Table S1. Systematic human error reduction and prediction approach (SHERPA) table of selected tas... more Table S1. Systematic human error reduction and prediction approach (SHERPA) table of selected tasks assigned medium probability and criticality levels showing risks and supervision levels as reported by subject matter experts. (PDF 177 kb)
Figure S1. Color coded NGT feeding HTA for missed task steps showing distribution of consensus am... more Figure S1. Color coded NGT feeding HTA for missed task steps showing distribution of consensus among the SMEs for the tasks reported as often missed. (PNG 274 kb)
Table S2. Systematic human error reduction and prediction approach analysis table of the 47-nasog... more Table S2. Systematic human error reduction and prediction approach analysis table of the 47-nasogastric tube feeding tasks. (PDF 304 kb)
Data describing the use of Ergonomics methods in eliciting quality and safety issues during task ... more Data describing the use of Ergonomics methods in eliciting quality and safety issues during task sharing in selected neonatal settings in Kenyan neonatal inpatient settings. This is part of the larger work carried out by the Health Services that Deliver for Newborns (HSD-N) projec
HIV self-testing practices among Health Care Workers: feasibility and options for accelerating HI... more HIV self-testing practices among Health Care Workers: feasibility and options for accelerating HIV testing services in Ethiopia
For development of any country the role of women education is the crucial one, especially for thi... more For development of any country the role of women education is the crucial one, especially for third world countries like Ethiopia. Thus, the main purpose of this study is to examine the impact of women education on economic development in Ethiopia. To conduct this study the data was collected from secondary sources. These secondary data includes different records on women education from different books and some published materials. On the collected data, descriptive analysis such as percentage, tables and ratios were carried out to come up with major findings. In the analysis part different variables to measure enrollment rate at different levels of education like: Gross Enrolment Rate (GER), Net Enrollment rate (NER), Apparent Intake rate (AIR) and Gross party index (GPI) were used. Based on the results the study reached into conclusion that educating women has a positive impact on economic development even if girls were always been in a disadvantageous position in terms of access...
Background: 45% of all child deaths in Kenya are attributed to neonatal mortality. The high depen... more Background: 45% of all child deaths in Kenya are attributed to neonatal mortality. The high dependency of sick newborns on skilled care calls for the availability of a reliable and adequate nursing workforce. However, this is often not the case in Kenya, the nursing workforce is faced with acute shortage challenges making provision of quality care difficult. Innovative means of maximising existing workforce’s potential to enable provision of quality care to sick newborns such as task shifting have shown some potential. Defining roles, functions and limitations are imperative for task shifting to be effective. Task analysis, as an ergonomics method, can be used to describe tasks currently done by nurses. Objectives: This study aimed to use Hierarchical Task Analysis (HTA) in describing selected shared nursing tasks and to identify where potential errors may occur using Systematic Human Error Reduction and Prediction Approach (SHERPA). Approach: In liaison with the Ministry of Health,...
Submitted in partial fulfillment of the requirements for the Degree of Masters of Science in Mobi... more Submitted in partial fulfillment of the requirements for the Degree of Masters of Science in Mobile Telecommunication Innovation
Neonatal mortality currently accounts for 22 deaths out of 1,000 live births in Kenya, making up ... more Neonatal mortality currently accounts for 22 deaths out of 1,000 live births in Kenya, making up nearly half of all child mortality in the country (Murphy, Gathara, et al., 2018). Thus, reducing neonatal mortality is a key policy concern in Kenya in line with meeting the third Sustainable Development Goal (SDG) (Gathara et al., 2018). To achieve this, high-quality care for sick and hospitalized babies is imperative. For highly dependent populations, the high quality of care needed is labour intensive and requires appropriate and adequate skilled nurse staffing (Murphy, Gathara, et al., 2018). Unfortunately, there are major nursing workforce deficits in Kenyan facilities and while addressing these can be expensive and challenging (Aiken et al., 2017; Wakaba et al., 2014), changes in how care is organized and delivered could reduce avoidable neonatal deaths
Neonatal mortality currently accounts for 45% of all child mortality in Kenya, standing at 22 per... more Neonatal mortality currently accounts for 45% of all child mortality in Kenya, standing at 22 per 1000 live births. Access to basic but high quality inpatient neonatal services for small and sick newborns will be key in reducing neonatal mortality. Neonatal inpatient care is reliant on nursing care, yet explicit nursing standards for such care do not currently exist in Kenya. We reviewed the Nursing Council of Kenya 'Manual of Clinical Procedures' to identify tasks relevant for the care of inpatient neonates. An expert advisory group comprising major stakeholders, policy-makers, trainers, and frontline health-workers was invited to a workshop with the purpose of defining tasks for which nurses are responsible and the minimum standard with which these tasks should be delivered to inpatient neonates in Kenyan hospitals. Despite differences in opinions at the beginning of the process, consensus was reached on the minimum standards of neonatal nursing. The key outcome was a comp...
