scholarly journals Stepping Up Lady Health Worker (LHW) Program and Integrating the Electronic Immunization Record and Tracking System into the Program as a Pilot Project in the Underserved District of Quetta, Balochistan, Pakistan

2021 ◽  
Vol 10 (3) ◽  
pp. 133-139
Author(s):  
Tehrima Rai
Keyword(s):  
Health Worker ◽  
Small Businesses ◽  
Health Workers ◽  
Tracking System ◽  
Pilot Project ◽  
Healthcare Services ◽  
Health Priorities ◽  
District Health ◽  
Record System ◽  
Lady Health Worker

Pakistan is one of those countries which are continuously struggling with providing essential primary healthcare services, especially in rural and underserved areas. To combat vaccine-preventable diseases, the Expanded Program on Immunization (EPI) has been active since 1978. Additionally, Lady Health Worker Program (LHWP) fits best with district health priorities of mother and child healthcare, family planning and National Immunization Days (NIDs). However, Pakistan faces many challenges. One is significant disparities in allocation and retention of LHW between provinces such as Punjab and Balochistan. Others are the lack of formal training and management of LHWs and a lack of immunization record system leading to vaccine wastage and broken logistics. How other low to middle-income countries (LMIC) are addressing these issues, is evident from Bangladesh and India. The Shasthya Shebika (SS) Program of Bangladesh is unique in having strategies for focused, structured training and retention of community health workers (CHWs) who receive small loans to establish funds, which they use to sell medical products to the community. To tackle the issue of lack of immunization data and vaccination wastage due to inadequate inventory, India has launched an Electronic Vaccination Intelligence Network (eVIN). The Ministry of Health, Pakistan has the potential to start a healthcare project to address the challenges mentioned above. The recommendations include allocation of 500 LHW (lady health workers) in the underserved district of Quetta in Balochistan with the implementation of retention strategies by funding LHW for small businesses, providing a formal educational structure and training and supervision of LHWs for innovative electronic immunization system. LHWs will have access to relevant educational materials and electronic devices such as tablets.

Current situation and factors impact to continuous training of health worker at Tan Thanh District Health Center, Long An province in the period of 2017-2019

2021 ◽  
Vol 05 (03) ◽  
pp. 86-93
Author(s):  
Thi Ut Hien Le ◽  
◽  
Van Hoang Nguyen ◽  
Huyen Chu
Keyword(s):  
Health Center ◽  
Health Worker ◽  
Health Workers ◽  
Secondary Data ◽  
Current Situation ◽  
Continuous Training ◽  
District Health ◽  
Factors Influencing ◽  
Depth Interview ◽  
Negative Factors

Objectives: The study aims to describe the current situation and need for continuous training and analyze some factors influencing the continuous training situation of nurses at Tan Thanh District Health Center, Long An Province in period of 2017 - 2019. Methods: A study of qualitative and qualitative research was conducted through interviews with 113 health workers and 10 in-depth interview and retrospect of secondary data on continuing training for 3 years from 2017 - 2019 at Tan Thanh District Health Center, Long An province. Results: There were only 30.1% of health workers participated in continuous training reached 48 class-hour per 2 years in compliance with Circular 22/2013/TT-BYT. Positive factors come from the organization of training if the training content is necessary and appropriate and the training course provided certificate. Some negative factors were limited funding and the lack of time for for continuing training due to overload of working. Conclusion: The Health Center should have a plan to allocate funds and human resource to ensure the implementation of the continuous training reached 48 class-hour per 2 years and cooperate with the needs of health workers. Key words: Continuous training; health worker

scholarly journals Stakeholder Perceptions and Context of the Implementation of Performance-Based Financing in District Hospitals in Mali

2019 ◽  
Vol 8 (10) ◽  
pp. 583-592 ◽  
Author(s):  
Tony Zitti ◽  
Lara Gautier ◽  
Abdourahmane Coulibaly ◽  
Valéry Ridde
Keyword(s):  
Reproductive Health ◽  
Health Personnel ◽  
Health Workers ◽  
Health Management ◽  
Participant Observation ◽  
Pilot Project ◽  
District Health ◽  
Performance Based Financing ◽  
District Hospitals

