1
|
Msomi NL, Ross AJ. Social accountability challenges and recommendations by community service rehabilitation therapists. S Afr Fam Pract (2004) 2024; 66:e1-e9. [PMID: 38949449 PMCID: PMC11219701 DOI: 10.4102/safp.v66i1.5936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 07/02/2024] Open
Abstract
BACKGROUND Social accountability entails providing equitable and accessible services that are tailor-made for the community's healthcare needs and enable rehabilitation therapists to improve the efficiency and efficacy of healthcare delivery and their response. Enabling them to provide optimal care during their community service year requires understanding the gaps in their knowledge, experience and the support they provide to the communities they service. METHODS Four in-depth individual interviews and four focus group discussions were conducted via Zoom. The qualitative responses to the questions related to the challenges and recommendations associated with social accountability in clinical settings were analysed using an inductive thematic approach via NVIVO. RESULTS Four sub-themes emerged for each of the two areas of interest: the challenges relating to (1) budget and equipment constraints, (2) staff shortages, (3) cultural and language barriers and (4) scope of practice limitations. The recommendations related to (5) collaboration with community caregivers, (6) service inclusion in primary health care clinics, (7) improved executive management support and (8) continuing professional development. CONCLUSION Equipping graduates with the knowledge, skills and support needed to work in an under-resourced setting is essential for community service rehabilitation therapists to ensure social accountability, given that they often work alone, specifically in rural settings.Contribution: Being aware of the challenges that face community service rehabilitation therapists, having the necessary tools and health facility management support will enable ongoing improvements in their ability to provide socially accountable services.
Collapse
Affiliation(s)
- Ntandoyenkosi L Msomi
- Department of Family Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban.
| | | |
Collapse
|
2
|
Kamau M, Nyanja N, Lusambili AM, Shabani J, Mohamoud G. Knowledge, attitudes and beliefs toward polypharmacy among older people attending Family Medicine Clinic, Nairobi, Kenya. BMC Geriatr 2024; 24:132. [PMID: 38317102 PMCID: PMC10845745 DOI: 10.1186/s12877-024-04697-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 01/10/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Life expectancy has increased over the last century among older people, particularly those aged over 60 years. Aging is associated with increased disability, multiple chronic conditions, and increased use of health services managed with polypharmacy. There are few studies on polypharmacy and aging in sub-Saharan Africa, and it is unclear what older people know and their attitudes toward polypharmacy. This paper presents findings from a study that aimed to understand older people's knowledge, attitudes and beliefs about polypharmacy. METHODS A qualitative study using in-depth interviews of 15 patients aged 60 years and older who were taking more than five medications per day. The study was conducted at the Family Medicine Clinic (FMC), Aga Khan University Hospital, Nairobi. Data were analyzed using NVivo 12 software. RESULT Majority of participants had a good understanding of their underlying health conditions, but they did not know the specific names of the medications they were taking. Participants had diverse attitudes toward polypharmacy, with both positive and negative perceptions. Although adverse side effects were reported, participants remained positive because they believed these medicines were beneficial. Religion, faith and living healthy lifestyles were perceived to contribute to their positive attitude toward polypharmacy. Stigma and the cost of medication were reported as barriers. CONCLUSION This study provides valuable insights into the complexities of polypharmacy in older people. It highlights the importance of patient education, fostering strong patient-provider relationships, de-stigmatization, and improving medication affordability and accessibility. Further research could explore the polypharmacy of older people attending public institutions in rural Kenya.
Collapse
Affiliation(s)
- Maureen Kamau
- Department of Family Medicine, Aga Khan University Hospital, Nairobi, Kenya.
