Developing anatomical terms in an African language

Clinical and technical information imparted in most African languages involves inexact terminology and code switching, so it lacks the explanatory power characterised by the English language. African languages are absent in the tertiary science education environment and forums where African scientists could present scientific material in the medium of African languages. This limits the development of African languages in the scientific domain. There has recently been a trend in several African languages to develop and intellectualise them, especially in the field of medical sciences. The ChiShona language is used to explore the ability of an African language to develop new terminology, to name the vertebral skeleton and describe it scientifically. It uses word compounding to demonstrate terminology development. ChiShona has similarities with several hundred other Bantu languages in East, Central and Southern Africa. Advancing this language can promote similar developments in others, making them more explanatory for the lay public and health professionals

Methicillin-resistant Staphylococcus aureus in Zimbabwe

Introduction: The prevalence of Methicillin Resistant Staphylococcus aureus (MRSA) in Africa is sparsely documented. In Zimbabwe there is no routine patient or specimen screening for MRSA. The aim of this study was to document the presence and epidemiology of MRSA in Zimbabwe.Method: The study was done in one private sector laboratory with a national network that serves both public and private hospitals. The sample population included in-patients and outpatients, all ages, both genders, all races and only one positive specimen per patient was counted. Specimens testing positive for Staphylococcus aureus in this laboratory were further tested for MRSA using cefoxitin, by standard laboratory procedures. Data was collected from 1st June 2013 to 31st May 2014.Results: MRSA was positive in 30 of 407 [7.0%] cases of Stapylococcus aureus reported from the laboratory. All age groups were affected from neonates to geriatrics. All specimens had similar antibiotic susceptibility pattern. Resistance was high for most widely used drugs in Zimbabwe with high sensitivity to vancomycin, linezolid and teicoplanin.Conclusion: Although there are no recent reports in the literature of the presence of MRSA in Zimbabwe, this study documented a 7.0% prevalence. Resistance to common antibiotics is high and antibiotic oversight is required to control the emergence of resistance to these few expensive drugs.Funding: Study was supported by Department of Anaesthesia and Critical Care funds.Keywords: Methicillin Resistant Staphylococcus aureus, Zimbabwe, antibiotic resistance, vancomycin, teicoplani

A root-cause analysis of maternal deaths in Botswana: towards developing a culture of patient safety and quality improvement

BACKGROUND: In 2007, 95% of women in Botswana delivered in health facilities with 73% attending at least 4 antenatal care visits. HIV-prevalence in pregnant women was 28.7%. The maternal mortality ratio in 2010 was 163 deaths per 100 000 live births versus the government target of 130 for that year, indicating that the Millennium Development Goal 5 was unlikely to be met. A root-cause analysis was carried out with the aim of determining the underlying causes of maternal deaths reported in 2010, to categorise contributory factors and to prioritise appropriate interventions based on the identified causes, to prevent further deaths. METHODS: Case-notes for maternal deaths were reviewed by a panel of five clinicians, initially independently then discussed together to achieve consensus on assigning contributory factors, cause of death and whether each death was avoidable or not at presentation to hospital. Factors contributing to maternal deaths were categorised into organisational/management, personnel, technology/equipment/supplies, environment and barriers to accessing healthcare. RESULTS: Fifty-six case notes were available for review from 82 deaths notified in 2010, with 0–4 contributory factors in 19 deaths, 5–9 in 27deaths and 9–14 in nine. The cause of death in one case was not ascertainable since the notes were incomplete. The high number of contributory factors demonstrates poor quality of care even where deaths were not avoidable: 14/23 (61%) of direct deaths were considered avoidable compared to 12/32 (38%) indirect deaths. Highest ranking categories were: failure to recognise seriousness of patients’ condition (71% of cases); lack of knowledge (67%); failure to follow recommended practice (53%); lack of or failure to implement policies, protocols and guidelines (44%); and poor organisational arrangements (35%). Half the deaths had some barrier to accessing health services. CONCLUSIONS: Root-cause analysis demonstrates the interactions between patients, health professionals and health system in generating adverse outcomes for patients. The lessons provided indicate where training of undergraduate and postgraduate medical, midwifery and nursing students need to be intensified, with emphasis on evidence-based practice and adherence to protocols. Action plans and interventions aimed at changing the circumstances that led to maternal deaths can be implemented and re-evaluated

Family physician perceptions of climate change, migration, health, and healthcare in Sub-Saharan Africa : an exploratory study