Background: To improve the performance of the healthcare system, Mali’s government implemented a pilot project of performance-based financing (PBF) in the field of reproductive health. It was established in the Koulikoro region. This research analyses the process of implementing PBF at district hospital (DH) level, something which has rarely been done in Africa. Methods: This qualitative research is based on a multiple, explanatory, and contrasting case study with nested levels of analysis. It covered three of the 10 DHs in the Koulikoro region. We conducted 36 interviews: 12 per DH with council of circle’s members (2) and health personnel (10). We also conducted 24 non-participant observation sessions, 16 informal interviews, and performed a literature review. We performed data analysis using the Consolidated Framework for Implementation Research (CFIR). Results: Stakeholders perceived the PBF pilot project as a vertical intervention from outside that focused solely on reproductive health. Local actors were not involved in the design of the PBF model. Several difficulties regarding the quality of its design and implementation were highlighted: too short duration of the intervention (8 months), choice and insufficient number of indicators according to the priority of the donors, and impossibility of making changes to the model during its implementation. All health workers adhered to the principles of PBF intervention. Except for members of the district health management team (DHMT) involved in the implementation, respondents only had partial knowledge of the PBF intervention. The implementation of PBF appeared to be easier in District 3 Hospital compared to District 1 and District 2 because it benefited from a pre-pilot project and had good leadership. Conclusion: The PBF programme offered an opportunity to improve the quality of care provided to the population through the motivation of health personnel in Mali. However, several obstacles were observed during the implementation of the PBF pilot project in DHs. When designing and implementing PBF in DHs, it is necessary to consider factors that can influence the implementation of a complex intervention

scholarly journals Evaluation of Maternal Death Surveillance and Response System in Dewachefa Woreda, Oromia Zone, Amhara Region, Ethiopia, 2018

2020 ◽  
Author(s):  
Mengistie Tariku ◽  
Sewnet Wongiel Misikir ◽  
Simachew Animen Bantie ◽  
Abebe Habtamu Belete
Keyword(s):  
Health Worker ◽  
Maternal Death ◽  
Health Workers ◽  
Health Facilities ◽  
Maternal And Newborn Health ◽  
Health Extension Worker ◽  
District Health ◽  
Response System ◽  
Surveillance And Response ◽  
Focal Person

Abstract Background: Maternal death surveillance and response (MDSR) is the “litmus test” of the health system that provides evidence for accomplishment, links activities to results, makes maternal death visible at all levels, informs communities & health workers, increases country ownership of data, provides information in real time and allows improvement towards catching all maternal mortalities. The aim of study was to evaluate maternal death surveillance and response system in Dewachefa. Methods: A cross sectional study design was conducted in two health centers, five health post, district health office and from these facilities 32 health workers were included. Data were collected through focal person, health worker and health extension worker interview by using checklist. Collected data were entered into Epi data version 3.1. These data were exported to statistical package for social science for analysis. Analyzed data were presented in the form of text, table and figures. Result: The average completeness of weekly report form of the district was 77.4%. Twenty-eight (87.5%) of the health worker had not got Maternal death surveillance and response (MDSR) training. All visited health facilities and Woredas focal person were trained. The system had under notification of maternal death from the community, poor involvement of health facility staff, and discordance of data between public health emergency management, and maternal and newborn health unit report. Establish rapid response team that includes maternal and child health staff’s maternal death review committees in all health facilities.

scholarly journals Identifying factors that support community health worker motivation, job satisfaction, and retention in Haiti

2021 ◽  
Author(s):  
◽  
Keyword(s):  
Job Satisfaction ◽  
Health System ◽  
Community Health ◽  
Health Worker ◽  
Health Workers ◽  
Critical Role ◽  
Healthcare Services ◽  
Incentive Structures ◽  
Hard To Reach Populations ◽  
Health Project

Community health workers (CHWs) play a critical role in Haiti’s health system, by connecting communities—particularly rural and hard-to-reach populations—to healthcare services. The Frontline Health project conducted a study to better understand the types of incentive structures that can best support the CHWs in Haiti and this brief summarizes those findings.

scholarly journals Evaluation of Maternal Death Surveillance and Response System in Dewachefa Woreda, Oromia Zone, Amhara Region, Ethiopia, 2018

2020 ◽  
Author(s):  
Mengistie Tariku
Keyword(s):  
Health Worker ◽  
Maternal Death ◽  
Health Workers ◽  
Health Facilities ◽  
Maternal And Newborn Health ◽  
Health Extension Worker ◽  
District Health ◽  
Response System ◽  
Surveillance And Response ◽  
Focal Person

Abstract Background Maternal death surveillance and response (MDSR) is the “litmus test” of the health system that provides evidence for accomplishment, links activities to results, makes maternal death visible at all levels, informs communities & health workers, increases country ownership of data, provides information in real time and allows improvement towards catching all maternal mortalities. The aim of study was to evaluate maternal death surveillance and response system in Dewachefa. Methods A cross sectional study design was conducted in two health centers, five health post, district health office and from these facilities 32 health workers were included. Data were collected through focal person, health worker and health extension worker interview by using checklist. Collected data were entered into Epi data version 3.1. These data were exported to statistical package for social science for analysis. Analyzed data were presented in the form of text, table and figures. Result The average completeness of weekly report form of the district was 77.4%. Twenty-eight (87.5%) of the health worker had not got Maternal death surveillance and response (MDSR) training. All visited health facilities and Woredas focal person were trained. The system had under notification of maternal death from the community, poor involvement of health facility staff, and discordance of data between public health emergency management, and maternal and newborn health unit report. Establish rapid response team that includes maternal and child health staff’s maternal death review committees in all health facilities.

