Mixed‐methods evaluation of a continuing education approach to improving district hospital care for children in Lao PDR

Abstract

In low-and middle-income countries,10 to 20% percent of sick children seen in primary care need referral to hospital [1,2]. To improve child mortality in low-resource settings, the quality of first referral level hospital care -the "critical link" -needs to be addressed [1,3]. Resources to improve the quality of hospital care for children in settings with limited resources exist, including the Integrated Management of Childhood and Neonatal Illnesses (IMNCI), the WHO

Perspectives of Healthcare Providers in Maternal and Child Health Services in BokeoProvince, Lao People’s Democratic Republic: A Qualitative Study

“…Interviews highlighted the perception of Bokeo province's medical system as inferior to neighboring areas, prompting wealthier individuals to seek treatment elsewhere. Addressing this requires investment in medical equipment, facilities, and healthcare provider training, recruiting more skilled providers, and offering continual training, especially in remote regions (Nagpal et al, 2019;Safe et al, 2022).…”

Implementing learning into practice from continuous professional development activities: A scoping review of health professionals’ views and experiences

“…There were four studies utilizing cross-sectional surveys; and a further four studies using mixed methods, of which three were of sequential explanatory design consisting of an initial quantitative survey followed by qualitative interviews, (45,50,51) and one study consisting of analysis of medical records and semi-structured interviews. (52) In the majority of studies, implementation of learning was not the primary focus; rather it was an aspect of wider investigations, in varying extents, that were conducted with CPD participants to assess or evaluate elements of the CPD activity. A review of the speci c data collection tools reveals the extent to which studies were focused on implementation of learning.…”

“…(44,46) In three of the studies, investigations took place at multiple intervals after the CPD activity, attempting to explore both immediate and longer-term implementation of learning into practice. (45,52,54) These studies included administration of a postactivity survey immediately after the CPD activity and then, either re-administration of the survey after three months, (54) or phone interviews with a sample of respondents within three months. (45) One study conducted an analysis of medical records immediately after the CPD activity to evaluate the level of participants' implementation into learning, and these participants were then recruited to participate in focus groups six months later to investigate their views and experiences.…”

“…Use of theoretical models/frameworks Five studies utilized theoretical models or frameworks within their studies, however, the context of their use was not to speci cally capture implementation of learning. (49,50,(52)(53)(54) Two studies used an evaluation framework/model: the Kirkpatrick model was used to develop a survey that aimed to evaluate participants' perceptions of the effectiveness of the CPD activity (52); in a separate study, the Moore's evaluation framework was adapted to evaluate participants' sustained performance change. (53) A behavioural frameworks was used in one study: the Theoretical Domains Framework was used to develop an interview guide in a study investigating participants views of the barriers, facilitators and perceived impact of the CPD activity.…”

Covid-19: What went wrong after initial success in Laos?

“…Truls Østbye, professor at the Duke University School of Medicine’s Department of Community and Family Medicine, who worked on the 2016 survey, says that a “promising” approach for Laos might be learner led continuing education. One study found that a year of coaching on hospital care for children with reinforced feedback at two district hospitals in 2017 saw case management scores jump from 50% to 80% at one hospital and 52% to 97% at another 13…”