Dear people! Feedback is very important in developing a strong idea that can bring about change! Please feel free to pour out the 'kritiks' - of course we always prefer constructive feedback - but we are ready for all sorts!
You will have to create an account to give feedabck - it only takes a few moments - this is necessary for tracking and security!
Thanks people now off we go!!!!!
Dear Mbah,
I find your idea brilliant! I like this innovation for 2 things.
Firstly the patient participation; in most of Africa, patients do not have a voice and are hardly even informed about anything. this idea brings in patient and community particisption. Second, the use of district level as entry point has a higher chance of succeeding than if a central (ministerial or head of government) level. If this change was to effect in just 50% of health districts in Cameroon, the heallth system will be forced to change. Healthcare in Cameroon is a mess and I believe health workers are the most corrupt in Cameroon. I will hardly sleep on a public hospital bed!
What I find wanting in your idea is the way you touch timidly on the mobility aspect. mHealth is the future! This is the 'marines' of development. With the mobile aspect you will remove a lot of bias and also reach more people. Without exploring more this aspect (like having it coming to effect in the first year) your entry is 65% weaker! (mobile networks now reach 65% of people in Cameroon.
Hello TZ,
Thanks for your input. I will be working on the mobility aspects over the coming days. The problem is the complexity; but I have been having some ideas and consulting more IT guys. In a few weeks I am sure I will improve on this!
I will also aprreciate more contributions on this if you have some skills I could use.
Mbah
I think to involve patients in evaluating health care safety with respect to injection safety, you will need to develop special risk communication strategies that teach patients to observe whether or not an injection is safe. Common unsafe practices that lead to blood-borne virus transmission are (1) changing the needle to reuse a syringe, (2) reusing a needle and syringe on the same patient after re-entering a multi-dose vial with a used needle and syringe, and (3) reusing a needle and syringe to flush a patient's catheter. Images of these practices would be helpful, and so would a dialogue about "double dipping" (going back into a multidose vial with a used needle and syringe, contaminating it for the next patient). Hopefully there is a local idiom for double dipping (e.g., food at a party with dip) that you can use to make an analogy. You should teach patients to always watch and make sure their injection equipment comes out of a new sealed package. Finally, it is important to teach that HIV is a blood-borne virus - this alerts patients to the danger! In general people with less education only think of it as a sexually transmitted disease.
Thanks Savanna for your input.
I will work to highlight the importance of injection safety - actually through the media discussions, debates and dramas which follow results (scoring) of questions that are administered to patients, I will educate patients and health care workers on a lot of issues (including injection safety and proper waste disposal). Presently patients cannot even identify or know what an unsafe injection is; healthcare workers also have mispeprceptions about unsafe injections. For example, most healthcare workers (about 62% in Cameroon) will not change gloves between patients or share injection vials (especially lidocaine, ketamine and infusions) between patients because they have the misperception that this is safe. The media DDDs will seek to educate both patients and healthcare workers on this aspects using for example the 'One injection, one patient and one time only' methods.
I will incorporate these ideas to bring out his aspect in the innovation over the coming days.
Thanks!
Mbah
Thank you for sharing this idea, I am still unclear after glancing at your entry, what the mechanism will be to collect the community feedback and to feed it back to the district decision makers.
How will patients contribute their insights? Once collected, how will they be packaged and presented?
Dear Tyler,
Thanks for your input!
Due to the limited words required to describe the innovation I was unable to detail the questionnaire which is the mechanism I will use to collect community feedback; the results of this questionnaire is also what is used to influence decision making! Under 'innovation' section I briefly described this; I would have liked to upload the form, but only picture formats are allowed.
In short the mechanism for collection of community feedback is through the use of a 39 questions structured questionnaire with 5 forced choices which will score the hospital (through the patients responses)from +2 to -2. Each question can be analysed separately or together with other questions. For example one of these questions states thus: 'I paid more than 600 Francs to see the doctor/Nurse?' the options to respond are (this is same for all questions) 'strongly agree', agree', 'unsure', 'disagree', and strongly disagree' - these score -2, -1, 0, +1, +2 respectively. If 10 patients agree to this; the hospital score -1 (an average summation of all patients). A negative score implies hospital may actully be contributing to increasing morbidity.
Questionnaires will be collected by community representatives (these already exists and are voted in by community members). They also analyse the results to present to the decision makers and use these also to educate the community.
I found it quite challenging to incorporate in a few words (actually most of the times I present the document). It will be useful also if you understand all the explanation above to let me know how we could better mould this!
I will work on your questions in the innovation.
Thanks!
Mbah
Dear Mbah
your idea is a landmark idea to improve the Cameroon health care system and also that of sub Saharan Africa in a long term bacause it empowers the patients and the community. This idea also makes health workers accountable and effective.
