Berthollet Bwira Kaboru

Bio: Berthollet Bwira Kaboru is an academic researcher from Örebro University. The author has contributed to research in topics: Health care & Public health. The author has an hindex of 7, co-authored 16 publications receiving 193 citations. Previous affiliations of Berthollet Bwira Kaboru include Karolinska Institutet.

Nurses’ Roles and Experiences with Enhancing Adherence to Tuberculosis Treatment among Patients in Burundi: A Qualitative Study

Abstract: BackgroundIn TB control, poor treatment adherence is a major cause of relapse and drug resistance. Nurses have a critical role in supporting patients in TB treatment process. Yet, very little resea ...

Can biomedical and traditional health care providers work together? Zambian practitioners' experiences and attitudes towards collaboration in relation to STIs and HIV/AIDS care: a cross-sectional study

Abstract: Background: The World Health Organization's World health report 2006: Working together for health underscores the importance of human resources for health. The shortage of trained health professionals is among the main obstacles to strengthening low-income countries' health systems and to scaling up HIV/AIDS control efforts. Traditional health practitioners are increasingly depicted as key resources to HIV/AIDS prevention and care. An appropriate and effective response to the HIV/AIDS crisis requires reconsideration of the collaboration between traditional and biomedical health providers (THPs and BHPs). The aim of this paper is to explore biomedical and traditional health practitioners' experiences of and attitudes towards collaboration and to identify obstacles and potential opportunities for them to collaborate regarding care for patients with sexually transmitted infections (STIs) and HIV/AIDS. Methods: We conducted a cross-sectional study in two Zambian urban sites, using structured questionnaires. We interviewed 152 biomedical health practitioners (BHPs) and 144 traditional health practitioners (THPs) who reported attending to patients with STIs and HIV/AIDS.

Engaging Informal Providers in TB control: What Is the Potential in the Implementation of the WHO Stop TB Strategy? A Discussion Paper

Abstract: The World Health Organization (WHO) Stop TB Strategy calls for involvement of all healthcare providers in tuberculosis (TB) control There is evidence that many people with TB seek care from informal providers before or after diagnosis, but very little has been done to engage these informal providers Their involvement is often discussed with regard to DOTS (directly observed treatment - short course), rather than to the implementation of the comprehensive Stop TB Strategy This paper discusses the potential contribution of informal providers to all components of the WHO Stop TB Strategy, including DOTS, programmatic management of multi-drug-resistant TB (MDR-TB), TB/HIV collaborative activities, health systems strengthening, engaging people with TB and their communities, and enabling researchThe conclusion is that with increased stewardship by the national TB program (NTP), informal providers might contribute to implementation of the Stop TB Strategy NTPs need practical guidelines to set up and scale up initiatives, including tools to assess the implications of these initiatives on complex dimensions like health systems strengthening

Midwives' challenges and factors that motivate them to remain in their workplace in the Democratic Republic of Congo-an interview study.

Abstract: The Democratic Republic of Congo (DRC) has high maternal mortality and a low number of midwives, which undermines the achievement of goal 3 of the Sustainable Development Goals (SDGs) for 2030, specifically the health of the mother and newborn. Scaling up the midwifery workforce in relation to number, quality of healthcare, and retention in service is therefore critical. The aim of this study was to investigate midwives’ challenges and factors that motivate them to remain in their workplace in the DRC. Data were collected in two out of 26 provinces in the DRC through ten focus group discussions with a total of 63 midwives working at ten different healthcare facilities. Transcribed discussions were inductively analysed using content analysis. The midwives’ challenges and the factors motivating them to remain in their workplace in the DRC are summarised in one main category—Loving one’s work makes it worthwhile to remain in one’s workplace, despite a difficult work environment and low professional status—consisting of three generic categories: Midwifery is not just a profession; it’s a calling is described in the subcategories Saving lives through midwifery skills, Building relationships with the women and the community, and Professional pride; Unsupportive organisational system is expressed in the subcategories Insufficient work-related security and No equitable remuneration system, within Hierarchical management structures; and Inadequate pre-conditions in the work environment includes the subcategories Lack of resources and equipment and Insufficient competence for difficult working conditions. Midwives in the DRC are driven by a strong professional conscience to provide the best possible care for women during childbirth, despite a difficult work environment and low professional status. To attract and retain midwives and ensure that they are working to their full scope of practice, we suggest coordinated actions at the regional and national levels in the DRC and in other low-income countries with similar challenges, including (i) conducting midwifery education programmes following international standards, (ii) prioritising and enforcing policies to include adequate remuneration for midwives, (iii) involving midwives’ associations in policy and planning about the midwifery workforce, and (iv) ensuring that midwives’ working environments are safe and well equipped.

What is the role of informal healthcare providers in developing countries? A systematic review.

