scholarly journals Health system preparedness for COVID-19 and its impacts on frontline health care workers in Nepal: a qualitative study among frontline healthcare workers and policymakers

2021 ◽  
pp. 1-29
Author(s):  
Nipun Shrestha ◽  
Shiva Raj Mishra ◽  
Saruna Ghimire ◽  
Bishal Gyawali ◽  
Sujan Babu Marahatta ◽  
...  
Keyword(s):  
Health Care ◽  
Private Sector ◽  
Health System ◽  
Health Care Workers ◽  
Clinical Care ◽  
Control Measures ◽  
Coordination Mechanism ◽  
Structured Interviews ◽  
The Poor ◽  
Care Workers

Abstract Background: Rapidly growing coronavirus disease 2019 (COVID-19) pandemic has brought unprecedented challenges to the health system in Nepal. The main objective of this study was to explore the health system preparedness for COVID-19 and its impacts on frontline health care workers in Nepal. Methods: Semi-structured interviews were conducted among 32 health care workers who were involved in clinical care of COVID-19 patients and four policymakers who were responsible for COVID-19 control and management at central and provincial level. All interviews were conducted through telephone or internet-based tools such as Zoom and Skype. All interviews were audio-recorded, transcribed into English, and coded using inductive and deductive approaches. Results: Both health care workers and policymakers reported failure to initiate pre-emptive control measures at the early stages of the outbreak as the pivot in pandemic control. Although several measures were rolled out when cases started to appear, the overall health system preparedness was low. The poor governance, and coordination between three tiers of government was compounded by the inadequate personal protective equipment for health care workers, insufficient isolation beds for patients, and poor engagement of the private sector. Additionally, health care workers experienced various degrees of stigma because of their profession and yet were able to maintain their motivation to continue working in the forefront. Conclusion: Preparedness for COVID-19 was affected by the poor coordination between three tiers of governance. Specifically, the lack of human resources, inadequate logistic chain management and laboratory facilities for testing COVID-19 appeared to have jeopardized the health system preparedness and escalated the pandemic in Nepal. Despite the poor preparedness, and health and safety concerns, health care workers maintained their motivation. There is an urgent need for an effective coordination mechanism between various tiers of health structure (including private sector) in addition to incentivizing the health care workers for the current and future pandemics.

scholarly journals Health System Preparedness in Tackling the COVID-19 in Nepal: a Qualitative Study Among Frontline Healthcare Workers and Policymakers

2020 ◽  
Author(s):  
Nipun Shrestha ◽  
Shiva Raj Mishra ◽  
Saruna Ghimire ◽  
Bishal Gyawali ◽  
Sujan Babu Marahatta ◽  
...  
Keyword(s):  
Health System ◽  
Clinical Care ◽  
Health And Safety ◽  
Control Measures ◽  
Coordination Mechanism ◽  
Structured Interviews ◽  
Laboratory Facilities ◽  
Care Workers ◽  
Control And Management ◽  
Frontline Healthcare Workers

Abstract BackgroundRapidly growing coronavirus disease 2019 (COVID-19) pandemic has brought unprecedented challenges to the health system in Nepal. The main objective of this study was to explore the characteristics and drivers of the health system preparedness towards COVID-19 and its impacts on frontline health care workers (HCWs) in Nepal.MethodsSemi-structured interviews (SSIs) were conducted among 32 HCWs who were involved in clinical care of COVID-19 patients and four policymakers who were responsible for COVID-19 control and management at central and provincial level. Participants were included from all seven provinces of Nepal. All SSIs were conducted through telephone or internet based tools such as Zoom and Skype. All interviews were audio-recorded, transcribed into English, and coded using inductive and deductive approaches.ResultsBoth HCWs and policymakers reported failure to initiate pre-emptive control measures at the early stages of the outbreak as the pivot in pandemic control. Although several measures were rolled out when cases started to appear, the overall health system preparedness was low. Specifically, there was inadequate personal protective equipment for HCWs, insufficient isolation beds for patients, poor coordination between the three tiers of governance, and poor engagement of the private sector. Additionally, HCWs experienced various degrees of stigma because of their profession and yet were able to maintain their motivation to continue working in the forefront.ConclusionThis study identified poor preparedness of the health system in the course of Nepal's COVID-19 response embedded in the governance. Specifically, the lack of human resources, inadequate logistic chain management and laboratory facilities for testing COVID-19 appeared to have jeopardized the health system preparedness and escalated the pandemic in Nepal. Despite the poor preparedness, and health and safety concerns, HCWs maintained their motivation. Urgent efforts are required to reform the governance and coordination mechanism in addition to incentivizing the HCWs for the current and future pandemics.

scholarly journals The psychosocial effects of being quarantined following exposure to COVID-19: A qualitative study of Lebanese health care workers

2020 ◽  
Vol 66 (6) ◽  
pp. 560-565 ◽  
Author(s):  
Mirna Fawaz ◽  
Ali Samaha
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Health Care Professionals ◽  
Control Measures ◽  
Mental Wellbeing ◽  
Care Providers ◽  
Structured Interviews ◽  
Psychosocial Effects ◽  
Care Workers

