scholarly journals Workload pressure of nurses at an emergency satellite hospital in Peshawar Pakistan

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H M Khan
Keyword(s):  
Health Services ◽  
Health System ◽  
Nursing Staff ◽  
Health Workforce ◽  
Health Workers ◽  
Working Hours ◽  
Management Tool ◽  
Planning And Management ◽  
High Concern ◽  
Efficient Planning

Abstract Introduction Health managers face challenges to respond to the demands of the population with limited resources. Balancing the health workforce is of high concern as the health workers are indispensable resource in a health system. The objective of this study was to determine the workload pressure of nurses working at an Emergency Satellite Hospital for efficient planning and management. Methods The Workload Indicators of Staffing Need (WISN) method was used for this study which is a human resource management tool which determines the number of health workers required to cope with the workload and asses the workload pressure by using the available service statistics. It calculates the level of staff shortage or surplus in a facility and the ratio of actual to the required number of staff determines the workload pressure with which the staff is coping. Results According to the findings of the study there were 1966 available working hours for the nurses in a year. Out of this time 33.33% was taken by support activities of all nurses, 18.75% by additional activities of some of the nurses and 47.92% by health services activities of all the nurses. At the time of the study there were 4 nurses working in the in the hospital but according to the calculations based on WISN 3 nurses were required to carry out the activities identified by the experts working group. The study shows that there was no workload pressure on the nursing staff as the WISN ratio was 1.33 and one nurse was surplus. Conclusions The study found that there was no workload pressure on the nursing staff and one nurse was surplus who can be adjusted in any other unit where there is more need of nursing staff. This can increase the overall productivity and the demands of the population for health services can be responded to in an efficient way. Key messages Balancing the health workforce in any institution is of high concern as the health workers are the most costly, least readily available and indispensable resource in a health system. Efficient planning and management of health workforce is essential for better productivity.

scholarly journals Community Empowerment in Health: An Exploratory Study in Rural Community of a District of West Bengal

2020 ◽  
pp. 11-19
Author(s):  
Dipta Kanti Mukhopadhyay ◽  
Sujishnu Mukhopadhyay ◽  
Nivedita Das ◽  
Tarun Kumar Sarkar ◽  
Fasihul Akbar ◽  
...  
Keyword(s):  
Health Services ◽  
Health System ◽  
National Health ◽  
Rural Areas ◽  
West Bengal ◽  
Health Workers ◽  
Community Empowerment ◽  
Current Status ◽  
Health Staff ◽  
Key Informants

Background: Community empowerment is the process and outcome where community itself is able to identify, prioritize health problems and address them. It has been considered as the key strategy for scalability and sustainability of health services. Objectives: To explore the status of community empowerment in health in rural areas in West Bengal, India and the interplay of different stakeholders. Methods: A cross-sectional, qualitative study was conducted in 2017 – 2018 among the people residing in rural areas of Birbhum district in West Bengal, India who utilized the public health system (lay informants), formal and informal leaders of the community, community level health workers and peripheral health staff (key informants). Three community blocks, two sub-centers from each block and one village from each sub-center were selected randomly. In-depth interviews were conducted among 36 lay and 36 key informants using Laverack’s nine dimension model of community empowerment. Framework analysis was done to summarize data. Results: Participation of people was restricted to awareness and utilization of existing health services. Unmet aspiration for greater participation was noted among a small section of the community. They were mostly fitted to the role of beneficiaries. Functioning of village level organization to promote communitization as envisaged in national health programmes was largely deficient. The community health workers acted as the most peripheral appendages of formal health system rather than the health activists to empower community regarding community’s health. Conclusion: Although, every national health programme advocated community empowerment, the current status and the process of empowerment in health is in nascent stage.

scholarly journals Safety of health workers: a key priority in COVID-19 pandemic

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Bhakta Bahadur K.C.
Keyword(s):  
Health System ◽  
Capacity Building ◽  
Health Workforce ◽  
Health Workers ◽  
Building Blocks ◽  
Political Commitment ◽  
Safety Equipment ◽  
High Exposure ◽  
The World ◽  
High Level

Although, the health workforce is one of the most significant building blocks of the health system, the preparation to ensure safety from COVID-19 remains inadequate across the world. Therefore, there is an increasingly growing number of health workers being infected from COVID-19 globally, making health workers the most vulnerable population to the pandemic. Most of the countries lack the safety equipment in place resulting in high exposure of health workers to this fatal SARS-COV2. Besides these, health workers' behaviour is also contributing infection to themselves. A high-level political commitment together with the investment in the health sectors to increase the supply of protective gears and capacity building of health workers is key to save and protect them from COVID-19 pandemic.

