Background: Haiti has experienced rapid urbanization that has exacerbated poverty and undernutrition in large slum areas. Stunting affects 1 in 5 young children.Objective: We aimed to test the ...efficacy of a daily lipid-based nutrient supplement (LNS) for increased linear growth in young children.Design: Healthy, singleton infants aged 6–11 mo (n = 589) were recruited from an urban slum of Cap Haitien and randomly assigned to receive: 1) a control; 2) a 3-mo LNS; or 3) a 6-mo LNS. The LNS provided 108 kcal and other nutrients including vitamin A, vitamin B-12, iron, and zinc at ≥80% of the recommended amounts. Infants were followed monthly on growth, morbidity, and developmental outcomes over a 6-mo intervention period and at one additional time point 6 mo postintervention to assess sustained effects. The Bonferroni multiple comparisons test was applied, and generalized least-squares (GLS) regressions with mixed effects was used to examine impacts longitudinally.Results: Baseline characteristics did not differ by trial arm except for a higher mean age in the 6-mo LNS group. GLS modeling showed LNS supplementation for 6 mo significantly increased the length-for-age z score (±SE) by 0.13 ± 0.05 and the weight-for-age z score by 0.12 ± 0.02 compared with in the control group after adjustment for child age (P < 0.001). The effects were sustained 6 mo postintervention. Morbidity and developmental outcomes did not differ by trial arm.Conclusion: A low-energy, fortified product improved the linear growth of young children in this urban setting. The trial was registered at clinicaltrials.gov as NCT01552512.
To assess the process and outcomes of the implementation of an electronic fingerprint initiative as part of quality improvement in three health facilities in the Northern Department of Haiti, in ...terms of its acceptability, adoption, feasibility, fidelity, and sustainability. In Haiti, poor attendance of the healthcare workforce is a nationwide problem, closely related to the quality of care. Three health institutions have tried to implement an electronic fingerprint system to monitor and improve attendance.
An exploratory and qualitative descriptive study of the implementation outcomes of the fingerprint initiative. It was based on semi-structured interviews and one group discussion using purposeful sampling techniques to recruit participants, and an open coding system and deductive approach to analyze the data using ATLAS.ti 8.
The fingerprint initiative was successfully implemented in a non-governmental organization supported health facility but, despite some planning, it was never implemented in the public health facilities. The acceptability of the implementation was high in the not-for-profit organization and low in the public settings, mostly in relation to the presence of champions and the leadership at each health facility.
We recommend more involvement of the leadership of health facilities in the different phases of the implementation process in order to guarantee acceptability, adoption, fidelity and sustainabiliy. More research is needed to articulate this technology-driven initiative in the Haitian health system.
ObjectiveAlthough illegal abortion is believed to be widely practised in Haiti, few data exist on such practices. We aimed to learn about illegal abortion access, methods, and perceived barriers to ...abortion-related care. Additionally, we aimed to identify the proportion of unscheduled antepartum visits to a public hospital that were attributable to unsafe abortion in Cap Haitien, Haiti.Study designWe conducted eight focus groups with women (n=62) and 13 interviews with women’s health providers and subsequently administered a survey to pregnant or recently pregnant women (20 weeks of gestation or less) presenting to the hospital from May 2013 to January 2014 (n=255).ResultsAmong the focus groups, there was widespread knowledge of misoprostol self-managed abortion. Women described use of multiple agents in combination with misoprostol. Men played key roles in abortion decision-making and in accessing misoprostol.Among the 255 pregnant or recently pregnant women surveyed, 61.2% (n=150) reported the current pregnancy was unintended and 30% (n=78) reported attempting an induced abortion. The majority of women used misoprostol either alone or as a part of the medication/herb regimen for their self-managed abortion (85.1%, n=63).ConclusionsAwareness of methods to induce abortion is high among women in urban Haiti and appears widely practised; yet knowledge of the safest self-managed abortion options remains incomplete. Access to safer abortion services could improve maternal health in Haiti.
Analyses of the present data are reported in the article “What are the characteristics of the champion that influence the implementation of quality improvement programs?” 5. Data were collected from ...April to September 2019 using a qualitative data collection tool, an interview guide (see Appendix 1). A total of 21 staff were interviewed from three different health facilities in the Northern Department of Haiti. They gave their perceptions about the qualities and the characteristics of the champions involved in the planning and implementation of quality improvement initiatives in the health facilities in order to introduce change for a better quality of care.
This data article provides an overview of the content of those interviews in terms of the characteristics of the champions.
In addition, instructions are included about the output of Atlas ti software.
You could reuse those data to get a better understanding of the quality and the characteristics of the champions that play a critical role in the implementation of quality improvement programs.
The dataset includes the following:
- Raw data: interviews transcripts
- The Atlas ti software outputs: codes and quotations
- The codebook
Improving diabetes care in Northern Haiti John T Devlin; Nancy Charles Larco; Philippe Larco ...