Background: Since the outbreak of the novel Coronavirus (COVID-19), health care professionals in Lebanon have been diligently serving as the frontline of defense. In the light of challenging economic and political circumstances, putting their community wellbeing as a priority, and abiding by quarantine and strict infection control measures, health care professionals risk both their physical and mental wellbeing. Objective: The aim of this study is to explore the psychosocial effects of being quarantined following exposure to COVID-19 among Lebanese health care professionals. Method: An exploratory qualitative research design was employed, where semi-structured interviews were carried out involving a sample of 13 Lebanese health care providers working at various COVID-19 units. Results: The qualitative analysis has revealed four themes namely ‘Fears of contracting and spreading the virus’, ‘Conflict between professional duty and family obligation’, ‘Stigma of being infected’, and ‘Inadequate or inaccurate information’. Conclusion: COVID-19 quarantine has been posing intense psychological challenges among Lebanese health care workers which are worsened at times by the economic instability; thus, health care policymakers are urged to take proper action nationwide to alleviate longlisting implications and support the health care providers in fulfilling their mission.

Interventions for Improving Health Care Workers’ Retention in Epidemics – a Scoping Review

2021 ◽  
Author(s):  
Zahra Zarei Jelyani ◽  
Sadra Valiee ◽  
Mohammad Kia ◽  
Ali jajarmizadeh ◽  
Sajad Delavari
Keyword(s):  
Health Care ◽  
Human Resources ◽  
Health System ◽  
Human Health ◽  
Scoping Review ◽  
Health Care Workers ◽  
Health Resources ◽  
The United States ◽  
Human Beings ◽  
Care Workers

Abstract Introduction: Generally, in Epidemics, such as COVID-19, health care workers (HCWs) faces many problems which lead to a shortage and weakening of human resources in the health system. Therefore, using effective strategies to retain human resources is one of the most important issues during outbreaks. This study aims to collect and classify the proposed interventions to strengthen human health resources and their sustainability during epidemics through scoping review.Methods: In this scoping review study, 2300 studies were retrieved through searching international databases –PubMed, Embase, Scopus and Web of Science. The retrieved studies were screened, and finally, 50 studies were included for analysis. The strategies were classified using inductive qualitative content analysis.Results: Most of the studies were conducted in the United States and the United Kingdom. The target population in 39 studies was all health workers; five studies were on physicians, five studies on nurses, and only one study on dentists. The proposed interventions were classified into five categories: preparation, protection, support, treatment, and feedback. Discussion: Most studies focused on providing interventions in one or two dimensions of human resources, but these interventions were summarized and categorized in this review. Therefore, this study has a holistic view of various dimensions of strengthening and maintaining human health resources during epidemics by providing a thematic map. Considering that human beings are multidimensional, policymakers and managers of the health system should use a set of interventions that simultaneously cover different aspects of their needs to strengthen and maintain HCWs.

AIDS Dementia Complex: The Perception of Loss of Functional Ability

2002 ◽  
Vol 65 (11) ◽  
pp. 509-514
Author(s):  
Kate Gregory ◽  
Deanna Gibbs
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Functional Ability ◽  
Aids Dementia Complex ◽  
Limited Information ◽  
Loss Of Function ◽  
Structured Interviews ◽  
Aids Dementia ◽  
Care Workers ◽  
And Function

AIDS Dementia Complex (ADC) is a subcortical dementia often associated with HIV disease. Despite undergoing numerous assessments of cognition and function to determine their need for personal care assistance, there is limited information on how individuals with ADC view their functional and cognitive impairments and the subsequent effect on their lifestyle. This study investigated issues of concern to clients with ADC in order to provide a greater understanding of the psychological effect of the loss of functional ability. A qualitative design was used to explore individuals' experience of ADC and clarify their insight and perception regarding the loss of function. The participants were selected by the use of purposeful sampling techniques. Information was obtained through semi-structured interviews and analysed using an analytic induction method. Five main themes were identified as being important in relation to the perception of functional ability. Discrepancies emerged between the insights of individuals with ADC regarding their level of function and their need for assistance and support with activities of daily living, compared with those of the health care workers involved in their care. Health care workers need to have an awareness of the insight that individuals with ADC may have into their functional ability when addressing issues of supported accommodation and level of assistance required.

scholarly journals Factors for late initiation of antenatal care in Dar es Salaam, Tanzania: A qualitative study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Saidi Mgata ◽  
Stephen Oswald Maluka
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Health System ◽  
Pregnant Women ◽  
Health Care Workers ◽  
Cultural Beliefs ◽  
Dar Es Salaam ◽  
World Health ◽  
Health Providers ◽  
Care Workers

