scholarly journals Stakeholders’ perspectives on the management of diabetic retinopathy for a district health system – South Africa

2017 ◽  
Vol 76 (1) ◽  
Author(s):  
Zaheera Abdool ◽  
Kovin S. Naidoo ◽  
Linda Visser

Background: Clinical practice guidelines for the management of diabetic retinopathy (DR) adopted in various countries show variations in methods of examinations, screeners and classification systems. The South African National Guidelines for the frequency of referral of patients with diabetes mellitus (DM) for DR assessment were developed more than a decade ago. They do not specify the role of primary healthcare workers (PHCW) to manage DR at primary healthcare (PHC) level. The primary objective of this study was to establish the current role of PHCW in managing diabetic eye disease.Method: A cross-sectional study was conducted, and questionnaires were distributed to a total of 181 healthcare practitioners (HCPs) in public health institutions situated in the northern eThekwini district of KwaZulu-Natal. Clinics and community health centres (CHCs) were selected based on the assumption that PHC nurses, general practitioners or medical officers (MOs) and ophthalmic nurses practice at these institutions. The hospitals selected were the referral institutions for the selected clinics and CHCs. The questionnaires distributed included questions relating to the DR classification systems usage, HCP interaction and opinions on how HCPs could be valuable in managing DR.Results: Only two out of the five ophthalmic nurses were familiar with the grading classification systems for DR. Ophthalmic nurses had less interaction with general practitioners or MOs (40.0%) than the PHC nurses (60.0%). Only 2.4% of the PHC nurses interacted with ophthalmologists. Four of the five ophthalmic nurses indicated that PHC nurses would be valuable in the management of DR by taking visual acuity (VA) and conducting a pinhole test. More than 60% of the general practitioners or MOs (65.6%) suggested that ophthalmic nurses do a fundus examination. Ophthalmologists indicated that the PHC nurses were the least capable (17.7%) to screen for DR.Conclusion: Primary healthcare workers such as PHC nurses, ophthalmic nurses, general practitioners or MOs and optometrists have specific roles to play in DR management, which includes its prevention, detection, grading, referral and monitoring.

Author(s):  
Yasir Almuzaini ◽  
Nour Abdulmalek ◽  
Sujoud Ghallab ◽  
Abdulaziz Mushi ◽  
Yara Yassin ◽  
...  

Heat-related illnesses (HRIs), such as heatstroke (HS) and heat exhaustion (HE), are common complications during Hajj pilgrims. The Saudi Ministry of Health (MoH) developed guidelines on the management of HRIs to ensure the safety of all pilgrims. This study aimed to assess healthcare workers’ (HCWs) adherence to the updated national guidelines regarding pre-hospital and in-hospital management of HRIs. This was a cross-sectional study using a questionnaire based on the updated HRI management interim guidelines for the Hajj season. Overall, compliance with HE guidelines scored 5.5 out of 10 for basic management and 4.7 out of 10 for advanced management. Medical staff showed an average to above average adherence to pre-hospital HS management, including pre-hospital considerations (7.2), recognition of HS (8.1), case assessment (7.7), stabilizing airway, breathing, and circulation (8.7), and cooling (5). The overall compliance to in-hospital guidelines for HS management were all above average, except for special conditions (4.3). In conclusion, this survey may facilitate the evaluation of the adherence to Saudi HRIs guidelines by comparing annual levels of compliance. These survey results may serve as a tool for the Saudi MoH to develop further recommendations and actions.


2021 ◽  
Author(s):  
Mohamed Ghaith Al-Kuwari ◽  
Mariam AbdelMalik ◽  
Asma Ali Al-Nuaimi ◽  
Jazeel Abdulmajeed ◽  
Hamad Eid Al-Romaihi ◽  
...  