| | - Njeri Nyanja
- Department of Family Medicine, Aga Khan University Hospital, Nairobi, Kenya
| | | | - Jacob Shabani
- Department of Family Medicine, Aga Khan University Hospital, Nairobi, Kenya
| | - Gulnaz Mohamoud
- Department of Family Medicine, Aga Khan University Hospital, Nairobi, Kenya
| |
Collapse
|
3
|
Nxumalo CT, Tokwe L, Ngcobo SJ, Gam NP, Mchunu GG, Makhado L. Exploring the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa: a descriptive phenomenological study. Int J Qual Stud Health Well-being 2023; 18:2247622. [PMID: 37639491 PMCID: PMC10464539 DOI: 10.1080/17482631.2023.2247622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 08/09/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The incidence and prevalence of COVID-19 continues to escalate globally, with the consequence to quality of life, the economies of nations and various sectors of society. While there is substantial research on the impact and experiences of the COVID-19 pandemic, little remains known about the perceptions and lived experiences of families living with people diagnosed with COVID-19, particularly within the South African context. PURPOSE To explore the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa. METHODS A descriptive phenomenological design was used. Data were collected from 15 participants who were family members of people diagnosed with COVID-19 in South Africa. Purposive snowball sampling was used to identify and recruit participants, and data were collected at community level in KwaZulu-Natal, Western Cape and Gauteng, South Africa. Individual in-depth interviews were used to collect the data, and an audio tape was used to record all interviews. Data were transcribed verbatim and analysed using a phenomenological data analysis processes. Ethical approval to conduct the study was obtained from the University of KwaZulu-Natal Research Ethics Committee-reference number: BREC00003228/2021. RESULTS Four super-ordinate themes emerged in relation to the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa. The superordinate themes were: (1) sources of information about COVID-19, (2) pandemic perceptions and experiences, (3) impact of diagnosis and related burden and (4) aftermath of living with a family member diagnosed with COVID-19. DISCUSSION AND CONCLUSION Family members' perceptions and lived experiences of COVID-19 are largely influenced by media, moreover, the impact of diagnosis has consequences for the physical, mental and emotional well-being of family members. Diagnosis disrupts family dynamics by depleting financial resources due to the caregiver burden experienced. The findings thus imply that provision of psychosocial support is imperative for families living with persons diagnosed with COVID-19.
Collapse
Affiliation(s)
- Celenkosini Thembelenkosini Nxumalo
- Academic Development Unit, Faculty of Health Sciences, Durban University of Technology, Ritson Campus, Durban, South Africa
- Department of Nursing, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Lwandile Tokwe
- School of Nursing, Faculty of Community and Health Sciences, University of Western Cape, Cape Town, South Africa
| | - Silingene Joyce Ngcobo
- Department of Nursing, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Nkululeko Phalson Gam
- Centre for quality Promotion and Assurance, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Gugu Gladness Mchunu
- Executive Dean, Faculty of Health Sciences, Durban University of Technology, Ritson Campus, Durban, South Africa
| | - Lufuno Makhado
- Executive Dean, School of Public Health, University of Venda, Thohoyandou, South Africa
| |
Collapse
|
4
|
Christopher C, KC B, Shrestha S, Blebil AQ, Alex D, Mohamed Ibrahim MI, Ismail N. Medication use problems among older adults at a primary care: A narrative of literature review. Aging Med (Milton) 2022; 5:126-137. [PMID: 35783113 PMCID: PMC9245166 DOI: 10.1002/agm2.12203] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/21/2022] [Accepted: 02/27/2022] [Indexed: 11/09/2022] Open
Abstract
Appropriate medication use is one of the most significant challenges among the older population. Although medication use problems are well documented at the secondary and tertiary health care level, the evidence at the primary care level of OECD region is limited. A narrative review of existing literature was conducted through a nonsystematic search for original articles through electronic search databases, Ovid Medline, Google Scholar from 2001 to 2021, and a combination of citation references. Medication use problems are prevalent in older adults at the primary care level. The main issues of medication use identified were as follows; nonadherence, adverse drug events, accessibility, polypharmacy, inappropriate medications, belief about medications, lack of knowledge and awareness, and lack of deprescribing. In addition, the current review has identified the possibilities of the problems: many medications, forgetfulness, lack of deprescribing, lack of communication, poor understanding, and limited awareness of inappropriate medications. This review found that various medication use problems subclusters were identified to impact the health care need among older adults. Therefore, effective interventions targeting these issues need to be developed to reduce medication use problems among older adults at a primary care level.