How are you planning to take care of these community members ? Most of them feel that their services have to be paid for by the public hospital and the administering of these questions need educated community workers. There is also going to be a bias with this type of questionnaires.what about self administered questionnaires .These community worker have destroyed the management committee in many health areas because of their high demands for money when they render their services to the community.Most of them are using this as a full time job.please we have to think about the guys how represent these communities. most of them are as corrupt as the health worker or even more.
African governments!
I think the Cameroonian government has to understand some Human right issue first. The right of all human to quality health care must be ensured to prevent deaths and injuries. Health care must be available , accessible and of high quality . Failure to provide such care is a violation of human right to life, health and equality. The health care in Cameroon is a mess for many reason.
1) health workers are not well payed for their services. They have one of the worst salary in Africa main cause for corruption
2) government does not invest up to 5 % of it's Income on health
3) hospital are poorly constructed and not well equipped .
NB: no forgetting corruption.
The government has to establish health facilities where needed and ensure that they are fully functional; guarantee that no person is denied free health services by universal insurance and create a surveillance mechanism to identify and review corruption.
Dear Munoh,
Thanks for your input!
The key to solving health allocation is first to make the patients to agitate and say 'NO' to bad governance and bad quality of services. Patients will only agitate and stand up against poor quality of services when they are empowered! The healthcare workers have not been working hard enough to fight for increased budget allocation to health nor improved working conditions (salaries included!). This is largely due to the fact that they 'milk extra money'from patients and provide 'whatever' service they can provide with 'whatever' means they have. They problem of not changing gloves and multi use of vials is often due to healthcare workers trying to 'economise' on their 'P.P.' stocks(P.P. is a term used by HCWs in Cameroon to call their 'private practice' within the hospital!). This leads to a tendency to reuse injection materials (lidocaine vials, gloves, etc)which is actually the peak of bad quality services!
The media DDD aspect of this innovation will also include debates on HCW salaries and health budget allocation - but this time with evidence for need for change!
I will try to work in clear steps in this process from:
1) Community feedback collection
2) Use of results to influence decision making at district level
3) Incorporating evidence in media DDD to educate patients, Healthcare workers and policy makers.
Thanks!
Mbah
Dear All,
Thanks for all the feedback so far; this is proving very useful to this idea and moulding it into a better idea. I will be adding more pictures, links and even a video over the coming weeks!
So stay tuned!
Meantime more comments are still welcomed!
Mbah
Comentarios
Dear people! Feedback is very important in developing a strong idea that can bring about change! Please feel free to pour out the 'kritiks' - of course we always prefer constructive feedback - but we are ready for all sorts!
You will have to create an account to give feedabck - it only takes a few moments - this is necessary for tracking and security!
Thanks people now off we go!!!!!
Dear Mbah,
I find your idea brilliant! I like this innovation for 2 things.
Firstly the patient participation; in most of Africa, patients do not have a voice and are hardly even informed about anything. this idea brings in patient and community particisption. Second, the use of district level as entry point has a higher chance of succeeding than if a central (ministerial or head of government) level. If this change was to effect in just 50% of health districts in Cameroon, the heallth system will be forced to change. Healthcare in Cameroon is a mess and I believe health workers are the most corrupt in Cameroon. I will hardly sleep on a public hospital bed!
What I find wanting in your idea is the way you touch timidly on the mobility aspect. mHealth is the future! This is the 'marines' of development. With the mobile aspect you will remove a lot of bias and also reach more people. Without exploring more this aspect (like having it coming to effect in the first year) your entry is 65% weaker! (mobile networks now reach 65% of people in Cameroon.
Good job mate!
TZ
Hello TZ,
Thanks for your input. I will be working on the mobility aspects over the coming days. The problem is the complexity; but I have been having some ideas and consulting more IT guys. In a few weeks I am sure I will improve on this!
I will also aprreciate more contributions on this if you have some skills I could use.
Mbah
I think to involve patients in evaluating health care safety with respect to injection safety, you will need to develop special risk communication strategies that teach patients to observe whether or not an injection is safe. Common unsafe practices that lead to blood-borne virus transmission are (1) changing the needle to reuse a syringe, (2) reusing a needle and syringe on the same patient after re-entering a multi-dose vial with a used needle and syringe, and (3) reusing a needle and syringe to flush a patient's catheter. Images of these practices would be helpful, and so would a dialogue about "double dipping" (going back into a multidose vial with a used needle and syringe, contaminating it for the next patient). Hopefully there is a local idiom for double dipping (e.g., food at a party with dip) that you can use to make an analogy. You should teach patients to always watch and make sure their injection equipment comes out of a new sealed package. Finally, it is important to teach that HIV is a blood-borne virus - this alerts patients to the danger! In general people with less education only think of it as a sexually transmitted disease.
Thanks Savanna for your input.
