Building back better children's surgical services toward universal health coverage: Perspectives from Bangladesh and Zimbabwe

IntroductionThis article is part of the Research Topic ‘Health Systems Recovery in the Context of COVID-19 and Protracted Conflict’. Children's surgical services are crucial, yet underappreciated, for children's health and must be sufficiently addressed to make and sustain progress toward universal health coverage (UHC). Despite their considerable burden and socioeconomic cost, surgical diseases have been relatively neglected in favor of communicable diseases living up to their inauspicious moniker: ‘the neglected stepchild of global health'. This article aims to raise awareness around children's surgical diseases and offers perspectives from two prototypical LMICs on strengthening surgical services in the context of health systems recovery following the COVID-19 experience to make and sustain progress toward UHC.ApproachWe used a focused literature review supplemented by the perspectives of local experts and the 6-components framework for surgical systems planning to present two case studies of Bangladesh and Zimbabwe. The lived experiences of the authors are used to describe the impact of COVID-19 on respective surgical systems and offer perspectives on building back the health system and recovering essential health services for sustainability and resilience.FindingsWe found that limited high-level policy and planning instruments, an overburdened and under-resourced health and allied workforce, underdeveloped surgical infrastructure (from key utilities to essential medical products), lack of locally generated research, and the specter of prohibitively high out-of-pocket costs for children's surgery are common challenges in both countries that have been exacerbated by the COVID-19 pandemic.DiscussionContinued chronic underinvestment and inattention to children's surgical diseases coupled with the devastating effect of the COVID-19 pandemic threaten progress toward key global health objectives. Urgent attention and investment in the context of health systems recovery is needed from policy to practice levels to improve infrastructure; attract, retain and train the surgical and allied health workforce; and improve service delivery access with equity considerations to meet the 2030 Lancet Commission goals, and make and sustain progress toward UHC and the SDGs

The Application of Program Monitoring the Health of the Baby Through the SMS-Based Immunization Activities

The application of information technology in the health sector is increasingly experiencing intensive development because improvements are needed for the medical world through the application of technologies and programs that are appropriate for the benefit of therapy, care and process monitoring. In this research, the team will carry out the design process of monitoring infant health using SMS-based information technology. The purpose of this study is to provide a solution so that babies born can undergo the immunization process properly using a special application and is equipped with a design such that it is easy to use, operated based on an SMS gateway. So that mothers and babies are born always get accurate information about immunization activity until the baby's age limit is exactly 59 weeks and without errors. SMS gateway based applications can be implemented in health centers or hospital services. This application has a range of up to several cities in the vicinity which are close to health care centers or hospitals that are responsible for providing the fastest service Keywords Immunization of infants, infant health, SMS gatewa

Pharmacy Stores Profitability and Sustainability in Bulawayo, Zimbabwe

Zimbabwe\u27s catastrophic economic decline resulted in a high unemployment rate (95%), declining socioeconomic indicators, pharmacy stores\u27 unprofitability and lower sustainability. Profitable pharmacy stores play a fundamental role in ensuring public access to medication. Lack of pharmacy profitability leads to poor healthcare delivery, resulting in increased morbidity and mortality. A healthy population is panacea to economic growth and prosperity and enhances human dignity, social cohesion, and the quality of life. In this qualitative, descriptive multicase study design, using Porter\u27s business strategies theory and the Deming process of quality assurance as conceptual frameworks, data from 11 pharmacy stores leaders in Bulawayo, Zimbabwe were collected during interviews with open-ended questions. Participants were assumed to have influence, knowledge, and a personal stake in the pharmacy sector and that their views and experiences could address the research question of lack of pharmacy profitability and sustainability. Data were explored, categorized, and tabulated to assist drawing empirical findings and conclusions that could answer the research question. Using software the data were analyzed and themes such as the centrality of strategy in running profitable pharmacies, customer care, reimbursements by medical insurance firms, the role of the legal and regulatory frameworks on pharmacies, and mergers of single-owner pharmacies emerged. Findings from the results might provide strategies for those in the pharmacy retail sector and individuals who intend to explore the sector. Individuals who read results of the study might be influenced to lobby government on behalf of the sector to relax prohibitive regulations

