scholarly journals Influence of social-cultural factors and gender on health workforce absenteeism: a qualitative study from Nigeria

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
O Omwujekwe
Keyword(s):  
Rural Areas ◽  
Health Workers ◽  
Health Sector ◽  
Structural Factors ◽  
Dual Practice ◽  
Social Events ◽  
Rural And Urban ◽  
Child Bearing ◽  
Enugu State ◽  
And Gender

Abstract Background Absenteeism is widespread across the Nigerian health sector among all cadres of providers. Little is known about the health worker incentives and drivers of absenteeism among staff working in primary health care settings in rural areas in Enugu State. Methods We focused on six primary care centers in rural and urban regions in Enugu State, south-east Nigeria. We conducted in-depth interviews and focus group discussions with 70 respondents living nearby: comprising 12 frontline health workers, 12 healthcare managers, 6 Health Facility Committee leaders and 40 service users. We used thematic data analysis, drawing on conceptualisations of culture and gender. Results Socio-cultural causes of absenteeism included gender roles (caregiving responsibilities, home keeping, child bearing issues, etc.), marital status, attending to social events and cultural ceremonies. Consequently, women were more likely to be absent than men, given traditional roles (e.g. home keeping, caregiving, farming) and child bearing. Male absenteeism reflected a need to generate additional income through dual practice and other jobs. Sanctions against those absent was similar for men and women. Individual health workers who were connected to politically powerful individuals “godmothers” or “godfathers” were able to use these connections to improve their placements and protect themselves from potential sanction. Conclusions Effective strategies to tackle absenteeism will require socio-economic and these factors to be taken into account when addressing health systems and structural factors. Long-term change also requires addressing the power imbalances that give rise to these conditions, something that is likely to be especially challenging.

scholarly journals Challenges and policy opportunities in nursing in Saudi Arabia

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Mohammed Alluhidan ◽  
Nabiha Tashkandi ◽  
Fahad Alblowi ◽  
Tagwa Omer ◽  
Taghred Alghaith ◽  
...  
Keyword(s):  
Human Resources ◽  
Rural Areas ◽  
Health Workers ◽  
Human Resources For Health ◽  
Health Sector ◽  
Postgraduate Education ◽  
Work Load ◽  
Nursing School ◽  
Quality Healthcare ◽  
And Gender

Abstract Background The Kingdom of Saudi Arabia’s (KSA) health sector is undergoing rapid reform in line with the National Transformation Program, as part of Saudi’s vision for the future, Vision 2030. From a nursing human resources for health (HRH) perspective, there are challenges of low nursing school capacity, high employment of expatriates, labor market fragmentation, shortage of nurses in rural areas, uneven quality, and gender challenges. Case presentation This case study summarizes Saudi Ministry of Health (MOH) and Saudi Health Council’s (SHCs) evaluation of the current challenges facing the nursing profession in the KSA. We propose policy interventions to support the transformation of nursing into a profession that contributes to efficient, high-quality healthcare for every Saudi citizen. Key to the success of modernizing the Saudi workforce will be an improved pipeline of nurses that leads from middle and high school to nursing school; followed by a diverse career path that includes postgraduate education. To retain nurses in the profession, there are opportunities to make nursing practice more attractive and family friendly. Interventions include reducing shift length, redesigning the nursing team to add more allied health workers, and introducing locum tenens staffing to balance work-load. There are opportunities to modernize existing nurse postgraduate education, open new postgraduate programs in nursing, and create new positions and career paths for nurses such as telenursing, informatics, and quality. Rural pipelines should be created, with incentives and increased compensation packages for underserved areas. Conclusions Critical to these proposed reforms is the collaboration of the MOH with partners across the healthcare system, particularly the private sector. Human resources planning should be sector-wide and nursing leadership should be strengthened at all levels.

