Institution
University of Zambia
Education•Lusaka, Lusaka, Zambia•
About: University of Zambia is a education organization based out in Lusaka, Lusaka, Zambia. It is known for research contribution in the topics: Population & Health care. The organization has 2593 authors who have published 4402 publications receiving 122411 citations. The organization is also known as: UNZA.
Topics: Population, Health care, Acquired immunodeficiency syndrome (AIDS), Public health, Tuberculosis
Papers published on a yearly basis
Papers
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TL;DR: Programmes aimed at integrating community-based health workers into health systems should adequately consider multiple incentives, effective management, supervision and support from the district if such programmes are to effectively contribute towards improved primary healthcare.
Abstract: In order to address the challenges facing the community-based health workforce in Zambia, the Ministry of Health implemented the national community health assistant strategy in 2010. The strategy aims to address the challenges by creating a new group of workers called community health assistants (CHAs) and integrating them into the health system. The first group started working in August 2012. The objective of this paper is to document their motivation to become a CHA, their experiences of working in a rural district, and how these experiences affected their motivation to work. A phenomenological approach was used to examine CHAs’ experiences. Data collected through in-depth interviews with 12 CHAs in Kapiri Mposhi district and observations were analysed using a thematic analysis approach. Personal characteristics such as previous experience and knowledge, passion to serve the community and a desire to improve skills motivated people to become CHAs. Health systems characteristics such as an inclusive work culture in some health posts motivated CHAs to work. Conversely, a non-inclusive work culture created a social structure which constrained CHAs’ ability to learn, to be innovative and to effectively conduct their duties. Further, limited supervision, misconceptions about CHA roles, poor prioritisation of CHA tasks by some supervisors, as well as non- and irregular payment of incentives also adversely affected CHAs’ ability to work effectively. In addition, negative feedback from some colleagues at the health posts affected CHA’s self-confidence and professional outlook. In the community, respect and support provided to CHAs by community members instilled a sense of recognition, appreciation and belonging in CHAs which inspired them to work. On the other hand, limited drug supplies and support from other community-based health workers due to their exclusion from the government payroll inhibited CHAs’ ability to deliver services. Programmes aimed at integrating community-based health workers into health systems should adequately consider multiple incentives, effective management, supervision and support from the district. These should be tailored towards enhancing the individual, health system and community characteristics that positively impact work motivation at the local level if such programmes are to effectively contribute towards improved primary healthcare.
50 citations
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TL;DR: The prevalence of having engaged in a physical fight among in-school adolescents in Santiago, Chile is found to be similar to what has been reported in diverse settings in Africa, Europe and North America.
50 citations
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TL;DR: The findings show that women were confined to bed during the whole labour and delivery period, food and drinks were withheld, and no gowns were provided, and many present maternity ward routines should be carefully studied.
50 citations
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TL;DR: An audit of the operations performed and the use of anaesthesia over one year at the University Teaching Hospital, two provincial hospitals, and five district or church hospitals in Zambia found that if more doctors were trained to give local and regional anaesthesia more necessary surgery could be performed.
Abstract: An audit of the operations performed and the use of anaesthesia over one year at the University Teaching Hospital, two provincial hospitals, and five district or church hospitals in Zambia was carried out. The aim of the audit was to determine what proportion of operations required full surgical training and to collect information on which recommendations for training surgeons in central Africa could be based. Of the 21,245 operations performed, 18,401 (86.4%) were found not to be complex, and the procedures could be taught to non-surgeons. General anaesthesia was used often, but if more doctors were trained to give local and regional anaesthesia more necessary surgery could be performed.
49 citations
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TL;DR: QFT-GIT may not be more sensitive than the TST to detect risk factors associated with tuberculous infection and there is little evidence in the data to support the hypotheses that positivity in QFT- GIT is more related to recent infection and less affected by HIV than theTST.
Abstract: INTRODUCTION: The utility of T-cell based interferon-gamma release assays for the diagnosis of latent tuberculosis infection remains unclear in settings with a high burden of tuberculosis. OBJECTIVES: To determine risk factors associated with positive QuantiFERON-TB Gold In-Tube (QFT-GIT) and tuberculin skin test (TST) results and the level of agreement between the tests; to explore the hypotheses that positivity in QFT-GIT is more related to recent infection and less affected by HIV than the TST. METHODS: Adult household contacts of tuberculosis patients were invited to participate in a cross-sectional study across 24 communities in Zambia and South Africa. HIV, QFT-GIT and TST tests were done. A questionnaire was used to assess risk factors. RESULTS: A total of 2,220 contacts were seen. 1,803 individuals had interpretable results for both tests, 1,147 (63.6%) were QFT-GIT positive while 725 (40.2%) were TST positive. Agreement between the tests was low (kappa = 0.24). QFT-GIT and TST results were associated with increasing age (adjusted OR [aOR] for each 10 year increase for QFT-GIT 1.15; 95% CI: 1.06-1.25, and for TST aOR: 1.10; 95% CI 1.01-1.20). HIV positivity was less common among those with positive results on QFT-GIT (aOR: 0.51; 95% CI: 0.39-0.67) and TST (aOR: 0.61; 95% CI: 0.46-0.82). Smear positivity of the index case was associated with QFT-GIT (aOR: 1.25; 95% CI: 0.90-1.74) and TST (aOR: 1.39; 95% CI: 0.98-1.98) results. We found little evidence in our data to support our hypotheses. CONCLUSION: QFT-GIT may not be more sensitive than the TST to detect risk factors associated with tuberculous infection. We found little evidence to support the hypotheses that positivity in QFT-GIT is more related to recent infection and less affected by HIV than the TST.
49 citations
Authors
Showing all 2635 results
Name | H-index | Papers | Citations |
---|---|---|---|
Alimuddin Zumla | 100 | 747 | 43284 |
David Clark | 73 | 652 | 24857 |
Sten H. Vermund | 69 | 606 | 22181 |
Paul A. Kelly | 68 | 208 | 16836 |
Francis Drobniewski | 67 | 293 | 17371 |
Ayato Takada | 67 | 273 | 14467 |
Karl Peltzer | 60 | 880 | 18515 |
Hirofumi Sawa | 55 | 325 | 11735 |
Peter Godfrey-Faussett | 52 | 173 | 8486 |
Igor J. Koralnik | 52 | 197 | 10186 |
Peter Mwaba | 48 | 132 | 7386 |
Alison M. Elliott | 48 | 299 | 7772 |
Kelly Chibale | 47 | 337 | 7713 |
Chihiro Sugimoto | 47 | 325 | 7737 |
Sian Floyd | 47 | 163 | 6791 |