Objectives:Addressing the issue of mental health disorders in the community is a significant challenge for Indonesia’s healthcare professionals.This study aimed to explore the challenges that community health workers...Objectives:Addressing the issue of mental health disorders in the community is a significant challenge for Indonesia’s healthcare professionals.This study aimed to explore the challenges that community health workers(CHWs)encounter while providing mental health services in the community.Methods:Forty CHWs were selected to participate in the study by purposive sampling method from July to August 2023 in seven primary health centers(PHCs)among three cites of Indonesia.Focus group discussions were used to collect data.All of data were analyzed using the interpretive phenomenological analysis method.Results:Considering the participants’voluntary CHW role,the results were organized into five themes.These comprised two themes of challengesdfamily stigma and limited understanding of mental disorders,and three themes regarding efforts to overcome the challengesdmaintaining self-motivation,fostering self-efficacy,and using communication skills when approaching families and patients.Conclusions:Upskilling and empowering CHWs helps to enhance community mental health.Thus,it is crucial to support CHWs through training programs that aim to improve mental health literacy and communication skills and diminish family stigma.展开更多
Health workers(HW)are on the frontline fighting against the COVID-19 pandemic,they are exposed to multiple occupational hazards.This article analyzed the comprehensive measures of protecting HWs during the COVID-19 re...Health workers(HW)are on the frontline fighting against the COVID-19 pandemic,they are exposed to multiple occupational hazards.This article analyzed the comprehensive measures of protecting HWs during the COVID-19 response in China.Occupational health protection of HWs was one of the key strategies of the public health measures adopted against the COVID-19 outbreak from the earliest stage in China.This prioritization of HWs health protection was based on the technical and policy guidance of WHO and International Labor Organization as well as the experiences from previous outbreaks in China.The comprehensive measures in China can be summarized as‘6P-approach’:public health emergency response,prompt learning from lessons,proactive measures of occupational health,precaution strategies against occupational hazards,personal protective equipment and medical devices supply,and professional networking.Through this 6P-approach,China was able to minimize the incidence of COVID-19 infection among HWs,while successfully containing the outbreak dxuing the first quarter of 2020.Although the COVID-19 vaccines have been rolled out,however,the COVID-19 pandemic is still under rapidly evolving situation.Experiences from China may provide other countries with an example of prioritizing and incorporating occupational health protection of HWs in their public health measures responding to the COVID-19 pandemic.展开更多
<span style="font-family:Verdana;"><strong>Background:</strong> The outbreak of COVID-19 has continued to threaten the existence of the human race. The novelty and unstable epidemiologic pa...<span style="font-family:Verdana;"><strong>Background:</strong> The outbreak of COVID-19 has continued to threaten the existence of the human race. The novelty and unstable epidemiologic pattern of the virus had generated so much concern among the global health experts. These concerns were found to be escalated among the frontline health care workers to the extent of impeding the timeliness of the response activities. To slow down the spread of the already established community transmission through the surveillance activities, the concern of the health workers at the community level needs to be addressed. Therefore, this study assessed the concern about COVID-19 pandemic among primary health workers in Oyo State, Nigeria. <strong>Methods:</strong> This was an online cross-sectional survey conducted among primary health care workers in Oyo State between March and April 2020. Using a two-stage sampling technique, we recruited 284 respondents. A semi-structured questionnaire linked to the Google form was used to collect data. Data were analyzed using IBM SPSS version 25;bivariate analysis was done using Chi-square and binary logistic regression was used to identify the predictors of health workers’ concern at 5% level of significance. <strong>Results:</strong> The mean age of respondents was 45.0 ± 9.0 years. The proportion of the respondents who had good knowledge of COVID-19 was 52.5%. In the domains of concern, 66.9%, 53.2%, 51.4%, and 46.5% of the respondents expressed government-related, self-satisfaction related, work-related and social-status related concerns respectively. Male respondents were less likely to express concern about COVID-19 compared with their female counterparts (aOR = 0.39, 95% CI = 0.20 - 0.76). Nurses/midwives (aOR = 0.21, 95% CI = 0.05 - 0.85) had lesser likelihood of expressing concern about COVID-19 while middle staff (aOR = 2.5, 95% CI = 1.18 - 5.39) and income earner of ≥N200,000 (aOR = 2.3, 95% CI = 1.34 - 3.92) had higher likelihood of expressing concern about COVID-19. <strong>Conclusion:</strong> The study highlights an average knowledge of COVID-19 among the respondents. Government-related and self-satisfaction related concerns were expressed by the majority of the Primary Health Care (PHC) workers. Now that the second wave of COVID-19 is moving with much more fatality across much of Africa, including Nigeria, it is therefore imperative to address these concerns through a holistic policy that addresses the welfare, safety and capacity building of the health care workers (HCWs).</span>展开更多
<p align="justify"> <span style="font-family:Verdana;">Background:<span style="font-family:Verdana;"> Indigent selected for their health care is complex and poses enormo...<p align="justify"> <span style="font-family:Verdana;">Background:<span style="font-family:Verdana;"> Indigent selected for their health care is complex and poses enormous challenges. The actors involved have an influence on health actions and their perception is decisive for better care for the indigent. Little evidence exists on these perceptions and this paper has captured this. <span style="font-family:Verdana;">Methods:<span style="font-family:Verdana;"> A case study involved 163 participants with a questionnaire and an interview guide. The quantitative responses were classified according to a measurement scale, proportions and overall indices of perception (Ip) and satisfaction (CSAT) were calculated. The relationship between variables was investigated using chi-square. Thematic analysis was used with qualitative data. The study met ethical requirements. <span style="font-family:Verdana;">Results: <span style="font-family:Verdana;">The participants had a positive perception of the selection: Ip = 0.77, but a minority (1/5) were dissatisfied with the selection. The perception of selection did not differ significantly depending on the experience of the actors. For the vast majority, the definition of indigent was satisfactory (CSAT = 91.4). The selection was done in a top down fashion and steps such as setting up committees, informing stakeholders, had shortcomings which negatively impacted the effectiveness of the selection. The needs of the participants included transparency in the indigent select process, matching the tools for selecting the indigent to the context, strengthening of local action, deconstruction of prejudices in terms of the indigent, power of actors to act, and importance for health services to reach out to the indigent. <span style="font-family:Verdana;">Conclusion: <span style="font-family:Verdana;">Considering the perception of the actors as well as their needs will improve the selection for effective care of the indigent.展开更多
Biosecurity measures are essential for protecting pig health, however, these practices are not always utilized by smallholder farmers in Cambodia. This study aimed to assess the knowledge and practices, in terms of pi...Biosecurity measures are essential for protecting pig health, however, these practices are not always utilized by smallholder farmers in Cambodia. This study aimed to assess the knowledge and practices, in terms of pig biosecurity measures, of individual stakeholders involved in pig production in rural and peri-urban households in Cambodia. A survey tool was developed and administered using Kobotoolbox, an online electronic survey tool. Surveys were conducted in the provinces of Kampong Thom, Siem Reap, and Battambang during December 2017 to September 2018. There were 225 pig farmers, 43 village animal health workers (VAHWs), 3-district veterinarians (DVs), and 81 feed store owners enrolled in the study. Results showed that several biosecurity guidelines are not followed or well understood by farmers. Specific concerning practices included using natural boars, sharing pig equipment (e.g. scales), feeding kitchen waste, managing other livestock, handling manure, and not restricting access by visitors (VAHWs or DVs, boar owners, pig buyers, neighbors, and meat sellers). Thus, education of pig smallholder farmers and VAHWs on pig biosecurity is needed for improving pig health and production, economic value, and livelihood of smallholder farmers in Cambodia.展开更多