Collapse
Affiliation(s)
| | - Bhuvan KC
- School of PharmacyMonash University MalaysiaSubang JayaMalaysia
| | - Sunil Shrestha
- School of PharmacyMonash University MalaysiaSubang JayaMalaysia
| | - Ali Qais Blebil
- School of PharmacyMonash University MalaysiaSubang JayaMalaysia
| | - Deepa Alex
- Jeffrey Cheah School of Medicine and Health SciencesMonash University MalaysiaSubang JayaMalaysia
| | | | | |
Collapse
|
5
|
Antimicrobial Prescribing Confidence and Knowledge Regarding Drug Resistance: Perception of Medical Students in Malaysia and the Implications. Antibiotics (Basel) 2022; 11:antibiotics11050540. [PMID: 35625184 PMCID: PMC9137524 DOI: 10.3390/antibiotics11050540] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/15/2022] [Accepted: 04/17/2022] [Indexed: 02/01/2023] Open
Abstract
Worldwide, microbes are becoming more challenging by acquiring virulent skills to adapt and develop antimicrobial resistance (AMR). This is a concern as AMR increases morbidity, mortality, and costs. Consequently, physicians need to be trained on appropriate antimicrobial prescribing, starting as medical students. Objective: To evaluate medical students’ confidence in antimicrobial prescribing and AMR. Methods: Cross-sectional study assessing medical students’ knowledge, perception, and confidence in prescribing antimicrobials and AMR in a Malaysian University. A universal sampling method was used. Results: Most responding students believed that educational input regarding overall prescribing was sufficient. Regarding the principle of appropriate and accurate prescriptions, female medical students had less knowledge (odds ratio (OR) = 0.51; 95% confidence interval (CI) 0.25–0.99; p = 0.050). Year-IV and Year-V medical students had more excellent knowledge than Year-III students regarding confidence in potential antibiotic prescribing once qualified. Year-V students also showed an appreciably higher confidence in the broad principles of prescribing, including antibiotics for infectious diseases, compared to those in other years. Conclusion: Overall, medical students gain more knowledge and confidence regarding the potential prescribing of antimicrobials as their academic careers progress. This is important given concerns with the current excessive use of antimicrobials in Malaysia.
Collapse
|
6
|
Alaazi DA, Stafinski T, Menon D. Health Insurance Exemptions for Older Ghanaians: Stakeholder Perspectives on Challenges Confronting an Ambitious Policy. J Aging Soc Policy 2022; 34:607-625. [PMID: 35259079 DOI: 10.1080/08959420.2022.2046992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The health and wellbeing of older adults have taken center-stage in global policy agendas in recent times. In 2003, Ghana introduced an insurance exemption policy to eliminate financial barriers to healthcare for older adults and other vulnerable population groups. Embedded within the National Health Insurance Scheme (NHIS), this policy ostensibly guarantees free healthcare for older adults at publicly-funded facilities across the country. In this paper, we applied the implementation problem framework to identify gaps in the implementation of the exemptions policy and their impact on the healthcare experiences of older adults. Our data collection involved qualitative interviews with a purposive sample of community-residing older adults, health workers, community leaders, and policymakers. Our thematic data analysis identified resource, substantive, bureaucratic, political, and administrative constraints in the policy implementation process which, in turn, affected quality healthcare delivery. While most of these constraints are general challenges confronting the NHIS, they serve to undermine the intent of the scheme's exemptions policy. In particular, despite the exemptions, older adults continued to pay out-of-pocket for certain categories of treatments and medications, creating as yet financial barriers to healthcare. We present policy recommendations for addressing these implementation challenges, including suggestions to decentralize, depoliticize, and financially liberate the operations of the NHIS.
Collapse
Affiliation(s)
- Dominic A Alaazi
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Tania Stafinski
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Devidas Menon
- School of Public Health, University of Alberta, Edmonton, Canada
| |
Collapse
|
7
|
Tseng YH, Li YL, Luu S, Luh DL. Respect in the Eyes of Non-Urban Elders: Using Qualitative Interviews to Distinguish Community Elders' Perspective of Respect in General and Healthcare Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042171. [PMID: 35206360 PMCID: PMC8871856 DOI: 10.3390/ijerph19042171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/28/2022] [Accepted: 02/08/2022] [Indexed: 12/10/2022]
Abstract
This study aimed to describe the connotation of respect for community elders in daily situations, and discuss the elderly's views on respect for healthcare services. A qualitative research design was conducted to interview elders from a non-urban area in Changhua, Taiwan. Study sites were Lukang and Ershui. A total of 52 people were interviewed, with an average age of 75 years old. Based on Grounded theory, the thematic analysis method was used to analyze data. This study found that respect from the perspective of the elderly can be divided into three categories: (1) verbal expression, (2) non-verbal behavior, and (3) behavior combined with appropriate language. We found that elders use the performance of healthcare service providers to discuss respect in the field of healthcare services. Respect can also be shown in the physical environment in healthcare settings. This study found that, for the community elders, respect is an individual's subjective feelings regarding the process of interpersonal interaction. Compared to daily life, the respect of the elderly for the healthcare setting has increased the element of the environment. In addition, it was found that elderly people have lower expectations and requirements for respect in healthcare settings.
