Digital Access to Research: Prospects of the Technology Bank Project of the United Nations

In 2016, the United Nations General Assembly officially established the Technology Bank Project aimed at supporting and strengthening Science, Technology and Innovations (STI) in selected Least Developed Countries (LDCs). The focus area of the project was to promote digital access to research and technology in LDCs. Working in partnership with research4life, a partnership of 5 UN agencies (WHO, FAO, WIPO, ILO, UNEP), highly rated science publishers, Cornell and Yale Universities, that have been providing free access to global academic research through the five research4life programmes, as well as in collaboration with the Uganda Focal Persons, the Technology Bank aims to achieve its objective. The DAR (Digital Access to Resources) activities of the Technology Bank started in September 2018, in Uganda. The activities were then officially launched in a workshop at Uganda Christian University (UCU) on the 7th of November 2018. Subsequent activities and workshops were held in which the project reached out to many researchers and institutions. This paper, therefore, presents a summary of DAR activities and their spread within the country until December 2018

Bypassing proximal health care facilities for acute care: a survey of patients in a Ghanaian Accident and Emergency Centre

Objective  To characterise the population that presents to the Accident and Emergency Centre (AEC) at Komfo Anokye Teaching Hospital (KATH) and to identify risk factors associated with bypassing proximal care facilities. Methods  A structured questionnaire was verbally administered to patients presenting to the AEC over 2 weeks. The questionnaire focused on the use of health care resources and characteristics of current illness or injury. Measures recorded include demographics, socioeconomic status, chief complaint, transportation and mobility, reasons for choosing KATH and health care service utilisation and cost. Results  The total rate of bypassing proximal care was 33.9%. On multivariate analysis, factors positively associated with bypassing included age older than 38 years (OR: 2.18, P 0.04) and prior visits to facility (OR 2.88, P 0.01). Bypassers were less likely to be insured (OR 0.31, P 0.01), to be seeking care due to injury (OR 0.42, P 0.03) and to have previously sought care for the problem (OR 0.10, P  <   0.001). Conclusions  Patients who bypass facilities near them to seek care at an urban AEC in Ghana do so for a combination of reasons including familiarity with the facility, chief complaint and insurance status. Understanding bypassing behaviour is important for guiding health care utilisation policy decisions and streamlining cost‐effective, appropriate access to care for all patients. Objectif:  Caractériser la population se présentant au Centre des Accidents et des Urgences à l’Hôpital Universitaire Komfo Anokye, et identifier les facteurs de risque associés au contournement des services de soins proximaux. Méthodes:  Un questionnaire structuré a été administréà des patients se présentant au Centre des Accidents et des Urgences durant deux semaines. Le questionnaire portait sur l’utilisation des ressources de soins de santé et les caractéristiques de la maladie ou la blessure en cours. Les mesures enregistrées comprenaient la démographie, le statut socioéconomique, la plainte principale, le transport et la mobilité, les raisons de choisir l’Hôpital Universitaire Komfo Anokye, l’utilisation et les coûts des services de soins de santé. Résultats:  La proportion totale des contournements des soins proximaux était de 33,9%. En analyse multivariée, les facteurs positivement associés au contournement comprenaient l’âge de plus de 38 ans (OR: 2,18; P = 0,04) et des visites préalables au service (OR: 2,88; P = 0,01). Les patients contournant étaient: moins susceptibles d’être assurés (OR: 0,31, P = 0,01), à la recherche de soins pour des blessures (OR: 0,42; P = 0,03) et d’avoir recherché des soins précédemment pour le même problème (OR: 0,10; P < 0,001). Conclusions:  Les patients qui contournent les services près d’eux pour rechercher des soins dans un centre urbain des accidents et des urgences au Ghana, le font pour une combinaison de raisons, y compris la familiarisation avec le service, la plainte principale et le statut d’assurance. Comprendre le comportement de contournement est important pour guider les décisions de la politique d’utilisation des soins de santé et la rationalisation du coût‐efficacité, pour l’accès approprié aux soins pour tous les patients. Objetivo:  Caracterizar la población que se presenta en el Centro para Accidentes y Emergencias del Hospital Universitario de Komfo Anokye, e identificar los factores de riesgo asociados con el pasar por alto los cuidados ofrecidos en centros cercanos. Métodos:  Se administró verbalmente, a lo largo de dos semanas, un cuestionario estructurado a los pacientes que se presentaron en el Centro para Accidentes y Emergencias. El cuestionario estaba enfocado al uso de recursos sanitarios y a las características de la enfermedad o lesión actual. Las medidas registradas incluían datos demográficos, estatus socioeconómico, principal motivo de consulta, transporte y movilidad, las razones para escoger el Hospital Universitario Komfo Anokye, y el uso de los servicios sanitarios y su coste. Resultado:  La tasa total de haber evitado los centros cercanos fue del 33.9%. En un análisis multivariado, los factores asociados de forma positiva con el haber pasado de utilizar un centro cercano incluían tener una edad mayor de 38 años (OR: 2.18, P 0.04) y haber realizado visitas anteriores al centro sanitario (OR 2.88, P 0.01). Los pacientes que evitaban un centro cercano tenían una mayor probabilidad de no estar asegurados (OR 0.31, P 0.01), de buscar ayuda por una lesión (OR 0.42, P 0.03), y de previamente haber buscado ayuda sanitaria para el problema (OR 0.10, P  <   0.001). Conclusiones:  Los pacientes que pasaban de utilizar centros cercanos y buscan ayuda en un centro urbano para accidentes y emergencias en Ghana lo hacen por una combinación de razones que incluyen el estar familiarizados con el centro, la causa por la que consultan, y el estar o no asegurados. Entender el comportamiento de pasar de un centro cercano es importante para tener en cuenta a la hora de realizar políticas sanitarias y ofrecer acceso a cuidados apropiados y coste‐efectivos para todos los pacientes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92092/1/j.1365-3156.2012.02984.x.pd