The Role of Rural and Urban Geography and Gender in Community Stigma Around Mental Illness

2020 ◽  
pp. 109019812097496
Author(s):  
Shawnda Schroeder ◽  
Chih Ming Tan ◽  
Brian Urlacher ◽  
Thomasine Heitkamp
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Rural Areas ◽  
Mental Health Disorders ◽  
Mental Illness Stigma ◽  
Stigma Scale ◽  
Rural And Urban ◽  
Health Disorders ◽  
And Gender

Empirical evidence describes the negative outcomes people with mental health disorders experience due to societal stigma. The aim of this study was to examine the role of gender and rural-urban living in perceptions about mental illness. Participants completed the Day’s Mental Illness Stigma Scale, a nationally validated instrument for measuring stigma. Directors of Chambers of Commerce in North Dakota distributed the electronic survey to their members. Additionally, distribution occurred through use of social media and other snowball sampling approaches. Analysis of data gathered from 749 participants occurred through examination of the difference in perceptions based on geography and gender. The zip codes of residence were sorted to distinguish between rural and urban participants. Application of weighting measures ensured closer alignment with the general population characteristics. Findings indicate that for the majority of the seven stigma measures the Day’s Mental Illness Stigma Scale examines, the coefficient of rural–gender interactions was positive and highly significant with higher levels of stigma in rural areas. Females exhibited lower stigma perceptions than males. However, women living in rural areas held higher degrees of stigma compared to urban residing females. Implications of the study include the need to advance mental health literacy campaigns for males and people residing in rural communities. Additional empirical studies that examine the role of geography and gender in understanding stigma toward people with mental health disorders will result in improved treatment outcomes due to increased and focused educational efforts.

Two Models for Change in the Health Services in Zimbabwe

1985 ◽  
Vol 15 (3) ◽  
pp. 451-468 ◽  
Author(s):  
Gerald Bloom
Keyword(s):  
Health Services ◽  
Rural Areas ◽  
Health Workers ◽  
Private Insurance ◽  
Health Sector ◽  
Developed Countries ◽  
Insurance Companies ◽  
Political Commitment ◽  
Future Health ◽  
Mortality And Morbidity

The health situation in pre-Independence Zimbabwe was much as elsewhere in the Third World. While the majority suffered excess mortality and morbidity, the affluent enjoyed a health status similar to that of the populations of developed countries. The health services also showed the familiar pattern, with expenditure concentrated on sophisticated facilities in the towns, leaving the rural majority with practically no services at all. With the coming of Majority Rule, the previous pattern of controlling access to facilities on the basis of race could not continue. Two broad routes forward were defined. On the one hand, the private doctors, the private insurance companies, and the settler state proposed a model based on improving urban facilities, depending on a trickle-down to eventually answer the needs of the rural people. On the other hand, the post-Independence Ministry of Health advocated a policy of concentrating on developing services in the rural areas. The pattern of the future health service will depend on the capacity of the senior health planners and on the enthusiasm of front-line health workers but, of overriding importance will be the political commitment to answer the needs of the majority and the outcome of the inevitable struggle for access to scarce health sector resources.

scholarly journals Clients’ willingness to pay for immunization services in the urban and rural primary health centers of Enugu state, Nigeria

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Edmund Ndudi Ossai ◽  
Akinola Ayoola Fatiregun
Keyword(s):  
Willingness To Pay ◽  
Rural Areas ◽  
Urban Areas ◽  
Health Centers ◽  
Childhood Immunization ◽  
Cross Sectional ◽  
Primary Health ◽  
Rural And Urban ◽  
Immunization Services ◽  
Enugu State

Our study aims at determining the pattern of willingness of clients to pay for childhood immunization services in urban and rural primary health centers of Enugu state, Nigeria. Using a cross-sectional design, 800 clients who presented with their children/wards to receive childhood immunization services were selected at the primary health center in rural and urban local government areas of the state. The mean age was 28.9±4.5 and 26.7±5.1 years in the urban and rural areas respectively. About 54.5% of clients in the urban and 55.3% in the rural area were willing to pay for immunization services. The clients willingness to pay was influenced by: non satisfaction with immunization services, (OR=0.3, 95%CI: 0.2- 0.5), younger age, (OR=1.4, 95%CI: 1.0-2.0) marital status (OR=2.8, 95%CI: 1.2-6.5), proximity to health centers (OR=0.6, 95%CI: 0.4- 0.8), and delivering in a private health facility (OR=0.4, 95%CI: 0.1-0.9). The study suggests that the economic value that clients give to immunization services was similar in the rural and urban areas, and this could be increased by improving the level of clients’ satisfaction for the services among others.