AbstractBackgroundCOVID-19 transmission was significant amongst Healthcare workers worldwide.AimThis study aims to estimate the risk of exposure for COVID-19 across Primary Healthcare workers in the State of Qatar. Methods: A cross-sectional descriptive study was conducted to study the burden of COVID-19 among staff working at PHCC during the COVID-19 pandemic from March 1 to October 31, 2020.Results1,048 (87.4%)of the infected HCWs belonged to the age group below 45 years, and 488 (40.7%) HCWs were females. 450 (37.5%) were HCWs clinical staff working in one of the 27 PHCC HCs; Despite the increased patient footfall and risk environment, the COVID HCs had an attack rate of 10.1%, which is not significantly different from the average attack rate of 8.9% among staff located in other HCs (p-value =0.26). Storekeepers, engineering & maintenance staff, housekeeping staff, support staff, and security staff (outsourced positions) had the highest positivity rates, 100%, 67.2%, 47.1%, 32.4%, and 29.5% respective positivity rates.ConclusionsThe elevated risk of infection amongst outsourced healthcare workers can be explained by environmental factors such as living conditions. On the other hand, better containment within clinical healthcare workers can be attributed to strict safety training and compliance with preventative measures which is recommended to be implemented across all settings.


Author(s):  
Michael Olabode Tomori ◽  
Funmilayo Adenike Fadiji

COVID-19 pandemic has required swift revamping of health systems and public health measures at a scale never observed. The pandemic emergence has a direct effect on the health system, negatively affecting its capacity as depletion of resources are now channelled to curb the emergency of the communicable disease, especially among individuals living with HIV disease which drew our attention to how individuals suffering from HIV and people who needed to know their HIV status has not been able to visit the health facilities due to the effect of coronavirus pandemic on the supply of the test kits used in the health facilities. This study evaluated the effect of the coronavirus pandemic on the supply chain of HIV test kits in Ondo State, Nigeria. The primary objective was to determine the effect of the coronavirus pandemic on the supply of HIV test kits in Ondo State. The research was a sequential cross-sectional design using a quantitative method of analysis with a total sample size of 100 respondents with all samples drawn from 30 supported health facilities in the state. In addition, literature review was also used to know the effect of the coronavirus on reach of 95% of UNAIDS 2030 target. The study used both descriptive and inferential methods of data analysis where the descriptive statistics comprise of frequency distribution, percentage distribution, weighted mean score, and standard deviation while the inferential method of data analysis used ordinal least square (simple linear regression) to determine the effect of coronavirus pandemic on the supply chain test kits. Findings from the result concluded that pandemic and the methods of supply chain management indicated a significant effect. In addition, from the review the major impacts of COVID-19 were innovation, increased technology, research and development, depletion of supply chain personnel. Therefore, there is a need to develop national guidelines on supply chain strategy for emergencies in Nigeria as well as adhere strictly to some recommendations made in the study.


2021 ◽  
pp. 205343452110616
Author(s):  
Budi Yanti ◽  
Nurdarlila Armita ◽  
Iskandar Zakaria

Introduction Health workers are at high risk of contracting the disease because they are at the forefront of assisting COVID19 patients. Globally, Indonesia has the worst death toll of health workers. Many previous studies have shown the differences in knowledge, attitudes, and behavior of health workers in handling with the COVID19 pandemic. This study aims to asses the role of knowledge, attitudes, and health workers' preparedness during the COVID-19 pandemic in Aceh Pidie Jaya District. Methods A cross-sectional study and the data were collected by distributing online questionnaires about knowledge, attitudes, behavior, and preparedness related to the COVID-19 at 12 Pidie Jaya District health centers. The knowledge, behavior, and preparedness parameters used Guttman and Likert scales to measure the workers' attitudes. Chi-square test was used to evaluate the relationship between knowledge, attitudes, behavior, and preparedness. Results In this study, 377 health workers were selected, the majority of respondents' education level was diploma, level 3 (257, 76.3%), and one-third of the respondents did not attend training. There are 197 (58.5%) respondents who had good knowledge, 177 (52.5%) positive attitudes, 283 (84%) good behavior, and 173 (51, 3%) well prepared. Furthermore, good knowledge, positive attitude, and good behavior had a significant correlation statistically with well prepared during the pandemic (p < 0.05). Discussion Most of the health workers in Aceh Pidie Jaya have good knowledge, positive attitudes, and good behavior that create adequate preparedness. Even though training is still very limited, educational attainment would remain the cornerstone for preparedness to encounter COVID-19.