Hygiene treatment of the hands of health workers is the most important condition for the prevention of infections related to medical care (assessment of the implementation of the pilot project)

2020 ◽  
pp. 12-19
Author(s):  
Nikolay Vladimirovich Shestopalov ◽  
◽  
Izabella Aleksandrovna Khrapunova ◽  
Tatyana Nikolaevna Shestopalova ◽  
Vasiliy Gennadevich Akimkin ◽  
...  
Keyword(s):  
Medical Care ◽  
Health Workers ◽  
Pilot Project ◽  
Important Condition ◽  
Care Assessment ◽  
Prevention Of Infections

scholarly journals Building trust and enhancing localization to improve access to women’s health services in Afghanistan

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F R Rab ◽  
S S Stranges ◽  
A D Thind ◽  
S S Sohani
Keyword(s):  
Health Care ◽  
Health Services ◽  
Vulnerable Populations ◽  
Time Trend ◽  
Health Workers ◽  
Healthcare Services ◽  
Delivery Of Healthcare ◽  
Care Services ◽  
Women And Children ◽  
Delivery Of Health Services

Abstract Background Over 34 million people in Afghanistan have suffered from death and devastation for the last four decades as a result of conflict. Women and children have borne the brunt of this devastation. Afghanistan has some of the poorest health indicators in the world for women and children. In the midst of armed conflict, providing essential healthcare in remote regions in the throws of conflict remains a challenge, which is being addressed the Mobile Health Teams through Afghan Red Crescent (ARCS). To overcome socio-cultural barriers, ARCS MHTs have used local knowledge to hire female staff as part of the MHTs along with their male relatives as part of MHT staff. The present study was conducted to explore the impact of engaging female health workers as part of MHTs in conflict zones within Afghanistan on access, availability and utilization of maternal and child health care. Methods Quantitative descriptive and time-trend analysis were used to evaluate impact of introduction of female health workers. Qualitative data is being analyzed to assess the possibilities and implications of engaging female health workers in the delivery of health services. Results Preliminary results show a 96% increase in uptake of services for expectant mothers over the last four years. Average of 18 thousand services provided each month by MHTs, 70% for women and children. Service delivery for women and children significantly increased over time (p < 0.05) after inclusion of female health workers in MHTs. Delivery of maternity care services showed a more significant increase (p < 0.001). Time trend and qualitative analyses is ongoing. Conclusions Introduction of female health workers significantly improved uptake of health care services for women and children especially in extremely isolated areas controlled by armed groups in Afghanistan. Engaging with local stakeholders is essential for delivery of health services for vulnerable populations in fragile settings like Afghanistan. Key messages Understanding cultural norms results in socially acceptable solutions to barriers in delivery of healthcare services and leads to improvements in access for women and children in fragile settings. Building local partnerships and capacities and using local resources result in safe, efficient and sustainable delivery of healthcare services for vulnerable populations in fragile settings.

Stakeholders’ Perspectives on the Unmet Needs and Health Priorities of the Urban Poor in South-East Nigeria

2021 ◽  
pp. 0272684X2110334
Author(s):  
Ifeyinwa Arize ◽  
Daniel Ogbuabor ◽  
Chinyere Mbachu ◽  
Enyi Etiaba ◽  
Benjamin Uzochukwu ◽  
...  
Keyword(s):  
Urban Areas ◽  
Urban Poor ◽  
Health Workers ◽  
Cost Of Care ◽  
Health Needs ◽  
Health Priorities ◽  
Primary Health Care System ◽  
Dual Practice ◽  
Double Burden ◽  
Primary Health

Relatively little is known about readiness of urban health systems to address health needs of the poor. This study explored stakeholders’ perception of health needs and strategies for improving health of the urban poor using qualitative analysis. Focus group discussions (n = 5) were held with 26 stakeholders drawn from two Nigerian states during a workshop. Urban areas are characterised by double burden of diseases. Poor housing, lack of basic amenities, poverty, and poor access to information are determinants of health of the urban poor. Shortage of health workers, stock-out of medicines, high cost of care, lack of clinical practice guidelines, and dual practice constrain access to primary health services. An overarching strategy, that prioritises community-driven urban planning, health-in-all policies, structured linkages between informal and formal providers, financial protection schemes, and strengthening of primary health care system, is required to address health needs of the urban poor.

