Introduction: In this study, we developed a simplified artificial intelligence to support the clinical decision-making of medical personnel in a resource-limited setting.Methods: We selected seven infectious disease categories that impose a heavy disease burden in the central Vietnam region: mosquito-borne disease, acute gastroenteritis, respiratory tract infection, pulmonary tuberculosis, sepsis, primary nervous system infection, and viral hepatitis. We developed a set of questionnaires to collect information on the current symptoms and history of patients suspected to have infectious diseases. We used data collected from 1,129 patients to develop and test a diagnostic model. We used XGBoost, LightGBM, and CatBoost algorithms to create artificial intelligence for clinical decision support. We used a 4-fold cross-validation method to validate the artificial intelligence model. After 4-fold cross-validation, we tested artificial intelligence models on a separate test dataset and estimated diagnostic accuracy for each model.Results: We recruited 1,129 patients for final analyses. Artificial intelligence developed by the CatBoost algorithm showed the best performance, with 87.61% accuracy and an F1-score of 87.71. The F1-score of the CatBoost model by disease entity ranged from 0.80 to 0.97. Diagnostic accuracy was the lowest for sepsis and the highest for central nervous system infection.Conclusion: Simplified artificial intelligence could be helpful in clinical decision support in settings with limited resources.

Background: Immunization is an effective preventive health intervention. In Cameroon, the Expanded Program on Immunization (EPI) aims to vaccinate children under 5 years of age for free, but vaccination coverage has consistently remained below the national target. Vaccines are distributed based on the target population size, factoring in wastage norms. However, the vaccine wastage rate (VWR) may differ among various settings. Our study aimed to assess vaccine wastage for different site settings, seasonality, and vaccine types in comparison to vaccination coverage in order to provide comprehensive insights on vaccine wastage.Methods: A retrospective data collection and analysis were conducted on immunization and vaccine wastage data in the Littoral Region of Cameroon during 2016 and 2017. Health districts were classified as urban or rural, seasonality was categorized as rainy or dry season, and vaccine types were grouped into liquid, lyophilized, oral, and injectable vaccines. VWRs and vaccination coverage rates (VCRs) were calculated, and the vaccine waste factor was investigated.Results: The VWR of Bacillus Calmette-Guérin (BCG; 32.19%) was the highest, followed by measles and rubella (MR; 19.05%) and yellow fever (YF; 18.34%) among all EPI vaccines in the Littoral Region of Cameroon during 2016 and 2017. Single-dose vaccine vials exhibited lower VWRs than multi-dose vials. Dry season was associated with higher VWRs for most vaccines, although more lyophilized vaccines (BCG, MR, YF vaccines) were wasted in rainy season in 2016. The VWR was persistently higher in rural than urban health districts. The months of February and November saw a decrease in VCRs. The study found an overall negative correlation between VCR and VWR.Conclusions: Multiple factors may cause wastage of EPI vaccines in Cameroon. Vaccination area characteristics, seasonality, types of vaccines such as multi- or single-dose, lyophilized or injectable vaccines are related to VWRs in Littoral Region. Further research on vaccine wastage and vaccination coverage across Cameroon is needed to better understand the socio-behavioral aspect of vaccine in-take that may affect the level of vaccination and vaccine wastage. Public health system strengthening is warranted to adapt more real-time monitoring of the VWR and VCR for each vaccine in the government’s immunization programs.

Purpose: This study analyzed the project outcomes to share lessons regarding the development of an emergency medicine education system in Vietnam. Methods: Retrospective evaluation was implemented using project outcome indicators. Results: A total of 13 training courses were administered, with the collaboration of international experts in Korea and Vietnam. A total of 23 kinds of emergency medicine education equipment were purchased, and a basic life support (BLS) and two advanced cardiac life support labs were remodeled to provide appropriate simulation training. Throughout the 2 years of the project, nine Vietnamese BLS instructors were approved by the Korea Association of Cardiopulmonary Resuscitation under American Heart Association. Results of evaluation by Korean international development experts were based on five criteria, provided by the Development Assistance Committee of the Organization for Economic Co-operation and Development, were excellent. Success factors were identified as partnership, ownership, commitment, government support, and global networking. Conclusion: Project indicators were all accomplished and received an excellent evaluation by external experts. For sustainable success, healthcare policy and legal regulation to promote high quality and safe service to the Vietnamese people are recommended.

Background: Nurses are an essential human resource to ensure a healthy population and support the socio-economic development. However, little research has focused on the capacity development of nurses. Objective: The performance of a capacity development project for an undergraduate nursing program in Vietnam was reviewed to share lessons. Design: A descriptive case report. Setting: A baccalaureate nursing program in Vietnam from June 2014 to June 2016. Methods: A case report was analyzed in terms of the project's process, and the outcomes of 2 years' activities were evaluated. Results: Practice-based curriculum redesign and two basic nursing subjects were developed after five rounds of curriculum workshops. To improve application efficiency, two nursing experts were dispatched to provide instructions regarding the application of the new subjects. Three candidates were invited to complete their master's and doctoral studies in Korea. An advanced nursing education environment was supported with simulation labs equipped within a ubiquitous network. The result of experts' evaluation was excellent by every criterion of the Organization for Economic Co-operation and Development—Development Assistance Committee. Conclusions: The capacity development of a nursing program was possible through ownership, accountability, and results-based management. Gradual improvement in nursing academic and clinical capacity building based on research evidence can empower partner countries' nursing leadership. Introduction.

Community-based health insurance schemes help households to afford healthcare services. This paper describes healthcare facilities and community factors that are associated with the Improved Community Health Fund (iCHF) scheme in the Ubungo district of Tanzania. A cross-sectional descriptive study was conducted using online questionnaires that were completed by healthcare providers and community members in public-owned healthcare facilities in the Ubungo Municipal Council district of Dar es Salaam, Tanzania, between October and November 2021. The data were analyzed using descriptive statistics and the chi-squared test of association. We found a statistically significant relationship between income level and satisfaction with the iCHF scheme. For community-related factors, income level was statistically significant in the level of involvement in iCHF implementation among local leaders. Further, income level was statistically significant in relation to community behavior/culture toward the iCHF. Occupation was statistically significant in iCHF implementation, iCHF premiums, and iCHF membership size. A statistically significant relationship was also found between income, iCHF membership size, and iCHF premiums. Moreover, people would be willing to pay the required premiums if the quality of the healthcare services under the iCHF scheme improves. Therefore, the government should allocate resources to reduce the challenges that are facing iCHF implementation, such as the preference for a user fee scheme over the iCHF, the issues that are faced by enrollment officers, and inadequate iCHF premiums and membership size.