11 research outputs found
Does a bursary scheme for students in low- to middle-income countries influence outcomes in a master’s programme in Public Health?
Introduction
The People’s Open Access Education Initiative (Peoples-uni) provides online education for health professionals in Public Health at the master’s level. Although fees are low due to the use of volunteers and Open Educational Resources, a bursary scheme is provided to waive all or some of the fees. This study tests the hypothesis that student outcomes of completing and passing modules are higher among those given a bursary than others.
Methods
Data were retrieved for all students enrolling between 2009-2017, including demographics and module outcomes, where available. Multivariable logistic regression was used to identify factors associated with a successful bursary application, as well as to elicit whether a successful bursary application was associated with ever completing, or ever passing, a module.
Results
Data were obtained from 1499 students. Of these, 624 (42%) had ever completed a module, and 513 (34%) had ever passed a module. 503 students (34%) had applied for a bursary, of whom 285 (57%) were successful. After adjusting for demographic variables, employment status and education level, students who were given a bursary were more likely to ever pass a module (adjusted odds ratio [aOR] 2.3, 95% CI 1.7,3.3), as were those who applied for a bursary but were unsuccessful (aOR 1.9, 95% CI 1.3,2.8), compared with students who had not applied for a bursary. Similar results were obtained for the outcome of completing a module.
Conclusions
Students who were successful in gaining a bursary, as well as those who were not but still able to enroll, were more likely to complete or pass a module than those who did not apply. These results point to the success of the bursary scheme and give us confidence to continue to offer bursaries, in order to sustain the mission of improving population health through capacity building in low resource settings
Prevalence and risk factors associated with retinopathy in diabetic patients at Parirenyatwa Hospital outpatients’ clinic in Harare, Zimbabwe
Diabetic retinopathy is the fifth leading cause of blindness worldwide accounting for nearly 5% of all blindness. However, most of the prevalence and incidence data is from developed countries, with very limited information from sub-Saharan Africa. The study sought to determine the prevalence of, and factors associated with, retinopathy in diabetic patients. Diabetes mellitus patients attending the outpatients’ clinic at Parirenyatwa Group of Hospitals between October 2013 and July 2014 were recruited into this analytical cross-sectional study. Demographic information was collected. A nurse carried out anthropometric measurements. An ophthalmologist using slit lamp indirect ophthalmoscopy with a 20-diopter and a 90-diopter lens diagnosed retinopathy. Blood samples were collected and analysed for triglycerides, total cholesterol, HDL cholesterol, glycosylated hemoglobin and serum creatinine. A total of 340 patients were enrolled into the study, of whom 73.2% were female. Mean (SD) age was 57.5 (14.9) years and there was no difference in age between females [57.6 (14.1) years] and males [57.2 (16.8) years]. The overall prevalence of diabetic retinopathy was 28.4%. Using multivariate logistic regression analysis retinopathy was associated with longerduration of diabetes mellitus (OR 1.06, 95% CI 1.03-1.09, p value ˂ 0.001) and lower serum creatinine (OR 0.99, 95% CI 0.97-1.00, p value 0.025). The prevalence of diabetic retinopathy was 28.4%. Longer duration of diabetes mellitus and lower serum creatinine, which is a marker of renal damage, were independent risk factors of diabetic retinopathy.Keywords: Diabetes mellitus; Diabetic retinopathy; Complications; Blindness; Prevalence; Risk facto
Nitrogen supply and cyanide concentration influence the enrichment of nitrogen from cyanide in wheat (Triticum aestivum L.) and sorghum (Sorghum bicolor L.)
Cyanide assimilation by the beta-cyanoalanine pathway produces asparagine, aspartate and ammonium, allowing cyanide to serve as alternate or supplemental source of nitrogen. Experiments with wheat and sorghum examined the enrichment of (15)N from cyanide as a function of external cyanide concentration in the presence or absence of nitrate and/or ammonium. Cyanogenic nitrogen became enriched in plant tissues following exposure to (15)N-cyanide concentrations from 5 to 200 microm, but when exposure occurred in the absence of nitrate and ammonium, (15)N enrichment increased significantly in sorghum shoots at solution cyanide concentrations of \u3e or =50 microm and in wheat roots at 200 microm cyanide. In an experiment with sorghum using (13)C(15)N, there was also a significant difference in the tissue (13)C:(15)N ratio, suggestive of differential metabolism and transport of carbon and nitrogen under nitrogen-free conditions. A reciprocal (15)N labelling study using KC(15)N and (15)NH(4)(+) and wheat demonstrated an interaction between cyanide and ammonium in roots in which increasing solution ammonium concentrations decreased the enrichment from 100 microm cyanide. In contrast, with increasing solution cyanide concentrations there was an increase in the enrichment from ammonium. The results suggest increased transport and assimilation of cyanide in response to decreased nitrogen supply and perhaps to ammonium supply
Open access publication of public health research in African journals
There are many claims to the benefits of open access publishing in general and for Africa in particular. This study aimed to describe the characteristics of scholarly journals expected to publish articles on public health from a number of African countries. Using African Journals Online and African Index Medicus, 174 journals from 13 African countries were identified. The six countries above the group’s median gross domestic product (GDP) published 145 journals, while the seven countries at or below the median GDP published 29 journals. Two thirds of the journals were freely available to download, but only a third had a Creative Commons licence, and most were not indexed. Around half of the journals levied full article processing charges (APCs) – journals from countries at median GDP or below were less likely to charge APCs than those from countries above the median GDP. One of the key findings is that only a few journals were indexed, limiting the ability of potential readers to find the results of research performed in local settings. The results suggest a need to assist journals and researchers to make the work they publish more accessible to the audience who might want to use the results
Is socio-economic status a determinant of HIV-related stigma attitudes in Zimbabwe? Findings from Project Accept