2020 ◽  
Author(s):  
Joko Mulyanto ◽  
Yudhi Wibowo ◽  
Dionne S. Kringos

Abstract Background In the current healthcare delivery system funded by National Health Insurance (NHI) in Indonesia, the gatekeeper role of primary care services is critical to ensuring equal healthcare access for the population. To be effective, gatekeeping relies on the performance of general practitioners (GPs). However, the perceptions held by Indonesian GPs about their gatekeeper role are not yet well documented. This study describes the self-perceived knowledge, attitudes and performance of Indonesian GPs with respect to the gatekeeper role and explores associated factors. Methods We conducted a cross-sectional study of all primary care facilities (N = 75) contracted by the regional NHI office in the Banyumas district. The 73 participating GPs completed a written questionnaire that assessed their knowledge, attitudes and performance in relation to the gatekeeper role. Personal and facility characteristics were analysed in a generalised linear model as possible associating factors.Results GPs scored relatively high in the domains of knowledge and performance but scored lower in their attitudes towards the gatekeeper role of primary care. In the full-adjusted model, no factors were significantly associated with the knowledge score. Work experience as GPs, private or civil service employment status and rural or urban location of the primary care facility were linked to attitude scores. Full- or part-time employment and type of facility were factors associated with the performance score. Conclusion GPs in Indonesia are knowledgeable and report that they adequately perform their function as gatekeepers in primary care. However, their attitudes towards the gatekeeper function are less positive. Attitudes and performance with respect to the primary care gatekeeper role are likely influenced more by contextual factors such as location and type of facility than by personal factors. Efforts to address contextual issues could include improvements in practice standards for privately practising physicians and public information campaigns about gatekeeping regulations. Such efforts will be crucial to improving the gatekeeper role of primary care in Indonesia and assuring efficient access to high-quality care for all.


2020 ◽  
Vol 62 (1) ◽  
Author(s):  
Collins C.E. Mbah ◽  
Zuberu B. Elabor ◽  
Olufemi B. Omole

Background: Healthcare workers (HCWs) are at risk of bloodborne infections from sharp instrument injuries and skin and mucous membrane exposures to contaminated blood and body fluids (BBF). While these have clinical and occupational health implications, little is known about BBF exposure and its reporting pattern in South African primary healthcare (PHC). The aim of this study was to determine the rate of BBF exposure, the extent of reporting and the reasons for not reporting among HCWs in PHC facilities in Johannesburg, South Africa.Methods: In a cross-sectional study involving 444 participants, an 18-item, self-administered questionnaire was used to collect information on socio-demographic characteristics, HCWs’ exposures to BBF in the last year, whether the exposure was reported and the reasons for not reporting. Analysis included descriptive statistics and chi-square test.Results: Most participants were nurses (87.4%) and female (88.1%). About a quarter of participants (112) reported having at least one BBF exposure in the last year. Overall, there were 355 exposures, resulting in 0.8 BBF exposure per HCW per year. Of these exposures, 291 (82.0%) were not reported. Common reasons for not reporting include lack of time (42.72%), perception that the source patient was at low risk for human immunodeficiency virus (24.7%) and concerns about confidentiality (22.5%). Blood and body fluids exposures involving nurses (p 0.001), sharp instrument (p 0.001) and HCWs aged 50 years (p = 0.02) were significantly more likely to be reported.Conclusion: This study found a high rate of underreporting of BBF exposures among HCWs in PHC facilities in Johannesburg, suggesting an urgent need for interventions to improve reporting.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Joseph Obiri Asante ◽  
Meng Jie Li ◽  
Jing Liao ◽  
Yi Xiang Huang ◽  
Yuan Tao Hao