Strengthening health promotion practice

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Van Den Broucke
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Promotion ◽  
Health Services ◽  
Health System ◽  
Workforce Development ◽  
Health Workforce ◽  
Developed Countries ◽  
Communicable Diseases ◽  
Public Health Workforce

Abstract Health services in most developed countries were developed to meet the needs of a demand-led health care, and focus mostly on treatment, cure and care. This system is challenged by the growing burden of non-communicable diseases, increased multi-morbidity, newly emerging communicable diseases, and increasing anti-microbial resistance. At the same time, widening health inequalities pose an additional threat to health systems that do not give enough attention to the factors that produce health. To address these challenges, it is necessary to reorient health services towards more preventive, people-centred and community-based approaches, with a more prominent role for health promotion, integrated within the wider health system. This shift of focus requires the strengthening of health workforce capacities to effectively implement health promotion. Whereas a competent health workforce has always been considered a key condition for the delivery of effective health services, the nature of the necessary 'competencies' is being redefined in the light of the current changes of the health system. Within the diversifying primary care and public health workforce, new skills and tasks must be added to existing professional roles, new professional profiles emerge, and collaborations between professions become more important. This presentation will consider the place of health promotion workforce development within the broader context of public health and health promotion capacity building systems targeting a diversifying primary care and public health workforce. Drawing on recent reviews it will provide an overview of existing capacity development systems in primary and secondary prevention and health promotion, and consider possibilities for integration and implementation of capacity systems within and across disciplinary boundaries.

scholarly journals Health workforce in India: opportunities and challenges

2019 ◽  
Vol 6 (10) ◽  
pp. 4596
Author(s):  
Kesavan Sreekantan Nair
Keyword(s):  
Nursing Education ◽  
Health System ◽  
Health Workforce ◽  
Health Workers ◽  
World Health ◽  
Public And Private ◽  
Better Regulation ◽  
Political Commitments ◽  
Health Organization ◽  
Workforce Density

Health system reforms in India during the past decade yielded an impressive growth of medical, dental and nursing education opportunities, but health workforce density remains low in comparison to the World Health Organization (WHO) norms. Apart from shortage, retaining qualified health workforce in the rural and underserved areas remains a huge challenge. This crisis is likely to persist until and unless health system addresses the fundamental requirements of health workers as envisaged in health policies. Concerted attention and long term political commitments are required to overcome health system barriers to achieve rural recruitment and retention across various cadres in states. As the major share of health workforce belongs to the private sector, their resources need to be harnessed to meet health system goals through partnerships and collaborations. There is an urgent need for better regulation and enforcement of standards in medical education and delivery of health services across the public and private sectors.

scholarly journals Engaging community health workers, technology, and youth in the COVID-19 response with concurrent critical care capacity building: A protocol for an integrated community and health system intervention to reduce mortality related to COVID-19 infection in Western Kenya

2021 ◽  
Vol 6 ◽  
pp. 15
Author(s):  
Neema Kaseje ◽  
Dan Kaseje ◽  
Kennedy Oruenjo ◽  
Joel Milambo ◽  
Margaret Kaseje
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Health Services ◽  
Health System ◽  
Community Health ◽  
Health Facility ◽  
Health Workers ◽  
Baseline Assessment ◽  
Western Kenya ◽  
Care Capacity

Globally, the number of COVID-19 infections is approaching 63 million; more than 1 million individuals have lost their lives. In Kenya, the number of infections has surpassed 80,000 and 1469 people have lost their lives. In Kenya, the community health strategy has been used to deliver essential health services since 2007. Furthermore, the population in Kenya is young (the median age is 21 years old) and Kenya is recognized as a technology hub in the East African region. Community-based health care, youth, and technology, are assets within the Kenyan context that can be leveraged to respond to the COVID-19 pandemic with concurrent strengthening of the critical care capacity at the health system level. This is a quasi-experimental study with quantitative and qualitative methods of data collection to complete a baseline assessment of community health unit and health facility service readiness in the study site of Siaya County in western Kenya. Following the baseline assessment, service ready community health units and health facilities with oxygen capacity will form intervention groups. At the community level, the intervention will consist of training youth, community health assistants and community health workers in screening, case detection, prevention, management and referral of COVID-19 cases with maintenance of essential health services. The community intervention will be enhanced by youth and use of digital tools. At the health facility level, the intervention will consist of training health care workers in basic critical care and caring for severe COVID-19 patients with maintenance of essential health services. The primary outcome measure will be mortality related to COVID-19 infection both at community and health facility levels. This study would be the first study to evaluate the effectiveness of an integrated approach in preparing for and implementing a robust pandemic response. Registration: ClinicalTrials.gov ID NCT04501458; registered on 6 August 2020.

