Browsing by Author "Loveday, Marian"

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    Addressing the tensions and complexities involved in commissioning and undertaking implementation research in low- and middle-income countries
    (BMJ, 2018) Doherty, Tanya; Lewin, Simon; Kinney, Mary; Sanders, David; Mathews, Cathy; Daviaud, Emmanuelle; Goga, Ameena; Bhana, Arvin; Besada, Donela; Vanleeuw, Lieve; Loveday, Marian; Odendaal, Willem; Leon, Natalie
    Rapid scale-up of new policies and guidelines, in the context of weak health systems in low/middle-income countries (LMIC), has led to greater interest and funding for implementation research. Implementation research in LMICs is often commissioned by institutions from high-income countries but increasingly undertaken by LMIC-based research institutions. Commissioned implementation research to evaluate large-scale, donor-funded health interventions in LMICs may hold tensions with respect to the interests of the researchers, the commissioning agency, implementers and the country government. We propose key questions that could help researchers navigate and minimise the potential conflicts of commissioned implementation research in an LMIC setting.
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    Approaches and strategies used in the training and supervision of Health Extension Workers (HEWs) delivering integrated community case management (iCCM) of childhood illness in Ethiopia: a qualitative rapid appraisal
    (Makerere University Medical School (Uganda), 2018) Nsibande, Duduzile; Loveday, Marian; Daniels, Karen; Sanders, David; Doherty, Tanya; Zembe, Wanga
    BACKGROUND: Globally, preventable and treatable childhood conditions such as pneumonia, diarrhoea, malaria, malnutrition and newborn conditions still account for 75% of under-five mortality. To reduce the mortality rate from these conditions, Ethiopia launched an ambitious Health Extension Programme (HEP) in 2003. Trained Community Health Workers (CHWs), named Health Extension Workers (HEWs) were deployed to deliver a package of care which includes integrated Community Case-Management (iCCM) of common childhood diseases. OBJECTIVES: This qualitative study aimed to explore approaches and strategies used in the HEW training and supervision as part of an evaluation of the Catalytic Initiative to Save a Million Lives. METHODS: A qualitative rapid appraisal study using focus group discussions and in-depth interviews was conducted. RESULTS: Training of HEWs followed a cascaded training of trainer approach supported by implementing partners under guidance of the Ministry of Health. A comprehensive planning phase enabled good coverage of districts and consistency in training approaches. Training was complemented by on-going supportive supervision. HEW motivation was enhanced through regular review meetings and opportunities for career progression. CONCLUSION: These findings describe a thorough approach to training and supervision of HEWs delivering iCCM in rural Ethiopia. Ongoing investments by partners will be critical for long-term sustainability.