scholarly journals Indiscriminate Use of Antibiotics in Neurotrauma Patients Referred for Expert Neurosurgical Care in a Developing Country

2019 ◽  
Vol 10 (04) ◽  
pp. 653-656
Author(s):  
Toyin A. Oyemolade ◽  
Toluyemi A. Malomo ◽  
Amos O. Adeleye
Keyword(s):  
Developing Country ◽  
Antibiotic Stewardship ◽  
Health Workers ◽  
Health Facilities ◽  
University Teaching ◽  
Antibiotic Administration ◽  
Cord Injury ◽  
Neurosurgical Treatment ◽  
Tissue Systems ◽  
Primary Health Facilities

Abstract Background In Nigeria, pre-neurosurgical care of most neurotrauma patients usually involves administration of many empirical agents including antibiotics with no apparent indications. This practice is fraught with two particular dangers: increase in health care costs and development of drug resistance. This study aimed to interrogate antibiotic stewardship in the pre-neurosurgical care of neurotrauma patients referred to our practice. Materials and Methods This 7-month prospective descriptive study was performed in one University Teaching Hospital of a developing country. Clinical data on all admitted neurotrauma patients with information on the pre-neurosurgical treatment received were captured and analyzed. Results There were 113 patients, 87(77.0%) males; 103(91.2%) had head injury, and 10(8.8%) spinal cord injury. Associated systemic injuries occurred in 47(41.6%): 40 involved skeletal and soft tissue systems, and 12(10.6%) presented with aspiration pneumonitis. These patients were referrals from public health facilities including primary health facilities (PHF), secondary (SHF), and tertiary (THF), as well as private clinics (PC). Antibiotics were given to 74 (65.5%) patients, with a probabilistic indication in only 17.6% (13/74) of these. The proportional distribution of this antibiotic administration according to the referral base was not statistically significant (χ2 =6.87, p = 0.3): 70% (14/20) from PHF, 56% (14/25) from SHF, 71% (23/32) from THF, and 63% (23/36) from PC. The antimicrobial agent administered was specified in 40 cases: Ceftriaxone was the commonest antibiotic agent implicated. Conclusion There is apparent unnecessary exposure of patients to antibiotics in the pre-neurosurgical care of neurotrauma in this study. There is, therefore, need for education on antibiotic stewardship to the group of health workers involved.

scholarly journals Environmental Variables Influencing Exclusive Breastfeeding Among Mothers Attending Postnatal Clinics in A Tertiary Health Institution

2021 ◽  
Vol 4 (6) ◽  
pp. 71-83
Author(s):  
Nwankwo I.P. ◽  
Ilo I.C.
Keyword(s):  
Exclusive Breastfeeding ◽  
Environmental Variables ◽  
Maternal Education ◽  
Health Workers ◽  
Tertiary Education ◽  
Health Facilities ◽  
University Teaching ◽  
Place Of Delivery ◽  
Breastfeeding Practices ◽  
Significant Difference

The current WHO/UNICEF feeding recommends that breastfeeding with good nutrition is essential to achieving the UN sustainable development goals. This study was carried out to assess the environmental variables influencing exclusive breastfeeding of infants aged 0–6 months in Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria. Three objectives guided the study. Cross sectional descriptive survey design was used for the study. The instrument for data collection was a structured questionnaire which was validated by experts and was administered to four hundred (400) post natal women of child bearing age who were randomly selected. The data collected were analyzed using statistical methods, which included mean, chi square, and t-test which were presented in frequencies and percentages. The result revealed that 44.7% of babies were exclusively breastfed while more than half (55.3%) were not exclusively breastfed. The result of this study also showed that maternal education had a significant effect on their exclusive breastfeeding pattern (P < 0.05) as 65.9% of mothers who breastfed exclusively had up to tertiary education. An association was also found between the parity of mother and breastfeeding practices. This is because 46.3% of mothers who had three or more children breastfed their children exclusively. This study showed a positive association between place of delivery and breastfeeding practices. Place of delivery revealed a significant difference between the two groups as exclusive breastfeeding was observed in 95.5% babies delivered in government health facilities compared with 4.5% delivered at private health facilities. Health workers should educate the mothers about the benefit of exclusive breastfeeding. Some other factors found to prevent mothers from practicing exclusive breastfeeding were finance, 36 (16.3%); personal reasons, 51 (20.1%); lack of time as they have to go back to work, 72 (32.6%); dissatisfaction, 40 (18.0%); stress, 9 (4.0%); baby's refusal, 7 (3.2%); and pains, 6 (2.7%).

scholarly journals Work motivation and job satisfaction among health workers at primary health facilities: a cross-sectional study from Nepal