Collapse
Affiliation(s)
- Yu-Hsien Tseng
- Department of Public Health, Chung Shang Medical University, No.110, Sec.1, Jianguo N.Rd., Taichung 40201, Taiwan; (Y.-H.T.); (Y.-L.L.)
| | - Yu-Ling Li
- Department of Public Health, Chung Shang Medical University, No.110, Sec.1, Jianguo N.Rd., Taichung 40201, Taiwan; (Y.-H.T.); (Y.-L.L.)
| | - Shyuemeng Luu
- School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 2nd Floor, 5850 College Street, P.O. Box 15000, Halifax, NS B3H 4R2, Canada;
| | - Dih-Ling Luh
- Department of Public Health, Chung Shang Medical University, No.110, Sec.1, Jianguo N.Rd., Taichung 40201, Taiwan; (Y.-H.T.); (Y.-L.L.)
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N.Rd., Taichung 40201, Taiwan
- Correspondence:
| |
Collapse
|
8
|
Karat AS, McCreesh N, Baisley K, Govender I, Kallon II, Kielmann K, MacGregor H, Vassall A, Yates TA, Grant AD. Estimating waiting times, patient flow, and waiting room occupancy density as part of tuberculosis infection prevention and control research in South African primary health care clinics. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000684. [PMID: 36962412 PMCID: PMC10021248 DOI: 10.1371/journal.pgph.0000684] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 06/13/2022] [Indexed: 01/13/2023]
Abstract
Transmission of respiratory pathogens, such as Mycobacterium tuberculosis and severe acute respiratory syndrome coronavirus 2, is more likely during close, prolonged contact and when sharing a poorly ventilated space. Reducing overcrowding of health facilities is a recognised infection prevention and control (IPC) strategy; reliable estimates of waiting times and 'patient flow' would help guide implementation. As part of the Umoya omuhle study, we aimed to estimate clinic visit duration, time spent indoors versus outdoors, and occupancy density of waiting rooms in clinics in KwaZulu-Natal (KZN) and Western Cape (WC), South Africa. We used unique barcodes to track attendees' movements in 11 clinics, multiple imputation to estimate missing arrival and departure times, and mixed-effects linear regression to examine associations with visit duration. 2,903 attendees were included. Median visit duration was 2 hours 36 minutes (interquartile range [IQR] 01:36-3:43). Longer mean visit times were associated with being female (13.5 minutes longer than males; p<0.001) and attending with a baby (18.8 minutes longer than those without; p<0.01), and shorter mean times with later arrival (14.9 minutes shorter per hour after 0700; p<0.001). Overall, attendees spent more of their time indoors (median 95.6% [IQR 46-100]) than outdoors (2.5% [IQR 0-35]). Attendees at clinics with outdoor waiting areas spent a greater proportion (median 13.7% [IQR 1-75]) of their time outdoors. In two clinics in KZN (no appointment system), occupancy densities of ~2.0 persons/m2 were observed in smaller waiting rooms during busy periods. In one clinic in WC (appointment system, larger waiting areas), occupancy density did not exceed 1.0 persons/m2 despite higher overall attendance. In this study, longer waiting times were associated with early arrival, being female, and attending with a young child. Occupancy of waiting rooms varied substantially between rooms and over the clinic day. Light-touch estimation of occupancy density may help guide interventions to improve patient flow.
