Jacob Mcknight
Datos Biográficos
| ID | 143141 |
|---|---|
| NOMBRE | Jacob Mcknight |
| NOMBRES | Jacob |
| APELLIDO | Mcknight |
| FIRMA | MCKNIGHT J |
| AFILIACIONES | University of Oxford |
| ORCID | 0000-0003-1340-2618 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 15 |
| TOTAL DE CITAS | 79 |
| TOTAL COMO AUTOR | 15 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2014 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 2 |
The normalisation of under-resourcing limits the potential for improvement of critical care
The reduced availability of materials, staff, and health infrastructure commonly seen in Low- and Middle-Income Country (LMIC) settings is known to directly limit the ability of a hospital to provide effective care to critically ill patients. We use Health Facility Assessments (HFAs), 'hospital journeys', and in-depth interviews across five secondary and tertiary referral-level government hospitals in Kenya to explore their readiness to provide E…
Covid-19 and unintended steps towards further equity in global health research
There was, and possibly still is, potential for COVID-19 to disrupt power inequities and contribute to positive transformation in global health research that increases equity. While there is consensus about the need to decolonise by transforming global health, and a roadmap outlining how we could approach it, there are few examples of steps that could be taken to transform the mechanics of global health research. This paper contributes lessons le…
Hospital care for critical illness in low-resource settings
Care for the critically ill patients is often considered synonymous with a hospital having an intensive care unit. However, a focus on Essential Emergency and Critical Care (EECC) may obviate the need for much intensive care. Severe COVID-19 presented a specific critical care challenge while also being an exemplar of critical illness in general. Our multidisciplinary team conducted research in Kenya and Tanzania on hospitals’ ability to provide E…
Policies and resources for strengthening of emergency and critical care services in the context of the global Covid-19 pandemic in Kenya
Critical illnesses cause several million deaths annually, with many of these occurring in low-resource settings like Kenya. Great efforts have been made worldwide to scale up critical care to reduce deaths from COVID-19. Lower income countries with fragile health systems may not have had sufficient resources to upscale their critical care. We aimed to review how efforts to strengthen emergency and critical care were operationalised during the pan…
Receive, Sustain, and Flow
Background: Hospital patients can become critically ill anywhere in a hospital but their survival is affected by problems of identification and adequate, timely, treatment. This is issue of particular concern in lower middle-income countries' (LMICs) hospitals where specialised units are scarce and severely under-resourced. "Cross-sectional" approaches to improving narrow, specific aspects of care will not attend to issues that affect patients' c…
Improving facility-based care
Attention has turned to improving the quality and safety of healthcare within health facilities to reduce avoidable mortality and morbidity. Interventions should be tested in health system environments that can support their adoption if successful. To be successful, interventions often require changes in multiple behaviours making their consequences unpredictable. Here, we focus on this challenge of change at the mesolevel or microlevel. Drawing …
Using treatment guidelines to improve antibiotic use
Clinical practice guidelines have the potential to improve quality of care through improving decision making and antibiotic prescription. These guidelines are particularly important in areas with limited laboratory and specialist capacity.\n\nFor some of the common conditions managed in the hospitals, guidelines are not available or are outdated.\n\nTo reduce irrational antibiotic use and contain the threat of antimicrobial resistance, the proces…
Information asymmetry in the Kenyan medical laboratory sector
BACKGROUND: Important information about medical laboratory providers is not readily available to all patients, clinicians nor regulators in Kenya. This study was conducted as part of a wider project aiming to improve access to high quality diagnostics by addressing information asymmetries in the Kenyan market for laboratory services. OBJECTIVES: The purpose of this study was to: 1) Gather pricing information for 49 common laboratory tests from me…
Lessons from a Health Policy and Systems Research programme exploring the quality and coverage of newborn care in Kenya
There are global calls for research to support health system strengthening in low-income and middle-income countries (LMICs). To examine the nature and magnitude of gaps in access and quality of inpatient neonatal care provided to a largely poor urban population, we combined multiple epidemiological and health services methodologies. Conducting this work and generating findings was made possible through extensive formal and informal stakeholder e…
Collective strategies to cope with work related stress among nurses in resource constrained settings
Kenyan neonatal nurses are asked to do the impossible: to bridge the gap between international standards of nursing and the circumstances they face each day. They work long hours with little supervision in ill-designed wards, staffed by far too few nurses given the pressing need. Despite these conditions, a single neonatal nurse can be tasked with looking after forty sick babies for whom very close care is a necessity. Our 18-month ethnography ex…
Evaluating hospital performance in antibiotic stewardship to guide action at national and local levels in a lower-middle income setting
BACKGROUND: Inappropriate use of antibiotics can lead to the development of resistant pathogens. Ensuring proper use of these important drugs in all healthcare facilities is essential. Unfortunately, however, very little is known about how antibiotics are used in LMIC clinical settings, nor to what degree antibiotic stewardship programmes are in place and effective. OBJECTIVE: We aimed to record all Antibiotic Stewardship policies and structures …