Global journal of medicine and public health,
02/2024, Letnik:
10, Številka:
6
Journal Article
Odprti dostop
Aims We attempted to improve clinical outcome measures (HbA1c, blood pressure, preventive foot care) in a high-risk population of diabetic patients living in Northern Haiti.
•It’s important for a champion to master those qualities in order to be successful: capacity to persuade, and a collective leadership style.•The following qualities of the champion facilitate the ...implementation of quality improvement programs: The ability to communicate and humility.•Empathy, accountability, capacity to inspire and motivate people, and vision are key ingredients for a successful champion.
Quality improvement in Healthcare is the new fashion actually. Rich countries and developing countries alike are trying to implement quality improvement initiatives to improve their performance and the quality of care. There is evidence in the scientific literature that the existence of a “champion” can play an important role in the successful implementation of quality improvement strategies. Most of the time, people get stuck at the implementation level: they know what to do but they fail to execute it in the organizational setting. That’s where a champion can be useful to facilitate the success of the change. There is a paucity of research on the link between the champion and the implementation of quality improvement programs. The aim of the study was to investigate the perceptions of stakeholders about the characteristics and qualities of the champion that could facilitate the successful implementation of quality improvement programs in health care settings in Haiti.
Twenty semi-structured individual interviews and one small group discussion (n = 4) with providers, administrators, directors, and NGO representatives were conducted during a six months period. The total sample size was twenty-four (n = 24). The methods were informed by grounded theory and the data were analyzed using the constant comparative method and thematic content analysis approach.
The analysis resulted in eleven themes describing the characteristics and qualities of a successful champion: Communication and persuasion, proactivity, humility, horizontal and collective leadership style, sense of responsibility and accountability, go-ahead type, empathy, dedication and motivation, ability to inspire and motivate people, have a vision, and encourage learning.
It is important to support and encourage champions in the health care systems in developing countries to master and exhibit those qualities and characteristics in order to lead a team for the successful implementation of quality improvement initiatives in the health facilities. More research is needed to understand how to better articulate those qualities in the context of the Haitian health care system.
The doctoral degree has traditionally been considered the path to teaching and research careers. The degree also provides a strong set of skills that can be applied in leadership roles in public, ...private, and nonprofit sectors. Numerous career options exist for public health education professionals with doctoral degrees outside of the teaching and research fields. This commentary discusses nontraditional career paths for professionals with doctoral degrees in public health. Three public health professionals describe why they chose to pursue a doctoral degree and how they applied their respective degrees to their work outside of the traditional academic and research areas.
Haiti has experienced rapid urbanization that has exacerbated poverty and undernutrition in large slum areas. Stunting affects 1 in 5 young children.
We aimed to test the efficacy of a daily ...lipid-based nutrient supplement (LNS) for increased linear growth in young children.
Healthy, singleton infants aged 6–11 mo (n = 589) were recruited from an urban slum of Cap Haitien and randomly assigned to receive: 1) a control; 2) a 3-mo LNS; or 3) a 6-mo LNS. The LNS provided 108 kcal and other nutrients including vitamin A, vitamin B-12, iron, and zinc at ≥80% of the recommended amounts. Infants were followed monthly on growth, morbidity, and developmental outcomes over a 6-mo intervention period and at one additional time point 6 mo postintervention to assess sustained effects. The Bonferroni multiple comparisons test was applied, and generalized least-squares (GLS) regressions with mixed effects was used to examine impacts longitudinally.
Baseline characteristics did not differ by trial arm except for a higher mean age in the 6-mo LNS group. GLS modeling showed LNS supplementation for 6 mo significantly increased the length-for-age z score (±SE) by 0.13 ± 0.05 and the weight-for-age z score by 0.12 ± 0.02 compared with in the control group after adjustment for child age (P < 0.001). The effects were sustained 6 mo postintervention. Morbidity and developmental outcomes did not differ by trial arm.
A low-energy, fortified product improved the linear growth of young children in this urban setting. The trial was registered at clinicaltrials.gov as NCT01552512.
This paper describes an evidence-based program plan for addressing hookworm infection in women of reproductive age; developed in response to the concern voiced by poor women in Cap Haitien, Haiti, ...that they suffer from "worms", and "low blood". A review of the literature is presented on the lifecycle and pathogenesis of hookworm, its impact on anemia status and pregnancy outcomes in women, drug efficacy and safety issues, and community-based control strategies. This review suggests that the anemia status and pregnancy outcomes of reproductive-aged women who live in areas where hookworm is highly prevalent can be improved by treating hookworm infection in the women before they enter pregnancy, and that this is best accomplished by periodically treating the entire community. This differs from the current approach of treating individual women after the first trimester of pregnancy. The approach and methodology of Community Directed Treatment (CDT), pioneered in rural settings by the African Programme for Onchocerciasis Control (APOC) in Africa, is proposed as an appropriate and cost-effective method for a community-wide anthelminthic drug distribution in the poor urban slum area of Fort St. Michel, Haiti. Specific program design issues are described, and a field guide for implementers was developed. The foundational implementation steps are discussed, as are future plans for program integration.
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