The roles of social media in disseminating HIV/AIDS information to young people aged 18-24 in Harare Zimbabwe

HIV infection is a serious problem among young persons aged 15-24 years in Zimbabwe. According to a United Nations statement, the reduction of HIV and AIDS in this age group is important for monitoring the epidemic among the general population. Because the legal age of majority in Zimbabwe is eighteen years, this study investigated the roles of social media to improve the dissemination of HIV/AIDS information to young people aged 18-24 in Harare. The main aim was to establish a model that encapsulates the special roles for social media to improve the dissemination of HIV/AIDS information to this target group. To collect relevant data, questionnaires and interviews with young people and HIV/AIDS organisations in Harare complemented an extensive literature review of the extant models for disseminating HIV/AIDS. The review revealed that there are several models for disseminating HIV/AIDS information via social media platforms. However, they lack the special requirements for an African city like Harare, and for this age group. Drawing on the strengths of these models and the unique data set generated by the research instruments, the study proposes a model fitting the special circumstances and challenges of 18-24 year old people in Harare. The Harare HIV/AIDS Information Dissemination Programme for Young People model (HAIDYP) will for the first time unite all Zimbabwean organisations involved in disseminating HIV/AIDS information to focus on a specially targeted group. This model is especially sensitive to the indigenous languages of Ndebele, Shona, and Venda languages and advocates links with international, regional, and national organisations. HAIDYP’s special counselling role elaborates on the formal and informal teaching dimensions of existing models, and it has the potential of extending the benefits of social media to improve the dissemination of HIV/AIDS in other cities in Zimbabwe.Thesis (PhD)--University of Pretoria, 2018.Information SciencePhDUnrestricte

Geneva Health Forum 2020 Poster Book

From 16 to 18 November 2020, the eighth edition of the Geneva Health Forum, which took place in the difficult context of the Covid 19 pandemic, hosted 165 posters. The present collection offers through 65 posters a wide range of topics discussed

Demographic and health survey

"The 2005-2006 Zimbabwe Demographic and Health Survey (2005-06 ZDHS) was implemented by the Central Statistical Office (CSO) from August 2005 to March 2006. The 2005-06 ZDHS is one of a series of surveys undertaken by the CSO as part of the Zimbabwe National Household Survey Capability Programme (ZNHSCP). Macro International Inc. provided technical assistance and funding through the MEASURE DHS project, a USAIDfunded project providing support for the implementation of population and health surveys in countries worldwide. The Ministry of Health and Child Welfare (MOH&CW), the Zimbabwe Family Planning Council (ZNFPC) and the Musasa Project contributed significantly to the design, implementation, and analysis of the ZDHS results. Other agencies and organizations facilitating the successful implementation of the survey through technical and/or financial support include the Government of Zimbabwe, the National Microbiology Reference Laboratory (NMRL), the USAID/Zimbabwe Mission, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the United Nations Population Fund (UNFPA), the United Nations Development Program (UNDP), the United Nations Children's Fund (UNICEF), the Centers for Disease Control and Prevention (CDC), and the United Kingdom Department for International Development (DFID). " - t.p. verso"March 2007."Also available via the World Wide Web.Includes bibliographical references (p. 297-298)

Facility linkages to HIV care and treatment as per entry point at a Norton Health Centre, Zimbabwe