Abstract Background Healthcare workers are often exposed to stressful working conditions at work which affect their quality of life. The study investigated the relationship between psychosocial risk factors, stress, burnout, and quality of life among primary healthcare workers in general medical practice in Qingyuan and Chaozhou cities in Guangdong province. Method The cross-sectional study was conducted in 108 primary health facilities including 36 community health centers (CHCs) across two developing cities in Guangdong province. A total of 873 healthcare workers completed the questionnaires. Quality of life was evaluated using The World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) and psychological risk factors were evaluated by the Copenhagen Psychosocial Questionnaire (COPSOQ). General quality of life and the quality of life domains were transformed into a score range from minimum 0 to 100 maximum. Higher scores indicated better quality of life and vice versa. Significant associations were verified using multiple regression analysis. Results Poor quality of life was observed in 74.6% of healthcare workers surveyed. General poor quality of life was significantly higher among workers who reported higher burnout (Beta = − 0.331, p < 0.001). In addition, workers with high levels of burnout, unmarried workers and female workers had a higher possibility of physical health. A greater risk of poor psychological health was observed among workers with high burnout, poor sense of community and those with lower educational levels. Workers who lacked social support, those with fewer possibilities for development had increased probability of poor quality of life in the social domain. Poor quality of life in the environmental domain was observed among workers who were dissatisfied with their jobs and workers with low salaries. Conclusions Primary healthcare workers in developing cities in China have a highly demanding and strained working environment and poor quality of life. Reducing job stress and improving work conditions may ultimately improve the well-being of primary healthcare workers.


2018 ◽  
Vol 14 (1) ◽  
pp. 63-68 ◽  
Author(s):  
P. Jha ◽  
S. Khurana ◽  
K. Ali ◽  
I. Ahmad ◽  
S. Verma

The primary objective of this narrative review was to evaluate the current literature and to provide further insight into the role of concurrent training on various components of physical health or performance. Literature was obtained by electronic searches of databases using specific keywords. Combined effect of training sessions proved to be as beneficial as drug interactions. Results from cross-sectional, longitudinal, and intervention studies are reviewed and discussed with main focus on physical parameters, such as body composition, physiological parameters, molecular adaptation, athlete’s perspective, order of execution, interference phenomena and recovery. In conclusion, concurrent resistance and endurance training is an effective method for enhancing overall fitness as well as improving quality of life.


Author(s):  
Clement Kevin Edet ◽  
Anthony Ike Wegbom ◽  
Victor Alangibi Kiri

Introduction: The primary healthcare workers (PHCWs) may be faced with a higher risk of infection of COVID-19, due to inadequate personal protective equipment (PPE) and lack of training on the disease control and prevention. This study was designated to evaluate the knowledge, attitude and practices (KAP) of PHCWs about COVID-19 in Rivers State, Nigeria. Methods: A facility cross-sectional survey was conducted involving the primary healthcare workers in Rivers State, Nigeria. The association between the KAP and demographic characteristics were tested with the Chi-square test, while the association existing among KAP were evaluated with Pearson correlation coefficient. Statistical significance was evaluated at P<0.05. Results: The proportion of respondents with good scores in knowledge, attitude, and COVID-19 related practices are 86.4% (10.66 ± 2.40), 85.0% (8.28 ± 1.94), and 97.3% (8.34 ± 1.39) respectively. Gender, occupation, and years of experience are associated with knowledge, whilst years of experience and marital status are associated with the attitude and level preventive practices; knowledge score also has significant positive linear associations with both attitude  and practices (  scores towards COVID-19. Conclusion: Based on these findings, we suggest that public health education programs should be sustained, and staff should be expose to more training and workshop regarding COVID-19 preventive practices. Furthermore, adequate personnel preventive equipment should be deployed at the primary healthcare facilities, as this will instill the right attitude and confidence in carrying out their duties without the fear of contracting the disease.


Sign in / Sign up

Export Citation Format

Share Document