This article investigates how international donor policies cultivate a form of biological sub-cit... more This article investigates how international donor policies cultivate a form of biological sub-citizenship for those with diabetes in Kenya. We interviewed 100 patients at a public hospital clinic in Nairobi, half with a diabetes diagnosis. We focus on three vignettes that illustrate how our study participants differentially perceived and experienced living with and seeking treatment and care for diabetes compared to other conditions, with a special focus on HIV. We argue that biological sub-citizenship, where those with HIV have consistent and comprehensive free medical care and those with diabetes must pay out-of-pocket for testing and treatment, impedes diabetes testing and treatment. Once diagnosed, many are then systematically excluded from the health care system due to their own inability to pay. We argue that the systematic exclusion from international donor money creates a form of biological sub-citizenship based on neoliberal economic policies that undermine other public hea...
The complexity of sickness among Kenya's urban poor cannot be dissociated from how social and... more The complexity of sickness among Kenya's urban poor cannot be dissociated from how social and health problems become syndemic. Increasingly diabetes and other non-communicable diseases (NCDs) are emerging among low-income populations that also are most afflicted by social stress and infection. This article examines how social stress, psychological distress, and physical illness among patients in a public hospital in Nairobi, Kenya, produce syndemic suffering, defined by lived experiences of syndemic clustering such as diabetes with depression and infection. We recruited 100 urban public hospital patients, of which half were women, and half had type 2 diabetes from June to August 2014. We administered written informed consent and collected anthropometrics and blood samples before we conducted lengthy mixed qualitative and survey interviews. We analyzed social stress in narrative interviews using content analysis and evaluated social and physical contributors to mental distress wi...
Background: Sharing tasks with lower cadre workers may help ease the burden of work on the constr... more Background: Sharing tasks with lower cadre workers may help ease the burden of work on the constrained nursing workforce in low-and middle-income countries but the quality and safety issues associated with shifting tasks are rarely critically evaluated. This research explored this gap using a Human Factors and Ergonomics (HFE) method as a novel approach to address this gap and inform task sharing policies in neonatal care settings in Kenya. Methods: We used Hierarchical Task Analysis (HTA) and the Systematic Human Error Reduction and Prediction Approach (SHERPA) to analyse and identify the nature and significance of potential errors of nasogastric tube (NGT) feeding in a neonatal setting and to gain a preliminary understanding of informal task sharing. Results: A total of 47 end tasks were identified from the HTA. Sharing, supervision and risk levels of these tasks reported by subject matter experts (SMEs) varied broadly. More than half of the tasks (58.3%) were shared with mothers, of these, 31.7% (13/41) and 68.3% were assigned a medium and low level of risk by the majority (≥4) of SMEs respectively. Few tasks were reported as 'often missed' by the majority of SMEs. SHERPA analysis suggested omission was the commonest type of error, however, due to the low risk nature, omission would potentially result in minor consequences. Training and provision of checklists for NGT feeding were the key approaches for remedying most errors. By extension these strategies could support safer task shifting. Conclusion: Inclusion of mothers and casual workers in care provided to sick infants is reported by SMEs in the Kenyan neonatal settings. Ergonomics methods proved useful in working with Kenyan SMEs to identify possible errors and the training and supervision needs for safer task-sharing.
