthcare facilities, supplemented by document reviews. The study employs AT to analyse the interactions between healthcare professionals, CDS tools and the broader healthcare system, identifying best practices and providing recommendations for optimising the use of CDS tools.
Findings
The study reveals that Tanzanian healthcare practitioners predominantly rely on non-computerised CDS tools, such as clinical guidelines prepared by the Ministry of Health. Despite the availability of Health Information Systems (HIS), these systems often lack comprehensive decision-support functionalities, leading practitioners to depend on traditional methods and their professional judgement. Significant challenges include limited accessibility to updated clinical guidelines, unreliable infrastructure and inadequate training. Adaptive strategies identified include using non-standardised tools like Medscape, professional judgement and reliance on past experiences and colleagues’ opinions.
Research limitations/implications
The investigation was constrained by access limitations because it was challenging to get some respondents to share information. However, a sufficient number of individuals participated in the interviews, and their knowledge was very beneficial in understanding the procedures and tools for clinical decision support.
Originality/value
This study contributes to AT by extending its application to a low-resource healthcare setting, uncovering new dimensions of the theory related to socio-cultural and technological constraints in healthcare facilities in Tanzania. It provides valuable insights into the practical barriers and facilitators of HIS and CDS tool implementation in developing countries, emphasising the need for context-specific adaptations, robust training programs and user-centred designs. The findings highlight the resilience and imagination of healthcare practitioners in adapting to systemic limitations, offering recommendations to enhance clinical decision-making and improve patient care outcomes in Tanzania.
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Iana Shaheen, Arash Azadegan and Donna Davis
To effectively meet their social objectives, humanitarian organizations need to be more innovative and find novel ways to stay competitive. Yet there has been limited focus on…
Abstract
Purpose
To effectively meet their social objectives, humanitarian organizations need to be more innovative and find novel ways to stay competitive. Yet there has been limited focus on innovation by humanitarian organizations. Part of the issue is the lack of new practices and novel approaches that can be used as benchmarks. This study focuses on food banks, a critical hub for the delivery of food in humanitarian supply chains and where the use of innovation seems to be more reported on.
Design/methodology/approach
Focusing on resource scarcity, a commonly referenced constraint by humanitarian organizations, the authors study how food and fund scarcity (versus abundance) influence the innovation efforts of twelve food banks in the United States. This study observes variations in behavior before and during the coronavirus disease 2019 (COVID-19) pandemic.
Findings
The authors find that food banks operating in high resource scarcity (food-scarce and fund-scarce) settings focus on process innovations. Food banks operating in low resource scarcity (food-abundant and fund-abundant) settings focus on product innovations. Food banks operating in food-abundant and fund-scarce settings focus on marketing innovations. Food banks operating in food-scarce and fund-abundant settings show the most extensive focus on innovation by relying on imitative innovations. The innovation focus for most food banks switches to process innovation during the COVID pandemic.
Originality/value
The study breaks down resource scarcity specific to food banks by differentiating food and funds, a novel approach to studying scarcity. Findings are novel as they suggest that operating context has a highly differentiating effect on what food banks focus on in terms of innovation. Operating context can lead to focus on process, product, imitative of market-related innovations. Finally, the study is novel because it explores how change in the environmental context due to disruptions can drastically modify the innovation focus of food banks.
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Collins Afriyie Appiah, Faustina O. Mensah, Frank E. A. Hayford, Vincent A. Awuuh and Daniel Edem Kpewou
The purpose of this study was to identify the predictors of child undernutrition and anemia among children 6–24 months old in the East Mamprusi district, Northern region, Ghana.
Abstract
Purpose
The purpose of this study was to identify the predictors of child undernutrition and anemia among children 6–24 months old in the East Mamprusi district, Northern region, Ghana.
Design/methodology/approach
This cross-sectional study recruited 153 children and their mothers. Weight, height and hemoglobin levels of the children were measured. A structured questionnaire based on the World Health Organization's indicators for assessing infant and young child feeding practices was used to collect data on parents' socioeconomic status, household characteristics, hygiene and sanitation practices, mothers' knowledge on feeding practices such as child's meal frequency and dietary diversity and child morbidity within the past two weeks. Predictors of child nutritional status were determined using multinomial logistic regression analysis.
Findings
Underweight in the children was significantly predicted by maternal knowledge on protein foods (AOR = 0.045, p = 0.008), time of initiation of complementary feeding (AOR = 0.222, p = 0.032) and maternal age (AOR = 9.455, p = 0.017). Feeding child from separate bowls (AOR = 0.239, p = 0.005), minimum meal frequency per child's age (AOR = 0.189, p = 0.007) and time of initiation of complementary feeding (AOR = 0.144, p = 0.009) were significant determinants of stunting among the children. Exclusive breast feeding (AOR = 7.975, p = 0.012) and child's past morbidity (AOR = 0.014, p = 0.001) significantly contributed to anemia among the children.
Research limitations/implications
This is a cross-sectional study and cannot establish causality. The small sample size also limits the generalizability of study findings. However, findings of the study highlight factors which could potentially influence the high rate of child undernutrition in the study setting.
