Karina Kielmann

Datos Biográficos

ID131424
NOMBREKarina Kielmann
NOMBRESKarina
APELLIDOKielmann
FIRMAKIELMANN K
AFILIACIONESQueen Margaret University
ORCID0000-0001-5519-1658
VERIFICADOSí
TOTAL DE OBRAS38
TOTAL DE CITAS30
TOTAL COMO AUTOR38
TOTAL COMO EDITOR0
PRIMER AÑO DE PUBLICACIÓN2000
AÑO MÁS RECIENTE DE PUBLICACIÓN2026
ÍNDICE H4

  • Systemic challenges in the supply and distribution of medicines in conflict-affected areas of Mali

    Open AccessMohamed Ali Ag Ahmed, Mama Konta et al.ARTICLEGlobal Health Action2026

    BACKGROUND: The conflicts that have been ongoing for over a decade in different Sahel countries, including Mali, have a negative impact on the supply and distribution of medicines. OBJECTIVE: This study aims to identify and analyze the key contextual challenges affecting the supply and distribution of medicines in conflict-affected areas in Mali. METHODS: This study adopts a qualitative study design. First, we conducted 28 interviews with key sta…

  • Contextual constraints and dilemmas influencing health providers’ prescription practices in a conflict-affected area

    Open AccessIssa Coulibaly, Yacouba Diarra et al.ARTICLEPLOS Global Public Health2025

    Armed conflicts present complex, multidimensional challenges that severely compromise both access to and the quality of healthcare, including the adequate prescription of essential medicines. This study aimed to identify and understand the factors underlying the irrational prescribing of medicine in areas affected by armed conflict in the Mopti region in Mali. An exploratory qualitative study was conducted using a semi-structured interview guide …

  • Access to essential medicines for noncommunicable diseases during conflicts

    Open AccessSaleh Aljadeeah, Belen Tarrafeta et al.ARTICLEPLOS Global Public Health2025

    Access to essential medicines is a critical component of healthcare. Conflicts severely disrupt pharmaceutical supply chains. This study examines the availability and prices of essential noncommunicable diseases (NCDs) medicines in Northern Syria, and explores the underlying factors contributing to medicine shortages and price variability. We applied a mixed-methods approach, combining a cross-sectional quantitative survey based on the World Heal…

  • Irrational medicine use and its associated factors in conflict-affected areas in Mali

    Open AccessMohamed Ali Ag Ahmed, Alassane Seydou et al.ARTICLEGlobal Health Action2025

    BACKGROUND: Rational use of essential medicines is a critical step towards prevention and treatment of many illnesses. However, it represents a significant challenge worldwide, and particularly for under-resourced health systems in conflict-affected areas. OBJECTIVE: To assess barriers to rational use of essential medicines at primary healthcare level in conflict-affected areas of Mali. METHODS: We conducted a cross-sectional study in twenty rand…

  • Barriers and enablers towards integrated care for survivors of sexual violence in humanitarian settings

    Open AccessEngy Sawah, Karina Kielmann et al.ARTICLEGlobal Public Health2025

    In humanitarian settings with high levels of sexual violence (SV), care is often offered through fragmented silos, exacerbating the burden on the health workforce and survivors. We aimed to identify contextual and health systems barriers and enablers to providing integrated medical and mental health & psychosocial support (MHPSS) in the care for SV survivors in humanitarian settings. Using Valentijn's framework, a qualitative, real-time Delphi st…

  • Access to medicines among asylum seekers, refugees and undocumented migrants across the migratory cycle in Europe

    Open AccessSaleh Aljadeeah, Anil Babu Payedimarri et al.ARTICLEBMJ Global Health2024

    INTRODUCTION: Access to essential medicines is a critical element of health systems and an important measure of their performance. Migrants may face barriers in accessing healthcare, including essential medicines, throughout the migration cycle, which includes the stages of departure from home or residence countries, transit through non-European or European countries, reception and settlement in a country in Europe and deportation. We aim to prov…

  • Qualitative system dynamics modelling to support the design and implementation of tuberculosis infection prevention and control measures in South African primary healthcare facilities

    Open AccessKarin Diaconu, Aaron S Karat et al.ARTICLEHealth Policy and Planning2024

    Tuberculosis infection prevention and control (TB IPC) measures are a cornerstone of policy, but measures are diverse and variably implemented. Limited attention has been paid to the health system environment, which influences successful implementation of these measures. We used qualitative system dynamics and group-model-building methods to (1) develop a qualitative causal map of the interlinked drivers of Mycobacterium tuberculosis (Mtb) transm…