Effective linkage to HIV care and treatment for all people diagnosed with HIV is crucial if positive treatment outcomes are to be realised. The study used the client records for all those newly diagnosed with HIV through the two entry points for HIV testing between January 2016 and December 2016. The aim of the study was to determine the proportions between the linkages to HIV care and treatment as per entry point for the people diagnosed with HIV at a Norton Health Centre in Zimbabwe. More importantly, the study sought to make recommendations to improve linkage per entry point. This was achieved through determining the proportion of individuals diagnosed with HIV that had documented evidence of linkage to HIV care and treatment by entry point. The study also evaluated the association between the entry point of HIV diagnosis and the linkage to HIV care and treatment.. In total, 239 clients’ records were reviewed who were over the age of 16 years. Overall, 144 (60%) had documented evidence of being linked to HIV care while about 95 (40%) of the client records had no documented evidence of linkage to HIV care. 143(60%) had documented evidence of initiation on antiretroviral therapy (ART) while about 96 (40%) had no documented evidence of initiation on ART. A statistically significant association between entry point for HIV diagnosis and the linkage to HIV care and treatment was demonstrated. A statistically significant higher proportion of females was demonstrated to be linked to HIV care and treatment than for males. The Prevention of Mother to Child Transmission of HIV (PMTCT) entry point showed higher linkages than OPD and wards entry point. Therefore, there is need to make put measures in place that encourage all clients that are diagnosed with HIV through the various entry points at the health centre to be linked to HIV care and treatment. The study made recommendations based on the findings. It is also recommended that male partners be encouraged to accompany their female expectant partners when attending PMTCT sessions. Youth were found to be lower in terms of linkages and the youth user friendly centre is recommended so as to attract more youths to come for testing.Health StudiesM.A. (Public Health

Reducing under-five mortality in Makonde district’s public healthcare institutions: an exploratory investigation into the potential role of emerging technologies.

Doctoral Degree. University of KwaZulu-Natal, Durban.Under-five mortality rate remains unacceptably high globally, with Sub-Saharan Africa being the region with the worst under-five mortality outcomes. The United Nations reported that an average of 15 000 under-fives died daily in 2018, translating to 5.3 million under-fives dying annually. The United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) estimated that up to 5.5 million under-fives died in 2021. The outbreak of the Coronavirus Disease 2019 (COVID-19) worsened the situation for child healthcare in low-resource settings due to overwhelmed and strained healthcare systems. Promoting the health and well-being of under-fives remains a priority of the United Nations and its member states, as evidenced by the setting of under-five mortality goals in both the expired Millennium Development Goals and the current Sustainable Development Goals. Globally, under-five mortality outcomes are meagrely improving, registering a 4 per cent improvement in 18 years. Zimbabwe is one of the countries with high under-five mortality rates, with the Midlands and Mashonaland West provinces having the worst under-five mortality rates, according to the 2019 Multiple Indicator Cluster Survey (MICS) report. Despite the evidence of emerging technologies helping to reduce under-five mortality rates in other regions and countries like the United States of America, the United Kingdom and South-West Nigeria, the potential of such technologies to reduce under-five mortality rates in Zimbabwe’s public healthcare institutions has not been explored. Although Zimbabwe has registered improvements in under-five mortality rates over the years through such programmes as free healthcare for under-fives in public health facilitie s, child immunisation programmes, provision of nutritional supplements and prevention of mother-to-child transmission (PMTCT), the rates are still unacceptably high and above the SDG target of 23 per 1 000 live births, making Zimbabwe ranked amongst the fifty countries with the highest early childhood mortality in the world. The country’s poor under-five mortalit y rates suggest that the existing methods need to be complemented by different approaches. Guided by three theoretical frameworks, the Diffusion of Innovation, the Unified Theory of Acceptance and Use of Technology and the Capabilities Approach, the researcher explored the potential role of emerging technologies in reducing under-five mortality in Makonde District, Zimbabwe. The key deliverables of this study included a framework for the adoption of emerging technologies to reduce under-five mortality in resource-constrained settings like Makonde district. An exploratory sequential mixed-methods design was used, in which 20 healthcare professionals from Makonde public health facilities participated in interviews and a focus group, while 90 healthcare professionals and 391 mothers of under-five children xi responded to questionnaires. The researcher used purposive and snowball sampling to identify interview and focus group participants, where experience and whether one works in the paediatric ward, works with children or pregnant women were critical considerations. Mothers of under-fives were randomly sampled. The study revealed that the participants arguably value under-fives the most and would accept any technology intended to improve their health and wellbeing. They perceive emerging technologies as helpful in areas like improving diagnosis, minimising loss to follow-ups and providing data-driven, evidence-based and personalised paediatrics. The impediments to adoption included the fear of medico-legal hazards, centralisation of digital health decision-making, network problems, resistance to change and demoralised workforce. There is generally poor knowledge of emerging technologies by healthcare professionals in Makonde District. The study proffers recommendations on what needs to be done for emerging technologies to be adopted in Makonde District’s public healthcare institutions to reduce under-five mortality. An adoption framework is also presented.No isiZulu abstract available