Background: The global drive to scale up mental health services and eliminate the treatment gap requires incorporating mental health services into primary health care (PHC). Primary health care provides comprehensive,...Background: The global drive to scale up mental health services and eliminate the treatment gap requires incorporating mental health services into primary health care (PHC). Primary health care provides comprehensive, continuous, and coordinated care and if need be provides referrals to higher levels of care. However, for these services to meet the basic objective of PHC, it is necessary to determine healthcare workers’ preparedness for caring for the mentally ill. Therefore, this study aimed to examine health workers’ preparedness for integrating mental healthcare into primary settings in a rural community in Nigeria. Methodology: A descriptive research design was used to conduct the study among all 215 primary healthcare workers within Nkanu West Local Government Area (LGA). The instrument for data collection was a structured questionnaire constructed by the author. A pilot study was conducted on 10% of the sample population. Cronbach’s Alpha formula was used to estimate the reliability coefficient (0.85). The collected data were analysed with descriptive statistical frequencies and percentages. Results: Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20. Findings show that healthcare workers’ preparedness to care for the mentally ill at the primary healthcare centre is quite low. It was also found that mental illness is still shredded by stigma as a result of poor awareness. Consequently, there is still a persistent pervasive belief system that Mental illness is a form of retribution from the gods for one’s wrong deed in the study area. Conclusion: It was concluded that few of the respondents were prepared for the care of the mentally ill which might be a result of poor awareness about mental health and the negative stereotype given about mental health. From the analysis, it can be deduced that health workers exhibit some degree of positive attitude towards care of the mentally ill, though, mental illness is associated with stigmatization due to a lack of public understanding of mental disorders. There was strong support for integrating mental health into primary health care by health care providers. Therefore there is a need for community education and building of the capacity of healthcare workers for integration of the care of the mentally ill to be feasible in PHC centres.展开更多
Introduction: Frontline health workers who work in COVID-19 isolation treatment centers are susceptible to developing mental health issues due to the overwhelming workload and stress associated with their job. Thus un...Introduction: Frontline health workers who work in COVID-19 isolation treatment centers are susceptible to developing mental health issues due to the overwhelming workload and stress associated with their job. Thus understanding their lived experiences provides insights that helps alleviate health worker burnout and improving their quality of life thereby leading to an efficient delivery of health care services during a pandemic. Aim: To understand the lived experiences of front line health workers during the COVID-19 pandemics at Levy Mwanawasa Teaching University Hospital. Design and Methods: A qualitative interpretative phenomenological study design was used. Purposive sampling method was adopted to select the 14 participants who took part in the study. The data were collected through face-to-face, audio-taped interviews using an in-depth interview guide, after which the responses were transcribed verbatim before using NVIVO to generate codes. The data were analyzed using thematic method. Results: The lived experiences of the participants were found to be mainly negative with few positive experiences. Their lived experiences were mainly negative emotional and psychological experiences including fear, anger, depression, frustration, anxiety and sadness. The thoughts that were identified included thoughts of surviving through the pandemic, thoughts of getting infected, and dying. The frontline health workers also experienced some personal and professional changes as they offered health services in the COVID-19 wards. The personal changes reported included;social limitations and collapse of extra income business while the professional changes included a change in the way health services were delivered, a gain in knowledge and skills and shaping of a career path. The main challenges experienced were limited resources (man power, resuscitation equipment, drugs, personal protective equipment), limited literature on the disease and limited social interactions. Conclusion and Recommendations: Relevant stakeholders should come on board in order to offer support during a pandemic or a similar situation so as to better the experience of frontline health workers with particular attention directed towards the provision of adequate resources to enable them deliver their services effectively. Frontline health workers perspectives and opinions should be taken into account by the institution’s administrators and policymakers when planning for and managing a pandemic.展开更多
Objective: to provide theoretical basis for the reform of gout patient management by understanding the status quo and existing problems of gout management, strengthening the education of patients and grass-roots healt...Objective: to provide theoretical basis for the reform of gout patient management by understanding the status quo and existing problems of gout management, strengthening the education of patients and grass-roots health personnel, and building a more reasonable and standardized management mode. Content and methods: to develop strategies for education and management of gout patients;Education and training of primary health workers;A gout management team with the linkage of "superior hospital specialties, grassroots medical institutions and patients" is preliminarily constructed. Results: based on our own unit and the medical community unit, we preliminarily constructed a gout management team, which reduced the average annual acute attacks of gout patients by 3.54 times, improved renal function of 66.7% patients, and reduced the use rate of antibiotics by 100%. Conclusion: through the standardized management and education of patients and grassroots health personnel, the establishment of a gout management team with the linkage of "superior hospital-primary medical institutions-patients" can effectively control the condition of patients with gout, reduce the acute attack of gout and the abuse of antibiotics in the acute period, and improve the prognosis.展开更多
This paper presents the perceptions of health workers (HWs) on medical waste management (MWM) issues in Tanzanian hospitals. The perceived total waste generation rates were lower than the actual measurements. Administ...This paper presents the perceptions of health workers (HWs) on medical waste management (MWM) issues in Tanzanian hospitals. The perceived total waste generation rates were lower than the actual measurements. Administrators perceived lower rates than implementers. The results indicated three categories of medical waste which are given due attention, that is, sharps waste, pathological and infectious waste. Other wastes like radioactive, chemical, pharmaceutical, pressurized containers receive very little attention. Container colour coding and labelling was negligible, while improvised containers are still in use. Medical waste is transported within hospitals manually, with little efforts on mechanized transportation. Poor waste storage was observed, while the prominent medical waste treatment technologies are medium temperature incinerators. Off-site transportation of medical waste is practiced, where the waste is finally dumped or buried. The hospitals are currently utilizing public-private partnership schemes for MWM in only one aspect of off-site transportation. Three main problems which require high attention include: Weaknesses in hospital management, poor MWM infrastructure, and lack of skills and knowledge on MWM among HWs. Knowledge and awareness among HWs on health hazards associated with poor MWM is low (with exception of cholera, HIV and typhoid). Few PPE types are supplied and used in the hospitals, leading to poor diseases prevention. There is also low knowledge among HWs on administrative issues related to MWM in Tanzanian hospitals.展开更多
The coronavirus disease 2019(COVID-19)pandemic has led to heightened levels of anxiety and stress levels towards the health threats posed by the SARS-CoV-2 virus.At least 10%of those infected were health workers.In ad...The coronavirus disease 2019(COVID-19)pandemic has led to heightened levels of anxiety and stress levels towards the health threats posed by the SARS-CoV-2 virus.At least 10%of those infected were health workers.In addition,a large proportion of infected cases and deaths were possibly due to SARS-CoV-2 infections acquired in hospitals or long-term care facilities.Health workers,especially those working on the frontline play a crucial role in controlling and preventing the COVID-19 pandemic.Previous studies reported that health workers were exposed to severe emotional stress(i.e.,burnout,depression and anxiety symptoms)during the outbreaks of infectious diseases including severe acute respiratory syndrome(SARS),Ebola and Middle East respiratory syndrome(MERS).It is therefore important to be aware that prolonged exposure to moderate-to severe stress can have negative health consequences and reduce the work performance of health workers.Therefore,some immediate measures should be taken by the health care institutions and relevant health authorities to ensure that Chinese health workers are better supported in caring for large number of COVID-19 patients.Future studies should examine the health status and work efficiency of health workers working in high stress environment amidst the COVID-19 pandemic or other disasters.展开更多