  • Cost-effectiveness of tuberculosis infection prevention and control interventions in South African clinics

    Open AccessFiammetta Bozzani, Nicky McCreesh et al.ARTICLEBMJ Global Health2023

    Introduction Nosocomial Mycobacterium tuberculosis ( Mtb ) transmission substantially impacts health workers, patients and communities. Guidelines for tuberculosis infection prevention and control (TB IPC) exist but implementation in many settings remains suboptimal. Evidence is needed on cost-effective investments to prevent Mtb transmission that are feasible in routine clinic environments. Methods A set of TB IPC interventions was codesigned wi…

  • HIV Pre-exposure Prophylaxis (PrEP) Care in Belgium

    Open AccessAnke Rotsaert, Jef Vanhamel et al.ARTICLEAIDS and Behavior2023

  • Estimating the contribution of transmission in primary healthcare clinics to community-wide TB disease incidence, and the impact of infection prevention and control interventions, in KwaZulu-Natal, So…

    Open AccessNicky McCreesh, Aaron S Karat et al.ARTICLEBMJ Global Health2022

    BACKGROUND: ) transmission in healthcare facilities in high burden settings. WHO guidelines on tuberculosis (TB) infection prevention and control (IPC) recommend a range of measures to reduce transmission in healthcare settings. These were evaluated primarily based on evidence for their effects on transmission to healthcare workers in hospitals. To estimate the overall impact of IPC interventions, it is necessary to also consider their impact on …

  • Facilitating access to medicines and continuity of care for Ukrainian refugees

    Open AccessSaleh Aljadeeah, Joris Michielsen et al.ARTICLEBMJ Global Health2022

    Aljadeeah S, Michielsen J, Ravinetto R, et al. Facilitating access to medicines and continuity of care for Ukrainian refugees: exceptional response or the promise of more inclusive healthcare for all migrants? BMJ Global Health . 2022;7(8): e010327

  • The role of emergent champions in policy implementation for decentralised drug-resistant tuberculosis care in South Africa

    Open AccessSacha Roxanne Le Roux, Waasila Jassat et al.ARTICLEBMJ Global Health2022

    OBJECTIVE: Champions are recognised as important to driving organisational change in healthcare quality improvement initiatives in high-income settings. In low-income and middle-income countries with a high disease burden and constrained human resources, their role is highly relevant yet understudied. Within a broader study on policy implementation for decentralised drug-resistant tuberculosis care in South Africa, we characterised the role, stra…

  • Estimating waiting times, patient flow, and waiting room occupancy density as part of tuberculosis infection prevention and control research in South African primary health care clinics

    Open AccessAaron S Karat, Nicky McCreesh et al.ARTICLEPLOS Global Public Health2022

    Transmission of respiratory pathogens, such as Mycobacterium tuberculosis and severe acute respiratory syndrome coronavirus 2, is more likely during close, prolonged contact and when sharing a poorly ventilated space. Reducing overcrowding of health facilities is a recognised infection prevention and control (IPC) strategy; reliable estimates of waiting times and ‘patient flow’ would help guide implementation. As part of the Umoya omuhle study, w…

  • Beyond checklists

    Open AccessStella Arakelyan, Hayley Macgregor et al.ARTICLEPLOS Global Public Health2022

    Sub-optimal implementation of infection prevention and control (IPC) measures for airborne infections is associated with a rise in healthcare-acquired infections. Research examining contributing factors has tended to focus on poor infrastructure or lack of health care worker compliance with recommended guidelines, with limited consideration of the working environments within which IPC measures are implemented. Our analysis of compromised tubercul…

  • Direct estimates of absolute ventilation and estimated Mycobacterium tuberculosis transmission risk in clinics in South Africa

    Open AccessPeter G Beckwith, Aaron S Karat et al.ARTICLEPLOS Global Public Health2022

    Healthcare facilities are important sites for the transmission of pathogens spread via bioaerosols, such as Mycobacterium tuberculosis . Natural ventilation can play an important role in reducing this transmission. We aimed to measure rates of natural ventilation in clinics in KwaZulu-Natal and Western Cape provinces, South Africa, then use these measurements to estimate Mycobacterium tuberculosis transmission risk. We measured ventilation in cli…

  • Using system dynamics modelling to estimate the costs of relaxing health system constraints

    Open AccessFiammetta Bozzani, Karin Diaconu et al.ARTICLEHealth Policy and Planning2022