Maintaining Distance and Staying Immersed
The Health Services that Deliver for Newborns (HSD-N) project is supported by a multidisciplinary team with experience in ethnographic work, epidemiology, and health systems. The project aims to investigate the projected need for neonatal inpatient services; what existing infrastructure and human resource capacity is available supporting access for this population; utilization of these services; and the quality of existing nursing care services. …
Kenya at war
Kenya's invasion of southern Somalia, which began in October 2011, has turned into an occupation of attritionwhile "blowback" from the invasion has consolidated in a series of deadly Al-Shabaab attacks within Kenya. This article reviews the background to the invasion, Operation Linda Nchi, and the prosecution of the war by Kenya's Defence Forces up to the capture of the city of Kismayo and the contest to control its lucrative port. The second sec…
Understanding al-Shabaab
Harakat al-Shabaab al-Mujahideen has proven itself to be a highly adaptable organisation. Their most recent evolution has seen them transform from an overt, military and governmental force in southern Somalia to a covert, insurgent and anarchic force in Kenya. This article indicates how al-Shabaab has reinvented itself in Kenya. Both ‘clan’ and ‘Islam’ are often thought of as immutable factors in al-Shabaab's make-up, but here we show that the or…
Designing the Expanded Programme on Immunisation (EPI) as a service
Expanded Programme on Immunisation (EPI) vaccination rates remain well below herd immunity in regions of many countries despite huge international resources devoted to both financing and access. We draw upon service marketing theory, organisational sociology, development anthropology and cultural consumer research to conduct an ethnographic study of vaccination delivery in Jimma Zone, Ethiopia - one such region. We find that Western public health…
Kenya at war
Kenya's invasion of southern Somalia, which began in October 2011, has turned into an occupation of attritionwhile "blowback" from the invasion has consolidated in a series of deadly Al-Shabaab attacks within Kenya. This article reviews the background to the invasion, Operation Linda Nchi, and the prosecution of the war by Kenya's Defence Forces up to the capture of the city of Kismayo and the contest to control its lucrative port. The second sec…
Understanding al-Shabaab
Harakat al-Shabaab al-Mujahideen has proven itself to be a highly adaptable organisation. Their most recent evolution has seen them transform from an overt, military and governmental force in southern Somalia to a covert, insurgent and anarchic force in Kenya. This article indicates how al-Shabaab has reinvented itself in Kenya. Both ‘clan’ and ‘Islam’ are often thought of as immutable factors in al-Shabaab's make-up, but here we show that the or…
Collective strategies to cope with work related stress among nurses in resource constrained settings
Kenyan neonatal nurses are asked to do the impossible: to bridge the gap between international standards of nursing and the circumstances they face each day. They work long hours with little supervision in ill-designed wards, staffed by far too few nurses given the pressing need. Despite these conditions, a single neonatal nurse can be tasked with looking after forty sick babies for whom very close care is a necessity. Our 18-month ethnography ex…
Maintaining Distance and Staying Immersed
The Health Services that Deliver for Newborns (HSD-N) project is supported by a multidisciplinary team with experience in ethnographic work, epidemiology, and health systems. The project aims to investigate the projected need for neonatal inpatient services; what existing infrastructure and human resource capacity is available supporting access for this population; utilization of these services; and the quality of existing nursing care services. …
Designing the Expanded Programme on Immunisation (EPI) as a service
Expanded Programme on Immunisation (EPI) vaccination rates remain well below herd immunity in regions of many countries despite huge international resources devoted to both financing and access. We draw upon service marketing theory, organisational sociology, development anthropology and cultural consumer research to conduct an ethnographic study of vaccination delivery in Jimma Zone, Ethiopia - one such region. We find that Western public health…
Kenya at war
Kenya's invasion of southern Somalia, which began in October 2011, has turned into an occupation of attritionwhile "blowback" from the invasion has consolidated in a series of deadly Al-Shabaab attacks within Kenya. This article reviews the background to the invasion, Operation Linda Nchi, and the prosecution of the war by Kenya's Defence Forces up to the capture of the city of Kismayo and the contest to control its lucrative port. The second sec…
Understanding al-Shabaab
Harakat al-Shabaab al-Mujahideen has proven itself to be a highly adaptable organisation. Their most recent evolution has seen them transform from an overt, military and governmental force in southern Somalia to a covert, insurgent and anarchic force in Kenya. This article indicates how al-Shabaab has reinvented itself in Kenya. Both ‘clan’ and ‘Islam’ are often thought of as immutable factors in al-Shabaab's make-up, but here we show that the or…
Evaluating hospital performance in antibiotic stewardship to guide action at national and local levels in a lower-middle income setting
BACKGROUND: Inappropriate use of antibiotics can lead to the development of resistant pathogens. Ensuring proper use of these important drugs in all healthcare facilities is essential. Unfortunately, however, very little is known about how antibiotics are used in LMIC clinical settings, nor to what degree antibiotic stewardship programmes are in place and effective. OBJECTIVE: We aimed to record all Antibiotic Stewardship policies and structures …
