Exclusive breast-feeding in the first six months: findings from a cross-sectional survey in Mulago hospital, Uganda.

Background: Improving maternal and child health, one of the key UN Sustainable Development Goals (SDGs), is a major challenge in sub-Saharan Africa. Exclusive breast-feeding contributes significantly to child survival and development, but many mothers in Africa do not exclusively breastfeed their infants. This paper reports a study in Mulago hospital in Kampala. The study aims to identify factors influencing mothers' choices of infant feeding practices. Methods: Mixed methods were used. Respondents included 362 lactating mothers and health workers. Participants were who came for treatment were selected using simple random sampling. EpiInfor and SPSS were used for analysing the data and presented as descriptive study. Results: Results indicate that socio-demographic factors including age and education level influence mothers' ability and willingness to breastfeed exclusively for the first six months. Awareness about breast-feeding was mainly obtained from health centres, leaving mothers unable to attend these centres to miss out on vital information about exclusive breast-feeding. Around 43% of health workers were unaware of the country's Young and Infant Feeding Policy Guidelines. Conclusions: To increase the rate of exclusive breast-feeding in Uganda, it is important that community health is strengthened, and health workers are trained on national breast-feeding policies.

Experiences of Work-Related Stress Among Female Healthcare Workers During the COVID-19 Public Health Emergency: A Qualitative Study in the United Arab of Emirates.

Objective: Frontline healthcare workers experienced high levels of psychological distress and emotional turmoil due to the changes necessitated by the COVID-19 public health emergency. Given that workplace stress can negatively influence both quality of work, and job performance, this study sought to explore the lived experiences of work-related stress among female healthcare workers in United Arab of Emirates during the COVID-19 pandemic. Methods: A qualitative phenomenological investigation was performed using a purposive sampling approach. A total of 26 semi-structured interviews were conducted with female healthcare workers who worked directly with COVID-19 patients. Using Giorgi's descriptive method, the data were analyzed to identify the main themes. Results: Three main themes emerged from the data analysis, with nine categories under these themes. The first theme was "sources of work-related stress." The participants reported a high workload, fear of being infected and transmitting the virus to others, and uncertainty and lack of knowledge regarding COVID-19 to be the main sources of their work-related stress. The second theme was "challenges of working during the pandemic." The participants related being challenged by changes in the organization of care, the need to use personal protective equipment, a work-life imbalance, and witnessing patients' suffering. The third theme was "coping strategies." The participants perceived having sources of social support and using self-adjustment skills to be helpful strategies in terms of coping with the stressful situations they experienced. Conclusion: The findings suggest a number of strategies and interventions that could be used at the individual and institutional levels to promote the preparedness and efficacy of healthcare workers during future crises and public health emergencies.

Determinants predicting the electronic medical record adoption in healthcare: A SEM-Artificial Neural Network approach.

An Electronic Medical Record (EMR) has the capability of promoting knowledge and awareness regarding healthcare in both healthcare providers and patients to enhance interconnectivity within various government bodies, and quality healthcare services. This study aims at investigating aspects that predict and explain an EMR system adoption in the healthcare system in the UAE through an integrated approach of the Unified Theory of Acceptance and Use of Technology (UTAUT), and Technology Acceptance Model (TAM) using various external factors. The collection of data was through a cross-section design and survey questionnaires as the tool for data collection among 259 participants from 15 healthcare facilities in Dubai. The study further utilised the Artificial Neural Networks (ANN) algorithm and the Partial Least Squares Structural Equation Modeling (PLS-SEM) in the analysis of the data collected. The study's data proved that the intention of using an EMR system was the most influential and predictor of the actual use of the system. It was also found that TAM construct was directly influenced by anxiety, innovativeness, self-efficacy, and trust. The behavioural intention of an individual regarding EMR was also proved to positively influence the use of an EMR system. This study proves to be useful practically by providing healthcare decision-makers with a guide on factors to consider and what to avoid when implementing strategies and policies.

Achieving Sustainable Development Goals (SDGs) in Sub-Saharan Africa (SSA): A Conceptual Review of Normative Economics Frameworks.

Background: The health status of the Sub-Saharan African (SSA) countries is well below that of the rest of the world. Coupled with low per capita income, these countries have agreed and committed themselves to raising their health status equitable standard by addressing United Nations (UN) Sustainability Development Goal number 3 (SDG3) by 2030. Addressing SDG3 requires increased and equitable funding for universal health coverage, healthcare infrastructure, efficient resource allocation, improved priority setting, reduction in corruption, and other strategies. However, what is urgently needed to improve priority setting processes or meaningful health system reform, among other things. There is therefore a need for the exploration of the economic and non-economic (which includes social justice) explicit criteria that ought to form the normative framework for Decision Making. These explicit criteria include efficiency, burden of disease, equality (strict egalitarianism), equity, and explicit criteria. Methods: The ultimate aim was to identify explicit values/principles/criteria that can be used to formulate an ideal normative framework to be used to guide decision Making so as to improve SDG3 in SSA. We synthesized selected literature on the normative frameworks for priority setting processes in health in SSA was undertaken, and the explicit criteria which, ought to guide these frameworks were identified. The form of the Social Welfare function and its principles was identified. Results and Conclusions: The framework and its explicit criteria for priority setting in the SSA countries that ought to be adopted in order to improve their SDG3 was identified-Non-Welfarist framework. This framework allows utility, health and other important social values/attributes/principles to enter the normative SWF. It is argued that such a framework ought to be specified empirically and concurrently by the decision-makers and members of the community representatives. Community representatives ought to be recognized as legitimate claimants of the resources determined, and should therefore be allowed to have a role in specifying the arguments in the SWF and what weights to be attached to the stated arguments. This implies that the selection of options in decision-making should focus on maximizing benefit and minimizing the opportunities forgone as stated in the framework.

Setting Priorities in Childhood Cancer in Low Income Countries Using Nominal Group Technique: Experience from an International Childhood Cancer Forum Exercise in Bangladesh

Background and Objectives: Cancer is one of the major causes of mortality and morbidity worldwide. The incidence of paediatric cancer in particular, in Bangladesh is alarming and most of these patients die without correct diagnosis and adequate medical treatment (MOHFW, 2008). There is a clear disparity in access to care between rural and urban areas (WHO, 2015; Rahman, 2001). There are no established formal childhood cancer registry systems to help inform planning decisions across the country. Most importantly, there are no explicit priorities or methods for identifying such priorities in Low and Middle Income Countries (LMICs). We used a Nominal Group Technique (NGT) method during the International Childhood Cancer Forum (ICCF) for setting priorities. The following two key objectives were addressed: Trialling the NGT in Bangladesh as a priority setting tool; and identify childhood cancer priorities in Bangladesh. Methods: The Nominal Group Techniques (NGT) method was used to elicit information from the participants of ICCF to identify priorities for research and interventions for childhood cancer care in Bangladesh. Participants were divided into four groups. Each group discussed one question each. Two questions focused on cancer research, and the other two focused on interventions. Results: In regards to outcomes, NGT successfully identified the scale of childhood cancer care and identified priorities/action areas to address in Bangladesh. Six priorities were identified and a successful collaboration for implementation has been established with several international organisations. Conclusion: Nominal group technique was found to be an effective tool to identify research and intervention priorities to address childhood cancer in a developing country. For resource limited countries in similar situations, they could benefit from adopting this approach in healthcare settings.