Medication error affecting newborns' sight: a national response.

There have been several reports in Kenya of the wrong use of chlorhexidine digluconate solution 7.1% in the eyes of babies, resulting in chemical injury. Nyawira Mwangi spoke with Michael Gichangi, lead ophthalmologist at Kenya's Ministry of Health, about this problem

Analysis of an international collaboration for capacity building of human resources for eye care: case study of the college-college VISION 2020 LINK.

BACKGROUND: There is an extreme health workforce shortage in Eastern, Central, and Southern Africa. Shortage of eye care workers impedes effective implementation of prevention of blindness programs. The World Health Organization has identified education, partnership, leadership, financing, and policy as intertwined interventions that are critical to resolving this crisis on the long term. CASE PRESENTATION: The VISION 2020 LINK between the College of Ophthalmology of Eastern, Central, and Southern Africa and the Royal College of Ophthalmologists in the United Kingdom aims to increase the quantity and quality of eye care training in East, Central, and Southern Africa through a focus on five strategic areas: fellowship examination for ophthalmologists, training the trainers, curriculum development for residents in ophthalmology and ophthalmic clinical officers, continuous professional development (CPD), and mentoring program for young ophthalmologists. This study examined how education and partnership can be linked to improve eye care, through an evaluation of this north-south link based on its own targets and established frameworks to guide north-south links. METHODS: An exploratory qualitative case study design was used. Twenty-nine link representatives were recruited through purposive sampling and snowballing. Face-to-face interviews were conducted using a semi-structured interview schedule that incorporated the components of a successful link from an existing framework. Documents pertaining to the link were also examined. Thematic analysis was used for data analysis. RESULTS: The findings revealed that the perception to the contribution of the link to eye care in the region is generally positive. Process indicators showed that the targets in three strategic objectives of the link have been achieved. Framework-based evaluation also showed that the link is successful. Mutual learning and development of friendships were the most commonly identified success factors. Inadequate awareness of the link by college members is a key challenge. CONCLUSION: The study concludes that the link is active and evolving and has achieved most of its targets. Further developments should be directed to influence health system strengthening in Eastern, Central, and Southern Africa more strategically. The study recommends expansion of the scope of collaboration to involve multiple health system building blocks

Identifying the need to institutionalize digital equity among faculty: the experience of the Kenya Medical Training College

BackgroundThe use of digital tools and applications in health professions education is increasing exponentially, however this has the potential to increase the digital inequities with the resulting effect of vulnerable groups facing an increased risk of digital exclusion. It is therefore important to approach digitalization with contextual determinants of the intended and unintended impact in mind. We present a perspective paper on digital equity, informed by lessons learnt at the Kenya Medical Training College (KMTC).MethodsUsing a case description methodology, we examined routine educational data collected from faculty at KMTC in November 2022. This included quantitative and qualitative data on access, ownership, utilization, confidence and skills to create, share, and exchange knowledge on the institution’s learning management system. We used these factors as the conceptual framework for understanding how faculty adopt digitalization in health professions education.Results306 faculty responded to the survey (response rate 27.8%) of whom 90.8 and 75.2% had personal laptops at home and at work and 75.9% had internet at work. 53.4% (n = 163) knew they had accounts created on the institution’s learning management system (LMS) majority of whom had basic skills and were able to perform skills such as logging in and accessing learning resources. However, a minority had advanced skills needed for teaching and learning in the LMS.ConclusionMedical education institutions in LMICs need to adopt programs to enhance digital literacy and monitoring of access, utilization and self-efficacy across all learner and faculty groups, to ensure that digital technologies reduce rather than exacerbate existing inequities

Emergency management: penetrating eye injuries and intraocular foreign bodies

Penetrating injuries require immediate first aid and urgent referral to a specialist, particularly if there is a foreign body in the eye

Emergency management: penetrating eye injuries and intraocular foreign bodies.

