Browsing by Subject "LMICs"

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    Perceptions of Global Health Engagements in Relation to the COVID-19 Pandemic Among Health Care Workers and Administrators in Western Kenya: Protocol for a Multistage Qualitative Study
    (JMIR, 2023-07-19) Amick, Erick; Naanyu, Violet; Bucher, Sherri; Henry, Beverly W.; Pediatrics, School of Medicine
    Background: There has been significant interest in global health in low- and middle-income countries (LMICs) among individuals living in high-income countries (HICs) over the past 30 years. Much of the literature on global health engagements (GHEs) has been presented from the perspective of individuals from high-income countries. Local stakeholders such as health care workers and health care administrators represent critical constituencies for global health activities, yet their perspectives are underrepresented in the literature. The purpose of this study is to examine the experiences of local health care workers and administrators with GHEs in Kenya. We will explore the perceived role GHEs play in preparing the health system to address a public health crisis, as well as their role in pandemic recovery and its aftermath. Objective: The aims of this study are to (1) examine how Kenyan health care workers and administrators interpret experiences with GHEs as having advantaged or hindered them and the local health system to provide care during an acute public health crisis and (2) to explore recommendations to reimagine GHEs in a postpandemic Kenya. Methods: This study will be conducted at a large teaching and referral hospital in western Kenya with a long history of hosting GHEs in support of its tripartite mission of providing care, training, and research. This qualitative study will be conducted in 3 phases. In phase 1, in-depth interviews will be conducted to capture participants' lived experience in relation to their unique understandings of the pandemic, GHEs, and the local health system. In phase 2, group discussions using nominal group techniques will be conducted to determine potential priority areas to reimagine future GHEs. In phase 3, in-depth interviews will be conducted to explore these priority areas in greater detail to explore recommendations for potential strategies, policies, and other actions that might be used to achieve the priorities determined to be of highest importance. Results: The study activities commenced in late summer 2022, with findings to be published in 2023. It is anticipated that the findings from this study will provide insight into the role GHEs play in a local health system in Kenya and provide critical stakeholder and partner input from persons hitherto ignored in the design, implementation, and management of GHEs. Conclusions: This qualitative study will examine the perspectives of GHEs in relation to the COVID-19 pandemic among Kenyan health care workers and health care administrators in western Kenya using a multistage protocol. Using a combination of in-depth interviews and nominal group techniques, this study aims to shed light on the roles global health activities are perceived to play in preparing health care professionals and the health system to address an acute public health crisis.
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    Predictors of trajectories of child neurodevelopment in the first 2 years of life in LMICs: A systematic review and meta-analysis protocol
    (Research Square, 2025-04-16) Nyakato, Mary; Nakasujja, Noeline; Idro, Richard; Akena, Dickens; Naggayi, Shubaya Kasule; Ssemata, Andrew Sentoogo; Nakitende, Anne Jacqueline; Nyangoma, Betty; Ouma, Simple; Ssenkusu, John Mbaziira; Chandy, John C.; Bangirana, Paul; Pediatrics, School of Medicine
    Background: In low-and-middle-income countries (LMICs), children are exposed to multiple risks that may compromise their neurodevelopment, especially during the early years. Early childhood developmental trajectories are crucial, especially in such at-risk populations as they help predict future neurocognitive potential. In LMICs where numerous factors shape child neurodevelopment, describing neurodevelopment trajectories and understanding the predictors that shape them is imperative for early intervention. The systematic review and meta-analysis will determine the predictors of trajectories of child neurodevelopment during the first 2 years of life in LMICs. Methods and analysis: The Preferred Reporting Items for Systematic Review and meta-analysis protocols (PRISMA-P) guidelines will be followed while performing this review. PubMed, Psych INFO, EMBASE, and Google Scholar databases and reference lists of relevant articles will be searched for articles. Selected publications will be uploaded to Endnote to remove duplicates and reviewed by title, abstract, and full text to identify those meeting the eligibility criteria. Longitudinal studies on child neurodevelopment and associated predictors among children aged ≤ 24 months in LMICs will be included. Screening, data extraction, and critical appraisal will be done by two autonomous reviewers. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) will evaluate the risk of bias and funnel plot asymmetry, publication bias. The I 2 statistics will be used to test for heterogeneity in the selected studies and STATA-18 and EPPI-reviewer software for statistical analysis. A random-effects meta-analysis will be undertaken. Discussion: The protocol describes a systematic review and meta-analysis aimed at identifying factors influencing neurodevelopment trajectories during the first 2 years of life in LMICs. The review findings may provide a comprehensive understanding of the factors that influence child neurodevelopment, particularly in the first 2 years of life in LMICs, help identify critical windows of opportunity for intervention, and potentially guide the design of age and contextually appropriate interventions for optimizing neurodevelopmental outcomes, especially in this context.