Objective: Although there are adult vaccination schemes in our country, there are serious deficiencies in the way that doctors direct the patients to this vaccination, but also patients have to make and demand these v...Objective: Although there are adult vaccination schemes in our country, there are serious deficiencies in the way that doctors direct the patients to this vaccination, but also patients have to make and demand these vaccinations. The aim of our study is to identify the shortcomings in this area and draw a roadmap for what arrangements should be made in terms of physicians and patients in order to increase adult immunization rates in primary care. Method: We conducted a two-phase, multicentered, descriptive clinical trial between October and December 2017. The first phase of the trial was carried out with patients from 3 Family Health Centers in Antalya, Istanbul and Osmaniye. Patients to be interviewed were selected voluntarily among Family Health Center’s applicants. The second phase of the trial was carried out with health workers, who were participated to trial from 26 different provinces of Turkey. In the process, a questionnaire of 19 questions was applied to primary health care workers by the internet. Results: 490 patients were included in the study. There was a significant difference between gender, age, education level and guideline follow-up and vaccination status of patients [p Conclusion: As a result of the studies including our study about adult vaccination, only 10% - 20% of the targeted groups in adults can be vaccinated. However, just like in childhood during adulthood, vaccinations protect individuals from diseases and provide economic benefits. Firstly, the knowledge level of physicians on adult immunization should be updated with in-service trainings, they should first be convinced to vaccinate because they are in risk group and then they should be recommended vaccination to patient to increase the vaccination rates.展开更多
Community health workers(CHWs)represent the backbone of primary health systems,especially in many low-and middle-income countries(LMICs).The coronavirus disease 2019(COVID-19)pandemic stretched health sys-tems and inc...Community health workers(CHWs)represent the backbone of primary health systems,especially in many low-and middle-income countries(LMICs).The coronavirus disease 2019(COVID-19)pandemic stretched health sys-tems and increased the workload for CHWs.The objective of this scoping review was to identify the mental health symptoms experienced among CHWs in LMICs during the COVID-19 pandemic.We searched PubMed for published literature,from January 1,2020 to December 31,2022 that focused on documenting the experiences of burnout,distress,and mental health symptoms among CHWs in LMICs.The quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Tool.Included studies were grouped into the follow-ing broad thematic categories:(1)symptoms experienced;(2)drivers of different mental health symptoms;and(3)strategies for coping with different symptoms.We identified 10 cross-sectional,qualitative,and observational studies from 11 LMICs in South and Southeast Asia,South America,and Eastern/Southern Africa that assessed the mental health burden CHWs faced during the pandemic.The studies identified disorders and symptoms such as depression,anxiety,fear,burnout,worsened stress,and fatigue.Contributing factors included increased work-load,financial constraints,and an understaffed and underequipped workplace.CHWs reported using different adaptive responses like humor,support from family and colleagues,denial,and substance use,and asked for recommended regular mental health checkups and counseling.More research and policies should be targeted to-wards promoting the mental wellbeing of CHWs to help ensure responsive and resilient health systems in LMICs in the face of future emerging public health threats.展开更多
The study aimed at assessment of level of task performance of Primary Health Care Worker （PHCWs） according to their professional designations in selected Local Government Areas （LGA） in Enugu State. Descriptive su...The study aimed at assessment of level of task performance of Primary Health Care Worker （PHCWs） according to their professional designations in selected Local Government Areas （LGA） in Enugu State. Descriptive survey research was used. 291 PHCWs were randomly selected from 9 LGA using a multistage method. Questionnaire was used to collect data and the instrument was validated using test-retest method with correlation coefficient of 0.79. The findings show that Community Health Extension Workers （CHEWs） performed higher than Environmental Health Officer （EVO） and Community Health Officers （CHOs） in the area of health education concerning prevailing health problems and method of control. They scored 66.09% as against 52.8% and 60.61% for EVO and CHEW respectively. The result showed that the professional designation has no significant effect （P 〈 0.05） on the level of task performed by PHCW and their levels of task performance were low. It was recommended that public Health physicians and Nurses should be involved in the PHC in Enugu State to provide the fight supervision to the PHCW.展开更多
Objectives: To propose the improvements measures by analysing the influencing factors of hand hygiene (HH) compliance by observing the behaviour of health care workers (HCWs). Method: The observational study was condu...Objectives: To propose the improvements measures by analysing the influencing factors of hand hygiene (HH) compliance by observing the behaviour of health care workers (HCWs). Method: The observational study was conducted at a public tertiary hospital in Zhejiang, China, from September 2018 to March 2021. A total of 58 HH observers were trained to conduct a direct observation on the HH behaviors of personnel in the hospital amongst the health care workers. We have observed over 9000 hand hygiene opportunities. The collected data were classified according to time factors, department parameters, and profession conduct of the observed. Hand hygiene (HH) compliance rates were calculated for each category, and a chi-square test was used to analyze differences of the HH compliance rates. Furthermore, binary logistic regression was used for multivariate analysis in each of the hand hygiene moments. Results: The HH compliance rates of HCWs were statistically different before and after the Corona Virus Disease 2019 (COVID-19) pandemic, in the morning and the afternoon, this was observed per parameters stated into objectives on weekdays vs non weekdays. And we found that HH compliance rates drop off a cliff from weekdays to non-weekdays. Conclusions: COVID-19, departments, professions, and weekdays were all factors that influence HH compliance amongst HCWs. However, the influencing factors were not all present in every HH behavior, and had different intensities of influence on HH compliance amongst the HCWs. These findings provide some reference for us to propose improvement measures.展开更多
Background: In Pakistan, the crucial role of Lady Health Workers (LHWs) cannot be over looked and must be supported. Their alliance position between the community and health system allows them to provide services to t...Background: In Pakistan, the crucial role of Lady Health Workers (LHWs) cannot be over looked and must be supported. Their alliance position between the community and health system allows them to provide services to the most marginalised groups. However, LHWs face numerous challenges and issues resulting in reduced efficiency and effectiveness of LHW program. Aims: The study aims to identify the challenges highlighted in various studies that undermine the performance of LHWs and attempts to combine the recommendations of the studies for addressing these challenges. Methods: Literature search included articles from 2000 to 2024. PubMed and Google Scholar were the main search engines utilized. Initial search resulted in 1380 articles, out of which only those showing a link to the study title were included in the study. From the total articles searched, 55 were selected for writing this article. Results: Literature highlighted the importance of community selection, monitoring, monetary as well as non-financial incentives;trainings;availability of supervision, workload balance, monitoring;recognition, clarity on roles, resources and uninterrupted supply of logistics, support and embedment of LHWs in community and health system. Lack or poor quality of these aspects may lead to low performance of LHWs. Conclusions: This paper explores the extent of issues and challenges faced by LHWs in Pakistan. A number of interventions appear to be effective in improving the efficiency of LHWs in Pakistan. The review may serve as an essential resource for program planners and decision-makers in improving the effectiveness and efficiency of LHW programs.展开更多