2020 ◽  
Author(s):  
Pratik Khanal ◽  
Bishnu P Choulagai ◽  
Pawan Acharya ◽  
Sharad Onta
Keyword(s):  
Job Satisfaction ◽  
Career Development ◽  
Work Motivation ◽  
Health Workers ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Health ◽  
Primary Health Facilities

Abstract BackgroundWork motivation and job satisfaction are linked with the performance and retention of health workforce. Primary health facilities, mostly comprising mid-level health workers, serve the majority of the population in Nepal. The aim of the study was to assess the determinants of job satisfaction in relation to socio-demographics, job characteristics and work motivation status among health workers working in primary health facilities. MethodsA cross-sectional study was conducted in Jhapa district in Eastern Nepal covering 40 primary health facilities. The data collection involved 151 self-administered questionnaire interviews and 16 in-depth interviews with health workers. Mean differences in work motivation among those satisfied and unsatisfied with their job was examined using t tests. Logistic regression with 95% confidence interval at p<0.05 was used for identifying associated factors with job satisfaction. Thematic analysis was done to analyze qualitative data. ResultsAmong the study participants, 78.2% were either auxiliary health workers or auxiliary nurse midwives. The median employment period of health workers was 174 months. On the 5-point Likert scale, the mean score of work motivation was highest for team work (3.99) and lowest for financial motivation (2.21). Higher age of health workers and satisfaction with career development, and financial motivation were significantly associated with job satisfaction. The qualitative findings also revealed that the majority of the health workers were not satisfied with the existing career development opportunities, availability of resources in health facility, or financial motivation. ConclusionSatisfaction with career development and financial motivation significantly increased job satisfaction among health workers. Resource availability in health facility, recognition of work and management support affected work motivation and job satisfaction of health workers. A focus on improving work environment through increased financial motivation and career development opportunities as well as investing in primary health facilities with increased resource support is recommended to improve job satisfaction.

scholarly journals Exploring the perspectives and experiences of health workers at primary health facilities in Kenya following training

2013 ◽  
Vol 7 (1) ◽  
Author(s):  
Rachel Jenkins ◽  
Caleb Othieno ◽  
Stephen Okeyo ◽  
Julyan Aruwa ◽  
Jan Wallcraft ◽  
...  
Keyword(s):  
Health Workers ◽  
Health Facilities ◽  
Primary Health ◽  
Primary Health Facilities

scholarly journals Work motivation and job satisfaction among health workers of primary health facilities: a mixed-methods study from Nepal

2020 ◽  
Author(s):  
Pratik Khanal ◽  
Bishnu P Choulagai ◽  
Pawan Acharya ◽  
Sharad Onta
Keyword(s):  
Job Satisfaction ◽  
Mixed Methods ◽  
Career Development ◽  
Health Facility ◽  
Work Motivation ◽  
Health Workers ◽  
Health Facilities ◽  
Mixed Methods Study ◽  
Primary Health ◽  
Primary Health Facilities

Abstract Background Work motivation and job satisfaction are linked with the performance and retention of health workforce. Primary health facilities, mostly comprising of mid-level health workers, serve majority of the population in Nepal. The aim of the study was to assess the determinants of job satisfaction in relation to socio-demographics, job characteristics and work motivation status among health workers working in primary health facilities. Methods A mixed-methods study was conducted in Jhapa district in Eastern Nepal covering 40 primary health facilities. The data collection involved 151 self-administered questionnaire interviews and 16 in-depth interviews with the health workers. Mean differences in work motivation among those satisfied and unsatisfied with their job was examined using t tests. Logistic regression with 95% confidence interval at p<0.05 was used for identifying associated factors with job satisfaction. Thematic analysis was done for qualitative data. Results Among the study participants, 78.2% were either auxiliary health workers or auxiliary nurse midwives. The median employment period of health workers was 174 months. In the likert scale of five points, the mean score of work motivation was highest for team work (3.99) and lowest for financial motivation (2.21). Age of health workers and satisfaction with career development, and financial motivation were significantly associated with job satisfaction. The qualitative findings also revealed that majority of the health workers were not satisfied with the existing career development opportunities, availability of resources in health facility and financial motivation. Conclusions Dissatisfaction with career development and financial motivation was significantly associated with lower odds of job satisfaction among health workers. Additionally, resource availability in health facility, recognition of work and management support affected job satisfaction. A focus on improving work environment through increased financial motivation and career development opportunities as well as investing in primary health facilities with increased resource support is recommended to improve job satisfaction.