HIV related stigma and discrimination is a known barrier for HIV prevention and care. We aimed to assess the relationship between socio-economic status (SES) and HIV related stigma in Zimbabwe. This paper uses data from Project Accept, which examined the impact of community-based voluntary counseling and testing intervention on HIV incidence and stigma. Total of 2522 eligible participants responded to a psychometric assessment tool, which assessed HIV related stigma and discrimination attitudes on 4 point Likert scale. The tool measured three components of HIVrelated stigma: shame, blame and social isolation, perceived discrimination, and equity. Participants’ ownership of basic assets was used to assess the socio-economic status. Shame, blame and social isolation component of HIV related stigma was found to be significantly associated with medium [odds ratio (OR)=1.73, P<0.01] and low SES (OR=1.97, P<0.01), indicating more stigmatizing attitudes by participants belonging to medium and low SES in comparison to high SES. For HIV related stigma and discrimination programs to be effective, they should take into account the socio-economic context of target population
Prevalence of and Factors Associated with Nephropathy in Diabetic Patients Attending an Outpatient Clinic in Harare, Zimbabwe
Prevalence of and Factors Associated with Nephropathy in Diabetic Patients Attending an Outpatients Clinic in Harare, Zimbabwe: Methodological Issues
Perceived value of applying Information Communication Technology to implement guidelines in developing countries; an online questionnaire study among public health workers
INTRODUCTION: Practice guidelines can be used to support healthcare decision making. We sought to identify the use, and barriers to the implementation, of electronic based guidelines to support decision-making in maternal and child healthcare (MCH) and the rational use of medicines, in developing countries. METHODS: Graduates who had gained the Master of Public Health degree through the Peoples-uni (postgraduate public health education in developing countries) were sent an online survey questionnaire which had been piloted. Two reminders were sent to non-respondents at intervals of 10 days. Results were explored using descriptive analyses. RESULTS: 44 of the potential 48 graduates from 16 countries responded – most were from Africa. 82% and 89% of respondents were aware of guidelines on MCH and the rational use of medicines respectively. Electronic guidelines were more available in university hospitals than in provincial hospitals or rural care. All respondents thought that guidelines could improve the delivery of quality care, and 42 (95%) and 41 (93%) respectively thought that computers and mobile or smartphones could increase the use of guidelines in service delivery. Lack of access to computers, need to buy phone credit, need for training in the use of either computerized or phone based guidelines and fear of increased workload were potential barriers to use. CONCLUSION: There is support for the use of electronic guidelines despite limited availability and barriers to use in developing countries. These findings, and other literature, provide a guide as to how the further development of ICT based guidelines may be implemented to improve health care decision making
Perceived value of applying Information Communication Technology to implement guidelines in developing countries; an online questionnaire study among public health workers
Introduction: Practice guidelines can be used to support healthcare decision making. We sought to identify the use, and barriers to the implementation, of electronic based guidelines to support decision-making in maternal and child healthcare (MCH) and the rational use of medicines, in developing countries.Methods: Graduates who had gained the Master of Public Health degree through the Peoples-uni (postgraduate public health education in developing countries) were sent an online survey questionnaire which had been piloted. Two reminders were sent to non-respondents at intervals of 10 days. Results were explored using descriptive analyses.Results: 44 of the potential 48 graduates from 16 countries responded – most were from Africa. 82% and 89% of respondents were aware of guidelines on MCH and the rational use of medicines respectively. Electronic guidelines were more available in university hospitals than in provincial hospitals or rural care. All respondents thought that guidelines could improve the delivery of quality care, and 42 (95%) and 41 (93%) respectively thought that computers and mobile or smartphones could increase the use of guidelines in service delivery. Lack of access to computers, need to buy phone credit, need for training in the use of either computerized or phone based guidelines and fear of increased workload were potential barriers to use.Conclusion: There is support for the use of electronic guidelines despite limited availability and barriers to use in developing countries. These findings, and other literature, provide a guide as to how the further development of ICT based guidelines may be implemented to improve health care decision making
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Mentored postdoctoral training in Zimbabwe: A report on a successful collaborative effort
Low-and-middle-income countries (LMICs) have high disease burdens, necessitating increased research. However, LMIC research output constitutes only 2% of global total. To increase output, researchers must be capacitated. The University of Zimbabwe (UZ) and the University at Buffalo (UB), developed and implemented the AIDS International Research Training Program (AITRP), in 2008, that focused on graduate scholars. The subsequent HIV Research Training Program (HRTP), begun in 2016, and piloted post-doctoral training to enhance research productivity at UZ. This report discusses the collaboration. As of 2016, prospective candidates applied by submitting letters of intent, research proposals, curriculum vitae and biographical sketches. The scholars research training included hypothesis and project development, completion of grant applications, research project budgets, research presentations to diverse audiences and the application of advanced statistics to research data. The first cohort of five postdoctoral scholars were trained at UZ and UB, between 2016 and 2019. Through the formalized postdoctoral training approach, scholars identified areas of focus. In 2017, one of the scholars obtained a National Institutes of Health (NIH) Emerging Global Leader Award and is now a highly-rated researcher based in South Africa. A second scholar made NIH D43 and K43 grant applications, while the remaining three are academicians and early researchers at UZ. Although research output in Africa and many LMICs is low, it can be built through cooperation similar to the UZ-UB HRTP. This manuscript reports on an effort aimed at building individual and institutional research capacity in Zimbabwe. This can serve as a model for building other similar training programs