Diffusion of e-health innovations in 'post-conflict' settings: a qualitative study on the personal experiences of health workers.

BACKGROUND: Technological innovations have the potential to strengthen human resources for health and improve access and quality of care in challenging 'post-conflict' contexts. However, analyses on the adoption of technology for health (that is, 'e-health') and whether and how e-health can strengthen a health workforce in these settings have been limited so far. This study explores the personal experiences of health workers using e-health innovations in selected post-conflict situations. METHODS: This study had a cross-sectional qualitative design. Telephone interviews were conducted with 12 health workers, from a variety of cadres and stages in their careers, from four post-conflict settings (Liberia, West Bank and Gaza, Sierra Leone and Somaliland) in 2012. Everett Roger's diffusion of innovation-decision model (that is, knowledge, persuasion, decision, implementation, contemplation) guided the thematic analysis. RESULTS: All health workers interviewed held positive perceptions of e-health, related to their beliefs that e-health can help them to access information and communicate with other health workers. However, understanding of the scope of e-health was generally limited, and often based on innovations that health workers have been introduced through by their international partners. Health workers reported a range of engagement with e-health innovations, mostly for communication (for example, email) and educational purposes (for example, online learning platforms). Poor, unreliable and unaffordable Internet was a commonly mentioned barrier to e-health use. Scaling-up existing e-health partnerships and innovations were suggested starting points to increase e-health innovation dissemination. CONCLUSIONS: Results from this study showed ICT based e-health innovations can relieve information and communication needs of health workers in post-conflict settings. However, more efforts and investments, preferably driven by healthcare workers within the post-conflict context, are needed to make e-health more widespread and sustainable. Increased awareness is necessary among health professionals, even among current e-health users, and physical and financial access barriers need to be addressed. Future e-health initiatives are likely to increase their impact if based on perceived health information needs of intended users

The Effects of Malaria On Some Laboratory Parameters in Sierra Leonean Children

Forty two (42)blood samples were collected from children showing clinical symptoms of malaria Trophozoites and/or gametocytes of P. falciparum were identified by microscopic examination of giemsa stained films in 22 samples (52.4%). Haemaglobin (Hb), Glutamate Pyruvate Transaminase (GPT), Bilirubin, Glucose and Ketone concentrations of these parasitaemia samples were compared with those of a non equivalent control group (n-31) of healthy children who were matched for age and sex, as far as possible with malarious group. There was a significant difference in the mean Hb concentration between the patients and controls with values of 6.14mg/dl and 10.15mg/dl respectively. The PCV levels also showed a similar pattern (25.95% to 35.95%). Higher bilirubin (22.15 to 0.98mg/dl) and GPT (61.32 to 22.831U/Ml) levels in the patients indicates some degree of haemolysis of red cells and necrosis of liver cells. The plasma glucose levels were lower in the patient compared with the controls (2.60 to 4.96mmol/l). Ketones were detected in 13(59%) of the 22 samples which tested positive for malaria parasites and none in the control group. These variations in Haematological and Biochemical parameters should enhance our knowledge in the pathogenesis of malaria in Sierra Leonean children. Nigerian Quarterly Journal of Hospital Medicine Vol.9, No.1 pp. 1-