scholarly journals A health worker knowledge, attitudes and practices survey of SARS-CoV-2 infection prevention and control in South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saiendhra Vasudevan Moodley ◽  
Muzimkhulu Zungu ◽  
Molebogeng Malotle ◽  
Kuku Voyi ◽  
Nico Claassen ◽  
...  
Keyword(s):  
South Africa ◽  
Health Worker ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Health Workers ◽  
Health Facilities ◽  
World Health ◽  
Infection Prevention And Control ◽  
Successful Implementation ◽  
And Control

Abstract Background Health workers are crucial to the successful implementation of infection prevention and control strategies to limit the transmission of SARS-CoV-2 at healthcare facilities. The aim of our study was to determine SARS-CoV-2 infection prevention and control knowledge and attitudes of frontline health workers in four provinces of South Africa as well as explore some elements of health worker and health facility infection prevention and control practices. Methods A cross-sectional study design was utilised. The study population comprised both clinical and non-clinical staff working in casualty departments, outpatient departments, and entrance points of health facilities. A structured self-administered questionnaire was developed using the World Health Organization guidance as the basis for the knowledge questions. COVID-19 protocols were observed during data collection. Results A total of 286 health workers from 47 health facilities at different levels of care participated in the survey. The mean score on the 10 knowledge items was 6.3 (SD = 1.6). Approximately two-thirds of participants (67.4%) answered six or more questions correctly while less than a quarter of all participants (24.1%) managed to score eight or more. A knowledge score of 8 or more was significantly associated with occupational category (being either a medical doctor or nurse), age (< 40 years) and level of hospital (tertiary level). Only half of participants (50.7%) felt adequately prepared to deal with patients with COVD-19 at the time of the survey. The health workers displaying attitudes that would put themselves or others at risk were in the minority. Only 55.6% of participants had received infection prevention and control training. Some participants indicated they did not have access to medical masks (11.8%) and gloves (9.9%) in their departments. Conclusions The attitudes of participants reflected a willingness to engage in appropriate SARS-CoV-2 infection prevention and control practices as well as a commitment to be involved in COVID-19 patient care. Ensuring adequate infection prevention and control training for all staff and universal access to appropriate PPE were identified as key areas that needed to be addressed. Interim and final reports which identified key shortcomings that needed to be addressed were provided to the relevant provincial departments of health.

scholarly journals Improving Tanzanian childbirth service quality

2018 ◽  
Vol 31 (3) ◽  
pp. 190-202 ◽  
Author(s):  
Jennie Jaribu ◽  
Suzanne Penfold ◽  
Cathy Green ◽  
Fatuma Manzi ◽  
Joanna Schellenberg
Keyword(s):  
Health Facility ◽  
Low Income ◽  
Healthcare Providers ◽  
Health Facilities ◽  
Rural District ◽  
Local Data ◽  
Content Type ◽  
Primary Health ◽  
Primary Health Facilities ◽  
Childbirth Care

Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

scholarly journals Health workers’ perceptions on where and how to integrate tobacco use cessation services into tuberculosis treatment; a qualitative exploratory study in Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elizeus Rutebemberwa ◽  
Kellen Nyamurungi ◽  
Surabhi Joshi ◽  
Yvonne Olando ◽  
Hadii M. Mamudu ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Tobacco Cessation ◽  
Health Workers ◽  
High Volume ◽  
Health Facilities ◽  
Hospital Treatment ◽  
Management Support ◽  
Tobacco Use Cessation ◽  
Tb Treatment

Abstract Background Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda. Methods Between March and April 2019, nine focus group discussions (FGDs) and eight key informant interviews were conducted among health workers attending to patients with tuberculosis on a routine basis in nine facilities from the central, eastern, northern and western parts of Uganda. These facilities were high volume health centres, general hospitals and referral hospitals. The FGD sessions and interviews were tape recorded, transcribed verbatim and analysed using content analysis and the Chronic Care Model as a framework. Results Respondents highlighted that just like TB prevention starts in the community and TB treatment goes beyond health facility stay, integration of tobacco cessation should be started when people are still healthy and extended to those who have been healed as they go back to communities. There was need to coordinate with different organizations like peers, the media and TB treatment supporters. TB patients needed regular follow up and self-management support for both TB and tobacco cessation. Patients needed to be empowered to know their condition and their caretakers needed to be involved. Effective referral between primary health facilities and specialist facilities was needed. Clinical information systems should identify relevant people for proactive care and follow up. In order to achieve effective integration, the health system needed to be strengthened especially health worker training and provision of more space in some of the facilities. Conclusions Tobacco cessation activities should be provided in a continuum starting in the community before the TB patients get to hospital, during the patients’ interface with hospital treatment and be given in the community after TB patients have been discharged. This requires collaboration between those who carry out health education in communities, the TB treatment supporters and the health workers who treat patients in health facilities.

