Diagnostic radiology capacity and demand in Zimbabwe : trends and forecast

Thesis (DTech (Radiology))--Cape Peninsula University of Technology, 2016.The aim of this study was to provide evidence basedforecast for radiology demand in Zimbabwe that would support policies aimed at optimising radiology resource allocation and utilisation. This was upon the realisation that the Ministry of Health and Childcare required such forecast in order to ensure equitable, accessible and quality health services as prescribed in the 2009-2015 National Health Strategy as well as in Section 29 and 76 of the Zimbabwean constitution. On the international perspective, many researchers have reported stable high demand for radiology services giving rise to long waiting lists and backlogs. In the United Kingdom’s National Health Services (NHS), there is general consensus that these waiting lists are caused by variation mismatches between capacity and demand for radiology services. Elsewhere, it has been reported that skill mix, role changes, dynamic nature of radiography teaching and learning, technology diffusion, service transaction time, overutilisation, and unjustified exposures are key drivers of high demand for radiology services. It has long been established that demand for radiology services is stochastic in nature, and therefore planning of future investments in radiology must be guided by an understanding of how these variables interact to model the criterion variable. However, there is paucity of information pertaining to key aspects of legitimate radiology demand forecasts. Formulation of these fundamental concepts formed the impetus of this study. A document review, interviews and non-participatory observations revealed that justification of radiology examinations, dynamic nature of radiography teaching and learning, diffusion of extended roles and technology, equipment and personnel capacity, and most importantly service transaction time all had an impact on the demand for radiology services in Zimbabwe. Limited diffusion of extended roles and technology had increased over a ten year period. Observed role changes were informal additions to the procedures normally carried out by radiographers and these were not supported by formal education. Consistent with global concerns, over utilisation and unjustified requests were a national concern. In situations where capacity outweighed demand, there was evidence that internal management of radiology departments was responsible for most variation mismatches which then gave rise to long waiting times

Diagnostic radiography requests in Zimbabwe’s public hospital complex: completeness, accuracy and justtification

A thesis submitted in fulfilment of the requirements for the degree Master of Technology: Diagnostic Radiography in the Faculty of Health and Wellness Sciences at the Cape Peninsula University of Technology, 2012Complete, accurate and justified radiological examination requests are prerequisite to radiological exposures. However, global research shows evidence of high numbers of incomplete and inaccurate requests as well as that up to 77% radiological exposures are unjustified. Plain lumbar spine and plain skull radiology examinations are reported as being procedures that generate high dose and a low diagnostic yield. This study was designed to objectively measure the completeness, accuracy and justification of these two examinations in an effort to make inferences that will contribute to an improved radiology service. This research could therefore have positive effects on optimisation of radiation protection in Zimbabwe. Methodology A non participatory prospective descriptive analytical document review of quota sampled radiological request forms for 200 plain skull and 200 plain lumbar spine examinations was employed. Data was captured using structured data collection instruments designed and tested by the researcher for this study. The instrument was designed using the IAEA-HHS4 (2010) minimum prescribed request data as a framework and adding additional form fields found to be relevant through a review of all identified radiological request template forms in use at the research site. Data analysis involved central tendency measures and inferential statistics. Results: The central tendency demonstrated for the two examinations was that generally referrers for plain lumbar spine and for plain skull radiology would respectively provide 38.9 +/- 0.6% and 40.2+/-0.5% overall examination request information. This information was significantly below expectation. There was however no significant difference between the samples’ means for the two examinations. The tendency demonstrated in patient information for lumbar spine and skull requests was that generally referrers would respectively provide 48.4 +/- 0.8% and 49.5+/- 0.8% patient information. These values were inclusive of each other and they were significantly (p=0.00 Sig.) below expectation. There was however no significant difference between the two examinations’ data. The tendency demonstrated for examination information was that referrers for the research site would generally provide 29.8+/-0.8% (lumbar) and 32.6+/-0.8% (Skull) examination information. These values were significantly (p=0.000 Sig.) below expectation and demonstrated a significant difference between the sample means for the two examinations. With respect to referrer information, the tendency demonstrated was that generally referrers for plain lumbar spine and for plain skull examinations would respectively provide 38+/- 1% and 38.5 +/- 0.8% referrer identification information. These were significantly below expectation (p= 0.000 Sig.) but there was no significant difference between the samples’ means with respect to referrer information. With respect to accuracy of request data, it was observed that 5% plain lumbar spine and 3% plain skull requests were specific in so far as information documented on request forms could unambiguously identify the area to be imaged. It was also observed that 22.5% (lumbar spine) and 12% (skull) examination requests were indicated and therefore justified. All requests forms were found to be legible. Conclusions: Generally, referrers to this research site tend to provide incomplete, inaccurate and unjustified radiological request data. The observed levels of completeness, accuracy and justification of requests were generally consistent between the two examinations relative to expectation. These levels had medico-legal implications and negative effects on optimisation of radiation protection to patients. Further research to establish causes of this variance in referral behaviour is recommended. The researcher also recommends further research to establish whether there is an association between requested examination and completeness, accuracy and justification of diagnostic radiology examination requests. Keywords: Radiation protection, radiological request, complete request, accurate request, justified request, plain skull imaging, plain lumbar spine imaging

Business continuity management and supply chain disruptions: A case of humanitarian organizations in Cyclone Idai in Zimbabwe

AbstractCatastrophic events, such as cyclones, floods, droughts, terrorism, or cybercrime, are astronomically on the increase the world over. These events disrupt businesses’ smooth continuity leading to reputational digital data and financial losses among others. Zimbabwe’s districts of Chimanimani and Chipinge in March 2019 experienced a catastrophic Cyclone Idai that highly disrupted various important business activities and the associated supply chains. This study, therefore, focuses on the impact of business continuity and organizational performance on mitigating the disruptive effects on major supply chains during a disaster. Ordinary Least Squares (OLS) regression model was used to analyse the relationship between supply chain disruption and business continuity. The study had a population of 82 humanitarian organizations and the researchers successfully administered questionnaires to a sample of 65 humanitarian organizations that participated in relief operations during Cyclone Idai in Zimbabwe. The results show that business continuity has a negative and significant effect on supply chain disruption. At 5% level of significance, business continuity has a positive effect of about 8%. This means that a marginal change in business continuity will result in significant 8% influence on mitigation of supply chain disruption in humanitarian relief efforts. The study findings will be useful to practitioners such as supply chain managers in coming up with strategies in case of supply chain disruption threats due to unseen shocks