Development and Initial Validation of a Frontline Health Worker mHealth Assessment Platform (MEDSINC®) for Children 2-60 Months of Age.

Approximately 3 million children younger than 5 years living in low- and middle-income countries (LMICs) die each year from treatable clinical conditions such as pneumonia, dehydration secondary to diarrhea, and malaria. A majority of these deaths could be prevented with early clinical assessments and appropriate therapeutic intervention. In this study, we describe the development and initial validation testing of a mobile health (mHealth) platform, MEDSINC®, designed for frontline health workers (FLWs) to perform clinical risk assessments of children aged 2-60 months. MEDSINC is a web browser-based clinical severity assessment, triage, treatment, and follow-up recommendation platform developed with physician-based Bayesian pattern recognition logic. Initial validation, usability, and acceptability testing were performed on 861 children aged between 2 and 60 months by 49 FLWs in Burkina Faso, Ecuador, and Bangladesh. MEDSINC-based clinical assessments by FLWs were independently and blindly correlated with clinical assessments by 22 local health-care professionals (LHPs). Results demonstrate that clinical assessments by FLWs using MEDSINC had a specificity correlation between 84% and 99% to LHPs, except for two outlier assessments (63% and 75%) at one study site, in which local survey prevalence data indicated that MEDSINC outperformed LHPs. In addition, MEDSINC triage recommendation distributions were highly correlated with those of LHPs, whereas usability and feasibility responses from LHP/FLW were collectively positive for ease of use, learning, and job performance. These results indicate that the MEDSINC platform could significantly increase pediatric health-care capacity in LMICs by improving FLWs' ability to accurately assess health status and triage of children, facilitating early life-saving therapeutic interventions.

Experience on the management of the first imported Ebola virus disease case in Senegal.

The Ebola virus disease, as a first epidemic in West Africa, stands as the most deadly one throughout history. Guinea, the source of the epidemic, Sierra Leone and Liberia remain the most strongly affected. That epidemic thoroughly destabilized the health system of those countries. Following Nigeria, Senegal received its first imported case from the neighboring Republic of Guinea. In that sub regional psychotic context, such a situation has been handled and managed starting from the potential of a health system that is already suitably structured. The organization of the response, the management of the communication system and the rigorous monitoring of contacts have been decisive in the control of the epidemic. Our countries have to be prepared in order to face health threats, and that is the reason why the need to empower our health systems is important.

[Needs assessment for continuing education and health promotion training for Senegalese chief nurses]. / Etude des besoins de formation continue en promotion de la santé pour les infirmières et infirmiers chefs de postes de santé (ICP) au Sénégal.

This study, whose purpose is to contribute to improving chief nurses' (ICP, French acronym) performance and practice in the realm of health promotion, was conducted in the medical region of Kaolak in Senegal. The objective is to identify the needs for ICP's continuing education and health promotion training and to delineate their priorities. This is a descriptive study characterised by a combined methodology which integrates a qualitative phase and a quantitative phase, in which six continuing education and training experts and 74 ICPs working in the region participated respectively. The method initially allowed the team to identify what are in theory the different types of health promotion skills that ICPs have, to validate this typology and it's contents through an expert panel and to adjust this to the practice of nursing at the community level in the Senegalese national context. Second, the range of training needs were measured by the ICPs and the classification of abilities was established in order of priority. This study allows for a comprehensive and detailed listing of needs for continuing education and training among Senegalese ICPs based on consensus on what their abilities are. The study also suggests that nurses' initial education and training be adapted and continuing education and training be established.