Abstract Background Antenatal care (ANC) provided by a trained health care provider is important for monitoring pregnancy thereby reducing potential risks for the mother and child during pregnancy and delivery. The World Health Organization (WHO) recommends at least four ANC visits to all pregnant women. While the proportion of women who attend at least one ANC in low-income countries is high, most pregnant women start their first ANC attendance very late. In Tanzania only 24% of pregnant women start their first ANC attendance before the fourth month of pregnancy. While factors for the utilization of antenatal care in general have been widely studied, there is paucity of studies on the factors affecting timing of the first ANC attendance. This study aimed to understand individual, community, and health system factors that lead to the delay in seeking ANC services among pregnant women in Ilala Municipal in Dar es Salaam region, Tanzania. Methods A qualitative exploratory study, using in-depth interviews with 20 pregnant women and five health care workers was conducted in three different health facilities in Dar es Salaam Tanzania. Thematic analysis approach was used to analyse the data. Results Individual perceptions of antenatal care, past experience with pregnancy, fear of pregnancy disclosure, and socio-cultural beliefs were the key individual and social factors for late ANC attendance. Shortage of trained health care workers, lack of spouse’s escort and health providers’ disrespect to pregnant women were the main health system barriers to early ANC attendance. Conclusions This study concludes that community members should be sensitized about the importance of early ANC attendance. Additionally, while spouse’s escort policy is important for promoting PMTCT, the interpretation of the policy should not solely be left to the health providers. District and regional health officials should provide correct interpretation of this policy.

When roles within interpreter-mediated psychiatric consultations speak louder than words

2020 ◽  
pp. 136346152093376 ◽  
Author(s):  
Sanja Kilian ◽  
Leslie Swartz ◽  
Xanthe Hunt ◽  
Ereshia Benjamin ◽  
Bonginkosi Chiliza
Keyword(s):  
South Africa ◽  
Health Care ◽  
Health Care Workers ◽  
Ad Hoc ◽  
Psychiatric Hospitals ◽  
Best Interests ◽  
Western Cape ◽  
Structured Interviews ◽  
Care Workers ◽  
Professional Interpreting

In South Africa, clinicians working in public psychiatric hospitals are mainly fluent in English and Afrikaans, while the majority of patients are not proficient in these languages. Due to a lack of professional interpreting services, informal, ad hoc interpreters are commonly employed in public psychiatric hospitals. We collected data on language practices in public psychiatric care in South Africa, and provide a detailed account of what happens when bilingual health care workers and cleaners haphazardly take on the additional role of interpreter. Data were collected during 2010 at a public psychiatric hospital in the Western Cape, South Africa. Thirteen interpreter-mediated psychiatric consultations were video-recorded, and 18 audio-recorded semi-structured interviews were conducted with the interpreters and clinicians who participated in the interpreter-mediated psychiatric consultations. Patients were proficient in isiXhosa (one of the 11 official languages of South Africa), the clinicians (all registrars) were first language English or Afrikaans speakers, while the health care workers (nurses and social workers) and cleaners were fluent in both the patients’ and clinician’s language. Our findings suggest that interpreters took on the following four roles during the interpreter-mediated psychiatric consultations: regulating turn-taking, cultural broker, gatekeeper and advocate. Our findings suggest that, despite interpreters and clinicians having the patient’s best interests at heart, it is the patient’s voice that becomes lost while the clinician and interpreter negotiate the roles played by each party.

Self-reported influenza vaccination rates among health care workers in a large health system

2008 ◽  
Vol 36 (8) ◽  
pp. 574-581 ◽  
Author(s):  
Mary Patricia Nowalk ◽  
Chyongchiou J. Lin ◽  
Richard K. Zimmerman ◽  
Dwight E. Fox ◽  
Mahlon Raymund ◽  
...  
Keyword(s):  
Health Care ◽  
Influenza Vaccination ◽  
Health System ◽  
Health Care Workers ◽  
Vaccination Rates ◽  
Care Workers

scholarly journals PREVALENCE OF LATENT TB INFECTION AMONG HEALTH CARE WORKERS, ALJAZEERA STATE TB CENTERS, SUDAN

2020 ◽  
Vol 5 (12) ◽  
pp. 465-470
Author(s):  
Juhaina Abdulraiem AL Mosharaf ◽  
Adam Abdalla Mater
Keyword(s):  
Health Care ◽  
Skin Test ◽  
Health Care Workers ◽  
Latent Tuberculosis ◽  
Health Care Facilities ◽  
Control Measures ◽  
Treatment Center ◽  
Infection Control Measures ◽  
Care Workers ◽  
Increased Risk

Health care workers (HCW) are at increased risk of latent tuberculosis infection (LTBI) from occupational exposure to Mycobacterium tuberculosis. The objective was to determine the prevalence and risk factors for LTBI among primary HCW in Aljazeera state Sudan. We conducted an analytical study, among HCW in TB treatment center using a structured questionnaire and an evaluated for LTBI using the tuberculin skin test among 367 HCW, the LTBI prevalence was 35.7%. (64.5%), We found that the following factors associated with LTBI in HCW were in age group 30-40 years was 63% ,75.2% of the participants didn't do the skin test for TB, and the high risk among the  lab technician represented 41.2%. Our study recommended implementation of sound TB infection control measures in all health care facilities with patients suspected of having infectious.

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