The standardized hypertension management provided by primary health care workers is an important part of China＇s recent health care reform efforts. Investigating 5,116 hypertensive patients from a cross-sectional sur...The standardized hypertension management provided by primary health care workers is an important part of China＇s recent health care reform efforts. Investigating 5,116 hypertensive patients from a cross-sectional survey conducted by the Chinese Center for Disease Control and Prevention in 2012, this study found that adherence to standardized hypertension management is associated with positive effects on hypertension- related knowledge, healthy lifestyle behavior, antihypertensive medical treatments, and blood pressure control. It will be necessary to provide primary health care workers with sufficient training and reasonable incentives to ensure the implementation and effectiveness of hypertension management.展开更多
Background Immunization is a crucial preventive measure to safeguard children under five years old against a range of diseases.In China,the coverage rate of non-National Immunization Program(non-NIP)vaccines can be im...Background Immunization is a crucial preventive measure to safeguard children under five years old against a range of diseases.In China,the coverage rate of non-National Immunization Program(non-NIP)vaccines can be improved by leveraging the recommendation from public health workers.Hence,understanding the influencing factors of recommendation behaviors assume paramount importance.This study aims to investigate influencing factors of public health workers’recommendation behaviors towards non-NIP vaccines,with a particular emphasis on financial incentives.Methods A cross-sectional survey was conducted using a multi-stage sampling method in 2019 from August to October.627 public health workers were recruited from 148 community healthcare centers in ten provincial-level administrative divisions in China.An anonymous questionnaire was used to collect demographic information,attitudes towards vaccination,and recommendation behaviors towards non-NIP vaccines,includingHaemophilus influenzae type b(Hib)vaccine,pneumococcal conjugate vaccine,varicella vaccine,and rotavirus vaccine.Descriptive analysis and multivariate logistic regression analysis were adopted in this study.Results Of the 610 public health workers with complete survey data,53.8%,57.4%,84.1%,and 54.1%often recommended Hib vaccine,pneumococcal pneumonia vaccine(PCV),varicella vaccine,and rotavirus vaccine,respectively.Logistic regression revealed that gender(Hib vaccine:OR=0.4,95%CI:0.2-0.8;PCV:OR=0.4,95%CI:0.2-0.8;rotavirus vaccine:OR=0.3,95%CI:0.2-0.6),financial incentives for non-NIP vaccination(Hib vaccine:OR=1.9,95%CI:1.1-3.6;PCV:OR=2.1,95%CI:1.1-3.9;rotavirus vaccine:OR=2.0,95%CI:1.1-3.8)and perception of vaccine safety(Hib vaccine:OR=2.7,95%CI:1.1-7.0;PCV:OR=3.2,95%CI:1.2-8.0;rotavirus vaccine:OR=3.0,95%CI:1.2-7.7)were associated with public health workers’recommendation towards Hib vaccine,PCV and rotavirus vaccine.Conclusions The findings highlighted public health workers’recommendation behaviors of non-NIP vaccines in China and revealed strong association between vaccine recommendation and financial incentives.This highlights the importance of financial incentives in public health workers’recommendation toward non-NIP vaccines in China.Proper incentives are recommended for public health workers to encourage effective health promotion in immunization practices.展开更多
Background:Developing countries have the potential to reach vulnerable and underserved populations marginalized by the country’s health care systems by way of community health work-ers(CHWs).It is imperative that hea...Background:Developing countries have the potential to reach vulnerable and underserved populations marginalized by the country’s health care systems by way of community health work-ers(CHWs).It is imperative that health care systems focus on improving access to quality continu-ous primary care through the use of CHWs while paying attention to the factors that impact on CHWs and their effectiveness.Objective:To explore the possible opportunities and challenges of integrating CHWs into the health care systems of developing countries.Methods:Six databases were examined for quantitative,qualitative,and mixed-methods stud-ies that included the integration of CHWs,their motivation and supervision,and CHW policy making and implementation in developing countries.Thirty-three studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programs.Thematic coding was conducted and evidence on the main categories of contextual factors influencing integration of CHWs into the health system was synthesized.Results:CHWs are an effective and appropriate element of a health care team and can assist in addressing health disparities and social determinants of health.Important facilitators of integration of CHWs into health care teams are support from other health workers and inclusion of CHWs in case management meetings.Sustainable integration of CHWs into the health care system requires the formulation and implementation of polices that support their work,as well as financial and nonfinancial incentives,motivation,collaborative and supportive supervision,and a manageable workload.Conclusions:For sustainable integration of CHWs into health care systems,high-performing health systems with sound governance,adequate financing,well-organized service delivery,and adequate supplies and equipment are essential.Similarly,competent communities could contrib-ute to better CHW performance through sound governance of community resources,promotion of inclusiveness and cohesion,engagement in participatory decision making,and mobilization of local resources for community welfare.展开更多
Objective:To assess perceived stress and coping capacity of frontline health workers from AIIMS during COVID-19 pandemic.Methods:This cross-sectional study conducted from May to July 2021 enrolled 694 participants.An ...Objective:To assess perceived stress and coping capacity of frontline health workers from AIIMS during COVID-19 pandemic.Methods:This cross-sectional study conducted from May to July 2021 enrolled 694 participants.An online questionnaire based on Google Forms was developed to collect the data.Participants were assessed using the validated Perceived Stress Scale and the Coping Resources Inventory Scale.Results:The age of participants were 27(23-52)years old.The majority of respondents(73.5%)felt moderately stressed.Of the 694 participants,83.0%of the 576 participants had average stress management skills.Sex,marital status,and profession were significantly associated with perceived stress.In addition,marital status and profession were significantly associated with coping capacity.Conclusions:The majority of participants have moderate stress levels and average coping skills.Frontline healthcare workers have to maintain mental and physical health.Achieving this requires early screening and stress management for healthcare workers.展开更多
Background: Healthcare workers are challenged by an imposing group of occupational hazards. These hazards include exposure to biological and non-biological hazards like ionizing radiation, stress, injury, infectious a...Background: Healthcare workers are challenged by an imposing group of occupational hazards. These hazards include exposure to biological and non-biological hazards like ionizing radiation, stress, injury, infectious agents, and chemicals. The aim of this study was to assess common occupational hazards among health workers at the Department of Health Services (DHS), Federal University of Technology, Owerri. Methods: A hospital-based cross-sectional study design was employed for the study, and a self-administered questionnaire was used for data collection. The SPSS Version 22.0 software was used for the analysis of the descriptive statistics obtained from the study. This study included both clinical and non-clinical health workers. A purposive sampling technique was used in recruiting a total of 94 respondents who participated in the study from September 2020 to April 2021. Results: A total of 94 respondents who participated in the study and among the participants, 33.3% (31) of the respondents were aged 31 - 40 years, and the majority of the health workers, 43.6% (41) had stayed between 1 - 5 years. Also, 92.6% (87) of the health workers have heard of occupational hazards. The study showed that 84.0% (79) of health workers had good knowledge of common occupational hazards. Biological hazards among health workers are 47.9% (45) cuts and wounds, 29.8% (28) direct contact with contaminated specimens/hazardous materials, and 26.6% (26) sharp related injuries, while for non-biological hazards, 44.7% (42) have slipped, tripped or fallen, and 35.1% (33) have been stressed. Common safety measures include 86.2% (81) washing their hands regularly;78.7% (74) using hand gloves;and 85.1% (80) agreeing they use face masks. Conclusion: Despite good knowledge of occupational hazards, participants at DHS were faced with certain hazards. It is recommended that the university, government, and policymakers revise and implement actions to provide health workers at DHS with equipment to encourage safety in work activity.展开更多
基金This research(study design,data collection and analysis)was funded by Program Riset Kolaborasi Indonesia(RKI)-World Class University(WCU)Lembaga Penelitian dan Pengabdian Masyarakat Universitas Airlangga Indonesia in 2023 with the number:974/UN3.LPPM/PT.01.03/2023.
