Health service needs and perspectives of remote forest communities in Papua New Guinea: study protocol for combined clinical and rapid anthropological assessments with parallel treatment of urgent cases

. 2020 Oct 31 ; 10 (10) : e041784. [epub] 20201031

Jazyk angličtina Země Anglie, Velká Británie Médium electronic

Typ dokumentu časopisecké články, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/pmid33130572
Odkazy

PubMed 33130572
PubMed Central PMC7733180
DOI 10.1136/bmjopen-2020-041784
PII: bmjopen-2020-041784
Knihovny.cz E-zdroje

INTRODUCTION: Our project follows community requests for health service incorporation into conservation collaborations in the rainforests of Papua New Guinea (PNG). This protocol is for health needs assessments, our first step in coplanning medical provision in communities with no existing health data. METHODS AND ANALYSIS: The study includes clinical assessments and rapid anthropological assessment procedures (RAP) exploring the health needs and perspectives of partner communities in two areas, conducted over 6 weeks fieldwork. First, in Wanang village (population c.200), which is set in lowland rainforest. Second, in six communities (population c.3000) along an altitudinal transect up the highest mountain in PNG, Mount Wilhelm. Individual primary care assessments incorporate physical examinations and questioning (providing qualitative and quantitative data) while RAP includes focus groups, interviews and field observations (providing qualitative data). Given absence of in-community primary care, treatments are offered alongside research activity but will not form part of the study. Data are collected by a research fellow, primary care clinician and two PNG research technicians. After quantitative and qualitative analyses, we will report: ethnoclassifications of disease, causes, symptoms and perceived appropriate treatment; community rankings of disease importance and service needs; attitudes regarding health service provision; disease burdens and associations with altitudinal-related variables and cultural practices. To aid wider use study tools are in online supplemental file, and paper and ODK versions are available free from the corresponding author. ETHICS AND DISSEMINATION: Challenges include supporting informed consent in communities with low literacy and diverse cultures, moral duties to provide treatment alongside research in medically underserved areas while minimising risks of therapeutic misconception and inappropriate inducement, and PNG research capacity building. Brighton and Sussex Medical School (UK), PNG Institute of Medical Research and PNG Medical Research Advisory Committee have approved the study. Dissemination will be via journals, village meetings and plain language summaries.

Anthropology School of Global Studies University of Sussex Falmer UK

Clinical Research London School of Hygiene and Tropical Medicine London UK

Ecology Biology Centre Institute of Entomology Ceske Budejovice Czech Republic

Evolution behaviour and environment School of Life Sciences University of Sussex Falmer UK

Faculty of Medicine and Global Health Research Institute University of Southampton Southampton UK

Global Health and Tropical Medicine New University of Lisbon Institute of Hygiene and Tropical Medicine Lisboa Portugal

Hospital for Tropical Diseases and Department of Dermatology University College London Hospitals NHS Foundation Trust London UK

Infectious Disease Research Laboratory National Centre for Infectious Diseases Singapore

Institute of Development Studies Falmer UK

International Institute for Environment and Development London UK

Medical Statistics Brighton and Sussex Medical School Falmer UK

Medicine James Cook University Townsville North Queensland Australia

New Guinea Binatang Research Centre Nagada Papua New Guinea

Papua New Guinea Institute of Medical Research Goroka Madang Papua New Guinea

Primary Care and Public Health and NIHR Global Health Research Unit on Neglected Tropical Diseases Brighton and Sussex Medical School Falmer UK

Primary Care and Public Health Brighton and Sussex Medical School Falmer UK

School of Pharmacy and Biomolecular Sciences University of Brighton Brighton UK

Sussex Sustainability Research Programme University of Sussex Falmer UK

Zoology Faculty of Science University of South Bohemia Ceske Budejovice Czech Republic

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