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

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

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