文摘Objectives:Addressing the issue of mental health disorders in the community is a significant challenge for Indonesia’s healthcare professionals.This study aimed to explore the challenges that community health workers(CHWs)encounter while providing mental health services in the community.Methods:Forty CHWs were selected to participate in the study by purposive sampling method from July to August 2023 in seven primary health centers(PHCs)among three cites of Indonesia.Focus group discussions were used to collect data.All of data were analyzed using the interpretive phenomenological analysis method.Results:Considering the participants’voluntary CHW role,the results were organized into five themes.These comprised two themes of challengesdfamily stigma and limited understanding of mental disorders,and three themes regarding efforts to overcome the challengesdmaintaining self-motivation,fostering self-efficacy,and using communication skills when approaching families and patients.Conclusions:Upskilling and empowering CHWs helps to enhance community mental health.Thus,it is crucial to support CHWs through training programs that aim to improve mental health literacy and communication skills and diminish family stigma.
基金supported by the Project of International Expert Consultation for the National Occupational Health System Innovation funded by the Ministry of Science and Technology of China in 2020-2022(Grant No.G20200001489).
文摘Health workers(HW)are on the frontline fighting against the COVID-19 pandemic,they are exposed to multiple occupational hazards.This article analyzed the comprehensive measures of protecting HWs during the COVID-19 response in China.Occupational health protection of HWs was one of the key strategies of the public health measures adopted against the COVID-19 outbreak from the earliest stage in China.This prioritization of HWs health protection was based on the technical and policy guidance of WHO and International Labor Organization as well as the experiences from previous outbreaks in China.The comprehensive measures in China can be summarized as‘6P-approach’:public health emergency response,prompt learning from lessons,proactive measures of occupational health,precaution strategies against occupational hazards,personal protective equipment and medical devices supply,and professional networking.Through this 6P-approach,China was able to minimize the incidence of COVID-19 infection among HWs,while successfully containing the outbreak dxuing the first quarter of 2020.Although the COVID-19 vaccines have been rolled out,however,the COVID-19 pandemic is still under rapidly evolving situation.Experiences from China may provide other countries with an example of prioritizing and incorporating occupational health protection of HWs in their public health measures responding to the COVID-19 pandemic.
文摘<span style="font-family:Verdana;"><strong>Background:</strong> The outbreak of COVID-19 has continued to threaten the existence of the human race. The novelty and unstable epidemiologic pattern of the virus had generated so much concern among the global health experts. These concerns were found to be escalated among the frontline health care workers to the extent of impeding the timeliness of the response activities. To slow down the spread of the already established community transmission through the surveillance activities, the concern of the health workers at the community level needs to be addressed. Therefore, this study assessed the concern about COVID-19 pandemic among primary health workers in Oyo State, Nigeria. <strong>Methods:</strong> This was an online cross-sectional survey conducted among primary health care workers in Oyo State between March and April 2020. Using a two-stage sampling technique, we recruited 284 respondents. A semi-structured questionnaire linked to the Google form was used to collect data. Data were analyzed using IBM SPSS version 25;bivariate analysis was done using Chi-square and binary logistic regression was used to identify the predictors of health workers’ concern at 5% level of significance. <strong>Results:</strong> The mean age of respondents was 45.0 ± 9.0 years. The proportion of the respondents who had good knowledge of COVID-19 was 52.5%. In the domains of concern, 66.9%, 53.2%, 51.4%, and 46.5% of the respondents expressed government-related, self-satisfaction related, work-related and social-status related concerns respectively. Male respondents were less likely to express concern about COVID-19 compared with their female counterparts (aOR = 0.39, 95% CI = 0.20 - 0.76). Nurses/midwives (aOR = 0.21, 95% CI = 0.05 - 0.85) had lesser likelihood of expressing concern about COVID-19 while middle staff (aOR = 2.5, 95% CI = 1.18 - 5.39) and income earner of ≥N200,000 (aOR = 2.3, 95% CI = 1.34 - 3.92) had higher likelihood of expressing concern about COVID-19. <strong>Conclusion:</strong> The study highlights an average knowledge of COVID-19 among the respondents. Government-related and self-satisfaction related concerns were expressed by the majority of the Primary Health Care (PHC) workers. Now that the second wave of COVID-19 is moving with much more fatality across much of Africa, including Nigeria, it is therefore imperative to address these concerns through a holistic policy that addresses the welfare, safety and capacity building of the health care workers (HCWs).</span>
文摘<p align="justify"> <span style="font-family:Verdana;">Background:<span style="font-family:Verdana;"> Indigent selected for their health care is complex and poses enormous challenges. The actors involved have an influence on health actions and their perception is decisive for better care for the indigent. Little evidence exists on these perceptions and this paper has captured this. <span style="font-family:Verdana;">Methods:<span style="font-family:Verdana;"> A case study involved 163 participants with a questionnaire and an interview guide. The quantitative responses were classified according to a measurement scale, proportions and overall indices of perception (Ip) and satisfaction (CSAT) were calculated. The relationship between variables was investigated using chi-square. Thematic analysis was used with qualitative data. The study met ethical requirements. <span style="font-family:Verdana;">Results: <span style="font-family:Verdana;">The participants had a positive perception of the selection: Ip = 0.77, but a minority (1/5) were dissatisfied with the selection. The perception of selection did not differ significantly depending on the experience of the actors. For the vast majority, the definition of indigent was satisfactory (CSAT = 91.4). The selection was done in a top down fashion and steps such as setting up committees, informing stakeholders, had shortcomings which negatively impacted the effectiveness of the selection. The needs of the participants included transparency in the indigent select process, matching the tools for selecting the indigent to the context, strengthening of local action, deconstruction of prejudices in terms of the indigent, power of actors to act, and importance for health services to reach out to the indigent. <span style="font-family:Verdana;">Conclusion: <span style="font-family:Verdana;">Considering the perception of the actors as well as their needs will improve the selection for effective care of the indigent.