Table S1. Systematic human error reduction and prediction approach (SHERPA) table of selected tas... more Table S1. Systematic human error reduction and prediction approach (SHERPA) table of selected tasks assigned medium probability and criticality levels showing risks and supervision levels as reported by subject matter experts. (PDF 177 kb)
Figure S1. Color coded NGT feeding HTA for missed task steps showing distribution of consensus am... more Figure S1. Color coded NGT feeding HTA for missed task steps showing distribution of consensus among the SMEs for the tasks reported as often missed. (PNG 274 kb)
Table S2. Systematic human error reduction and prediction approach analysis table of the 47-nasog... more Table S2. Systematic human error reduction and prediction approach analysis table of the 47-nasogastric tube feeding tasks. (PDF 304 kb)
Data describing the use of Ergonomics methods in eliciting quality and safety issues during task ... more Data describing the use of Ergonomics methods in eliciting quality and safety issues during task sharing in selected neonatal settings in Kenyan neonatal inpatient settings. This is part of the larger work carried out by the Health Services that Deliver for Newborns (HSD-N) projec
HIV self-testing practices among Health Care Workers: feasibility and options for accelerating HI... more HIV self-testing practices among Health Care Workers: feasibility and options for accelerating HIV testing services in Ethiopia
For development of any country the role of women education is the crucial one, especially for thi... more For development of any country the role of women education is the crucial one, especially for third world countries like Ethiopia. Thus, the main purpose of this study is to examine the impact of women education on economic development in Ethiopia. To conduct this study the data was collected from secondary sources. These secondary data includes different records on women education from different books and some published materials. On the collected data, descriptive analysis such as percentage, tables and ratios were carried out to come up with major findings. In the analysis part different variables to measure enrollment rate at different levels of education like: Gross Enrolment Rate (GER), Net Enrollment rate (NER), Apparent Intake rate (AIR) and Gross party index (GPI) were used. Based on the results the study reached into conclusion that educating women has a positive impact on economic development even if girls were always been in a disadvantageous position in terms of access...
Background: 45% of all child deaths in Kenya are attributed to neonatal mortality. The high depen... more Background: 45% of all child deaths in Kenya are attributed to neonatal mortality. The high dependency of sick newborns on skilled care calls for the availability of a reliable and adequate nursing workforce. However, this is often not the case in Kenya, the nursing workforce is faced with acute shortage challenges making provision of quality care difficult. Innovative means of maximising existing workforce’s potential to enable provision of quality care to sick newborns such as task shifting have shown some potential. Defining roles, functions and limitations are imperative for task shifting to be effective. Task analysis, as an ergonomics method, can be used to describe tasks currently done by nurses. Objectives: This study aimed to use Hierarchical Task Analysis (HTA) in describing selected shared nursing tasks and to identify where potential errors may occur using Systematic Human Error Reduction and Prediction Approach (SHERPA). Approach: In liaison with the Ministry of Health,...
Submitted in partial fulfillment of the requirements for the Degree of Masters of Science in Mobi... more Submitted in partial fulfillment of the requirements for the Degree of Masters of Science in Mobile Telecommunication Innovation
Neonatal mortality currently accounts for 22 deaths out of 1,000 live births in Kenya, making up ... more Neonatal mortality currently accounts for 22 deaths out of 1,000 live births in Kenya, making up nearly half of all child mortality in the country (Murphy, Gathara, et al., 2018). Thus, reducing neonatal mortality is a key policy concern in Kenya in line with meeting the third Sustainable Development Goal (SDG) (Gathara et al., 2018). To achieve this, high-quality care for sick and hospitalized babies is imperative. For highly dependent populations, the high quality of care needed is labour intensive and requires appropriate and adequate skilled nurse staffing (Murphy, Gathara, et al., 2018). Unfortunately, there are major nursing workforce deficits in Kenyan facilities and while addressing these can be expensive and challenging (Aiken et al., 2017; Wakaba et al., 2014), changes in how care is organized and delivered could reduce avoidable neonatal deaths
Neonatal mortality currently accounts for 45% of all child mortality in Kenya, standing at 22 per... more Neonatal mortality currently accounts for 45% of all child mortality in Kenya, standing at 22 per 1000 live births. Access to basic but high quality inpatient neonatal services for small and sick newborns will be key in reducing neonatal mortality. Neonatal inpatient care is reliant on nursing care, yet explicit nursing standards for such care do not currently exist in Kenya. We reviewed the Nursing Council of Kenya 'Manual of Clinical Procedures' to identify tasks relevant for the care of inpatient neonates. An expert advisory group comprising major stakeholders, policy-makers, trainers, and frontline health-workers was invited to a workshop with the purpose of defining tasks for which nurses are responsible and the minimum standard with which these tasks should be delivered to inpatient neonates in Kenyan hospitals. Despite differences in opinions at the beginning of the process, consensus was reached on the minimum standards of neonatal nursing. The key outcome was a comp...