scholarly journals Historicizing medical drones in Africa: a focus on Ghana

2021 ◽  
Vol 11 (1) ◽  
pp. 103-125
Author(s):  
Samuel Adu-Gyamfi ◽  
Razak Mohammed Gyasi ◽  
Benjamin Dompreh Darkwa
Keyword(s):  
Rural Areas ◽  
Healthcare Delivery ◽  
Health Sector ◽  
Healthcare Sector ◽  
Medical Systems ◽  
African Countries ◽  
Rural And Urban ◽  
The World ◽  
Mainstream Healthcare ◽  
The Impact

While the genesis of the drone technology is not clear, one thing is ideal: it emerged as a military apparatus and gained much attention during major wars, including the two world wars. Aside being used in combats and to deliver humanitarian services, drones have also been used extensively to kill both troops and civilians. Revolutionized in the 19th century, the drone technology was improved to be controlled as an unmanned aerial devices to mainly target troops. A new emerging field that has seen the application of the drone technology is the healthcare sector. Over the years, the health sector has increasingly relied on the device for timely transportation of essential articles across the globe. Since its introduction in health, scholars have attempted to address the impact of drones on healthcare across Africa and the world at large. Among other things, it has been reported by scholars that the device has the ability to overcome the menace of weather constraints, inadequate personnel and inaccessible roads within the healthcare sector. This notwithstanding, data on drones and drone application in Ghana and her healthcare sector in particular appears to be little within the drone literature. Also, few attempts have been made by scholars to highlight the use of drones in African countries. By using a narrative review approach, the current study attempts to address the gap above. Using this approach, a thorough literature search was performed to locate and assess scientific materials that focus on the application of drones in the military field and in the medical systems of Africa and Ghana in particular. With its sole responsibility to deliver items, stakeholders of health across several parts of the world have relied on drones to transport vital articles to health centers. Countries like Senegal, Madagascar, Rwanda and Malawi encouraged Ghana to consider the application of drones in her mainstream healthcare delivery. Findings from the study have revealed that Ghana’s adoption of the drone policy has enhanced the timely delivery of products such as test samples, blood and Personal Protective Equipment to various health centres and rural areas in particular. Drones have contributed to the delivery of equity in healthcare delivery in Ghana. We conclude that with the drone policy, the continent has the potential to record additional successes concerning the over-widened gap in healthcare between rural and urban populations.

scholarly journals Effects of relative pricing of alternative cooking energy sources on their substitution between rural and urban households in Enugu State, Nigeria

2020 ◽  
Vol 24 (1) ◽  
pp. 75-84
Author(s):  
Anthony NwaJesus Onyekuru ◽  
Eric Eboh ◽  
Chukwuma Otum Ume
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Primary Data ◽  
Energy Sources ◽  
Relative Pricing ◽  
Rural And Urban Areas ◽  
Energy Substitution ◽  
Rural And Urban ◽  
Cooking Energy ◽  
Enugu State