文摘Biosecurity measures are essential for protecting pig health, however, these practices are not always utilized by smallholder farmers in Cambodia. This study aimed to assess the knowledge and practices, in terms of pig biosecurity measures, of individual stakeholders involved in pig production in rural and peri-urban households in Cambodia. A survey tool was developed and administered using Kobotoolbox, an online electronic survey tool. Surveys were conducted in the provinces of Kampong Thom, Siem Reap, and Battambang during December 2017 to September 2018. There were 225 pig farmers, 43 village animal health workers (VAHWs), 3-district veterinarians (DVs), and 81 feed store owners enrolled in the study. Results showed that several biosecurity guidelines are not followed or well understood by farmers. Specific concerning practices included using natural boars, sharing pig equipment (e.g. scales), feeding kitchen waste, managing other livestock, handling manure, and not restricting access by visitors (VAHWs or DVs, boar owners, pig buyers, neighbors, and meat sellers). Thus, education of pig smallholder farmers and VAHWs on pig biosecurity is needed for improving pig health and production, economic value, and livelihood of smallholder farmers in Cambodia.
文摘Background: The global drive to scale up mental health services and eliminate the treatment gap requires incorporating mental health services into primary health care (PHC). Primary health care provides comprehensive, continuous, and coordinated care and if need be provides referrals to higher levels of care. However, for these services to meet the basic objective of PHC, it is necessary to determine healthcare workers’ preparedness for caring for the mentally ill. Therefore, this study aimed to examine health workers’ preparedness for integrating mental healthcare into primary settings in a rural community in Nigeria. Methodology: A descriptive research design was used to conduct the study among all 215 primary healthcare workers within Nkanu West Local Government Area (LGA). The instrument for data collection was a structured questionnaire constructed by the author. A pilot study was conducted on 10% of the sample population. Cronbach’s Alpha formula was used to estimate the reliability coefficient (0.85). The collected data were analysed with descriptive statistical frequencies and percentages. Results: Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20. Findings show that healthcare workers’ preparedness to care for the mentally ill at the primary healthcare centre is quite low. It was also found that mental illness is still shredded by stigma as a result of poor awareness. Consequently, there is still a persistent pervasive belief system that Mental illness is a form of retribution from the gods for one’s wrong deed in the study area. Conclusion: It was concluded that few of the respondents were prepared for the care of the mentally ill which might be a result of poor awareness about mental health and the negative stereotype given about mental health. From the analysis, it can be deduced that health workers exhibit some degree of positive attitude towards care of the mentally ill, though, mental illness is associated with stigmatization due to a lack of public understanding of mental disorders. There was strong support for integrating mental health into primary health care by health care providers. Therefore there is a need for community education and building of the capacity of healthcare workers for integration of the care of the mentally ill to be feasible in PHC centres.
文摘Introduction: Frontline health workers who work in COVID-19 isolation treatment centers are susceptible to developing mental health issues due to the overwhelming workload and stress associated with their job. Thus understanding their lived experiences provides insights that helps alleviate health worker burnout and improving their quality of life thereby leading to an efficient delivery of health care services during a pandemic. Aim: To understand the lived experiences of front line health workers during the COVID-19 pandemics at Levy Mwanawasa Teaching University Hospital. Design and Methods: A qualitative interpretative phenomenological study design was used. Purposive sampling method was adopted to select the 14 participants who took part in the study. The data were collected through face-to-face, audio-taped interviews using an in-depth interview guide, after which the responses were transcribed verbatim before using NVIVO to generate codes. The data were analyzed using thematic method. Results: The lived experiences of the participants were found to be mainly negative with few positive experiences. Their lived experiences were mainly negative emotional and psychological experiences including fear, anger, depression, frustration, anxiety and sadness. The thoughts that were identified included thoughts of surviving through the pandemic, thoughts of getting infected, and dying. The frontline health workers also experienced some personal and professional changes as they offered health services in the COVID-19 wards. The personal changes reported included;social limitations and collapse of extra income business while the professional changes included a change in the way health services were delivered, a gain in knowledge and skills and shaping of a career path. The main challenges experienced were limited resources (man power, resuscitation equipment, drugs, personal protective equipment), limited literature on the disease and limited social interactions. Conclusion and Recommendations: Relevant stakeholders should come on board in order to offer support during a pandemic or a similar situation so as to better the experience of frontline health workers with particular attention directed towards the provision of adequate resources to enable them deliver their services effectively. Frontline health workers perspectives and opinions should be taken into account by the institution’s administrators and policymakers when planning for and managing a pandemic.
文摘Objective: to provide theoretical basis for the reform of gout patient management by understanding the status quo and existing problems of gout management, strengthening the education of patients and grass-roots health personnel, and building a more reasonable and standardized management mode. Content and methods: to develop strategies for education and management of gout patients;Education and training of primary health workers;A gout management team with the linkage of "superior hospital specialties, grassroots medical institutions and patients" is preliminarily constructed. Results: based on our own unit and the medical community unit, we preliminarily constructed a gout management team, which reduced the average annual acute attacks of gout patients by 3.54 times, improved renal function of 66.7% patients, and reduced the use rate of antibiotics by 100%. Conclusion: through the standardized management and education of patients and grassroots health personnel, the establishment of a gout management team with the linkage of "superior hospital-primary medical institutions-patients" can effectively control the condition of patients with gout, reduce the acute attack of gout and the abuse of antibiotics in the acute period, and improve the prognosis.
文摘This paper presents the perceptions of health workers (HWs) on medical waste management (MWM) issues in Tanzanian hospitals. The perceived total waste generation rates were lower than the actual measurements. Administrators perceived lower rates than implementers. The results indicated three categories of medical waste which are given due attention, that is, sharps waste, pathological and infectious waste. Other wastes like radioactive, chemical, pharmaceutical, pressurized containers receive very little attention. Container colour coding and labelling was negligible, while improvised containers are still in use. Medical waste is transported within hospitals manually, with little efforts on mechanized transportation. Poor waste storage was observed, while the prominent medical waste treatment technologies are medium temperature incinerators. Off-site transportation of medical waste is practiced, where the waste is finally dumped or buried. The hospitals are currently utilizing public-private partnership schemes for MWM in only one aspect of off-site transportation. Three main problems which require high attention include: Weaknesses in hospital management, poor MWM infrastructure, and lack of skills and knowledge on MWM among HWs. Knowledge and awareness among HWs on health hazards associated with poor MWM is low (with exception of cholera, HIV and typhoid). Few PPE types are supplied and used in the hospitals, leading to poor diseases prevention. There is also low knowledge among HWs on administrative issues related to MWM in Tanzanian hospitals.