The use of information and communication technologies for accessing HIV and AIDS information by healthcare professionals in Zimbabwe

Philosophiae Doctor - PhDThis study sought to investigate the information needs of selected HIV and AIDS health organisations in Zimbabwe with a view to proposing a framework for developing an information access platform. ICTs can play a pivotal role in improving access to HIV and AIDS information and in coordinating HIV and AIDS activities in Zimbabwe. However, the development of ICTs in Zimbabwe’s health sector has been haphazard and idiosyncratic to a plethora of HIV and AIDS organisations operating in Zimbabwe. This study proposes a framework for the development of ICTs for accessing HIV and AIDS information in Zimbabwe. The needs-based framework was proposed after evaluating the information needs of healthcare workers and current health information technologies. An integrated theoretical framework incorporating the General System Theory, the Social Construction of Technology theory and the HOT-fit model was used to frame the study

Enhancing access to socioeconomic development information using mobile phone applications in rural Zimbabwe: the case of Matabeleland South Province.

Doctoral Degree. University of KwaZulu-Natal, Durban.Mobile phone access has grown exponentially, transforming access to information and communication in Africa. Mobile phone penetration has increased dramatically across the urban-rural, rich-poor and literate-illiterate divides, which other technologies failed to bridge. The number of mobile phone subscriptions grew astronomically, from less than two million in 1998 to more than 620 million subscribers in Africa (Carmody, 2012). Internet users grew 85-fold from 4.5m users in 2000 to over 388m users in Africa at a rate higher than any other region (Internetworldstas, 2018). Global mobile app downloads have reached 175 billion in 2017, generating more than $85 billion, yet most African countries possess an insignificant share of this, due to low literacy levels, low economic opportunities and an infrastructure that is still developing (The Guardian, 2014; Perez, 2018). The growing presence of mobile phones must be harnessed to enhance access to socioeconomic information, in order to improve standards of life in the global south. Scholars and communication enthusiasts have argued that simply providing access to the internet, without considering the relevance of content, will not change the fortunes of rural communities (Internet.org, 2014; GSMA, 2015). There is the need to provide localised and relevant content – such as local news, market prices and bus timetables – to these communities. This research resonates with Goal 9 of the Sustainable Development Goals, which seeks to increase access to information and communication technology, and provide universal and affordable access to the internet in least developed countries by 2020 (UN, 2016). In Zimbabwe, radio and television are basic technologies used for disseminating socioeconomic information, yet most of the rural communities have no access to radio and television signals, 37 years after independence. Rural mobile phone ownership is about 80%, and broadband penetration is 46.5% (ITU, 2013). In addition, Zimbabwe’s average rural literacy is about 90%. These two factors – high rural literacy levels and high rural mobile phone ownership – motivated the researcher to develop a mobile phone application prototype that could be utilised by rural communities to enhance their access to socioeconomic development information that could, in turn, anchor sustainable development. The mobile phone application prototype has the potential to provide a new platform for accessing socioeconomic development information in the rural areas of Zimbabwe, including information on agriculture, health, community activities, education and the markets, plus local and national news. These can all promote sustainable development. The study followed a seven-cycle design science research methodology, from problem identification to communicating the utility of the aertefact which guided the development of the mobile phone application (Hevner, 2007). The development of the prototype followed a user-centred design, as well user experience, where high-fidelity prototypes were presented to participants selected through a random sample to be part of the development process. This process is iterative, incorporating user feedback and redesign of the prototype until the users and developers agree on the design. After designing the prototype, participants were randomly selected to evaluate the mobile phone application prototype using an adapted TAM2, whose main constructs relate to perceived usefulness and ease of use (Davis, 1989)