Developing a competency-based curriculum in HIV for nursing schools in Haiti

<p>Abstract</p> <p>Background</p> <p>Preparing health workers to confront the HIV/AIDS epidemic is an urgent challenge in Haiti, where the HIV prevalence rate is 2.2% and approximately 10 100 people are taking antiretroviral treatment. There is a critical shortage of doctors in Haiti, leaving nurses as the primary care providers for much of the population. Haiti's approximately 1000 nurses play a leading role in HIV/AIDS prevention, care and treatment. However, nurses do not receive sufficient training at the pre-service level to carry out this important work.</p> <p>Methods</p> <p>To address this issue, the Ministry of Health and Population collaborated with the International Training and Education Center on HIV over a period of 12 months to create a competency-based HIV/AIDS curriculum to be integrated into the 4-year baccalaureate programme of the four national schools of nursing.</p> <p>Results</p> <p>Using a review of the international health and education literature on HIV/AIDS competencies and various models of curriculum development, a Haiti-based curriculum committee developed expected HIV/AIDS competencies for graduating nurses and then drafted related learning objectives. The committee then mapped these learning objectives to current courses in the nursing curriculum and created an 'HIV/AIDS Teaching Guide' for faculty on how to integrate and achieve these objectives within their current courses. The curriculum committee also created an 'HIV/AIDS Reference Manual' that detailed the relevant HIV/AIDS content that should be taught for each course.</p> <p>Conclusion</p> <p>All nursing students will now need to demonstrate competency in HIV/AIDS-related knowledge, skills and attitudes during periodic assessment with direct observation of the student performing authentic tasks. Faculty will have the responsibility of developing exercises to address the required objectives and creating assessment tools to demonstrate that their graduates have met the objectives. This activity brought different administrators, nurse leaders and faculty from four geographically dispersed nursing schools to collaborate on a shared goal using a process that could be easily replicated to integrate any new topic in a resource-constrained pre-service institution. It is hoped that this experience provided stakeholders with the experience, skills and motivation to strengthen other domains of the pre-service nursing curriculum, improve the synchronization of didactic and practical training and develop standardized, competency-based examinations for nursing licensure in Haiti.</p

Evaluating quality of obstetric care in low-resource settings: Building on the literature to design tailor-made evaluation instruments - an illustration in Burkina Faso

<p>Abstract</p> <p>Background</p> <p>There are many instruments available freely for evaluating obstetric care quality in low-resource settings. However, this profusion can be confusing; moreover, evaluation instruments need to be adapted to local issues. In this article, we present tools we developed to guide the choice of instruments and describe how we used them in Burkina Faso to facilitate the participative development of a locally adapted instrument.</p> <p>Methods</p> <p>Based on a literature review, we developed two tools: a conceptual framework and an analysis grid of existing evaluation instruments. Subsequently, we facilitated several sessions with evaluation stakeholders in Burkina Faso. They used the tools to develop a locally adapted evaluation instrument that was subsequently tested in six healthcare facilities.</p> <p>Results</p> <p>Three outputs emerged from this process:</p> <p>1) A comprehensive conceptual framework for the quality of obstetric care, each component of which is a potential criterion for evaluation.</p> <p>2) A grid analyzing 37 instruments for evaluating the quality of obstetric care in low-resource settings. We highlight their key characteristics and describe how the grid can be used to prepare a new evaluation.</p> <p>3) An evaluation instrument adapted to Burkina Faso. We describe the experience of the Burkinabé stakeholders in developing this instrument using the conceptual framework and the analysis grid, while taking into account local realities.</p> <p>Conclusions</p> <p>This experience demonstrates how drawing upon existing instruments can inspire and rationalize the process of developing a new, tailor-made instrument. Two tools that came out of this experience can be useful to other teams: a conceptual framework for the quality of obstetric care and an analysis grid of existing evaluation instruments. These provide an easily accessible synthesis of the literature and are useful in integrating it with the context-specific knowledge of local actors, resulting in evaluation instruments that have both scientific and local legitimacy.</p

Agricultural intensification and policy interventions: Exploring plausible futures for smallholder farmers in Southern Mali

Assessing how livelihoods in rural sub-Saharan Africa might change given future trends in socio-economic and biophysical conditions helps to identify and direct effective efforts towards poverty reduction. Based on existing literature, hypothetical changes in farmer practices and policy interventions were described and used to build five contrasting scenarios towards the year 2027. A simulation framework was developed to assess food self-sufficiency and income per capita now and in the future for a representative village of 99 households in Southern Mali. In the current situation, 26% of the farms were food self-sufficient and above the 1.9 US$ day−1 poverty line. This percentage would fall to 13% in the “Business as usual” scenario. In the “Dairy development” scenario, with intensification of livestock production and support to the milk sector, 27% of farms would be food self-sufficient and non-poor. Additional policy interventions targeting family planning and job creation outside agriculture would be needed to improve both household food self-sufficiency and income per capita. In this optimistic scenario, 77% of the farms would be non-poor and food self-sufficient in 2027. Additional programs to promote Integrated Pest Management, small-scale mechanization and mineral fertilizer on traditional cereals could allow a drastic increase in productivity and would lift 94% of the farm population out of poverty. Considering the entire heterogeneous farm population was crucial to accurately assess pathways out of poverty. Our study stresses the need for a strategic and multi-sectoral combination of interventions to improve livelihoods

Sitrep cholera 30 Novembre 2022

Cholera outbreak report, including total suspected cases, confirmed cases, hospitalziations, deaths, affected ages and geaographic distrubutions

Établissements privés de cure et de prévention : Conditions d'autorisation pour les soins aux assurés sociaux. Edition mise à jour au 15 mai 1956. [Décrets et annexes des Secrétariats d'Etat au travail et à la sécurité sociale et à la santé publique et à la population.]

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