scholarly journals Clinical effectiveness and cost effectiveness of individual mental health workers colocated within primary care practices: a systematic literature review

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042052
Author(s):  
Jean-Baptiste Woods ◽  
Geva Greenfield ◽  
Azeem Majeed ◽  
Benedict Hayhoe
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Cost Effectiveness ◽  
Health Worker ◽  
Health Workers ◽  
Risk Of Bias ◽  
Mental Health Workers ◽  
Mental Health Worker ◽  
Care Practices ◽  
Primary Care Practices

ObjectivesMental health disorders contribute significantly to the global burden of disease and lead to extensive strain on health systems. The integration of mental health workers into primary care has been proposed as one possible solution, but evidence of clinical and cost effectiveness of this approach is unclear. We reviewed the clinical and cost effectiveness of mental health workers colocated within primary care practices.DesignSystematic literature review.Data sourcesWe searched the Medline, Embase, PsycINFO, Healthcare Management Information Consortium (HMIC) and Global Health databases.Eligibility criteriaAll quantitative studies published before July 2019 were eligible for the review; participants of any age and gender were included. Studies did not need to report a certain outcome measure or comparator in order to be eligible.Data extraction and synthesisData were extracted using a standardised table; however, pooled analysis proved unfeasible. Studies were assessed for risk of bias using the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool and the Cochrane collaboration’s tool for assessing risk of bias in randomised trials.ResultsFifteen studies from four countries were included. Mental health worker integration was associated with mental health benefits to varied populations, including minority groups and those with comorbid chronic diseases. Furthermore, the interventions were correlated with high patient satisfaction and increases in specialist mental health referrals among minority populations. However, there was insufficient evidence to suggest clinical outcomes were significantly different from usual general practitioner care.ConclusionsWhile there appear to be some benefits associated with mental health worker integration in primary care practices, we found insufficient evidence to conclude that an onsite primary care mental health worker is significantly more clinically or cost effective when compared with usual general practitioner care. There should therefore be an increased emphasis on generating new evidence from clinical trials to better understand the benefits and effectiveness of mental health workers colocated within primary care practices.

scholarly journals Approaches to motivate physicians and nurses in low- and middle-income countries: a systematic literature review

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jaya Gupta ◽  
Mariya C. Patwa ◽  
Angel Khuu ◽  
Andreea A. Creanga
Keyword(s):  
Systematic Review ◽  
Randomized Trial ◽  
Health Worker ◽  
Work Motivation ◽  
Health Workers ◽  
Trial Group ◽  
Middle Income ◽  
Group Design ◽  
Middle Income Countries ◽  
Worker Motivation

AbstractPoor health worker motivation, and the resultant shortages and geographic imbalances of providers, impedes the provision of quality care in low- and middle-income countries (LMICs). This systematic review summarizes the evidence on interventions used to motivate health workers in LMICs. A standardized keyword search strategy was employed across five databases from September 2007 -September 2017. Studies had to meet the following criteria: original study; doctors and/or nurses as target population for intervention(s); work motivation as study outcome; study design with clearly defined comparison group; categorized as either a supervision, compensation, systems support, or lifelong learning intervention; and conducted in a LMIC setting. Two independent reviewers screened 3845 titles and abstracts and, subsequently, reviewed 269 full articles. Seven studies were retained from China (n = 1), Ghana (n = 2), Iran (n = 1), Mozambique (n = 1), and Zambia (n = 2). Study data and risk of bias were extracted using a standardized form. Though work motivation was the primary study outcome, four studies did not provide an outcome definition and five studies did not describe use of a theoretical framework in the ascertainment. Four studies used a randomized trial—group design, one used a non-randomized trial—group design, one used a cross-sectional design, and one used a pretest–posttest design. All three studies that found a significant positive effect on motivational outcomes had a supervision component. Of the three studies that found no effects on motivation, two were primarily compensation interventions and the third was a systems support intervention. One study found a significant negative effect of a compensation intervention on health worker motivation. In conducting this systematic review, we found there is limited evidence on successful interventions to motivate health workers in LMICs. True effects on select categories of health workers may have been obscured given that studies included health workers with a wide range of social and professional characteristics. Robust studies that use validated and culturally appropriate tools to assess worker motivation are greatly needed in the Sustainable Development Goals era.

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