Collapse
Affiliation(s)
- Aaron S Karat
- TB Centre, London School of Hygiene & Tropical Medicine, London, United Kingdom
- The Institute for Global Health and Development, Queen Margaret University, Edinburgh, United Kingdom
| | - Nicky McCreesh
- TB Centre, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Kathy Baisley
- TB Centre, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Africa Health Research Institute, School of Laboratory Medicine & Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Indira Govender
- TB Centre, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Idriss I Kallon
- Division of Social and Behavioural Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Centre for Evidence-Based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Karina Kielmann
- The Institute for Global Health and Development, Queen Margaret University, Edinburgh, United Kingdom
| | - Hayley MacGregor
- The Institute of Development Studies, University of Sussex, Brighton, United Kingdom
| | - Anna Vassall
- TB Centre, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Tom A Yates
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Alison D Grant
- TB Centre, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Africa Health Research Institute, School of Laboratory Medicine & Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
9
|
The Good Old Days: how Older Adults in Present-Day Ghana Compare themselves to Older Adults in Past Generations. J Cross Cult Gerontol 2021; 37:89-114. [PMID: 34860334 DOI: 10.1007/s10823-021-09445-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2021] [Indexed: 11/27/2022]
Abstract
This study explores nostalgia among older adults in present-day Ghana by investigating how they subjectively compare themselves to older adults in the past. A purposive sample of 23 older adults provided data through semi-structured face-to-face interviews and data analysis employed a general inductive approach, with a focus on content and thematic analytic procedures. The findings show an overall theme of 'the good old days', how participants compare themselves negatively to older adults in their past, believing and feeling that older adults in the past enjoyed better health and longevity and had more care and respect. While participants generally praise the past for its perceived virtue and vitality, they scold the present for a perceived degeneration. Findings of this study support theoretical descriptions and empirical research conclusions on nostalgia as: an emotionally invested remembrance of the past; a yearning to relive the past or reconnect with people and things past, or to return to places in the past; and an evocation of the beauty of the past in contrast to the ugliness of the present. Consonant with this, the study shows how participants evoke the beauty of the past, where, comparatively, older adults enjoyed a life of dignity. In what is characteristic of nostalgic evocations, participants reclaim the lost beautiful past, where people ate natural - healthy - foods, engaged in physically active work, and were stronger into late adulthood. Again, consonant with nostalgia as a discourse of critique of the present with the past as yardstick, participants express disenchantment with the present for a perceived steady degradation of the values of care, respect, and obedience to elders, which made older adults in past generations a privileged class. To this end, we may conclude that nostalgia not only speaks to the present from the past, it seeks to recreate the past in the future.
Collapse
|
10
|
Leveraging HIV Care Infrastructures for Integrated Chronic Disease and Pandemic Management in Sub-Saharan Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010751. [PMID: 34682492 PMCID: PMC8535610 DOI: 10.3390/ijerph182010751] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 12/31/2022]
Abstract
In Sub-Saharan Africa, communicable and other tropical infectious diseases remain major challenges apart from the continuing HIV/AIDS epidemic. Recognition and prevalence of non-communicable diseases have risen throughout Africa, and the reimagining of healthcare delivery is needed to support communities coping with not only with HIV, tuberculosis, and COVID-19, but also cancer, cardiovascular disease, diabetes, and depression. Many non-communicable diseases can be prevented or treated with low-cost interventions, yet implementation of such care has been limited in the region. In this Perspective piece, we argue that deployment of an integrated service delivery model is an urgent next step, propose a South African model for integration, and conclude with recommendations for next steps in research and implementation. An approach that is inspired by South African experience would build on existing HIV-focused infrastructure that has been developed by Ministries of Health with strong support from the U.S. President’s Emergency Response for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria. An integrated chronic healthcare model holds promise to sustainably deliver infectious disease and non-communicable disease care. Integrated care will be especially critical as health systems seek to cope with the unprecedented challenges associated with COVID-19 and future pandemic threats.
