Browsing by Author "Kiplagat, Jepchirchir"

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    A Global Health Reciprocal Innovation grant programme: 5-year review with lessons learnt
    (BMJ Publishing, 2023) Ruhl, Laura J.; Kiplagat, Jepchirchir; O'Brien, Rishika; Wools-Kaloustian, Kara; Scanlon, Michael; Plater, David; Thomas, Melissa R.; Pastakia, Sonak; Gopal-Srivastava, Rashmi; Morales-Soto, Nydia; Nyandiko, Winstone; Vreeman, Rachel C.; Litzelman, Debra K.; Laktabai, Jeremiah; Medicine, School of Medicine
    Unilateral approaches to global health innovations can be transformed into cocreative, uniquely collaborative relationships between low-income and middle-income countries (LMICs) and high-income countries (HIC), constituted as 'reciprocal innovation' (RI). Since 2018, the Indiana Clinical and Translational Sciences Institute (CTSI) and Indiana University (IU) Center for Global Health Equity have led a grants programme sculpted from the core elements of RI, a concept informed by a 30-year partnership started between IU (Indiana) and Moi University (Kenya), which leverages knowledge sharing, transformational learning and translational innovations to address shared health challenges. In this paper, we describe the evolution and implementation of an RI grants programme, as well as the challenges faced. We aim to share the successes of our RI engagement and encourage further funding opportunities to promote innovations grounded in the RI core elements. From the complex series of challenges encountered, three major lessons have been learnt: dedicating extensive time and resources to bring different settings together; establishing local linkages across investigators; and addressing longstanding inequities in global health research. We describe our efforts to address these challenges through educational materials and an online library of resources for RI projects. Using perspectives from RI investigators funded by this programme, we offer future directions resulting from our 5-year experience in applying this RI-focused approach. As the understanding and implementation of RI grow, global health investigators can share resources, knowledge and innovations that have the potential to significantly change the face of collaborative international research and address long-standing health inequities across diverse settings.
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    Assessing the impact of a primary care electronic medical record system in three Kenyan rural health centers
    (Oxford University Press, 2016-05) Tierney, William M.; Sidle, John E.; Diero, Lameck O.; Sudoi, Allan; Kiplagat, Jepchirchir; Macharia, Stephen; Shen, Changyu; Yeung, Ada; Were, Martin C.; Slaven, James E.; Wools-Kaloustian, Kara; Medicine, School of Medicine
    Objective: Efficient, effective health care requires rapid availability of patient information. We designed, implemented, and assessed the impact of a primary care electronic medical record (EMR) in three rural Kenyan health centers. Method: Local clinicians identified data required for primary care and public health reporting. We designed paper encounter forms to capture these data in adult medicine, pediatric, and antenatal clinics. Encounter form data were hand-entered into a new primary care module in an existing EMR serving onsite clinics serving patients infected with the human immunodeficiency virus (HIV). Before subsequent visits, Summary Reports were printed containing selected patient data with reminders for needed HIV care. We assessed effects on patient flow and provider work with time-motion studies before implementation and two years later, and we surveyed providers' satisfaction with the EMR. Results: Between September 2008 and December 2011, 72 635 primary care patients were registered and 114 480 encounter forms were completed. During 2011, 32 193 unique patients visited primary care clinics, and encounter forms were completed for all visits. Of 1031 (3.2%) who were HIV-infected, 85% received HIV care. Patient clinic time increased from 37 to 81 min/visit after EMR implementation in one health center and 56 to 106 min/visit in the other. However, outpatient visits to both health centers increased by 85%. Three-quarters of increased time was spent waiting. Despite nearly doubling visits, there was no change in clinical officers' work patterns, but the nurses' and the clerks' patient care time decreased after EMR implementation. Providers were generally satisfied with the EMR but desired additional training. Conclusions: We successfully implemented a primary care EMR in three rural Kenyan health centers. Patient waiting time was dramatically lengthened while the nurses' and the clerks' patient care time decreased. Long-term use of EMRs in such settings will require changes in culture and workflow.
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    Reciprocal innovation: A new approach to equitable and mutually beneficial global health partnerships
    (Taylor & Francis, 2023) Sors, Thomas G.; O’Brien, Rishika Chauhan; Scanlon, Michael L.; Bermel, Li Yuan; Chikowe, Ibrahim; Gardner, Adrian; Kiplagat, Jepchirchir; Lieberman, Marya; Moe, Sharon M.; Morales-Soto, Nydia; Nyandiko, Winstone M.; Plater, David; Rono, Betsy Cheriro; Tierney, William M.; Vreeman, Rachel C.; Wiehe, Sarah E.; Wools-Kaloustian, Kara; Litzelman, Debra K.; Medicine, School of Medicine
    Global health researchers often discount mutual learning and benefit to address shared health challenges across high and low- and middle-income settings. Drawing from a 30-year partnership called AMPATH that started between Indiana University in the US and Moi University in Kenya, we describe an innovative approach and program for mutual learning and benefit coined ‘reciprocal innovation.’ Reciprocal innovation harnesses a bidirectional, co-constituted, and iterative exchange of ideas, resources, and innovations to address shared health challenges across diverse global settings. The success of AMPATH in Kenya, particularly in HIV/AIDS and community health, resulted in several innovations being ‘brought back’ to the US. To promote the bidirectional flow of learning and innovations, the Indiana CTSI reciprocal innovation program hosts annual meetings of multinational researchers and practitioners to identify shared health challenges, support pilot grants for projects with reciprocal exchange and benefit, and produce educational materials to train investigators. The transformative power of global health to address systemic health inequities embraces equitable and reciprocal partnerships with mutual benefit across countries and communities of academics, practitioners, and policymakers. Leveraging a long-standing partnership, the Indiana CTSI has built a reciprocal innovation program with promise to redefine global health for shared wellbeing at a global scale.