Although family physicians (FPs) are community-oriented primary care generalists and should be the entry point for the populationâs interaction with the health system, they are underrepresented in research on the climate change, migration, and health(care) nexus (hereafter referred to as the nexus). Similarly, FPs can provide valuable insights into building capacity through integrating health-determining sectors for climate-resilient and migration-inclusive health systems, especially in Sub-Saharan Africa (SSA). Here, we explore FPsâ perceptions on the nexus in SSA and on intersectoral capacity building. Three focus groups conducted during the 2019 WONCA-Africa conference in Uganda were transcribed verbatim and analyzed using an inductive thematic approach. Participantsâ perceived interactions related to (1) migration and climate change, (2) migration for better health and healthcare, (3) health impacts of climate change and the role of healthcare, and (4) health impacts of migration and the role of healthcare were studied. We coined these complex and reinforcing interactions as continuous feedback loops intertwined with socio-economic, institutional, and demographic context. Participants identified five intersectoral capacity-building opportunities on micro, meso, macro, and supra (international) levels: multi-dimensional and multi-layered governance structures; improving FP training and primary healthcare working conditions; health advocacy in primary healthcare; collaboration between the health sector and civil society; and more responsibilities for high-income countries. This exploratory study presents a unique and novel perspective on the nexus in SSA which contributes to interdisciplinary research agendas and FP policy responses on national, regional, and global levels

A meta-analysis of the efficacy of preoperative surgical safety checklists to improve perioperative outcomes

Background. Meta-analyses of the implementation of a surgical safety checklist (SSC) in observational studies have shown a significant decrease in mortality and surgical complications.Objective. To determine the efficacy of the SSC using data from randomised controlled trials (RCTs).Methods. This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered with PROSPERO (CRD42015017546). A comprehensive search of six databases was conducted using the OvidSP search engine.Results. Four hundred and sixty-four citations revealed three eligible trials conducted in tertiary hospitals and a community hospital, with a total of 6 060 patients. All trials had allocation concealment bias and a lack of blinding of participants and personnel. A single trial that contributed 5 295 of the 6 060 patients to the meta-analysis had no detection, attrition or reporting biases. The SSC was associated with significantly decreased mortality (risk ratio (RR) 0.59, 95% confidence interval (CI) 0.42 - 0.85; p=0.0004; I2=0%) and surgical complications (RR 0.64, 95% CI 0.57 - 0.71; p<0.00001; I2=0%). The efficacy of the SSC on specific surgical complications was as follows: respiratory complications RR 0.59, 95% CI 0.21 - 1.70; p=0.33, cardiac complications RR 0.74, 95% CI 0.28 - 1.95; p=0.54, infectious complications RR 0.61, 95% CI 0.29 - 1.27; p=0.18, and perioperative bleeding RR 0.36, 95% CI 0.23 - 0.56; p<0.00001.Conclusions. There is sufficient RCT evidence to suggest that SSCs decrease hospital mortality and surgical outcomes in tertiary and community hospitals. However, randomised evidence of the efficacy of the SSC at rural hospital level is absent

How do non-attenders of faculty development offerings perceive their development as educators?

