Suchergebnisse

BACKGROUND: Parts of Zambia with very low malaria parasite prevalence and high coverage of vector control interventions are targeted for malaria elimination through a series of interventions including reactive case detection (RCD) at community level. When a symptomatic individual presenting to a community health worker (CHW) or government clinic is diagnostically confirmed as an incident malaria case an RCD response is initiated. This consists of a CHW screening the community around the incident case with rapid diagnostic tests (RDT) and treating positive cases with artemether-lumefantrine (AL, Coartem™) in accordance with national policy. Since its inception in 2011, Zambia's RCD programme has relied on anecdotal feedback from staff to identify issues and possible solutions. In 2014, a systematic qualitative programme review was conducted to determine perceptions around malaria rates, incentives, operational challenges and solutions according to CHWs, their supervisors and district-level managers. METHODS: A criterion-based sampling framework based on training regime and performance level was used to select nine rural health posts in four districts of Southern Province. Twenty-two staff interviews were completed to produce English or bilingual (CiTonga or Silozi + English) verbatim transcripts, which were then analysed using thematic framework analysis. RESULTS: CHWs, their supervisors and district-level managers strongly credited the system with improving access to malaria services and significantly reducing the number of cases in their area. The main implementation barriers included access (e.g., lack of rain gear, broken bicycles), insufficient number of CHWs for programme coverage, communication (e.g. difficulties maintaining cell phones and "talk time" to transmit data by phone), and inconsistent supply chain (e.g., inadequate numbers of RDT kits and anti-malarial drugs to test and treat uncomplicated cases). CONCLUSIONS: This review highlights the importance of a community surveillance system like RCD in shaping Zambia's malaria elimination campaign by identifying community-based infections that might otherwise remain undetected. At this stage the system must ensure it can meet growing public demand by providing CHWs the tools and materials they need to consistently carry out their work and expand programme reach to more isolated communities. Results from this review will be used to plan programme scale-up into other parts of Zambia.

PurposeThe purpose of this paper is to compare women's mentoring experience in nine countries within the Americas, and to explore linkages between personal characteristics, mentoring practices, mentoring functions, and consequences of being mentee.Design/methodology/approachA total of 1,146 successful women are questioned about their mentoring experiences as a mentee: 105 from Argentina, 210 from Brazil, 199 from Canada, 84 from Chile, 232 from Mexico, 126 from the USA, and 190 from three countries in the West Indies (Barbados, Jamaica, and St Vincent).FindingsMost of the women have more than one mentor. Across all countries mentoring practices are more strongly linked to career mentoring function while the age and gender of the mentor are more strongly linked to psychosocial mentoring. Mentoring from the perspective of mentee has the same directional relationship with situational and individual variables, but the significance of those relationships vary by country. A possible cultural difference is detected between Spanish and non‐Spanish speaking countries on the issue of mentoring practice.Research limitations/implicationsThe fact that the paper focuses only on successful women in this paper means the findings are not necessarily generalizable to other groups of women or men. The paper is also limited because mentoring functions are constrained to two: psychosocial and career. There may be more functions that mentoring could fulfill for the mentee.Practical implicationsCompanies' interest in fostering mentoring among their members, particularly women, should be aware that different mentoring functions are influenced by different factors. For example, formal mentoring programs appear to have a greater impact on career mentoring functions than on psychosocial mentoring functions. To support women in their careers, companies should institute formal mentoring programs; this is especially important in South American countries. Moreover, mentoring programs must be designed to be adaptive since the analyses indicated that there are significant differences by country in terms of many mentoring issues.Originality/valueIn the literature review, the paper finds linkages between culture, mentoring practices, characteristics of mentors and mentees, and mentoring functions, but no evidence that these linkages have been studied with a group of professionally successful women from different American countries, particularly non‐English speaking American countries.