Absrtact
Objective
To understand perspectives and experiences related to participation in a quality improvement collaborative (QIC) to improve person-centered care (PCC) for maternal health and family planning (FP) in Kenya.
Design and setting
Semi-structured qualitative interviews were conducted with members of the QIC in four public health facilities in Kenya.
Participants
Clinical and nonclinical public health facility staff who had participated in the QIC were purposively sampled to participate in the semi-structured interviews.
Intervention
A QIC was implemented across four public health facilities in Nairobi and Kiambu Counties in Kenya to improve PCC experiences for women seeking maternity or FP services.
Main outcome measure
Semi-structured interviews with participants of the QIC to understand perspectives and experiences associated with sensitization to and implementation of PCC behaviors in maternity and FP services.
Results
Respondents reported that sensitization to PCC principles resulted in multiple perceived benefits for staff and patients alike, including improved interactions with patients and clients, deeper awareness of patient and client preferences, and improved interpersonal skills and greater job satisfaction. Respondents also highlighted system-level challenges that impeded their ability to consistently provide high-quality PCC to women, namely staff shortages and frequent turnover, high patient volumes and lack of space in their respective health facilities.
Conclusion
Respondents were easily able to articulate perceived benefits derived from participation in this QIC, although they were equally able to identify challenges that hindered their ability to consistently provide high-quality PCC to women seeking maternity or FP services.
The main and most efficient measure to control potato cyst nematode (PCN) is the use of resistant cultivars. German and Dutch National Plant Protection Organizations (NPPOs) recently reported the emergence of Globodera pallida populations virulent on potato cultivars carrying resistance against pathotype 2/3. The development and virulence of the virulent population Oberlangen from Germany in comparison to the reference population G. pallida Pa3 Chavornay were investigated on resistant and susceptible cultivars in glasshouse experiments. Various life history traits associated with change in virulence were also assessed. Hatching of second-stage juveniles (J2s) was similar for both populations but incubation of cysts in potato root diffusate resulted in higher hatching rates compared to 3 mM Zinc Chloride and tap water. Both populations showed high penetration rates in the roots of the resistant and susceptible cultivars. However, only the population Oberlangen was able to complete the life cycle in the roots of the resistant potato cultivar. In 'Seresta', the resistance response restricted the formation of females by avirulent individuals in favor of males. Oberlangen was virulent on all cultivars tested. No difference in cyst size, number of eggs per cyst, length of juveniles, and males was found for Oberlangen and Chavornay on the susceptible cv. 'Desiree'. However, cysts of virulent populations from the same region Oberlangen was obtained from had a significantly larger diameter compared to avirulent populations. The population Oberlangen showed a higher reproduction and fitness than the reference population Chavornay on susceptible cultivars and could serve as a future reference population in testing of new potato cultivars for resistance against this new virulence type in Europe.
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