I will work to highlight the importance of injection safety - actually through the media discussions, debates and dramas which follow results (scoring) of questions that are administered to patients, I will educate patients and health care workers on a lot of issues (including injection safety and proper waste disposal). Presently patients cannot even identify or know what an unsafe injection is; healthcare workers also have mispeprceptions about unsafe injections. For example, most healthcare workers (about 62% in Cameroon) will not change gloves between patients or share injection vials (especially lidocaine, ketamine and infusions) between patients because they have the misperception that this is safe. The media DDDs will seek to educate both patients and healthcare workers on this aspects using for example the 'One injection, one patient and one time only' methods.
I will incorporate these ideas to bring out his aspect in the innovation over the coming days.
Thanks!
Mbah
Hi Mbah,
Thank you for sharing this idea, I am still unclear after glancing at your entry, what the mechanism will be to collect the community feedback and to feed it back to the district decision makers.
How will patients contribute their insights? Once collected, how will they be packaged and presented?
Thank you in advance for your response!
Best,
Tyler
Dear Tyler,
Thanks for your input!
Due to the limited words required to describe the innovation I was unable to detail the questionnaire which is the mechanism I will use to collect community feedback; the results of this questionnaire is also what is used to influence decision making! Under 'innovation' section I briefly described this; I would have liked to upload the form, but only picture formats are allowed.
In short the mechanism for collection of community feedback is through the use of a 39 questions structured questionnaire with 5 forced choices which will score the hospital (through the patients responses)from +2 to -2. Each question can be analysed separately or together with other questions. For example one of these questions states thus: 'I paid more than 600 Francs to see the doctor/Nurse?' the options to respond are (this is same for all questions) 'strongly agree', agree', 'unsure', 'disagree', and strongly disagree' - these score -2, -1, 0, +1, +2 respectively. If 10 patients agree to this; the hospital score -1 (an average summation of all patients). A negative score implies hospital may actully be contributing to increasing morbidity.
Questionnaires will be collected by community representatives (these already exists and are voted in by community members). They also analyse the results to present to the decision makers and use these also to educate the community.
I found it quite challenging to incorporate in a few words (actually most of the times I present the document). It will be useful also if you understand all the explanation above to let me know how we could better mould this!
I will work on your questions in the innovation.
Thanks!
Mbah
Dear Mbah
your idea is a landmark idea to improve the Cameroon health care system and also that of sub Saharan Africa in a long term bacause it empowers the patients and the community. This idea also makes health workers accountable and effective.
How are you planning to take care of these community members ? Most of them feel that their services have to be paid for by the public hospital and the administering of these questions need educated community workers. There is also going to be a bias with this type of questionnaires.what about self administered questionnaires .These community worker have destroyed the management committee in many health areas because of their high demands for money when they render their services to the community.Most of them are using this as a full time job.please we have to think about the guys how represent these communities. most of them are as corrupt as the health worker or even more.
African governments!
I think the Cameroonian government has to understand some Human right issue first. The right of all human to quality health care must be ensured to prevent deaths and injuries. Health care must be available , accessible and of high quality . Failure to provide such care is a violation of human right to life, health and equality. The health care in Cameroon is a mess for many reason.
1) health workers are not well payed for their services. They have one of the worst salary in Africa main cause for corruption
2) government does not invest up to 5 % of it's Income on health
3) hospital are poorly constructed and not well equipped .
NB: no forgetting corruption.
The government has to establish health facilities where needed and ensure that they are fully functional; guarantee that no person is denied free health services by universal insurance and create a surveillance mechanism to identify and review corruption.
Dear Munoh,
Thanks for your input!
The key to solving health allocation is first to make the patients to agitate and say 'NO' to bad governance and bad quality of services. Patients will only agitate and stand up against poor quality of services when they are empowered! The healthcare workers have not been working hard enough to fight for increased budget allocation to health nor improved working conditions (salaries included!). This is largely due to the fact that they 'milk extra money'from patients and provide 'whatever' service they can provide with 'whatever' means they have. They problem of not changing gloves and multi use of vials is often due to healthcare workers trying to 'economise' on their 'P.P.' stocks(P.P. is a term used by HCWs in Cameroon to call their 'private practice' within the hospital!). This leads to a tendency to reuse injection materials (lidocaine vials, gloves, etc)which is actually the peak of bad quality services!
The media DDD aspect of this innovation will also include debates on HCW salaries and health budget allocation - but this time with evidence for need for change!
I will try to work in clear steps in this process from:
1) Community feedback collection
2) Use of results to influence decision making at district level
3) Incorporating evidence in media DDD to educate patients, Healthcare workers and policy makers.
Thanks!
Mbah
Dear All,
Thanks for all the feedback so far; this is proving very useful to this idea and moulding it into a better idea. I will be adding more pictures, links and even a video over the coming weeks!
So stay tuned!
Meantime more comments are still welcomed!
Mbah
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