scholarly journals Factors influencing the migration intention of dental and medical graduates in developing countries

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Hajian ◽  
M H Khoshnevisan ◽  
S h Yazdani ◽  
M P Jadidfard
Keyword(s):  
Developing Countries ◽  
Developing Country ◽  
English Language ◽  
Health Workers ◽  
Service Planning ◽  
Primary Data ◽  
Pull Factors ◽  
Factors Influencing ◽  
Migration Decisions ◽  
Push And Pull

Abstract Background Migration of skilled health workers could result in shortage of human resources and rising inequalities in service provision in source countries. To date, most of relevant papers are focused on rate and reasons of migration while the need for conducting studies on modelling of factors is more vividly felt. The aim of this review was to determine the factors influencing the migration decisions of medical and dental graduates migrating from developing countries and to introduce a practical conceptual framework for health worker migration. Methods Electronic databases PubMed, Google Scholar and relevant Journals were systematically searched for English language publications from January 2009 to April 2019. The inclusion criteria were: 1) article stated factors affecting migration decisions of medical doctors and/or dentists, 2) the source country in the study was a developing country, 3) participants’ primary qualification country was in a developing country,4) the study used primary data both qualitative or quantitative. Results The search identified 814 articles from which we included 23 full-text studies after applying eligibility checklist. Push and pull theory was the most popular model to describe the migration driving factors. Poor socio-economic situation, political instability, lack of professional and educational opportunities together with family concerns found as strong common push factors that perpetuate migration. The most influencing pull factors were desire for better quality of life, career and training opportunities and financial gain. Conclusions Despite the fact that health workers migrate for different reasons, they follow a same route for decision to stay or leave their own countries. Un-fulfillment of expectations in mother land in addition to media reconstructed reality of life in foreign land can develop a positive attitude for migration Which should be considered before weighing up the push and pull factors of both sides. Key messages A better understanding of the migration motives of health professionals will help health authorities to improve their workforce recruitment and retention strategies and health service planning. Our simple yet comprehensive framework can mainly identify the development of migration desire through combining different models and concepts of migration, behavioral change, values, needs and so on.

scholarly journals ASSOCIATION BETWEEN DURATION AS A FISHERMAN, DISTANCE OF HEALTH FACILITIES AND SMOKING WITH PTERYGIUM'S DISEASE IN FISHERMAN IN BENGKULU

2021 ◽  
Vol 10 (1) ◽  
pp. 65-71
Author(s):  
Dwi Putri Sulistiya Ningsih ◽  
Ida Rahmawati
Keyword(s):  
Significant Relationship ◽  
Health Workers ◽  
Case Control ◽  
High Risk Group ◽  
Health Facilities ◽  
Observational Research ◽  
Validity And Reliability ◽  
Chi Square ◽  
Table Data ◽  
Methods Analytical

Background: Fishermen are a high risk group for developing pterygium. The high frequency of exposure to UV, wind, dust and sand when working makes the prevalence of pterygium among fishermen quite high. The city of Bengkulu, which is geographically located on the west coast of Sumatra Island which is directly facing the Indonesian Ocean, makes the majority of its population work as fishermen. Objectives: This study aims to determine the relationship between duration of being a fisherman, distance to health facilities and smoking with pterygium disease in a group of fishermen in, Bengkulu. Methods: Analytical observational research with case control design. The sample of 120 fishermen consisted of 40 cases and 80 controls, because researchers used a case-control ratio of 1:2. Sampling using purposive sampling method. The dependent variable was pterygium disease. Independent variables of duration as a fisherman, distance of health facilities and smoking. The research instrument uses a structured questionnaire that has been tested for validity and reliability with Alpha Cronbach value (0.996) > r table. Data were analyzed by Chi Square. Results: Based on the research results, it was found that there was a significant relationship with duration as a fisherman (≥ 21 years) (OR = 3.980; 95%CI = 1.404-11.284; p = 0.006) with pterygium disease. There is no relationship between smoking (OR = 1.246; 95%CI = 0.559-2.778; p = 0.590) with pterygium disease. There is a significant relationship between the distance of health facilities (OR = 5.133; 95%CI = 2.249-11.715; p = 0.000) with pterygium disease. Conclusion: The length of time working as a fisherman increases the risk of developing pterygium disease as the frequency of exposure to UV, dust, wind and sand increases. It is necessary to use personal protective equipment to reduce the risk of exposure and education from health workers so that the public can take good preventive measures.   Keywords: Duration as a fisherman, distance health facilities, smoking, pterygium.

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