Patients' views on improving sickle cell disease management in primary care: focus group discussion.

OBJECTIVES: To assess sickle cell disease (SCD) patient and carer perspectives on the primary care services related to SCD that they receive from their general practitioner (GP). DESIGN: A focus group discussion was used to elicit the views of patients about the quality of care they receive from their primary health-care providers and what they thought was the role of primary care in SCD management. The focus group discussion was video recorded. The recording was then examined by the project team and recurring themes were identified. A comparison was made with notes made by two scribes also present at the discussion. SETTING: Sickle Cell Society in Brent, UK. PARTICIPANTS: Ten participants with SCD or caring for someone with SCD from Northwest London, UK. MAIN OUTCOME MEASURES: Patients perceptions about the primary care services they received, and a list of key themes and suggestions. RESULTS: Patients and carers often bypassed GPs for acute problems but felt that GPs had an important role to play around repeat prescriptions and general health care. These service users believed SCD is often ignored and deemed unimportant by GPs. CONCLUSION: Participants wanted the health service to support primary health-care providers to improve their knowledge and understanding of SCD. Key themes and suggestions from this focus group have been used to help develop an educational intervention for general practice services that will be used to improve SCD management in primary care

Views of patients about sickle cell disease management in primary care: a questionnaire-based pilot study.

OBJECTIVES: To determine how patients with sickle cell disease (SCD) perceive the quality of care that they receive from their primary healthcare providers. DESIGN: A questionnaire-based pilot study was used to elicit the views of patients about the quality of care they have been receiving from their primary healthcare providers and what they thought was the role of primary care in SCD management. SETTING: Sickle Cell Society and Sickle Cell and Thalassaemia Centre, in the London Borough of Brent. PARTICIPANTS: One hundred questionnaires were distributed to potential participants with SCD between November 2010 and July 2011 of which 40 participants responded. MAIN OUTCOME MEASURES: Analysis of 40 patient questionnaires collected over a nine-month period. RESULTS: Most patients are generally not satisfied with the quality of care that they are receiving from their primary healthcare providers for SCD. Most do not make use of general practitioner (GP) services for management of their SCD. Collecting prescriptions was the reason most cited for visiting the GP. CONCLUSION: GPs could help improve the day-to-day management of patients with SCD. This could be facilitated by local quality improvement schemes in areas with high disease prevalence. The results of the survey have been used to help develop a GP education intervention and a local enhanced service to support primary healthcare clinicians with SCDs ongoing management

Factors affecting e-government adoption in Liberia: A practitioner perspective

Globally, e‐government implementation is growing, including in sub‐Saharan Africa, evidenced by the frequently reported benefits of e‐government programs in developed countries. The government of Liberia is pursuing an e‐government agenda to improve governance through the effective and efficient use of technology in the public sector. Liberia, one of the most underdeveloped countries in the world is bedeviled by over 10 years of civil war and most recently an Ebola virus outbreak which created severe human capacity gaps. The government has realized that in order to accelerate development and enhance its peoples' livelihood, it must integrate technology into its public administration procedures. However, the implementation of e‐government in Liberia has had mixed success. The objective of this research is to identify critical factors affecting the implementation of e‐government in Liberia. To achieve this aim, a reflective practitioner approach is employed as a lens to collect and guide the analysis of qualitative data. The data are collected through focus group discussion with senior IT practitioners (CIOs) of Liberia who are leading the delivery of e‐initiatives in Liberia. The factors identified are intended to guide how e‐government initiatives are implemented in Liberia. This research contributes to raising awareness about Liberia's e‐government program