Penetrating injuries require immediate first aid and urgent referral to a specialist, particularly if there is a foreign body in the eye

E-learning in medical education during COVID-19 pandemic: experiences of a research course at Kenya Medical Training College

BACKGROUND: E-learning has been widely adopted as a teaching and learning approach in medical education internationally. However, its adoption in low- and middle-income countries is still at an infantile stage. The use of e-learning may help to overcome some of the barriers to access to quality education and provide flexible, low-cost, user-centred, and easily updated learning. To address the need for research education during the COVID-19 pandemic, we developed and implemented an e-learning course for students enrolled in higher diploma courses at the Kenya Medical Training College (KMTC). In this paper, we report our experience teaching the online research course in resource-constrained settings to enable other medical educators, students and institutions in similar settings to understand the most appropriate approaches to incorporating e-learning interventions. METHODS: This was a cross-sectional study that reviewed the experiences of learners and lecturers on a research course at Kenya Medical Training College. All higher diploma students admitted to the college in the 2020/21 academic year were invited to take part in the study. We also included all lecturers that were involved in the coordination and facilitation of the course. We analysed qualitative and quantitative data that were collected from the e-learning platform, an online course-evaluation form and reports from course lecturers. RESULTS: We enrolled 933 students on the online research course. These students had joined 44 higher diploma courses in 11 campuses of the college. The students struggled to complete synchronous e-learning activities on the e-learning platform. Only 53 and 45% of the students were able to complete the pretest and the posttest, respectively. Four themes were identified through a thematic analysis of qualitative data (1) Students gained research competencies (2) Students appreciated the use of diverse e-learning technologies (3) Students felt overwhelmed by the research course (4) Technological challenges reduce the effectiveness of online learning. CONCLUSION: Our results suggest that e-learning can be used to teach complex courses, such as research in resource-constrained settings. However, faculty should include more asynchronous e-learning activities to enhance teaching and learning and improve student experiences

Empowering patients to manage their eye medication at home

Eye patients must manage their own treatment once they leave the clinic, our role is to ensure they can do so safely and effectively

Predictors of uptake of eye examination in people living with diabetes mellitus in three counties of Kenya.

BACKGROUND: Diabetic retinopathy (DR) is a significant public health concern that is potentially blinding. Clinical practice guidelines recommend annual eye examination of patients with diabetes for early detection of DR. Our aim was to identify the demand-side factors that influence uptake of eye examination among patients already utilizing diabetes services in three counties of Kenya. METHODS: We designed a clinic based cross-sectional study and used three-stage sampling to select three counties, nine diabetes clinics in these counties and 270 patients with diabetes attending these clinics. We interviewed the participants using a structured questionnaire. The two outcomes of interest were 'eye examination in the last 12 months' and 'eye examination ever'. The exposure variables were the characteristics of participants living with diabetes. RESULTS: The participants had a mean age of 53.3 years (SD 14.1) and an average interval of 4 months between visits to the diabetes clinic. Only 25.6% of participants had ever had an eye examination in their lifetime, while 13.3% had it in the preceding year. The independent predictors of uptake were referral by diabetes services, patient knowledge of diabetes eye complications, comorbid hypertension and urban or semi-urban residence. CONCLUSIONS: We conclude that access to retinal examination for DR is low in all three counties. An intervention that increases the knowledge of patients with diabetes about eye complications and promotes referral of patients with diabetes for eye examination may improve access to annual eye examination for DR

Realizing the potential of routinely collected data for monitoring eye health services to help achieve universal health coverage

In the recent World Report on Vision, the World Health Organization (WHO) highlighted the need to strengthen health information systems (HIS) for eye health, including data from population-based surveys and facility-based sources such as service and resource data. The report also outlined the importance of strengthening eye health to enable Universal Health Coverage. In high-income countries, facility-based data are increasingly used to monitor eye services and answer research questions, including under the banner of big data. While there are some examples of comprehensive and robust information systems for eye care in low- and middle-income countries (LMICs), the potential of facility-based data is yet to be realized in many LMICs. Here, we discuss the potential of strengthening the collection and use of facility-based data for eye health in LMICs to monitor Universal Health Coverage relevant aspects of service access, quality, and equity