Perceptions and experiences of frontline health managers and providers on accountability in a South African health district

Public primary health care and district health systems play important roles in expanding healthcare access and promoting equity. This study explored and described accountability for this mandate as perceived and experienced by frontline health managers and providers involved in delivering maternal, newborn and child health (MNCH) services in a rural South African health district. Methods: This was a qualitative study involving in-depth interviews with a purposive sample of 58 frontline public sector health managers and providers in the district office and two sub-districts, examining the meanings of accountability and related lived experiences. A thematic analysis approach grounded in descriptive phenomenology was used to identify the main themes and organise the findings. Results: Accountability was described by respondents as both an organisational mechanism of answerability and responsibility and an intrinsic professional virtue. Accountability relationships were understood to be multidirectional - upwards and downwards in hierarchies, outwards to patients and communities, and inwards to the 'self'

Seizures associated with fever and psychomotor development in primary health care in Kinshasa

peer reviewedUne étude prospective menée pendant 3 mois dans 2 centres des soins de santé primaires à Kinshasa, a permis de décrire les caractéristiques sémiologiques des Convulsions Fébriles (CF) présentées par 148 patients, âgés de 5 à 71 mois. Les CF ont été décrites en fonction de leur distribution, leur durée et leur répétition éventuelle. Les caractères latéralisés, prolongés et répétitifs étaient considérés comme des facteurs de gravité. Le Quotient de Développement psychomoteur (QDP) des patients a été évalué sur base de l’échelle de Gensini et Gavito, reprenant les domaines de la motricité, de la communication, et de l’adaptation. Le QDP était bas chez 6,7% des patients. 5% avaient un retard dans le domaine de la motricité, 3,4% dans le domaine de la communication, et 2,7% dans celui de l’adaptation. Nous n’avons pas noté de lien significatif entre le QDP global, et les facteurs de gravité des CF. Toutefois, tous les enfants ayant un retard dans le domaine de la motricité, avaient présenté des convulsions répétées avant leur admission: (p=0,02 [OR=1,096 (IC 95%) : 1,060 -1,128)]. La motricité était l’élément le plus significativement atteint chez les malades ayant présenté les CF. Cette observation mérite d’être validée par des études castémoins, incluant un plus grand nombre de sujets.Summary A prospective and descriptive study including 148 children (age: 5-71 months) presenting with febrile seizures (FS) at two Primary Health Care centres in Kinshasa, was conducted over a period of 3 months. Type of seizure (genaralized or focal), its duration, and its characteristic (recurrent or not), were documented, to assess the severity of the disorder. The Psychomotor Development (PMD) of each patient was evaluated, using the Gensini and Gavito scale and then the Psychomotor Development Quotient (PDQ) calculated, according to the motor, communication, and social domains. Main results were: a reduction in PDQ (6.7%), motor delay (5%), communication delay (3.4%), and social delay (2.7%), based on this scale. No significant link was found between global PDQ reduction and markers of FS severity. However, recurrent seizures seemed strongly associated to delayed motor development (p=0.02 [OR=1.096, CI: 1.060-1.128]). These findings suggest that the motor domain could be more affected in children presenting FS, especially those with recurrent seizures. This link needs to be clearly established through larger case-control studies

Prevalence and determinants of use of complementary and alternative medicine by hypertensive patients attending primary health care facilities in Kinshasa, Democratic Republic of the Congo: a cross-sectional study.

In the Democratic Republic of the Congo the control of hypertension is poor, characterized by an increasing number of reported cases of hypertension related complications. Poor control of hypertension is associated with non-adherence to antihypertensive medication. It is well established that the use of complementary and alternative medicine is one of the main factors of non-adherence to antihypertensive medication. The aim of this study is to determine the prevalence and factors associated with the use of complementary and alternative medicine.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Assessment of hypertension management in primary health care settings in Kinshasa, Democratic Republic of Congo.

Hypertension-related complications have become more diagnosed at secondary and tertiary care levels, in the Democratic Republic of the Congo (DRC), probably indicative of poor management of hypertensive patients at primary health care level. This study aimed to assess the management of hypertension in primary health care settings by using guidelines of the International Forum for Prevention and Control of HTN in Africa (IFHA).SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Task shifting in the management of hypertension in Kinshasa, Democratic Republic of Congo: a cross-sectional study.

The Democratic Republic of the Congo (DRC) is characterized by a high prevalence of hypertension (HTN) and a high proportion of uncontrolled HTN, which is indicative of poor HTN management. Effective management of HTN in the African region is challenging due to limited resources, particularly human resources for health. To address the shortage of health workers, the World Health Organization (WHO) recommends task shifting for better disease management and treatment. Although task shifting from doctors to nurses is being implemented in the DRC, there are no studies, to the best of our knowledge, that document the association between task shifting and HTN control. The aim of this study was to investigate the association between task shifting and HTN control in Kinshasa, DRC.SCOPUS: ar.jinfo:eu-repo/semantics/publishe