Practical implications
This study identifies determinants of undernutrition in the East Mamprusi district, an underresourced area in Ghana. This information could inform the development/reformulation of locally sensitive key messages and targeted intervention strategies to curb the high levels of child undernutrition in the East Mamprusi district of Ghana.
Originality/value
This study identifies maternal care practices as key potential drivers of undernutrition in a low-resource setting known for high prevalence of child undernutrition. It suggests insight for large-scale studies on the predictors of child undernutrition in Northern Ghana and other resource-poor settings.
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Elise Catherine Davis, Elizabeth T. Arana, John S. Creel, Stephanie C. Ibarra, Jesus Lechuga, Rachel A. Norman, Hannah R. Parks, Ali Qasim, David Y. Watkins and Bita A. Kash
The purpose of this article is to provide a general review of the health-care needs in Kenya which focuses on the role of community engagement in facilitating access and…
Abstract
Purpose
The purpose of this article is to provide a general review of the health-care needs in Kenya which focuses on the role of community engagement in facilitating access and diminishing barriers to quality care services. Health-care concerns throughout Kenya and the culture of Kenyan’s health-care practices care are considered.
Design/methodology/approach
A comprehensive review covered studies of community engagement from 2000 till present. Studies are collected using Google Scholar, PubMed, EBSCOhost and JSTOR and from government and nongovernment agency websites. The approach focuses on why various populations seek health care and how they seek health care, and on some current health-care delivery models.
Findings
Suggestions for community engagement, including defining the community, are proposed. A model for improved health-care delivery introduces community health workers (CHWs), mHealth technologies and the use of mobile clinics to engage the community and improve health and quality of care in low-income settings.
Practical implications
The results emphasize the importance of community engagement in building a sustainable health-care delivery model. This model highlights the importance of defining the community, setting goals for the community and integrating CHWs and mobile clinics to improve health status and decrease long-term health-care costs. The implementation of these strategies contributes to an environment that promotes health and wellness for all.
Originality/value
This paper evaluates health-care quality and access issues in Kenya and provides sustainable solutions that are linked to effective community engagement. In addition, this paper adds to the limited number of studies that explore health-care quality and access alongside community engagement in low-income settings.
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Louise Ackers, Hannah Webster, Richard Mugahi and Rachel Namiiro
The purpose of this paper is to present the findings of research on mothers and midwives’ understanding of the concept of respectful care in the Ugandan public health settings. It…
Abstract
Purpose
The purpose of this paper is to present the findings of research on mothers and midwives’ understanding of the concept of respectful care in the Ugandan public health settings. It focusses on one aspect of respect; namely communication that is perhaps least resource-dependent. The research found endemic levels of disrespect and tries to understand the reasons behind these organisational cultures and the role that governance could play in improving respect.
Design/methodology/approach
The study involved a combination of in-depth qualitative interviews with mothers and midwives together with focus groups with a cohort of midwives registered for a degree.
Findings
The findings highlight an alarming level of verbal abuse and poor communication that both deter women from attending public health facilities and, when they have to attend, reduces their willingness to disclose information about their health status. Respect is a major factor reducing the engagement of those women unable to afford private care, with health facilities in Uganda.
Research limitations/implications
Access to quality care provided by skilled birth attendants (midwives) is known to be the major factor preventing improvements in maternal mortality and morbidity in low income settings. Although communication lies at the agency end of the structure-agency continuum, important aspects of governance contribute to high levels of disrespect.
Originality/value
Whilst there is a lot of research on the concept of respectful care in high income settings applying this to the care environment in low resource settings is highly problematic. The findings presented here generate a more contextualised analysis generating important new insights which we hope will improve the quality of care in Uganda health facilities.
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Joshua Berman, Elizabeth Limakatso Nkabane, Sebaka Malope, Seta Machai, Brian Jack and William Bicknell
Hospital-based quality improvement (QI) programs are becoming increasingly common in developing countries as a sustainable method of strengthening health systems. The aim of this…
Abstract
Purpose
Hospital-based quality improvement (QI) programs are becoming increasingly common in developing countries as a sustainable method of strengthening health systems. The aim of this paper is to present the results and lessons learned from a QI program in a large, rural, district hospital in Lesotho, Southern Africa.
Design/methodology/approach
Over a 15-month period, a locally-relevant, hospital-wide QI program was developed and implemented. The QI program consisted of: planning meetings with district and hospitals staff; creation of multi-disciplinary QI teams; establishment of a QI steering committee; design and implementation of a locally appropriate QI curriculum; and monthly consultation from technical advisers. Initial QI programming was developed in three distinct areas: maternity care, out-patient care, and referral systems.
Findings
Partogram documentation in the maternity department increased by 78 percent, waiting time for critically ill patients in the out-patient department was reduced by 84 percent, and emergency referral times were reduced by 58 percent.
Originality/value
The design and early implementation of QI programs should focus on easily achievable, locally-relevant improvement projects. It was found that early successes helped to fuel further QI gains and the authors believe that the work building sustainable QI skill sets within hospital staff could be useful in the future when attempting to tackle larger national-level quality of care indicators. The findings add to the existing evidence suggesting that an increased use of locally-relevant quality improvement programming could help strengthen health care systems in low resource settings.
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