Thesis (MPhil)--Stellenbosch University, 2019.ENGLISH SUMMARY : Background: Faculty Development, as a means of addressing the educational needs of health professionals entering undergraduate and postgraduate teaching, has been undergoing continuous change of definition and expanding its scope of activities. The research literature has tended to focus on those that participate or attend faculty development activities. The Department of Health Professions Education at the University of Zimbabwe College of Health Sciences has been offering faculty development activities for seven years. There are members of faculty who have not attended all or most of these. From the literature, those who attend in other countries, describe the same constraints to participation as non-attenders, and yet still manage to attend. In higher education, faculty are recruited for their content expertise and have to develop pedagogic expertise, and faculty development activities assist in this process. The aim of this study is to explore how faculty who do not attend perceive their development and identity as educators. Methodology: This was a phenomenological study attempting to present, record, understand and be interpretive of the experience of faculty developing into teachers and educators. Non-attenders were defined as those who, in the last five years, have attended one or less faculty development offerings of the Department of Health Professions Education. Attendance registers were used to identify participants and purposive sampling was used to achieve a sample balanced for clinical and non-clinical roles, full and part-time, gender and years since appointment to the university. An interview schedule was used, with all the interviews recorded, transcribed, and member-checked before analysis commenced. Transcendental phenomenological analysis was used. Each subject’s own words, phrases, sentences and narratives related to the research question were extracted. These ‘moments of meaning’ were then arranged in clusters and themes before being combined and subjected to interpretation. Results and Discussion: Six faculty members were interviewed, and each transcript generated between 41-65 ‘moments of meaning’, from which duplications and redundancies were removed. The themes that emerged were related to becoming a teacher, professional identity and perception of personal development. In becoming a teacher, there was a diversity of pathways into teaching, participants had mainly been identified as academic or bright and encouraged to join or participate in the academic activities of their discipline on completion of postgraduate training. Health professionals usually come into higher education with an identity as a clinician already formed, and they must negotiate developing or adding a new one as an educator. The departments and professional association provided a network for the source and dissemination of information about teaching, learning and education research. This networking played was a key enabler of informal learning. Conclusion: The non-attenders were largely independent and organise their own learning opportunities, goals and objectives. Their drive and motivation can help other faculty, particularly in being able to articulate their learning needs, so that FD can be more purposive and needs directed.AFRIKAANSE OPSOMMING : Agtergrond: Fakulteitsontwikkeling (FO), as 'n manier om die onderrigbehoeftes van gesondheidswerkers wat voorgraadse en nagraadse onderrig betree aan te spreek, is deurlopend besig om geherdefinieer te word en die omvang van aktiwiteite uit te brei. Die navorsingsliteratuur is geneig om op diegene te konsentreer wat deelneem aan fakulteitsontwikkelingsaktiwiteite. Die Departement van Gesondheidsberoepe-onderrig aan die Universiteit van Zimbabwe College van Gesondheidswetenskappe bied reeds die afgelope sewe jaar fakulteitsontwikkelingsaktiwiteite aan. Daar is fakulteitslede wat nog geen, of die meeste van hierdie geleenthede, nie bygewoon het nie. Volgens die literatuur, beskryf diegene wat in ander lande wel bywoon, dieselfde beperkings tot deelname as nie-bywonendes, alhoewel hulle tog daarin slaag om die aktiwiteite by te woon. In hoër onderrig word fakulteitslede gewerf vir hul inhoudskundigheid en moet hulle pedagogiese kundigheid en fakulteitsontwikkelingsaktiwiteite help met hierdie ontwikkelingsproses. Die doel van hierdie studie is om te ondersoek hoe fakulteit wat nie bywoon nie, hul ontwikkeling en identiteit as opvoeders ervaar. Metodologie: Dit was 'n fenomenologiese studie wat gepoog het om die ervaring van fakulteitsontwikkeling van gesondheidsprofessionele opvoeders weer te gee, aan te teken, te begryp en te interpreteer. Nie-bywonendes is gedefinieer as diegene wat die afgelope vyf jaar een of minder fakulteitsontwikkelingsaanbiedinge van die Departement van Gesondheidsberoepe-onderrig bygewoon het. Bywoningsregisters is gebruik om deelnemers te identifiseer en doelgerigte steekproefnemings is gebruik om 'n steekproef te bereik wat gebalanseer is vir kliniese en nie-kliniese rolle, voltyds en deeltyds, geslag en jare sedert die aanstelling van die universiteit. 'n Onderhoudskedule is, tydens die opnames van al die onderhoude, wat getranskribeer en deur lede gekontroleer is, gebruik, voordat die ontleding begin het. Transendentale fenomenologiese analise is gebruik. Elke persoon of deelnemer se eie woorde, frases, sinne en vertellings wat met die navorsingsvraag verband gehou het, is aangehaal. Hierdie 'oomblikke van betekenis' is in groepe en temas gerangskik, voordat dit saamgevat en aan interpretasie onderwerp is. Resultate en bespreking: Ses fakulteitslede is ondervra, en elke transkripsie het tussen 41-65 'oomblikke van betekenis' gegenereer, waarvan duplikasies en onnodige inligting verwyder is. Die temas wat na vore gekom het, hou verband met die ontwikkeling van ʼn opvoeder, die professionele identiteit en die persepsie van persoonlike ontwikkeling. In die ontwikkeling van ʼn opvoeder, was daar 'n verskeidenheid van paaie na onderrig; deelnemers is hoofsaaklik as akademies of bekwaam geïdentifiseer en is aangemoedig om aan die akademiese aktiwiteite van hul vakgebiede deel te neem, na voltooiing van die nagraadse opleiding. Gesondheidswerkers sluit gewoonlik by hoër onderrig aan met 'n identiteit van 'n klinikus wat alreeds gevorm is, en hulle moet dan onderhandel oor die ontwikkeling hiervan of die byvoeging van 'n nuwe een as ‘n opvoeder. Die betrokke departemente en die professionele vereniging het 'n netwerk voorsien vir die bron en verspreiding van inligting oor onderrig, leer en onderrignavorsing. Hierdie netwerke wat uitgespeel het, was 'n belangrike faktor vir informele leer. Gevolgtrekking: Die nie-bywoners was grootliks onafhanklik en organiseer hul eie doelwitte, doelstellings en leergeleenthede. Hul dryfkrag en motivering kan ander lede van fakulteit help, veral om hul leerbehoeftes te artikuleer, sodat FO meer doelgerig en behoefte gerig kan wees.Master

Climate change, migration, and health(care) in primary care training

No abstract available

Synopses of the dissertations Masters of Medicine in Anaesthesia and Critical Care Medicine degrees of the University of Zimbabwe, College of Health Sciences (1990-2016)

No Abstrac