Collapse
|
11
|
Living at the Margins or Elevated Citizenship? Challenges and Opportunities for Social Participation Experienced by Older Adults in Ghana. AGEING INTERNATIONAL 2021. [DOI: 10.1007/s12126-021-09443-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
12
|
Kalu ME, Ojembe BU, Akinrolie O, Okoh AC, Adandom II, Nwankwo HC, Ajulo MS, Omeje CA, Okeke CO, Uduonu EM, Ezulike JC, Anieto EM, Emofe D, Nwachukwu EC, Ibekaku MC, Obi PC. Setting priorities for ageing research in Africa: A systematic mapping review of 512 studies from sub-Saharan Africa. J Glob Health 2021. [PMID: 34327003 PMCID: PMC8284542 DOI: 10.7189/11.15002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background In 2040, the older population's growth rate in sub-Saharan Africa (SSA) will be faster than those experienced by developed nations since 1950. In preparation for this growth, the National Institute on Aging commissioned the National Academies' Committee on Population to organize a workshop on advancing aging research in Africa. This meeting provided a platform for discussing some areas requiring improvement in aging research in SSA regions. We believed that conducting a systematic review of peer-reviewed articles to set priorities for aging research in SSA is warranted. Therefore, this article is the first in a Four-Part series that summaries the types and trends of peer-reviewed studies in SSA. Methods This systematic mapping review followed the Search-Appraisal-Synthesis-Analysis Framework. We systematically searched multiple databases from inception till February 2021 and included peer-reviewed articles conducted with/for older adults residing in SSA. Conventional content analysis was employed to categorize studies into subject-related areas. Results We included 512 studies (quantitative = 426, qualitative = 71 and mixed-method = 15). Studies were conducted in 32 countries. Quantitative studies included were observational studies: cross-sectional (n = 250, 59%), longitudinal (n = 126, 30%), and case-control (n = 12, 3%); and experimental studies: pre-post design (n = 4, 1%), randomized control trial (RCT, n = 12, 3%); and not reported (n = 21, 5%). Fifteen qualitative studies did not state their study design; where stated, study design ranged from descriptive (n = 14, 20%), ethnography (n = 12, 17%), grounded theory (n = 7, 10%), narrative (n = 5, 7%), phenomenology (n = 10, 14%), interpretative exploratory (n = 4, 6%), case studies (n = 4, 6%). Of the 15 mixed-method studies, seven did not state their mixed-method design. Where stated, design includes concurrent (n = 1), convergent (n = 1), cross-sectional (n = 3), informative (n = 1), sequential exploratory (n = 1) and retrospective (n = 2). Studies were classified into 30 (for quantitative studies) and seven (for qualitative and mixed-method) subject-related areas. HIV/AIDs-related and non-communicable diseases-related studies were the most predominant subject-related areas. No studies explored the transdisciplinary co-production of interventions. Conclusions There are glaring gaps in ageing research in SSA, especially mixed-methods and RCTs. A large number of studies focused on HIV/AIDs and non-communicable disease-related studies. National and international funding agencies should set up priority funding competitions for transdisciplinary collaborations in ageing research.
Collapse
Affiliation(s)
- Michael E Kalu
- Emerging Researchers & Professionals in Ageing - African Network, Nigeria (www.erpaan.org).,School of Rehabilitation Science, McMaster University, Hamilton Ontario Canada
| | - Blessing U Ojembe
- Emerging Researchers & Professionals in Ageing - African Network, Nigeria (www.erpaan.org).,Department of Health, Ageing & Society, McMaster University, Hamilton Ontario Canada
| | - Olayinka Akinrolie
- Emerging Researchers & Professionals in Ageing - African Network, Nigeria (www.erpaan.org).,Applied Health Science Program, University of Manitoba, Winnipeg, Canada
| | - Augustine C Okoh
- Emerging Researchers & Professionals in Ageing - African Network, Nigeria (www.erpaan.org)
| | - Israel I Adandom
- Emerging Researchers & Professionals in Ageing - African Network, Nigeria (www.erpaan.org).,Physiotherapy Department, Cedacrest Hospitals, Abuja, Nigeria
| | - Henrietta C Nwankwo
- Emerging Researchers & Professionals in Ageing - African Network, Nigeria (www.erpaan.org).,Faculty of Health Science, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Michael S Ajulo
- Emerging Researchers & Professionals in Ageing - African Network, Nigeria (www.erpaan.org)
| | - Chidinma A Omeje
- Emerging Researchers & Professionals in Ageing - African Network, Nigeria (www.erpaan.org).,Department of Medical Rehabilitation, College of Medicine, University of Nigeria, Nigeria