This study investigated the effects of relative pricing of alternative cooking energy sources on their substitution. The study was conducted in Enugu State Nigeria using primary data collected from two hundred and four households from rural and urban areas of the state, using structured questionnaires. The information collected were pattern and levels of energy use, relative pricing of alternative energies and energy substitution pattern. Data were analyzed using multiple regression analysis and Chow test. Results show that the energy sources used in the rural areas are fuelwood (51.5%) and kerosene (48.5), while those used in the urban areas are fuelwood (30.6%), charcoal (31.6%), kerosene (33.7%) and liquefied petroleum gas (4.1%). There was a relative cross inelastic nature of the energy sources. The price of fuel wood varied inversely and directly with quantities of kerosene demanded in the rural and urban areas, respectively, while the price of charcoal had an inverse relationship with the quantities of kerosene consumed in both urban and rural areas. In particular, policies geared towards subsidizng cost of kerosene and LPG and making them more readily available will lead to reduction in the use of fuelwoods and charcoal in both the rural and urban areas, thereby reducing excessive pressure on our forest and green house gas emission..Keywords: Energy substitution, energy pricing, forest conservation

scholarly journals Health Worker Absenteeism in Selected Health Facilities in Enugu State: Do Internal and External Supervision Matter?

2021 ◽  
Vol 9 ◽  
Author(s):  
Divine Ndubuisi Obodoechi ◽  
Obinna Onwujekwe ◽  
Martin McKee ◽  
Blake Angell ◽  
Prince Agwu ◽  
...  
Keyword(s):  
Health Worker ◽  
Rural Areas ◽  
Health Workers ◽  
Holistic Approach ◽  
Health Facilities ◽  
Health Coverage ◽  
Major Barrier ◽  
Worker Absenteeism ◽  
Enugu State

Background: Absenteeism is widespread in Nigerian health facilities and is a major barrier to achievement of effective Universal Health Coverage. We have examined the role of internal (by managerial staff within facilities) and external (by managers at a higher level) supervision arrangements on health worker absenteeism. Specifically, we sought to determine whether these forms of supervision have any role to play in reducing health worker absenteeism in health facilities in Enugu State Nigeria.Methods: We conducted interviews with 412 health workers in urban and rural areas of Enugu State, in South-Eastern Nigeria. We used binary logistic regression to estimate the role of different types of supervision on health worker absenteeism in selected health facilities in Enugu State.Results: Internal supervision arrangements significantly reduce health worker absenteeism (odds ratio = 0.516, p = 0.03). In contrast, existing external supervision arrangements were associated with a small but significant increase in absenteeism (OR = 1.02, 0.043). Those reporting a better financial situation were more likely to report being absent (OR = 1.36, p < 0.01) but there was no association with age and marital status of respondents. Our findings also pointed to the potential for alternative forms of supervision, provided in a supportive rather than punitive way, for example by community groups monitoring the activities of health workers but trying to understand what support these workers may need, within or beyond the work environment.Conclusion: The existing system of external supervision of absenteeism in health facilities in Nigeria is not working but alternatives that take a more holistic approach to the lived experiences of health workers might offer an alternative.

scholarly journals The Relationship between External and Internal Risk Factors with Pulmonary Tuberculosis in Children Aged 0-59 Months in Slums in Indonesia, 2013

2020 ◽  
Vol 12 (11) ◽  
pp. 116
Author(s):  
Made Agus Nurjana ◽  
Gunawan Gunawan ◽  
Dwi Hapsari Tjandrarini ◽  
Olwin Nainggolan
Keyword(s):  
Risk Factors ◽  
Pulmonary Tuberculosis ◽  
Rural Areas ◽  
Urban Areas ◽  
World Health ◽  
Rural And Urban ◽  
The Status ◽  
And Gender ◽  
One Year ◽  
Health Organization

BACKGROUND: Tuberculosis (Tb) remains a health problem throughout the world. World Health Organization (WHO) has set it as a “Global Emergency” disease. The difficulty of confirming the diagnosis of it in children, different from it in adults, causes the treatment of it in children often neglected. This problem is exacerbated by the supporting environmental conditions, namely living in slums, which makes the risk of transmission even higher. OBJECTIVE: To identify internal and external factors related to Tb in children aged 0-59 months living in slums in Indonesia. MATERIAL & METHOD: The data source used was the 2013 Basic Health Research (Riskesdas) using a sample of children less than five years old who lived in slums in 34 provinces in Indonesia. RESULTS: Logistic regression analysis found three risk factors, namely BCG immunization status (age-based), at-risk home environment, and gender (residential area-based). Vaccinated children under one year of age have the best probability of not suffering from pulmonary tuberculosis. Those who live in a house inhabited by less than five people, or in that occupied by more than four with no one of which smokes or does not suffer from pulmonary tuberculosis has a probability of not being exposed to it. Likewise, women who live in rural areas have almost two times less probability of suffering from it, compared to men in urban areas. CONCLUSION: Factors contributing to the prevalence of pulmonary tuberculosis in infants in slums are the status of BCG immunization, air cleanliness in the neighborhood, which can be seen from the differences of risks in rural and urban, and the number of inhabitants per house and their behavior.

