DOWNLOAD NOTES ZA WIZARA CMT 6 | NOTES ZA WIZARA CMT NTA LEVEL 6
CMT NTA LEVEL 6 NOTES ZA WIZARA
SEMESTER 1
- CMT06101: Entrepreneurship And Life Skills
- CMT06102: Leadership And Management
- CMT06103: Operational Research
- CMT06104: Basics Of Forensic Medicine
- CMT06105: Surgical Specialties
SEMISTER 2
- CMT06206: Apprenticeship In Obstetrics And Gynaecology
- CMT06207: Apprenticeship In Surgery
- CMT06208: Apprenticeship In Internal Medicine
- CMT06209: Apprenticeship In Paediatrics And Child Health
Below are Example of notes za wizara from Operational research
Definition of Terms
• Operational research: Research encompassing a wide range of problem-solving techniques and methods applied in the pursuit of improved decision-making and efficiency.
• Health information: Analyzed health data ready for use in decision making.
• Burden of disease: Refers to the magnitude and distribution of diseases within a population. It is a measure indicating loss of years of healthy life through disabling diseases in a specified population.
• Prioritization: Process of ranking the health problems/needs in a given community according to relevancy, urgency of required solution, political acceptability, feasibility of intervention, ethical acceptability, and if there is no duplication of efforts.
Identification of Health Care Problems in a Given Environment:
Dispensary Setting, Health Centre and District Level
Purposes for Identifying and Prioritizing Health Problems/Needs
• Description of health problems required for planning interventions. Planners need to know the magnitude and distribution of health needs in a population as well as of health resources, in order to formulate adequate policies and plan interventions.
• Acquire Information required to evaluate ongoing interventions with respect to:
o Coverage of health needs o Coverage of target group(s) o Acceptability and quality
o Costs
o Effects/impact, to assess progress and the need for adjustment on a routine basis
• Acquire Information required to define problem situations in interventions in any of the fields mentioned above and to analyse possible causes of health problems in order to find solutions.
o Causes of health problems may include lack of or inequitable distribution of resources, vague policies, and any environmental factors affecting needs, health services, and others.
Sources for Obtaining Information/Data on Health Problems at District Level
• Health Management Information System (HMIS) and Health Statistics Abstracts or Records from the health facilities
• Survey and research reports
• Project and programme plans and reports
• Vital statistics records
• Census
• District annual reports and financial reports
• Community felt needs (these are either expressed by people or their leaders on their own feelings, needs and priorities)
• Personal experience of health workers o An assessment of the operationality of your district health system (district health indicators)
• Any other relevant and available source of health information
Prioritization of Health Problems for Research
• Operational research is intended to provide information for decision-making to improve health care.
• The selection and analysis of the problem for research should involve those who are responsible for the health status of the community. This would include managers in the health- and health-related services, health care workers and community leaders, as well as researchers.
• Each problem that is proposed for research has to be judged according to certain guidelines or criteria.
• Before deciding on a research topic, each proposed topic must be compared with all other options.
Guidelines/Criteria for Prioritizing Problems for Research
• Relevance
• Avoidance of duplication
• Urgency of data needed (timeliness)
• Political acceptability of study
• Feasibility of study
• Applicability of results
• Ethical acceptability
Identification of Resource Requirements Using District Health Indicators
Some Examples of District Health Indicators
• Top ten causes of morbidity and mortality (Malaria, HIV and AIDS and others)
• Crude birth rate
• Infant mortality rate
• Under-five mortality rate
• Maternal mortality rate
• Population growth rate and district population
• Health facilities including private
• Patient bed ratio and bed occupancy
• Communication facilities (transport, telephone and roads)
District Health Indicators for Resource Allocation
• Geographical features
• Economic activities, including food production
• Literacy rates
• Demographic data (total population, women of child bearing age, children under one and under-five, population growth rate, crude birth rate, crude death rate, infant mortality rate, under-five mortality rate, maternal mortality rate)
• Epidemiological data (top 10 causes of morbidity and mortality) for inpatients and outpatients
• Health services provision and use (patient bed ratio, bed occupancy)
• Access to water and sanitation facilities
• Health resource data (human, material, financial) including distribution and gaps
• Physical health infrastructure e.g. status of buildings
• Major health status and health service problems by priority
• Membership of district health board and facility committees
• Communication facilities (transport, telephone, radio, roads)
• A district map with the necessary details, including divisions, wards, roads, health facilities
• Major key partners in health in the district, e.g. NGOs, private (for profit and non-profit) community
• Medical equipment
• Existing training institutions and training resources
• Available/functional health committees
Resource Requirements for the Local Area You Are Serving or Dealing With
• District/local health problems priorities
• HIV and AIDS control in the area
• Malaria, TB and Leprosy control
• Lowering Maternal mortality rate
• Lowering Infant, under-five mortality rates
• Reduction and control of top ten morbidity and mortality causes (district disease burden)
• Family planning
• Reduction of malnutrition
• Essential health service provision
Analysis of Clinical Information Derived from HMIS Data/Service Data
• A systematic process to analyze the problems in HMIS data should be completed jointly by the researcher, health workers, managers and community representatives. This is a very crucial step in designing the research because:
o It enables those concern to pool their knowledge of the problem o It clarifies the problem and possible factors that may be contributing to it o It facilitates decisions concerning the focus and scope of the research
Systematic Process Step 1
• Clarify the view points of managers, health care workers and relevant key people and researchers in relation to the problem.
o List all the problems in the area of concern and clarify with stakeholders on how they perceive the problem.
Systematic Process Step 2
• Further specify and describe the core problem and quantify it. Elaborate on the nature of the problem, the discrepancy between ‘what is’ and ‘what you prefer the situation to be’
• The distribution of the problem – who is affected, when and where
• The size and intensity of the problem – is it widespread? How severe is it? What are its consequences (such as disability, death, waste of resources)?
Systematic Process Step 3
After identifying the core problem you should:
• Identify factors that may have contributed to the problem
• Clarify the relationship between the problem and contributing factors
• It is helpful to visualize these interrelationships in the form of a DIAGRAM. The basic principles of constructing such a diagram are illustrated below (Figure 1)
• Figure 1 shows that relationships between contributing factors and the problem can be indicated by arrows, either one- way (for cause – effect relationships) or two- way. The arrows (for mutual relationships). The core problem can be identified by drawing a double line around it.
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