This article investigates how international donor policies cultivate a form of biological sub-cit... more This article investigates how international donor policies cultivate a form of biological sub-citizenship for those with diabetes in Kenya. We interviewed 100 patients at a public hospital clinic in Nairobi, half with a diabetes diagnosis. We focus on three vignettes that illustrate how our study participants differentially perceived and experienced living with and seeking treatment and care for diabetes compared to other conditions, with a special focus on HIV. We argue that biological sub-citizenship, where those with HIV have consistent and comprehensive free medical care and those with diabetes must pay out-of-pocket for testing and treatment, impedes diabetes testing and treatment. Once diagnosed, many are then systematically excluded from the health care system due to their own inability to pay. We argue that the systematic exclusion from international donor money creates a form of biological sub-citizenship based on neoliberal economic policies that undermine other public hea...
The complexity of sickness among Kenya's urban poor cannot be dissociated from how social and... more The complexity of sickness among Kenya's urban poor cannot be dissociated from how social and health problems become syndemic. Increasingly diabetes and other non-communicable diseases (NCDs) are emerging among low-income populations that also are most afflicted by social stress and infection. This article examines how social stress, psychological distress, and physical illness among patients in a public hospital in Nairobi, Kenya, produce syndemic suffering, defined by lived experiences of syndemic clustering such as diabetes with depression and infection. We recruited 100 urban public hospital patients, of which half were women, and half had type 2 diabetes from June to August 2014. We administered written informed consent and collected anthropometrics and blood samples before we conducted lengthy mixed qualitative and survey interviews. We analyzed social stress in narrative interviews using content analysis and evaluated social and physical contributors to mental distress wi...
Background: Sharing tasks with lower cadre workers may help ease the burden of work on the constr... more Background: Sharing tasks with lower cadre workers may help ease the burden of work on the constrained nursing workforce in low-and middle-income countries but the quality and safety issues associated with shifting tasks are rarely critically evaluated. This research explored this gap using a Human Factors and Ergonomics (HFE) method as a novel approach to address this gap and inform task sharing policies in neonatal care settings in Kenya. Methods: We used Hierarchical Task Analysis (HTA) and the Systematic Human Error Reduction and Prediction Approach (SHERPA) to analyse and identify the nature and significance of potential errors of nasogastric tube (NGT) feeding in a neonatal setting and to gain a preliminary understanding of informal task sharing. Results: A total of 47 end tasks were identified from the HTA. Sharing, supervision and risk levels of these tasks reported by subject matter experts (SMEs) varied broadly. More than half of the tasks (58.3%) were shared with mothers, of these, 31.7% (13/41) and 68.3% were assigned a medium and low level of risk by the majority (≥4) of SMEs respectively. Few tasks were reported as 'often missed' by the majority of SMEs. SHERPA analysis suggested omission was the commonest type of error, however, due to the low risk nature, omission would potentially result in minor consequences. Training and provision of checklists for NGT feeding were the key approaches for remedying most errors. By extension these strategies could support safer task shifting. Conclusion: Inclusion of mothers and casual workers in care provided to sick infants is reported by SMEs in the Kenyan neonatal settings. Ergonomics methods proved useful in working with Kenyan SMEs to identify possible errors and the training and supervision needs for safer task-sharing.
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