scholarly journals Assessing the Level of Satisfaction of Patients with TB-DOTS Implementation in Rural and Urban Centres of Selected Dots accredited facilities in Anambra State, Nigeria

2021 ◽  
pp. 42-50
Author(s):  
M. C. Ohamaeme ◽  
F. Ilika ◽  
C. C. Aniagboso ◽  
M. U. Elendu ◽  
C. R. Aniemena ◽  
...  
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Health Workers ◽  
Working Hours ◽  
Cross Sectional ◽  
Anambra State ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Level Of Satisfaction ◽  
Cost Implications

Background: This study assessed the level of satisfaction of patients with TB implementation in selected DOTS accredited facilities. Methodology: A comparative cross-sectional analytic study involving rural and urban areas implementing DOTS for TB in Anambra State was done. A total of 354 respondents (177 per sub population) were enrolled in the study. By exit interview respondents were administered the questionnaire that bordered on services rendered and cost implications of accessing treatment at the facilities. Results: A total of 162(91.5%) rural respondents were satisfied with appropriateness of working hours compared to 166(93.8%) participants in urban areas. Also 141(79.7%) respondents in rural areas were satisfied with waiting time compared to 155(87.6%) in urban areas and this was statistically significant p<0.004. For the cleanliness of the specimen bottle 138(77.8%) rural respondents compared to 148(83.6%) in urban areas were satisfied and this was statistically significant, p<0.001. Majority of the urban respondents 123(68.9%) were satisfied with respect offered by health workers compared to rural 114(64.4%), and this was also significant, p<0.000. Concerning cost incurred and information given by health workers more urban respondents 5(2.8%) were dissatisfied compared to rural 2(1.1%) though not statistically significant p= 0.378. However, satisfaction was slightly higher in urban (82.8%) compared to rural (80.8%) respondents, while the overall satisfaction in this study was 81.8%. Conclusion: Patient`s satisfaction is a panacea for successful DOTS implementation. We therefore recommend that satisfaction could be improved by provision patient-centred requests such as provision of multivitamins, transport, food among others to help improve DOTS because it will encourage attendance and adherence with better outcomes.

Politicians in Apron: Case Study of Rebel Health Services in Nepal

2009 ◽  
Vol 21 (4) ◽  
pp. 377-384 ◽  
Author(s):  
Bhimsen Devkota ◽  
Edwin R. van Teijlingen
Keyword(s):  
Health Services ◽  
Rural Areas ◽  
Health Workers ◽  
Health Sector ◽  
National Health System ◽  
Health Centers ◽  
Career Motivation ◽  
Integration Model ◽  
Services Delivery

This article presents the findings of a systematic review on the health consequences of Nepal’s armed conflict waged by the Maoists and the development and trajectory of their health workers. Nepal’s decade-long violent conflict resulted in more than 13 000 deaths, the destruction of more than 1000 health posts and poor health services delivery. At present, most of the former rebel health workers live in remote/rural areas and some are running health centers. The review found that the Maoists had trained more than 2000 health workers, who can be categorized into 4 levels. However, there is little evidence on their competencies and career motivation. The Maoists demand restructuring of the Nepalese health sector and the integration of their health workforce into the national health system. However, there has been no national discussion in Nepal of what kind of health reform and integration model is appropriate for a sustainable peace and improved service delivery.

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