    Health system constraints are increasingly recognized as an important addition to model-based analyses of disease control interventions, as they affect achievable impact and scale. Enabling activities implemented alongside interventions to relax constraints and reach the intended coverage may incur additional costs, which should be considered in priority setting decisions. We explore the use of group model building, a participatory system dynamic…

  • Complexity and evidence in health sector decision-making

    Open AccessShehani Perera, Justin Parkhurst et al.ARTICLEHealth Policy and Planning2022

    To better understand and plan health systems featuring multiple levels and complex causal elements, there have been increasing attempts to incorporate tools arising from complexity science to inform decisions. The utilization of new planning approaches can have important implications for the types of evidence that inform health policymaking and the mechanisms through which they do so. This paper presents an empirical analysis of the application o…

  • Health systems performance or performing health systems? Anthropological engagement with health systems research

    Open AccessKarina Kielmann, Eleanor Hutchinson et al.ARTICLESocial Science & Medicine2022Citada por: 5Referencias: 19

  • Modelling the effect of infection prevention and control measures on rate of Mycobacterium tuberculosis transmission to clinic attendees in primary health clinics in South Africa

    Open AccessNicky McCreesh, Aaron S Karat et al.ARTICLEBMJ Global Health2021

    Background Elevated rates of tuberculosis in healthcare workers demonstrate the high rate of Mycobacterium tuberculosis (Mtb ) transmission in health facilities in high-burden settings. In the context of a project taking a whole systems approach to tuberculosis infection prevention and control (IPC), we aimed to evaluate the potential impact of conventional and novel IPC measures on Mtb transmission to patients and other clinic attendees. Methods…

  • Health system influences on the implementation of tuberculosis infection prevention and control at health facilities in low-income and middle-income countries

    Open AccessGimenne Zwama, Karin Diaconu et al.ARTICLEBMJ Global Health2021

    BACKGROUND: Tuberculosis infection prevention and control (TB-IPC) measures are consistently reported to be poorly implemented globally. TB-IPC guidelines provide limited recognition of the complexities of implementing TB-IPC within routine health systems, particularly those facing substantive resource constraints. This scoping review maps documented system influences on TB-IPC implementation in health facilities of low/middle-income countries (L…

  • Organisational Culture and Mask-Wearing Practices for Tuberculosis Infection Prevention and Control among Health Care Workers in Primary Care Facilities in the Western Cape, South Africa

    Open AccessIdriss Ibrahim Kallon, Alison Swartz et al.ARTICLEInternational Journal of…2021

    Background : Although many healthcare workers (HCWs) are aware of the protective role that mask-wearing has in reducing transmission of tuberculosis (TB) and other airborne diseases, studies on infection prevention and control (IPC) for TB in South Africa indicate that mask-wearing is often poorly implemented. Mask-wearing practices are influenced by aspects of the environment and organisational culture within which HCWs work. Methods : We draw o…

  • We had to manage what we had on hand, in whatever way we could’

    Open AccessKarina Kielmann, Lindy Dickson-Hall et al.ARTICLEHealth Policy and Planning2021

    In 2011, the South African National TB Programme launched a policy of decentralized management of drug-resistant tuberculosis (DR-TB) in order to expand the capacity of facilities to treat patients with DR-TB, minimize delays to access care and improve patient outcomes. This policy directive was implemented to varying degrees within a rapidly evolving diagnostic and treatment landscape for DR-TB, placing new demands on already-stressed health sys…

  • It has become everybody’s business and nobody’s business’

    Open AccessC J Colvin, Idriss Ibrahim Kallon et al.ARTICLEGlobal Public Health2020

    South Africa is increasingly offering screening, diagnosis and treatment of tuberculosis (TB), and especially drug-resistant TB, at the primary care level. Nosocomial transmission of TB within primary health facilities is a growing concern in South Africa, and globally. We explore here how TB infection prevention and control (IPC) policies, historically focused on hospitals, are being implemented within primary care facilities. We spoke to 15 pol…

  • Balancing authority, deference and trust across the public–private divide in health care

    Open AccessKarina Kielmann, Vinita Datye et al.ARTICLEGlobal Public Health2014

    While concepts such as 'partnership' are central to the terminology of private-public mix (PPM), little attention has been paid to how social relations are negotiated among the diverse actors responsible for implementing these inter-sectoral arrangements. India's Revised National Tuberculosis Control Programme (RNTCP) has used intermediary agents to facilitate the involvement of private providers in the expansion of Directly Observed Therapy, Sho…

  • Public Health and The Poverty of Reforms

    Karina Kielmann