Interprofessional Health Care Leadership
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- ItemOpen AccessCollaborative capacity and structural features that enable team effectiveness: Perceptions of health care workers in Malawi(Kamuzu University of Health Sciences, 2021-08-01) Soko, Tulipoka Nellieresearch in acute health care settings has shown that Collaborative Capacity can be improved by the way an organization supports its staff. Lack of Collaborative Capacity results in fragmented health services which do not meet the multiple, complex condition, and needs of the patients. This study, therefore, investigated the perceptions of health care workers on the relationship between Collaborative Capacity and Structural Features that Enable Team Effectiveness, Leadership, and Patient-Centered Care in Blantyre, Malawi. The study employed a quantitative descriptive cross-sectional design. We adapted the Care Coordination survey and administered it to health care workers. Descriptive statistics, as well as univariate and multivariate analysis, were computed. The level of significance was set at p=.05. Analysis of Variance and the Kruskal-Wallis test were used to test differences in the mean ranks among variables. A total of 384 health care workers participated in the study by completing the Care Coordination Survey, resulting in a response rate of 100%. Collaboration Capacity differed significantly across Cadres/Roles. Health care workers had different Perceptions regarding Collaborative Capacity, Structural Features that Enable Team Effectiveness, Leadership and Patient-Centered Care. Health care workers’ Perceptions of Collaborative Capacity were positively associated with supportive organizational context and Patient-Centered Care. This study has established that Collaborative Capacity was positively associated with Communication and Information Technology, Staffing and Resources, Supervisory Support and Patient-Centered Care.
- ItemOpen AccessDeterminants of care for maternal near-miss cases at Kamuzu and Queen Elizabeth Central Hospitals in Malawi(Kamuzu University of Health Sciences, 2021-08-01) Somanje Kachale, FannieMaternal near-miss cases which are more frequent than maternal deaths can lead to more robust conclusions on problems and obstacles that have to be overcome during the process of maternal health care. In Malawi, there is little information on the circumstances surrounding maternal near-misses. The aim of the study was to describe determinants of care for maternal near-miss cases at Kamuzu and Queen Elizabeth Central Hospitals in Malawi. This study used a mixed methods approach to collect data on determinants of care for maternal near-miss cases at Kamuzu and Queen Elizabeth Central hospitals in Malawi. This was a convergent design in which both quantitative and qualitative data were collected simultaneously from February to July 2017. Quantitative and qualitative data were integrated through merging the two data sets with an aim to balance the respective strengths and weaknesses as well as maximizing the yield of the complementary sources of evidence. This study has found that the magnitude of maternal near-miss in the local setting is very high (35.1%, n=161). The demographic characteristics that were significantly linked to maternal near-misses in the local setting are marital status, occupation, admission mode, means of transport and age. The obstetric characteristics that were significantly associated with maternal near-miss were fetal presentation, mode of birth, birth status and child sex. However, age and mode of birth were strong determinants of maternal near-miss. Women aged 31-35 years had significantly 4 chances of experiencing maternal near-miss. Women who had laparotomy for uterine rupture had 83 chances of being a maternal near-miss case while those who had emergency caesarean had 4 times chances compared with those who had a vaginal birth. Using the adapted World Health Organization Quality of Care Assessment tool, the quality of care offered to women was found to be below standard and this was corroborated by reports from midwives who stated that some patients were not checked blood pressure, emergency care was not performed within 30 minutes of diagnosis, no handovers were made when transferring patients from theatre to postnatal ward. The magnitude of maternal near-miss was very high compared to other parts of Africa and numerous preventable determinant factors were identified. In addition, the quality of care provided to maternal near-miss cases was below standard. It is essential that Malawi should include maternal near-miss ratio as an indicator for evaluating its maternal health services.
- ItemOpen AccessReadiness for interprofessional education for health professionals: Perspectives of Faculty in the University of Malawi(Kamuzu University of Health Sciences, 2021-08-01) Chitsulo, Caroline GullianThis was a qualitative, exploratory, descriptive study, whose purpose was to explore faculty perspectives on readiness for interprofessional education (IPE) in the training of undergraduate health professionals at Kamuzu College of Nursing (KCN) and College of Medicine (COM), University of Malawi. Maximum variation sampling, a type of purposive sampling, was used to obtain heterogeneity in the sample, and to gain an understanding of how readiness for IPE was perceived and understood among different faculty members from the nursing, midwifery, medicine, and pharmacy programs at KCN and COM. The sample included 36 faculty members, heads of departments, and deans. Face-to-face, in-depth interviews and focus group discussions were conducted using semi-structured interview guides. Data analysis was done using content analysis. Findings revealed the following key themes: perceptions of IPE; perceived readiness characteristics for IPE; perceived needed skills for IPE; and proposed strategies for implementing IPE. Generally, participants expressed a positive attitude towards IPE and various forms of understanding of the concept of IPE. Additionally, IPE benefits and challenges related to IPE implementation were perceived. Most participants perceived themselves to be ready for IPE. However, differences emerged regarding institutional readiness for IPE. Participants perceived that institutions were ready in some areas, but not in others. The study also identified skills perceived needed for successful IPE implementation, with strategies for successful implementation being proposed. Even though the study revealed that most faculty members had a positive attitude toward IPE and that participants felt ready for IPE (self-perceived), the need for adequate preparation for IPE implementation was emphasized. It is therefore recommended that faculty development programs for IPE should be put in place before IPE can be implemented effectively. It is also important to obtain the views of key stakeholders about IPE.