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RÉSUMÉ Avec la croissance rapide de la population plus âgée, il est devenu urgent de trouver des approches en matière de soins de santé qui aident les personnes âgées à vieillir dans le milieu de leur choix, en assurant une réorientation philosophique des services de santé. Nous nous sommes penchés sur le projet Home Care Home First - Quick Response Project, réalisé dans une ville de l’Ouest canadien, afin de comprendre les perceptions de clients âgés de plus de 75 ans et de leurs aidants naturels quant aux services communautaires améliorés offerts par Home First. Le modèle méthodologique utilisé est celui de la description interprétative. Nous avons analysé les expériences de huit personnes âgées et de onze aidants naturels ayant fait appel à Home First. Les personnes âgées s’étaient toutes inscrites à Home First en raison d’un changement majeur dans leur état de santé. Quatre thèmes ont été identifiés : vieillir dans le milieu de son choix avec du soutien, la philosophie de soins, les processus de Home First et l’importance du programme. Dans l’ensemble, les clients et les aidants naturels ont réagi positivement aux services offerts dans le cadre du programme Home First. Les clients ont indiqué qu’ils appréciaient leur indépendance et désiraient vieillir dans les milieux de leur choix, qui reflétaient la communauté dans laquelle ils vivaient depuis de nombreuses années.

IntroductionThe burden of childhood mortality continues to be born largely by low-income and middle-income countries. The critical postdischarge period has been largely neglected despite evidence that mortality rates during this period can exceed inpatient mortality rates. However, there is a paucity of data on the paediatric discharge process from the perspective of the healthcare provider. Provider perspectives may be important in the development of an improved understanding of the barriers and facilitators to improving the transition from hospital to home.ObjectivesTo explore healthcare providers’ and facility administrators’ perspectives of the paediatric discharge process with respect to: (1) current procedures, (2) barriers and challenges, (3) ideas for change, (4) facilitators for change and (5) the importance of discharge planning.DesignA qualitative exploratory approach using focus groups (14) and in-depth interviews (7).SettingThis study was conducted at seven hospitals providing paediatric care in Uganda.ResultsCurrent discharge procedures are largely based on hospital-specific protocols or clinician opinion, as opposed to national guidelines. Some key barriers to an improved discharge process included caregiver resources and education, critical communication gaps, traditional practices, and a lack of human and physical resources. Teamwork and motivation to see improved paediatric transitions to home were identified as facilitators to implementing the ideas for change proposed by participants. The need for a standardised national policy guiding paediatric discharges, implemented through education at many levels and coupled with appropriate community referral and follow-up, was broadly perceived as essential to improving outcomes for children.ConclusionsAlthough significant challenges and gaps were identified within the current health system, participants’ ideas and the identified facilitators provide a significant basis from which change may occur. This work can facilitate the development of sustainable and effective interventions to improve postdischarge outcomes in Uganda and other similar settings.

Amidst the COVID‐19 pandemic and social uprisings demanding social and racial equity worldwide, there is an increasing demand for health justice training for health workers. However, there are scant evidence‐based assessments of the impact of such courses. Between 2010 and 2020, SocMed—a 501(c)3 non‐profit social justice organization—offered two distinct courses about health equity, the social determinants of health, and social medicine to health workers through the University of Minnesota in Minneapolis, Minnesota and Saint Mary Hospital Lacor in Gulu, Uganda. This study assesses the immediate impact of the SocMed curriculum on participants measured by a pre‐course and post‐course survey. In Minnesota, paired pre‐course and post‐course survey responses (mean n = 69; SD = 23) spanned years 2016–2019, while Uganda paired pre‐course and post‐course survey responses (mean n = 64; SD = 21) spanned years 2012–2013 and 2017–2019. Findings indicate that the course improved participants’ knowledge in all 24 of the topics in the Minnesota course and 42 of 44 topics in the Uganda course (significant at p < 0.05).

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