Conectar
by Sudim Sharma, Anjali Neupane, Dikshya Kandel, Pratibha Chalisay, Sabina Marasini, Budhi Setiawan, Deepak Chandra Bajracharya, Shyam Raj Upreti, Leela Khanal, Haruko Yokote, Chahana Singh, Kshitij Karki
BackgroundHome-Based Records (HBRs) are personal health documents intended to improve continuity of care and caregiver engagement across reproductive, maternal, newborn, and child health (RMNCH) services. In Nepal, both standalone (sHBR) and integrated (iHBR) models are implemented, yet comparative evidence on their utilization and implementation challenges is limited. This study examined utilization patterns and system-level barriers associated with sHBR in Madhesh Province and iHBR in Koshi Province.
MethodsWe conducted a comparative qualitative study with descriptive quantitative profiling between May 17 and August 27, 2024. A total of 100 semi-structured in-depth interviews were completed with caregivers, health workers, Female Community Health Volunteers, and program managers across two provinces. The study applied “kuragraphy,” an ethnographic approach integrating interviews and field observations to construct contextual case narratives. Socio-demographic data were analyzed descriptively using the statistical package for the social Sciences (SPSS). Informed by the Human Centered Design (HCD) approach, the qualitative data were thematically analyzed in Excel using the Journey to Health and Immunization (JTHI) framework.
ResultsCaregivers widely perceived HBRs as essential documents, primarily for immunization tracking and future service access. The iHBR was viewed as more comprehensive and user-friendly, particularly due to its illustrations, which improved comprehension among low-literacy users. However, understanding remained limited among illiterate and marginalized populations. Family involvement in record management was minimal and largely confined to mothers. Implementation barriers included inadequate training – particularly for iHBR use, limited decision-making authority among frontline health workers, incomplete documentation of non-immunization components, poor material quality of sHBR, and concerns regarding the sustainability of donor-supported iHBR initiatives.
ConclusionHBR utilization in Nepal is shaped by caregiver literacy, gender dynamics, and health-system readiness. Strengthening training, supportive supervision, user-centered design, and sustainable supply mechanisms will be essential to optimize HBR effectiveness and support equitable RMNCH service delivery.
by Tamara Muir, Chandra Sharma Poudyal, Romana De Lima, Farah Otaki
IntroductionCOVID-19 pandemic emerged in late 2019, leading to global disruption and forcing people to adapt to a new reality. The intensity of the pandemic affected many organisations’ preparedness, response, and recovery efforts, causing numerous businesses to struggle. Although no single theory fully explains why some businesses thrived during this time, the concept of organisational resilience stands out. Organisations with a resilient culture seemed better equipped to address risks, adapt effectively, and seize opportunities for innovation. Therefore, the purpose of the current study is to critically examine the response to COVID-19 of a medicine and health sciences university in Dubai, United Arab Emirates.
MethodsThe study relied on a convergent mixed methods approach to research. A tailor-made questionnaire was used to collect quantitative data using two 5-point Likert-type scales: ‘Opinions about Organizational Response’ and ‘Conducive Organizational Response Behaviours’ (where 110 current employees who were tenured during COVID-19 were selected, using purposive, non-probability sampling, and in turn invited to participate). Semi-structured interviews were conducted to collect qualitative data [where seven respondents who had completed the questionnaire and agreed to participate in follow-up interviews were selected (i.e., convenience, nonprobability sampling) and in turn invited to participate]. The quantitative data were descriptively and inferentially analysed. Qualitative data was analysed using an inductive six-step thematic approach. The quantitative findings were mapped onto the output of qualitative analysis using the iterative joint display analysis process.
ResultsA total of 70 employees completed the questionnaire (63.64%), and six out of seven invitees participated in the semi-structured interviews. The percentage of the total extent of agreement of ‘Opinions about Organizational Response’ score was 90.94%. As for the percentage of the total frequency of observation of ‘Conducive Organizational Response Behaviours’ score, it was 95.08%. The qualitative analysis generated a conceptual model, namely: ‘Enablers of Organizational Resilience’, with five interlinked themes namely: Preparedness and planning for uncertainty, Adaptation and agility, Team cohesion, Social responsibility, and Learning organisation. Four meta-inferences emerged from integrating the data findings: Response characteristics, Behaviour specificities, Consistency of opinions, and the Fundamental role of organizational culture.
ConclusionThe findings reveal that organizations, in the intersect between higher education and public health, should continue on innovatively investing in agile leadership, strategic partnerships, and a robust continuous learning and development culture to better navigate future disruptions.
FreshRSS