| | - Chukwuebuka O Okeke
- Emerging Researchers & Professionals in Ageing - African Network, Nigeria (www.erpaan.org).,Department of Medical Rehabilitation, Nnamdi Azikiwe University, Awka, Nigeria
| | - Ekezie M Uduonu
- Emerging Researchers & Professionals in Ageing - African Network, Nigeria (www.erpaan.org).,Department of Medical Rehabilitation, College of Medicine, University of Nigeria, Nigeria
| | - Juliet C Ezulike
- Emerging Researchers & Professionals in Ageing - African Network, Nigeria (www.erpaan.org).,Department of Social Work, University of Nigeria, Nsukka, Nigeria.,Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Ebuka M Anieto
- Emerging Researchers & Professionals in Ageing - African Network, Nigeria (www.erpaan.org).,Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa
| | - Diameta Emofe
- Emerging Researchers & Professionals in Ageing - African Network, Nigeria (www.erpaan.org).,Physiotherapy Department, Humanity Hospital Effurun, Delta State, Nigeria
| | - Ernest C Nwachukwu
- Emerging Researchers & Professionals in Ageing - African Network, Nigeria (www.erpaan.org).,Physiotherapy Department, Enugu State University of Science and Technology Teaching Hospital-Parklane, Enugu, Nigeria
| | - Michael C Ibekaku
- Emerging Researchers & Professionals in Ageing - African Network, Nigeria (www.erpaan.org).,Department of Physiotherapy, University of Benin Teaching Hospital, Benin city, Nigeria
| | - Perpetual C Obi
- Emerging Researchers & Professionals in Ageing - African Network, Nigeria (www.erpaan.org).,Physiotherapy Unit, Peak Wellness Centre, Abuja, Nigeria
| | | |
Collapse
|
13
|
Kalu ME, Ojembe BU, Akinrolie O, Okoh AC, Adandom II, Nwankwo HC, Ajulo MS, Omeje CA, Okeke CO, Uduonu EM, Ezulike JC, Anieto EM, Emofe D, Nwachukwu EC, Ibekaku MC, Obi PC. Setting priorities for ageing research in Africa: A systematic mapping review of 512 studies from sub-Saharan Africa. J Glob Health 2021; 11:15002. [PMID: 34327003 PMCID: PMC8284542 DOI: 10.7189/jogh.11.15002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND In 2040, the older population's growth rate in sub-Saharan Africa (SSA) will be faster than those experienced by developed nations since 1950. In preparation for this growth, the National Institute on Aging commissioned the National Academies' Committee on Population to organize a workshop on advancing aging research in Africa. This meeting provided a platform for discussing some areas requiring improvement in aging research in SSA regions. We believed that conducting a systematic review of peer-reviewed articles to set priorities for aging research in SSA is warranted. Therefore, this article is the first in a Four-Part series that summaries the types and trends of peer-reviewed studies in SSA. METHODS This systematic mapping review followed the Search-Appraisal-Synthesis-Analysis Framework. We systematically searched multiple databases from inception till February 2021 and included peer-reviewed articles conducted with/for older adults residing in SSA. Conventional content analysis was employed to categorize studies into subject-related areas. RESULTS We included 512 studies (quantitative = 426, qualitative = 71 and mixed-method = 15). Studies were conducted in 32 countries. Quantitative studies included were observational studies: cross-sectional (n = 250, 59%), longitudinal (n = 126, 30%), and case-control (n = 12, 3%); and experimental studies: pre-post design (n = 4, 1%), randomized control trial (RCT, n = 12, 3%); and not reported (n = 21, 5%). Fifteen qualitative studies did not state their study design; where stated, study design ranged from descriptive (n = 14, 20%), ethnography (n = 12, 17%), grounded theory (n = 7, 10%), narrative (n = 5, 7%), phenomenology (n = 10, 14%), interpretative exploratory (n = 4, 6%), case studies (n = 4, 6%). Of the 15 mixed-method studies, seven did not state their mixed-method design. Where stated, design includes concurrent (n = 1), convergent (n = 1), cross-sectional (n = 3), informative (n = 1), sequential exploratory (n = 1) and retrospective (n = 2). Studies were classified into 30 (for quantitative studies) and seven (for qualitative and mixed-method) subject-related areas. HIV/AIDs-related and non-communicable diseases-related studies were the most predominant subject-related areas. No studies explored the transdisciplinary co-production of interventions. CONCLUSIONS There are glaring gaps in ageing research in SSA, especially mixed-methods and RCTs. A large number of studies focused on HIV/AIDs and non-communicable disease-related studies. National and international funding agencies should set up priority funding competitions for transdisciplinary collaborations in ageing research.