Maintaining Distance and Staying Immersed
The Health Services that Deliver for Newborns (HSD-N) project is supported by a multidisciplinary team with experience in ethnographic work, epidemiology, and health systems. The project aims to investigate the projected need for neonatal inpatient services; what existing infrastructure and human resource capacity is available supporting access for this population; utilization of these services; and the quality of existing nursing care services. …
Lessons from a Health Policy and Systems Research programme exploring the quality and coverage of newborn care in Kenya
There are global calls for research to support health system strengthening in low-income and middle-income countries (LMICs). To examine the nature and magnitude of gaps in access and quality of inpatient neonatal care provided to a largely poor urban population, we combined multiple epidemiological and health services methodologies. Conducting this work and generating findings was made possible through extensive formal and informal stakeholder e…
Collective strategies to cope with work related stress among nurses in resource constrained settings
Kenyan neonatal nurses are asked to do the impossible: to bridge the gap between international standards of nursing and the circumstances they face each day. They work long hours with little supervision in ill-designed wards, staffed by far too few nurses given the pressing need. Despite these conditions, a single neonatal nurse can be tasked with looking after forty sick babies for whom very close care is a necessity. Our 18-month ethnography ex…
Using treatment guidelines to improve antibiotic use
Clinical practice guidelines have the potential to improve quality of care through improving decision making and antibiotic prescription. These guidelines are particularly important in areas with limited laboratory and specialist capacity.\n\nFor some of the common conditions managed in the hospitals, guidelines are not available or are outdated.\n\nTo reduce irrational antibiotic use and contain the threat of antimicrobial resistance, the proces…
Information asymmetry in the Kenyan medical laboratory sector
BACKGROUND: Important information about medical laboratory providers is not readily available to all patients, clinicians nor regulators in Kenya. This study was conducted as part of a wider project aiming to improve access to high quality diagnostics by addressing information asymmetries in the Kenyan market for laboratory services. OBJECTIVES: The purpose of this study was to: 1) Gather pricing information for 49 common laboratory tests from me…
Improving facility-based care
Attention has turned to improving the quality and safety of healthcare within health facilities to reduce avoidable mortality and morbidity. Interventions should be tested in health system environments that can support their adoption if successful. To be successful, interventions often require changes in multiple behaviours making their consequences unpredictable. Here, we focus on this challenge of change at the mesolevel or microlevel. Drawing …
Covid-19 and unintended steps towards further equity in global health research
There was, and possibly still is, potential for COVID-19 to disrupt power inequities and contribute to positive transformation in global health research that increases equity. While there is consensus about the need to decolonise by transforming global health, and a roadmap outlining how we could approach it, there are few examples of steps that could be taken to transform the mechanics of global health research. This paper contributes lessons le…
Hospital care for critical illness in low-resource settings
Care for the critically ill patients is often considered synonymous with a hospital having an intensive care unit. However, a focus on Essential Emergency and Critical Care (EECC) may obviate the need for much intensive care. Severe COVID-19 presented a specific critical care challenge while also being an exemplar of critical illness in general. Our multidisciplinary team conducted research in Kenya and Tanzania on hospitals’ ability to provide E…
Policies and resources for strengthening of emergency and critical care services in the context of the global Covid-19 pandemic in Kenya
Critical illnesses cause several million deaths annually, with many of these occurring in low-resource settings like Kenya. Great efforts have been made worldwide to scale up critical care to reduce deaths from COVID-19. Lower income countries with fragile health systems may not have had sufficient resources to upscale their critical care. We aimed to review how efforts to strengthen emergency and critical care were operationalised during the pan…
Receive, Sustain, and Flow
Background: Hospital patients can become critically ill anywhere in a hospital but their survival is affected by problems of identification and adequate, timely, treatment. This is issue of particular concern in lower middle-income countries' (LMICs) hospitals where specialised units are scarce and severely under-resourced. "Cross-sectional" approaches to improving narrow, specific aspects of care will not attend to issues that affect patients' c…
The normalisation of under-resourcing limits the potential for improvement of critical care
The reduced availability of materials, staff, and health infrastructure commonly seen in Low- and Middle-Income Country (LMIC) settings is known to directly limit the ability of a hospital to provide effective care to critically ill patients. We use Health Facility Assessments (HFAs), 'hospital journeys', and in-depth interviews across five secondary and tertiary referral-level government hospitals in Kenya to explore their readiness to provide E…
Medicine (12 obras) · Health care (10 obras) · Nursing (10 obras) · Political science (10 obras) · Business (8 obras) · Global Maternal and Child Health (6 obras) · Sociology (6 obras) · Kenya (5 obras) · Public relations (5 obras) · Economic growth (4 obras)