Road safety - threats and opportunities for poor countries

No Abstracts. African Health Sciences Vol.4(3) 2004: pp.199-20

Interrogating the Underlying Barriers to HIV Non-Protective Behaviors’ Control among University Students: Towards an Effective Psycho-Educational Mitigation

The study purposed to interrogate the underlying barriers to HIV non-protective behaviours’ control among university students, geared towards formulating an effective psycho-educational intervention for the same. The population was both male and female year three university students. The respondents were 12 for the focus group discussion and 15 for the in-depth interviews, selected purposively. Data analysis was done using thematic analysis. There was concurrent data analysis and discussion of findings. The findings revealed that university students continue to engage in HIV non-protective behaviours like lack of and inconsistent condom use, multiple sexual partners and low adherence to HIV messages and training due to factors associated with low socio-economic status, shame, lack of knowledge, flaws within the HIV messaging, to mention but a few. It is therefore concluded that HIV continues to soar among university students through non-protective conduct related to unsafe sex, multiple and concurrent sexual partners and low interest in and negative attitude towards uptake of HIV control messages. Hence, there is a need for a supply of condoms in socially safe spaces, education on condom use and the dangers of multiple sexual partners, economic empowerment, and most importantly, embracing an effective psycho-educational intervention that addresses the specific learning needs of university students about HIV and its contro

Trauma registries as a tool for improved clinical assessment of trauma patients in an urban African hospital

This combined retrospective and prospective study describes trauma patients in an urban African Hospital and assesses whether use of trauma registries leads to  improved clinical assesment. The Kampala Trauma Score (KTS) is assessed as an injury  severity filter. The level of clinical assessment was defined by Model Rural Trauma Project (MRTP) trauma triage criteria. Trauma registries were filled out  systematically for every alternate patient on arrival in the casualty department, and the patient status was recorded two weeks after admission. This retrospective study showed that 52% of the trauma patients were inadequately assessed.  Amongst the deaths, 72.7% had been inadequately assessed (p value = 0.0193). Prospective data showed that injuries were most common amongst young males (72.7%), in and around the city following road traffic injuries (50.7%). The  mean time between injury and arrival at the hospital was 0.363 hours (SD 0.331) and the mean hospital response time was 0.36 hours SD 0.245) The rate of inadequate assessment decreased significantly after the introduction of the registry (p value =  0.000). The case fatalities before and after the introduction of the registry was,  however, not statistically significant. The KTS  was found to be a reliable severity filter for injured patients, with a KTS score of less than 14 increasing the likelihood of death by at least three times. The results showed a cut off value of 12 by the ROC curve (0.8755; 95% CI = 0.8455 - 0.9055).Key words: trauma registries, audit, clinical assessment, Afric

Emergency and critical care services in Tanzania: a survey of ten hospitals.

