BackgroundTuberculosis is a major public health problem in Liberia. According to the World Health Organization (WHO), the incidence of tuberculosis in Liberia is significantly increasing from year to year. However, little is known about the performance of the programme and the challenges after the 14 years of civil war which ended in 2003.The purpose of the study was to evaluate the performance of the TB programme of Liberia.MethodsThe study utilised mixed research design; both quantitative and qualitative methods were used in this study conducted from 2013 to 2014. For the quantitative part of the study, a questionnaire, laboratory performance and eleven years TB programme data (2003–2013) were used. For the performance of tuberculosis laboratory testing, all the 107 functional tuberculosis microscopy centers in Liberia were included. For the qualitative part of the study, an interview of 10 informants and two focus group discussions (FGDs) were also conducted, each comprising of eight people. Themes and subthemes emerged from the two FGDs. Data was analysed in line with the Donabedian model. Quantitative findings were analysed and presented using both descriptive and inferential statistics.ResultsThe study findings pointed out that there was overall improvement in the performance of the tuberculosis control programme in Liberia from 2003 to 2013. The percentage of cured patients was 60% in 2005 and 62% in 2013. Percentage of treatment completed was 16% in 2005 and 21% in 2013. The case detection rate was 57% and treatment success rate 80% in 2013. The default rate was 11% in 2013. Of the 139 participants, 120 (86%) completed TB treatment while 19 (14%) did not.ConclusionBetween 2003 and 2013, the National Leprosy and Tuberculosis Control Programme (NLTCP) succeeded in restoring the TB services and improving some of the TB treatment outcomes including the Directly observed treatment short courses(DOTS) coverage. Despite these improvements, the TB treatment, laboratory services and human resource capacity lagged behind. The TB programme of Liberia needs to develop new strategies to address its challenges.

Professional nurse training in South Africa (SA) takes place within public nursing colleges, which are spread over the nine provinces. There are 14 such public nursing colleges in SA, with 34 sub-campuses. Professional nurse training is offered in terms of regulation R425 of the Nursing Act No. 50 of 1978, leading to registration as a nurse (general, psychiatry and community) or midwife. Anatomy and physiology (A&P) is a core subject taught in the first year of training. [1] The expectation is that on completion of education and training, students should have good observational, analysis and problem-solving skills, since modern nursing requires awareness of interactions between anatomical and physiological systems in pathological processes. [2] A background in A&P for the 4-year comprehensive basic nursing course is part of strict entry requirements for nursing students. Life sciences entail basic terminology that is used in human anatomy and physiology, and therefore form part of the admission requirements for the 4-year comprehensive basic nursing course. Without passes in life sciences, nursing colleges in SA do not admit applicants, regardless of their grade 12 score, to ensure that all students have at least a foundation in A&P. [3] The entry requirements for nurse training at the public nursing colleges in SA also include a grade 12 certificate with a minimum score of 25. Admission requirements in Australia are similar to those in the colleges under study, as mathematics, science and English are the prerequisite subjects for admission. [4] In Ghana, English, mathematics, science and some age restrictions are basic requirements for admission. Unlike in SA, applicants must be between the ages of 18 and 35 years. This means that applicants under or over the stipulated age categories are excluded from the applications even if they meet the other requirements for admission. [5] Background. Student nurses in South Africa view anatomy and physiology (A&P) as the most complex subject in the nursing curriculum. Objective. To describe the factors contributing toward inconsistent and fluctuating performance among student nurses doing A&P as a subject. Methods. The study adopted a quantitative descriptive design. Census sampling was used to draw a sample size of 114 respondents. A structured self-administered questionnaire with close-ended questions was used to collect data from the six nursing campuses under study. Raw data were captured using Excel spreadsheets, and descriptive and inferential statistics were used to analyse data. Results. The key findings were: (i) poor teaching strategies contributed to subject failure; (ii) lack of after-class sessions had an impact on failure; (iii) a shorter study period for examinations contributed to failure; and (iv) a language barrier also played an important role in students' failure in A&P. Conclusion. Student nurses struggle with and find A&P in nursing programmes challenging and anxiety-provoking. Nurse educators need to come up with innovative teaching strategies that w...

