Baseline Testing of the Health Effects of the MadiDrop in Limpopo Province, South Africa
Kelly McCain, Amanda Gaylord, Evie Stinger, & Catherine Reynolds
Abstract
Access to clean water remains a pressing need in the rural Limpopo province of South Africa. Low-cost point of-use water purification methods have the potential to greatly improve the health of children in this area. This water purification research conducted was therefore divided into two focuses: first, an analysis of the effect of different water chemistries on the effectiveness of the MadiDrop, a small ceramic disk impregnated with silver nanoparticles that continually disinfects stored water in households. Second was a collection of baseline data and the installation of point-of-use water purification interventions for a two-year long study on the impact of sustained intervention use on human health, specifically the growth of children. The consequent results suggest that the MadiDrop was effective at purifying water, except in situations with high turbidity. Data for the two-year-long study is still being collected
and analyzed.
Going Digital: Implementing an Electronic Medical Record in Totonicapan, Guatemala
John Preston Baker & Korey Marshall
Abstract
The initial version of an electronic medical record system (EMR), known as SABER 1.0, was implemented in the Emergency Department of an under-resourced hospital in Totonicapán, Guatemala. Over the course of one month
during the summer of 2016, Guatemalan medical students and physicians were trained to use the SABER software, and 63 initial test electronic records were produced. These initial trials indicated that electronic records only took 23 additional seconds to produce and resulted in significantly more patient data in comparison to paper records. In addition, survey results indicated that the Emergency Department staff were enthusiastic about adopting an EMR. However, they also expressed concerns about potential loss of data and difficulties involved in the incorporation of new technology in their hospital. Based upon these results, recommendations were made to continue with the implementation of SABER with several specific improvements that will increase speed, convenience, and functionality of the software. The SABER project demonstrates that EMRs can benefit both patients and staff in resource-limited
hospitals.
Perceptions of Discharge Instructions by Guatemalan and UVA Community Members and Clinicians
Joemar Priscila Pazos & Vatsal Patel
Abstract
Discharge instructions are a crucial piece to the continuum of care that patients should receive at the end of their time in the hospital and clinics. Unfortunately, many patients leave the hospital and health clinics with a limited understanding of their time in the medical center and an even worse understanding of what to expect after leaving the hospital or clinic. This paper looks at the perceptions on the discharge instructions and post-visitation summaries received from the perspective of patients and clinicians in Guatemala and at the UVA Health System. Ultimately, it was found that for patients who do not speak the native language, patients and physicians believe discharge
instructions can be improved. Patients and clinicians were
interviewed using qualitative surveys to learn about the current process of delivering post-visit instructions and their effectiveness.
Palliative Care Practices of Community Health Workers and Professional Nurses in Limpopo Province, South Africa
Mary Kay O'Brien, Jennifer Stueve, & Lillian Ware
Abstract
In Sub-Saharan Africa, shortages of health workers have negatively affected health care due to the severity of the HIV/AIDS epidemic as a result of migration to urban areas and to private institutions. As a
result, CHWs and professional nurses provide needed care in the community. This pilot study sought to understand palliative care practices of and challenges faced by CHWs and professional nurses as well as the feasibility and cultural appropriateness of the Palliative Care for Dignified Dying survey in the Vhembe district of Limpopo Province, South Africa. Through the use of focus group interviews, common themes were identified: Ubuntu and spirituality, direct care, comfort, self-care, and advocacy for bereaved children. This pilot study provided significant evidence that additional hospice facilities are needed in Vhembe district. Due to the HIV/AIDS epidemic and loss of cultural traditions resulting from loss of entire generations, now is a prime time to begin to establish a more prominent hospice community.
Microhub: Analyzing Higher Education Interventions in Rwanda's Refugee Camps
Porter Nenon, Kaija Flood, William Henagan, & Adam Jones
Abstract
This summer a team of three University of Virginia students (Porter Nenon, Political and Social Thought; Kaija Flood, Masters of Public Policy; Adam Jones, Economics) travelled to Rwanda to research the state and progress of higher education in the country’s refugee camps. The team hoped to learn about the political and cultural underpinnings of the education infrastructure in Rwandan refugee camps in order to better develop a social enterprise centered on this subject. The team’s research and social entrepreneurial efforts coalesced to form microHub. Once in country, Porter further established the team’s contacts in the higher education and refugee communities. After speaking with various advocacy groups, non-profits, politicians, and educators, microHub settled on working with two specific NGOs that combined the team’s interest in refugee aid and higher education. MicroHub (mHub) assesses Rwandan NGO education platforms to develop predictive statistics and technology implementation plans to better serve the displaced population within Rwanda.
CONFLUX JOURNAL
2018 ISSUE
Substance Abuse Screening for At-Risk Youth in Bluefields, Nicaragua
Joshua Moore & Emma McKimm Mitchell
Background
The purpose of this study was to identify factors related to substance abuse and explore concepts necessary for future development of a culturally appropriate substance abuse screening tool targeting at-risk youth in Bluefields, Nicaragua.
Methods
This secondary data analysis was guided by a qualitative descriptive approach using thematic analysis. Seven focus groups with young adult women were conducted, including either young adults, teachers, or parents.