文摘The coronavirus disease 2019(COVID-19)pandemic has led to heightened levels of anxiety and stress levels towards the health threats posed by the SARS-CoV-2 virus.At least 10%of those infected were health workers.In addition,a large proportion of infected cases and deaths were possibly due to SARS-CoV-2 infections acquired in hospitals or long-term care facilities.Health workers,especially those working on the frontline play a crucial role in controlling and preventing the COVID-19 pandemic.Previous studies reported that health workers were exposed to severe emotional stress(i.e.,burnout,depression and anxiety symptoms)during the outbreaks of infectious diseases including severe acute respiratory syndrome(SARS),Ebola and Middle East respiratory syndrome(MERS).It is therefore important to be aware that prolonged exposure to moderate-to severe stress can have negative health consequences and reduce the work performance of health workers.Therefore,some immediate measures should be taken by the health care institutions and relevant health authorities to ensure that Chinese health workers are better supported in caring for large number of COVID-19 patients.Future studies should examine the health status and work efficiency of health workers working in high stress environment amidst the COVID-19 pandemic or other disasters.
文摘Objective: Although there are adult vaccination schemes in our country, there are serious deficiencies in the way that doctors direct the patients to this vaccination, but also patients have to make and demand these vaccinations. The aim of our study is to identify the shortcomings in this area and draw a roadmap for what arrangements should be made in terms of physicians and patients in order to increase adult immunization rates in primary care. Method: We conducted a two-phase, multicentered, descriptive clinical trial between October and December 2017. The first phase of the trial was carried out with patients from 3 Family Health Centers in Antalya, Istanbul and Osmaniye. Patients to be interviewed were selected voluntarily among Family Health Center’s applicants. The second phase of the trial was carried out with health workers, who were participated to trial from 26 different provinces of Turkey. In the process, a questionnaire of 19 questions was applied to primary health care workers by the internet. Results: 490 patients were included in the study. There was a significant difference between gender, age, education level and guideline follow-up and vaccination status of patients [p Conclusion: As a result of the studies including our study about adult vaccination, only 10% - 20% of the targeted groups in adults can be vaccinated. However, just like in childhood during adulthood, vaccinations protect individuals from diseases and provide economic benefits. Firstly, the knowledge level of physicians on adult immunization should be updated with in-service trainings, they should first be convinced to vaccinate because they are in risk group and then they should be recommended vaccination to patient to increase the vaccination rates.
基金supported by grants from the National Institute of Mental Health(U19MH113211-01)and the Harvard Global Health Institute Burke Fellowship.
文摘Community health workers(CHWs)represent the backbone of primary health systems,especially in many low-and middle-income countries(LMICs).The coronavirus disease 2019(COVID-19)pandemic stretched health sys-tems and increased the workload for CHWs.The objective of this scoping review was to identify the mental health symptoms experienced among CHWs in LMICs during the COVID-19 pandemic.We searched PubMed for published literature,from January 1,2020 to December 31,2022 that focused on documenting the experiences of burnout,distress,and mental health symptoms among CHWs in LMICs.The quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Tool.Included studies were grouped into the follow-ing broad thematic categories:(1)symptoms experienced;(2)drivers of different mental health symptoms;and(3)strategies for coping with different symptoms.We identified 10 cross-sectional,qualitative,and observational studies from 11 LMICs in South and Southeast Asia,South America,and Eastern/Southern Africa that assessed the mental health burden CHWs faced during the pandemic.The studies identified disorders and symptoms such as depression,anxiety,fear,burnout,worsened stress,and fatigue.Contributing factors included increased work-load,financial constraints,and an understaffed and underequipped workplace.CHWs reported using different adaptive responses like humor,support from family and colleagues,denial,and substance use,and asked for recommended regular mental health checkups and counseling.More research and policies should be targeted to-wards promoting the mental wellbeing of CHWs to help ensure responsive and resilient health systems in LMICs in the face of future emerging public health threats.
文摘The study aimed at assessment of level of task performance of Primary Health Care Worker （PHCWs） according to their professional designations in selected Local Government Areas （LGA） in Enugu State. Descriptive survey research was used. 291 PHCWs were randomly selected from 9 LGA using a multistage method. Questionnaire was used to collect data and the instrument was validated using test-retest method with correlation coefficient of 0.79. The findings show that Community Health Extension Workers （CHEWs） performed higher than Environmental Health Officer （EVO） and Community Health Officers （CHOs） in the area of health education concerning prevailing health problems and method of control. They scored 66.09% as against 52.8% and 60.61% for EVO and CHEW respectively. The result showed that the professional designation has no significant effect （P 〈 0.05） on the level of task performed by PHCW and their levels of task performance were low. It was recommended that public Health physicians and Nurses should be involved in the PHC in Enugu State to provide the fight supervision to the PHCW.
文摘Objectives: To propose the improvements measures by analysing the influencing factors of hand hygiene (HH) compliance by observing the behaviour of health care workers (HCWs). Method: The observational study was conducted at a public tertiary hospital in Zhejiang, China, from September 2018 to March 2021. A total of 58 HH observers were trained to conduct a direct observation on the HH behaviors of personnel in the hospital amongst the health care workers. We have observed over 9000 hand hygiene opportunities. The collected data were classified according to time factors, department parameters, and profession conduct of the observed. Hand hygiene (HH) compliance rates were calculated for each category, and a chi-square test was used to analyze differences of the HH compliance rates. Furthermore, binary logistic regression was used for multivariate analysis in each of the hand hygiene moments. Results: The HH compliance rates of HCWs were statistically different before and after the Corona Virus Disease 2019 (COVID-19) pandemic, in the morning and the afternoon, this was observed per parameters stated into objectives on weekdays vs non weekdays. And we found that HH compliance rates drop off a cliff from weekdays to non-weekdays. Conclusions: COVID-19, departments, professions, and weekdays were all factors that influence HH compliance amongst HCWs. However, the influencing factors were not all present in every HH behavior, and had different intensities of influence on HH compliance amongst the HCWs. These findings provide some reference for us to propose improvement measures.
文摘Background: In Pakistan, the crucial role of Lady Health Workers (LHWs) cannot be over looked and must be supported. Their alliance position between the community and health system allows them to provide services to the most marginalised groups. However, LHWs face numerous challenges and issues resulting in reduced efficiency and effectiveness of LHW program. Aims: The study aims to identify the challenges highlighted in various studies that undermine the performance of LHWs and attempts to combine the recommendations of the studies for addressing these challenges. Methods: Literature search included articles from 2000 to 2024. PubMed and Google Scholar were the main search engines utilized. Initial search resulted in 1380 articles, out of which only those showing a link to the study title were included in the study. From the total articles searched, 55 were selected for writing this article. Results: Literature highlighted the importance of community selection, monitoring, monetary as well as non-financial incentives;trainings;availability of supervision, workload balance, monitoring;recognition, clarity on roles, resources and uninterrupted supply of logistics, support and embedment of LHWs in community and health system. Lack or poor quality of these aspects may lead to low performance of LHWs. Conclusions: This paper explores the extent of issues and challenges faced by LHWs in Pakistan. A number of interventions appear to be effective in improving the efficiency of LHWs in Pakistan. The review may serve as an essential resource for program planners and decision-makers in improving the effectiveness and efficiency of LHW programs.