Collapse
Affiliation(s)
- Michael E Kalu
- Emerging Researchers & Professionals in Ageing – African Network, Nigeria (www.erpaan.org)
- School of Rehabilitation Science, McMaster University, Hamilton Ontario Canada
| | - Blessing U Ojembe
- Emerging Researchers & Professionals in Ageing – African Network, Nigeria (www.erpaan.org)
- Department of Health, Ageing & Society, McMaster University, Hamilton Ontario Canada
| | - Olayinka Akinrolie
- Emerging Researchers & Professionals in Ageing – African Network, Nigeria (www.erpaan.org)
- Applied Health Science Program, University of Manitoba, Winnipeg, Canada
| | - Augustine C Okoh
- Emerging Researchers & Professionals in Ageing – African Network, Nigeria (www.erpaan.org)
| | - Israel I Adandom
- Emerging Researchers & Professionals in Ageing – African Network, Nigeria (www.erpaan.org)
- Physiotherapy Department, Cedacrest Hospitals, Abuja, Nigeria
| | - Henrietta C Nwankwo
- Emerging Researchers & Professionals in Ageing – African Network, Nigeria (www.erpaan.org)
- Faculty of Health Science, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Michael S Ajulo
- Emerging Researchers & Professionals in Ageing – African Network, Nigeria (www.erpaan.org)
| | - Chidinma A Omeje
- Emerging Researchers & Professionals in Ageing – African Network, Nigeria (www.erpaan.org)
- Department of Medical Rehabilitation, College of Medicine, University of Nigeria, Nigeria
| | - Chukwuebuka O Okeke
- Emerging Researchers & Professionals in Ageing – African Network, Nigeria (www.erpaan.org)
- Department of Medical Rehabilitation, Nnamdi Azikiwe University, Awka, Nigeria
| | - Ekezie M Uduonu
- Emerging Researchers & Professionals in Ageing – African Network, Nigeria (www.erpaan.org)
- Department of Medical Rehabilitation, College of Medicine, University of Nigeria, Nigeria
| | - Juliet C Ezulike
- Emerging Researchers & Professionals in Ageing – African Network, Nigeria (www.erpaan.org)
- Department of Social Work, University of Nigeria, Nsukka, Nigeria
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Ebuka M Anieto
- Emerging Researchers & Professionals in Ageing – African Network, Nigeria (www.erpaan.org)
- Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa
| | - Diameta Emofe
- Emerging Researchers & Professionals in Ageing – African Network, Nigeria (www.erpaan.org)
- Physiotherapy Department, Humanity Hospital Effurun, Delta State, Nigeria
| | - Ernest C Nwachukwu
- Emerging Researchers & Professionals in Ageing – African Network, Nigeria (www.erpaan.org)
- Physiotherapy Department, Enugu State University of Science and Technology Teaching Hospital-Parklane, Enugu, Nigeria
| | - Michael C Ibekaku
- Emerging Researchers & Professionals in Ageing – African Network, Nigeria (www.erpaan.org)
- Department of Physiotherapy, University of Benin Teaching Hospital, Benin city, Nigeria
| | - Perpetual C Obi
- Emerging Researchers & Professionals in Ageing – African Network, Nigeria (www.erpaan.org)
- Physiotherapy Unit, Peak Wellness Centre, Abuja, Nigeria
| | | |
Collapse
|
14
|
Payne CF, Mall S, Kobayashi L, Kahn K, Berkman L. Life-Course Trauma and Later Life Mental, Physical, and Cognitive Health in a Postapartheid South African Population: Findings From the HAALSI study. J Aging Health 2020; 32:1244-1257. [PMID: 32207348 DOI: 10.1177/0898264320913450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To investigate the relationships between exposure to life-course traumatic events (TEs) and later life mental, physical, and cognitive health outcomes in the older population of a rural South African community. Method: Data were from baseline interviews with 2,473 adults aged ≥40 years in the population-representative Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) study, conducted in 2015. We assessed exposure to 16 TEs, and used logistic regression models to estimate associations with depression, post-traumatic stress disorder (PTSD), activities of daily living disability, and cognitive impairment. Results: Participants reported an average of 5 (SD = 2.4) TEs over their lifetimes. Exposure was ubiquitous across sociodemographic and socioeconomic groups. Trauma exposure was associated with higher odds of depression, PTSD, and disability, but not with cognitive health. Discussion: Results suggest that TEs experienced in earlier life continue to reverberate today in terms of mental health and physical disability outcomes in an older population in rural South Africa.
Collapse
Affiliation(s)
| | - Sumaya Mall
- University of the Witwatersrand, Johannesburg, South Africa
| | | | - Kathy Kahn
- University of the Witwatersrand, Johannesburg, South Africa.,Umeå University, Sweden
| | - Lisa Berkman
- University of the Witwatersrand, Johannesburg, South Africa.,Harvard T.H. Chan School of Public Health, Cambridge, USA
| |
Collapse
|