scholarly journals Nursing staff dynamics and implications for maternal health provision in public health facilities in the context of HIV/AIDS

Author(s):  
Loveday Penn-Kekana ◽  
Duane Blaauw ◽  
Khin Tint ◽  
Desiree Monareng ◽  
Jane Chege
2020 ◽  
Author(s):  
Robert Alhassan ◽  
Benedicta Quarshie-Odoo Karley ◽  
Francis Ennin Ackah ◽  
Irene Adodoaji

Abstract Background It is estimated that millions of patients are affected by healthcare associated infections (HAIs) each year. In Ghana, high prevalence of HAIs in relations to septic and surgical wounds has been largely attributed to poor adherence to standard policy protocols on wound management by clinical staff especially nurses. Objective Explore the extent to which nursing staff adhere to the policy protocol on management of septic and surgical wounds in selected public health facilities in Ghana. Methodology An analytic cross-sectional study among nursing staff (n=140) in three government facilities in the Volta region of Ghana. Subjective and objective performance scores of staff on adherence proxies were compared using the Wilcoxon Signed-rank test, and univariate ordered logistic regression analysis used to predict staff likelihood of adherence to standard policy protocols on septic and surgical wound care. Findings Overall, staff self-rated themselves higher on subjective performance proxies relative to their objective scores (p<0.05). Staff with more years of work experience did not translate into a higher likelihood of adhering to standard protocol on wound healing (Coef.= -0.49, CI=-0.93 -0.05, p=0.036). Conversely, being a senior nursing officer relative to other professional ranks increases staff likelihood of complying with standard policy protocol for wound care (Coef. 5.27, CI=0.59 9.95, p=0.027) relative to lower rank of nurses. Conclusion There is the need for accelerated in-service training for staff on standard protocols for wound are coupled with supportive supervisions. Staff adherence to standard quality care should be a pre-requisite for licensing of health facilities by regulatory bodies like Health Facilities Regulatory Agency and National Health Insurance Authority.


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045997
Author(s):  
Abhijit Pakhare ◽  
Ankur Joshi ◽  
Rasha Anwar ◽  
Khushbu Dubey ◽  
Sanjeev Kumar ◽  
...  

ObjectivesHypertension and diabetes mellitus are important risk factors for cardiovascular diseases (CVDs). Once identified with these conditions, individuals need to be linked to primary healthcare system for initiation of lifestyle modifications, pharmacotherapy and maintenance of therapies to achieve optimal blood pressure and glycaemic control. In the current study, we evaluated predictors and barriers for non-linkage to primary-care public health facilities for CVD risk reduction.MethodsWe conducted a community-based longitudinal study in 16 urban slum clusters in central India. Community health workers (CHWs) in each urban slum cluster screened all adults, aged 30 years or more for hypertension and diabetes, and those positively screened were sought to be linked to urban primary health centres (UPHCs). We performed univariate and multivariate analysis to identify independent predictors for non-linkage to primary-care providers. We conducted in-depth assessment in 10% of all positively screened, to identify key barriers that potentially prevented linkages to primary-care facilities.ResultsOf 6174 individuals screened, 1451 (23.5%; 95% CI 22.5 to 24.6) were identified as high risk and required linkage to primary-care facilities. Out of these, 544 (37.5%) were linked to public primary-care facilities and 259 (17.8%) to private providers. Of the remaining, 506 (34.9%) did not get linked to any provider and 142 (9.8%) defaulted after initial linkages (treatment interrupters). On multivariate analysis, as compared with those linked to public primary-care facilities, those who were not linked had age less than 45 years (OR 2.2 (95% CI 1.3 to 3.5)), were in lowest wealth quintile (OR 1.8 (95% CI 1.1 to 2.9), resided beyond a kilometre from UPHC (OR 1.7 (95% CI 1.2 to 2.4) and were engaged late by CHWs (OR 2.6 (95% CI 1.8 to 3.7)). Despite having comparable knowledge level, denial about their risk status and lack of family support were key barriers in this group.ConclusionsThis study demonstrates feasibility of CHW-based strategy in promoting linkages to primary-care facilities.


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