Outcomes
The major themes related to substance abuse and screening barriers which emerged from the interviews were: (1) issues related to economic contextual factors, risky behaviors, and the at-risk population; (2) local resources and barriers to accessing them; and (3) grassroots ideas for action related to regionally relevant solutions, sports and engagement, and health communication.
Qualitative Analysis of Childhood Nutrition Improvement Efforts in Charlottesville, Virginia
Alisha Gupta & Stephanie Davis
Background
Childhood malnutrition and obesity are heavily correlated with the rising availability of low-cost, high-calorie, and nutrient-poor foods. Nationally, over 12 million children (aged 6-19), or approximately 20% of all children, are obese. More specifically, in Charlottesville, Virginia, the prevalence of overweight and obese children has remained at 35% throughout the past decade. In order to address local childhood obesity, the Charlottesville food justice network (CFJN) collaboratively works to identify the opportunities and barriers to accessing healthy nutritious foods for community residents.
Methods
Researchers conducted 11 semi-structured interviews with CFJN professionals to determine overlapping barriers across both individual and community efforts in Charlottesville. The interview data was coded and analyzed using thematic analysis.
Outcomes
Qualitative data suggested that the most common challenges professionals see in Charlottesville revolved around children’s behaviors and perceptions of foods, food literacy issues, program planning, societal influences, and socioeconomic factors.
Complications after Cesarean Section in Rwanda
Paulin Banguti, Eugene Tuyishime, Brigitte Kalala, Shefali Hegde, Jessica Amick, & Marcel Durieux
Background
Women in sub-Saharan Africa face a disproportionate risk of severe injury or death in childbirth compared to Western countries. In 2016, Rwanda’s maternal mortality rate (MMR) stood at 320 deaths per 100,000 live births. Government investment in education and health infrastructure has allowed for an astonishing decreasing trend in maternal death. However, high rates of Cesarean section (CS) place undue stress on the health system, expose patients to unnecessary surgical risks, and predispose women to subsequent delivery complications.
Methods
In an attempt to better understand the modifying effect of CS on immediate health outcomes, anesthesiologists at the Centre Hospitalier de Kigali (CHUK) designed a comprehensive project to measure CS complications. We analyzed a sample of 340 patient charts who were admitted in CHUK to identify the age, referral hospital, reason for cesarean section and other demographic factors relating to morbidity and mortality of mothers and infants.
Outcomes
We found peritonitis and sepsis to be the most common complications in mothers post-CS. We found no significant relationship between geographic distance from the hospital and mortality and between type of delivery and mortality.
Discussion
Inclusion criteria for our study excluded those who did not survive the travel from the district hospital and CHUK, which limited our results. Future research groups should collect data from a larger population set and explore the feasibility of data collection directly from the district hospitals. We obtained comprehensive information on CS rates from the main referral hospitals, which can be used to develop protocols to limit unnecessary CS, as well as to address the surprisingly high rates of peritonitis and sepsis.
Comparison of Consistent and Infrequent Condom Users Among University Students in Thohoyandou, South Africa
Dana Kiernan & Neeka Nazari
Background
Sexual and reproductive health affects an individual's ability to live a healthy life. Many factors influence sexual health and relationships, including societal and familial values, religion, social determinants, gender, and socioeconomic status. This paper addresses condom use as an avenue to sexual health among female university students in Limpopo, South Africa, at the University of Venda (UNIVEN).
Methods
Using both a quantitative survey and qualitative interviews, we looked for systematic differences between participants who reported consistent condom use and those who reported infrequent condom use.
Outcomes
Of the 38 female participants, 20 were sexually active. Seven reported consistent condom use, and 13 reported inconsistent use. We did not find statistically significant differences between the two groups, likely due to the small and relatively homogenous sample. However, participants’ responses pointed to cultural and societal factors that impact condom use. These factors include gender inequality, power dynamics within relationships, and the threat of violence in relationships.
Discussion
Though our research focused on women, any policy or intervention developed to promote women's sexual health should include men, as men play a critical role in improving women’s current social standing and increasing equality within relationships.
Restructuring Resilience: Sustainable Housing Solutions in Gyumri, Armenia
Bethany Gordon, Leon Yacoubian, Lynn Kha, Katherine Genuario, Lillie Mayfield, Meghan Jones, & Santiago Roca
Background
In 1988, a 6.8 magnitude earthquake left approximately 17,000 Gyumri residents homeless in the middle of winter. Since these devastating events, the residents of Gyumri District 104 in Armenia have lived in incredibly poor conditions that negatively impact their health and impede their abilities to improve their socio-economic status. This systemic problem will require a multi-faceted solution.
Methods
An interdisciplinary group of University of Virginia students formed a research team called Tuff Armenia. Our research process began in 2016 with a 10-day trip where we familiarized ourselves with the cultural context and met community members. A year later, we returned to Gyumri for six weeks to formally characterize the needs, challenges, and capabilities of the community through interviews, photo-voice, and community engagement.
Outcomes
This data was utilized by a fourth-year capstone class in the Department of Civil and Environmental Engineering during the Fall 2017 semester. This class analyzed potential building sites in Gyumri and developed the first iteration of a housing construction proposal. The class intends to produce shovel-ready engineering and architectural design plans by the end of the Spring 2018 semester.