文摘The standardized hypertension management provided by primary health care workers is an important part of China＇s recent health care reform efforts. Investigating 5,116 hypertensive patients from a cross-sectional survey conducted by the Chinese Center for Disease Control and Prevention in 2012, this study found that adherence to standardized hypertension management is associated with positive effects on hypertension- related knowledge, healthy lifestyle behavior, antihypertensive medical treatments, and blood pressure control. It will be necessary to provide primary health care workers with sufficient training and reasonable incentives to ensure the implementation and effectiveness of hypertension management.
基金This work was supported by the Bill&Melinda Gates Foundation(INV034554)。
文摘Background Immunization is a crucial preventive measure to safeguard children under five years old against a range of diseases.In China,the coverage rate of non-National Immunization Program(non-NIP)vaccines can be improved by leveraging the recommendation from public health workers.Hence,understanding the influencing factors of recommendation behaviors assume paramount importance.This study aims to investigate influencing factors of public health workers’recommendation behaviors towards non-NIP vaccines,with a particular emphasis on financial incentives.Methods A cross-sectional survey was conducted using a multi-stage sampling method in 2019 from August to October.627 public health workers were recruited from 148 community healthcare centers in ten provincial-level administrative divisions in China.An anonymous questionnaire was used to collect demographic information,attitudes towards vaccination,and recommendation behaviors towards non-NIP vaccines,includingHaemophilus influenzae type b(Hib)vaccine,pneumococcal conjugate vaccine,varicella vaccine,and rotavirus vaccine.Descriptive analysis and multivariate logistic regression analysis were adopted in this study.Results Of the 610 public health workers with complete survey data,53.8%,57.4%,84.1%,and 54.1%often recommended Hib vaccine,pneumococcal pneumonia vaccine(PCV),varicella vaccine,and rotavirus vaccine,respectively.Logistic regression revealed that gender(Hib vaccine:OR=0.4,95%CI:0.2-0.8;PCV:OR=0.4,95%CI:0.2-0.8;rotavirus vaccine:OR=0.3,95%CI:0.2-0.6),financial incentives for non-NIP vaccination(Hib vaccine:OR=1.9,95%CI:1.1-3.6;PCV:OR=2.1,95%CI:1.1-3.9;rotavirus vaccine:OR=2.0,95%CI:1.1-3.8)and perception of vaccine safety(Hib vaccine:OR=2.7,95%CI:1.1-7.0;PCV:OR=3.2,95%CI:1.2-8.0;rotavirus vaccine:OR=3.0,95%CI:1.2-7.7)were associated with public health workers’recommendation towards Hib vaccine,PCV and rotavirus vaccine.Conclusions The findings highlighted public health workers’recommendation behaviors of non-NIP vaccines in China and revealed strong association between vaccine recommendation and financial incentives.This highlights the importance of financial incentives in public health workers’recommendation toward non-NIP vaccines in China.Proper incentives are recommended for public health workers to encourage effective health promotion in immunization practices.
文摘Background:Developing countries have the potential to reach vulnerable and underserved populations marginalized by the country’s health care systems by way of community health work-ers(CHWs).It is imperative that health care systems focus on improving access to quality continu-ous primary care through the use of CHWs while paying attention to the factors that impact on CHWs and their effectiveness.Objective:To explore the possible opportunities and challenges of integrating CHWs into the health care systems of developing countries.Methods:Six databases were examined for quantitative,qualitative,and mixed-methods stud-ies that included the integration of CHWs,their motivation and supervision,and CHW policy making and implementation in developing countries.Thirty-three studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programs.Thematic coding was conducted and evidence on the main categories of contextual factors influencing integration of CHWs into the health system was synthesized.Results:CHWs are an effective and appropriate element of a health care team and can assist in addressing health disparities and social determinants of health.Important facilitators of integration of CHWs into health care teams are support from other health workers and inclusion of CHWs in case management meetings.Sustainable integration of CHWs into the health care system requires the formulation and implementation of polices that support their work,as well as financial and nonfinancial incentives,motivation,collaborative and supportive supervision,and a manageable workload.Conclusions:For sustainable integration of CHWs into health care systems,high-performing health systems with sound governance,adequate financing,well-organized service delivery,and adequate supplies and equipment are essential.Similarly,competent communities could contrib-ute to better CHW performance through sound governance of community resources,promotion of inclusiveness and cohesion,engagement in participatory decision making,and mobilization of local resources for community welfare.
文摘Objective:To assess perceived stress and coping capacity of frontline health workers from AIIMS during COVID-19 pandemic.Methods:This cross-sectional study conducted from May to July 2021 enrolled 694 participants.An online questionnaire based on Google Forms was developed to collect the data.Participants were assessed using the validated Perceived Stress Scale and the Coping Resources Inventory Scale.Results:The age of participants were 27(23-52)years old.The majority of respondents(73.5%)felt moderately stressed.Of the 694 participants,83.0%of the 576 participants had average stress management skills.Sex,marital status,and profession were significantly associated with perceived stress.In addition,marital status and profession were significantly associated with coping capacity.Conclusions:The majority of participants have moderate stress levels and average coping skills.Frontline healthcare workers have to maintain mental and physical health.Achieving this requires early screening and stress management for healthcare workers.
文摘Background: Healthcare workers are challenged by an imposing group of occupational hazards. These hazards include exposure to biological and non-biological hazards like ionizing radiation, stress, injury, infectious agents, and chemicals. The aim of this study was to assess common occupational hazards among health workers at the Department of Health Services (DHS), Federal University of Technology, Owerri. Methods: A hospital-based cross-sectional study design was employed for the study, and a self-administered questionnaire was used for data collection. The SPSS Version 22.0 software was used for the analysis of the descriptive statistics obtained from the study. This study included both clinical and non-clinical health workers. A purposive sampling technique was used in recruiting a total of 94 respondents who participated in the study from September 2020 to April 2021. Results: A total of 94 respondents who participated in the study and among the participants, 33.3% (31) of the respondents were aged 31 - 40 years, and the majority of the health workers, 43.6% (41) had stayed between 1 - 5 years. Also, 92.6% (87) of the health workers have heard of occupational hazards. The study showed that 84.0% (79) of health workers had good knowledge of common occupational hazards. Biological hazards among health workers are 47.9% (45) cuts and wounds, 29.8% (28) direct contact with contaminated specimens/hazardous materials, and 26.6% (26) sharp related injuries, while for non-biological hazards, 44.7% (42) have slipped, tripped or fallen, and 35.1% (33) have been stressed. Common safety measures include 86.2% (81) washing their hands regularly;78.7% (74) using hand gloves;and 85.1% (80) agreeing they use face masks. Conclusion: Despite good knowledge of occupational hazards, participants at DHS were faced with certain hazards. It is recommended that the university, government, and policymakers revise and implement actions to provide health workers at DHS with equipment to encourage safety in work activity.