In Ethiopia the health system is underdeveloped and much of the rural population has limited access to modern health services. The Ethiopian government introduced the Health Extension Program which is a community-based health care delivery system aimed at accessing essential health services such as malaria treatment through its health extension workers (HEWs). The objective of this study was to evaluate factors influencing malaria treatment practice of health extension workers (HEWs) and patient adherence to antimalarial drugs. A qualitative research design that is explorative and descriptive was used. Data was collected by means of (1) in-depth individual interviews among 20 HEWs, and seven focus group discussions with malaria treated patients. Data was analyzed thematically. Four themes emerged from the data, namely: (1) health facility related factors, (2) HEWs related factors, (3) patient related factors, and (4) community related factors. Improving the availability of essential resources such as rapid diagnostic test kits (RDT) and antimalarial drugs, improving the community’s perception towards antimalarial drug effectiveness and adequately educating patients on how to take antimalarial drugs can improve malaria treatment practice of the HEWs and patient adherence to antimalarial drugs.

Short Research ReportNurse educators are not born to be teachers, but becoming effective at teaching requires special knowledge and skills. [1] This competency is achieved by student nurse educators (SNEs) undergoing teaching practice (TP) sessions to acquire pedagogical skills and learn how to teach. In South Africa (SA), preparation of nurse educators is done at universities by departments of nursing science. At the institution concerned in the present study, TP is a component of a bachelor's degree programme leading to registration as a nurse educator. The degree is offered online, as the university is an open distance electronic learning institution (ODEL). It is undertaken by students who are at their third-year level of training in a simulated environment for a period of 1 week.Simulation workshops are a common feature of student teacher preparation and are done in other countries to teach SNEs how to teach. In India and Iraq, TP is termed a simulation workshop and forms part of SNE preparation as an educator. [2] The link between theory and practice is often skewed in favour of theory. The one-week exposure of SNEs currently practiced at the institution under study is short, to enable them to rapidly acquire the requisite pedagogical skills. ObjectivesThe aims of the study were to: • explore the experiences of SNEs who attend the TP workshop • gather suggestions from participants on improving TP • develop a supportive framework to guide and enhance TP. MethodsA qualitative, phenomenological research design to gain insight into the depth, richness and complexities inherent in the lived experiences of SNEs who attend TP workshops was adopted. TP workshops at the institution under study are spread over a period of 3 months, from June to September of each year. Data were obtained from two groups: the first group (9 students) attended between 14 and 18 July 2018 and the second group (11 students) between 14 and 18 August 2018.Using non-probability purposive sampling, a total of 20 (out of 35) SNEs participated in the study after signing consent forms. Data were obtained from SNEs using written narratives as proposed by Hopwood and Paulson. [3] Participants were requested to reflect on their experiences and to write them down on the narrative guide that was given to each participant. The guide included two questions: • Share your experiences on TP workshops you have attended.• How can the quality of TP workshops be enhanced for maximum acquisition of pedagogical skills? Give suggestions.Data were analysed using Tesch's (1990) eight steps of the coding process. The researcher read and re-read written narratives, identifying similar ideas and patterns which were coded and grouped together into themes.

Background. Tuberculosis (TB) is a major public health problem in Liberia. Little is known about the TB laboratory performance of Liberia and the challenges after the 14 years of civil war which ended in 2003. The purpose of the study was to evaluate the TB laboratory performance of Liberia. Methods. A cross-sectional study was conducted from 2014 to 2015. The study was conducted using quantitative data of TB case findings, sputum microscopy proficiency testing, and on-site assessment of sputum microscopy laboratories in Liberia. 80 laboratories participated in the proficiency testing. Besides, four years’ (2012–2015) TB case finding data obtained from the National Leprosy and Tuberculosis Control Programme (NLTCP) were used to complement the study. The data were analysed using descriptive statistics. Results. From the 80 TB sputum microscopy testing laboratories participating in proficiency testing, only 20 (25%) scored acceptable performance. 46 (58%) TB microscopy laboratories reported quantification errors for the proficiency panel slide 6 which was 3+. The national TB smear-positive cases notified were 4342 in 2012 but decreased to 3820 and 2448 in 2013 and 2014, respectively. The TB smear case detection rate showed an increase from 68% in 2010 to 78% in 2011 and a decrease to 60%, 57%, and 42% in 2012, 2013, and 2014, respectively. Conclusion. Between 2010 and 2013, the NLTCP succeeded in increasing the number of TB sputum microscopy laboratories. At most of the TB microscopy sites, the TB laboratory quality system was not implemented. The NLTCP of Liberia should develop strategies to overcome its challenges in TB laboratory testing.