While there is a need for good quality care for patients with serious reversible disease in all countries in the world, Emergency and Critical Care tends to be one of the weakest parts of health systems in low-income countries. We assessed the structure and availability of resources for Emergency and Critical Care in Tanzania in order to identify the priorities for improving care in this neglected specialty. Ten hospitals in four regions of Tanzania were assessed using a structured data collection tool. Quality was evaluated with standards developed from the literature and expert opinion. Important deficits were identified in infrastructure, routines and training. Only 30% of the hospitals had an emergency room for adult and paediatric patients. None of the seven district and regional hospitals had a triage area or intensive care unit for adults. Only 40% of the hospitals had formal systems for adult triage and in less than one third were critically ill patients seen by clinicians more than once daily. In 80% of the hospitals there were no staff trained in adult triage or critical care. In contrast, a majority of equipment and drugs necessary for emergency and critical care were available in the hospitals (median 90% and 100% respectively. The referral/private hospitals tended to have a greater overall availability of resources (median 89.7%) than district/regional hospitals (median 70.6). Many of the structures necessary for Emergency and Critical Care are lacking in hospitals in Tanzania. Particular weaknesses are infrastructure, routines and training, whereas the availability of drugs and equipment is generally good. Policies to improve hospital systems for the care of emergency and critically ill patients should be prioritised

Citywide Trauma Experience in Mwanza, Tanzania: A Need for Urgent Intervention.

Trauma remains a leading cause of morbidity and mortality in resource limited countries. There is paucity of published reports on trauma care in Tanzania, particularly the study area. This study was carried out to describe our experiences in trauma management outlining the etiological spectrum, injury characteristics and treatment outcome of trauma patients at our local setting and compare our results with those from other centers in the world. A descriptive prospective study of trauma patients was conducted at Bugando Medical Centre from April 2010 to March 2012. Statistical data analysis was done using SPSS software version 17.0. A total of 5672 trauma patients were enrolled in the study. The male to female ratio was 2.3: 1. The majority of patients were in the 2nd decade of life. Road traffic accident was the most common cause of trauma accounting for 60.7% of cases. The majority of patients (76.6%) sustained blunt injuries. Musculoskeletal (68.5%) and head/neck (52.6%) were the most frequent body region injured. Soft tissue injuries (open wounds) and fractures were the most common injuries accounting for 82.8% and 76.8% respectively. Majority of patients (74.4%) were treated surgically with wound debridement (94.0%) being the most frequently performed procedure. Postoperative complications were recorded in 31.5% of cases.The overall median duration of hospitalization was 26 days (range 1 day to 144 days). Mortality rate was 16.7%. Patients who had polytrauma, burn injuries and those who had tetanus and long bone fractures stayed longer in the hospital and this was statistically significant (P < 0.001), whereas the age > 65 years, severe trauma, admission Systolic Blood Pressure < 90 mmHg, presence of tetanus, severe head injury, the duration of loss of consciousness, the need for intensive care unit admission and finding of space occupying lesion on CT scan of the brain significantly influenced mortality (P < 0.001). Trauma resulting from road traffic accidents remains a major public health problem in this part of Tanzania. Urgent preventive measures targeting at reducing the occurrence of road traffic accidents is necessary to reduce the incidence of trauma in this region

An Investigation on the Economic Impact of Congolese Refugees on Host Communities in Rwamwanja Refugee Settlement, Kamwenge District

This study investigated the economic impact of Congolese refugees on host communities in the Rwamwanja Refugee Settlement, Kamwenge District, Uganda, using a sample of 200 refugees. The research explored how the presence of refugees affects local economies, focusing on employment, household income, agricultural productivity, and small business activities. Data was collected through household surveys, interviews with key stakeholders, and focus group discussions, offering a comprehensive view of the economic interactions between refugees and host communities. The findings revealed mixed economic impacts. On one hand, refugees contribute positively to the local economy by filling labor gaps in agriculture and small-scale trade, thus enhancing the livelihoods of some host community members. Refugees’ involvement in the local labor market, particularly in agricultural activities, has increased overall productivity. However, the influx of refugees has also strained local resources, particularly land, healthcare, and education services, leading to competition for these resources. Many host households report increased pressure on food security and limited access to land, as refugees often engage in agricultural activities that drive up demand for available arable land. The study further indicated that the establishment of refugee-run businesses has created employment opportunities for both refugees and host community members, though the profitability of these ventures remains low due to limited access to capital and market constraints. The study recommends that policies should be put in place to strengthen the integration of refugees into local economies while mitigating resource competition. This includes promoting sustainable agricultural practices, providing targeted economic support for small business ventures, and improving public services such as healthcare and education to alleviate strain on the host community. Additionally, mechanisms for shared resource management between refugees and hosts should be explored to ensure equitable distribution. The study concludes by emphasizing the need for a balanced approach that harnesses the economic potential of refugees while addressing the challenges faced by host communities. Ensuring that refugees can contribute positively without overwhelming local resources is critical for fostering long-term peace, stability, and mutual benefit in the region. The study highlights the importance of inclusive economic policies that recognize the interdependence of refugees and host communities in development planning