Abstract: Informal health care providers (IPs) comprise a significant component of health systems in developing nations. Yet little is known about the most basic characteristics of performance, cost, quality, utilization, and size of this sector. To address this gap we conducted a comprehensive literature review on the informal health care sector in developing countries. We searched for studies published since 2000 through electronic databases PubMed, Google Scholar, and relevant grey literature from The New York Academy of Medicine, The World Bank, The Center for Global Development, USAID, SHOPS (formerly PSP-One), The World Health Organization, DFID, Human Resources for Health Global Resource Center. In total, 334 articles were retrieved, and 122 met inclusion criteria and chosen for data abstraction. Results indicate that IPs make up a significant portion of the healthcare sector globally, with almost half of studies (48%) from Sub-Saharan Africa. Utilization estimates from 24 studies in the literature of IP for healthcare services ranged from 9% to 90% of all healthcare interactions, depending on the country, the disease in question, and methods of measurement. IPs operate in a variety of health areas, although baseline information on quality is notably incomplete and poor quality of care is generally assumed. There was a wide variation in how quality of care is measured. The review found that IPs reported inadequate drug provision, poor adherence to clinical national guidelines, and that there were gaps in knowledge and provider practice; however, studies also found that the formal sector also reported poor provider practices. Reasons for using IPs included convenience, affordability, and social and cultural effects. Recommendations from the literature amount to a call for more engagement with the IP sector. IPs are a large component of nearly all developing country health systems. Research and policies of engagement are needed.

Delayed Care Seeking for Fatal Pneumonia in Children Aged under Five Years in Uganda: A Case-Series Study/ Recours Aux Soins Trop Tardif Pour Des Cas De Pneumonie Mortelle Touchant Des Enfants Moins De Cinq Ans En Ouganda : Etude Cas-Temoins/ Retraso En Las Busqueda De Atencion Para Casos De Neumonia Mortal En Menores De Cinco Anos En Uganda: Estudio De Serie De Casos

Abstract: Background Reduction of childhood mortality due to acute respiratory infections is a worldwide health priority. (1) More than 2 million children die annually of acute respiratory infections, most often pneumonia. (2) In sub-Saharan Africa, the estimated proportion of death in children aged under 5 years attributed to pneumonia is 17-26%. (3) Prompt recognition and treatment with an effective drug is crucial, as the case-fatality rate in untreated children is high (sometimes exceeding 20%) (4) and death can occur after 3 days of illness. (5) In areas with endemic malaria, symptom overlap led to common mistreatment of pneumonia with antimalarials rather than appropriate antibiotics, probably increasing incidence of severe pneumonia. (6) Risk factors for fatal pneumonia include poor socioeconomic status, incomplete immunization schemes, malnutrition, late care seeking and inadequate treatment. (1,5) Yet cheap and effective tools exist for pneumonia prevention and care. Generally, the recommendations focus on improvement in vaccine coverage for measles, Haemophilus influenzae type B and pertussis, community education, improved nutrition, training of health providers in diagnostic and treatment algorithms, use of effective antibiotics, and timely referral of severely ill cases. (5,7-9) However, in 2004, only 29% of Ugandan children with symptoms suggestive of pneumonia were reported to have used first-line or second-line antibiotics during illness. (6) We use two hypotheses to investigate the contributing barriers for appropriate care seeking: most children live, fall ill and die beyond the reach of public health facilities and are treated at home or in the private sector; and interventions target single diseases, rather than febrile children with either multiple concurrent infections or overlapping symptoms, thus risking incorrect treatment. (10) Weak public health systems, with deficient financial and human resources, poor organization of health services, and lack of information about the local disease burden, are an underlying cause of these constraints. (11) In Asia, several countries successfully treat childhood pneumonia in the community with oral antibiotics delivered by lay health workers. (12) Despite WHO/United Nations Children's Fund (UNICEF) recommendations that countries can reduce pneumonia mortality in community settings by "integrating community pneumonia treatment activities with other efforts and initiatives that promote child health, especially malaria and diarrhoea treatment at the household and community levels", (13) no country in Africa has made such interventions policy. In low-income countries, where most children die outside the formal health system, likely cause of death is determined by interviews with carers on symptoms preceding death. These interviews are referred to as verbal autopsies. However, a few studies have investigated care-seeking behaviour preceding a child death (14-17) to identify inadequacies in the home, community, health facilities and the referral mechanisms. We propose to call these social autopsies. Previous studies have mostly looked at care seeking before malaria deaths (18-20) and we found only one for pneumonia deaths. (5) Our aim was to review case histories for children who had died of possible pneumonia to investigate child mortality on the basis of the carers' experience. Methods Study area and population This case-series study was done in the Iganga/Mayuge Demographic Surveillance Site (DSS) in Uganda. This DSS encompasses 67 000 people in 13 400 households. About 17% are children is aged less than 5 years. There is one hospital, eight public health centres, three nongovernmental organization (NGO) clinics, and 122 drug shops in the DSS. The site is a member of the international DSS organization In Depth and largely follows its standard methods. The DSS generates population-based data on key demographic events three times a year, and household, socioeconomic and education data once a year. …

European Health Care Reform: Analysis of Current Strategies; Back to Bismarck: Eastern European Health Care Systems in Transition

Abstract: Richard B Saltman, Josep Figueras WHO Regional Office of Europe, £13, pp 310 ISBN 92 890 1336 2 Jorgen Marree, Peter P Groenewegen Ashgate Avebury, £32.50, pp 138 ISBN 1 85972 617 8 Bismarck, Beveridge, and Semashko—what do these names have in common? Each man has given his name to a model that describes one of the predominant types of statutory financing of Europe's healthcare systems. In fact, the Semashko model, used by countries of the former Eastern bloc, does not exist any more. However, it was the starting point for all countries of central and eastern Europe and of the Commonwealth of Independent States when they decided to move towards the social insurance system (Bismarck model). Models have always been used to describe and simplify complex things. Reading European Health Care Reform reminded me of the breathtaking moment when I first saw the large map of “Biochemical pathways” …