scholarly journals Nurse practitioners and pharmacist prescribers in primary health care: A realist evaluation of the New Zealand experience

2021 ◽  
Author(s):  
◽  
Tara Officer
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
New Zealand ◽  
Health Services ◽  
Health System ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Health Workforce ◽  
Primary Health ◽  
Advanced Practitioner

<p>Internationally, health workforce redesign provides a means to cope with an increasing demand for health services. The development of advanced practitioner professions provides a major change in health service delivery that challenges traditional practice boundaries. Yet, we know very little about how to introduce such roles into existing health systems successfully. This research investigates how nurse practitioner and pharmacist prescriber roles are developing in New Zealand primary health care, and what is needed to better support the future development of these roles.  A realist methodology guided this research. The study used a qualitative research design involving semi-structured interviews of (1) policy, training, and advocacy stakeholders; (2) primary health care nurse practitioners, pharmacist prescribers, and general practitioners; and (3) patients of advanced practitioners and carers of patients using such services. Documents provided by interviewees relating to practice-specific roles supplemented these interviews. Data analysis facilitated the generation, testing, and refinement of theories on nurse practitioner and pharmacist prescriber role development.  This research provided an account of the complexities of developing new health professional roles in an already established health system. Theories formed in this research considered advanced practitioner role creation, realisation, and subsequent delivery of health services. Mechanisms for their development included: (1) engagement in planning and integrating roles; (2) establishing opportunities as part of a well-defined career pathway; and (3) championing role uptake and work to full scopes of practice. Various health system and workplace contexts, practitioner goals, and patient needs influenced the ability for these mechanisms to trigger and thus have an effect on role development.  Theories arising from this research emphasise the complexity inherent in the development of advanced practitioner roles. In addition, the findings demonstrate that a structured and informed health workforce redesign could improve use of roles, such as those of the nurse practitioner and pharmacist prescriber. In light of these results, this study recommends, implementing a national strategy that aligns policy and practice decisions if we are to succeed in making better use of such practitioner skills and expertise.</p>

scholarly journals Trust of community health workers influences the acceptance of community-based maternal and child health services

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Merridy Grant ◽  
Aurene Wilford ◽  
Lyn Haskins ◽  
Sifiso Phakathi ◽  
Ntokozo Mntambo ◽  
...  
Keyword(s):  
Child Health ◽  
Health Services ◽  
Health System ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Child Health Services ◽  
Community Members ◽  
Community Based ◽  
Complex Relationships ◽  
And Child Health

Background: Community health workers (CHWs) are a component of the health system in many countries, providing effective community-based services to mothers and infants. However, implementation of CHW programmes at scale has been challenging in many settings.Aim: To explore the acceptability of CHWs conducting household visits to mothers and infants during pregnancy and after delivery, from the perspective of community members, professional nurses and CHWs themselves.Setting: Primary health care clinics in five rural districts in KwaZulu-Natal, South Africa.Methods: A qualitative exploratory study was conducted where participants were purposively selected to participate in 19 focus group discussions based on their experience with CHWs or child rearing.Results: Poor confidentiality and trust emerged as key barriers to CHW acceptability in delivering maternal and child health services in the home. Most community members felt that CHWs could not be trusted because of their lack of professionalism and inability to maintain confidentiality. Familiarity and the complex relationships between household members and CHWs caused difficulties in developing and maintaining a relationship of trust, particularly in high HIV prevalence settings. Professional staff at the clinic were crucial in supporting the CHW’s role; if they appeared to question the CHW’s competency or trustworthiness, this seriously undermined CHW credibility in the eyes of the community.Conclusion: Understanding the complex contextual challenges faced by CHWs and community members can strengthen community-based interventions. CHWs require training, support and supervision to develop competencies navigating complex relationships within the community and the health system to provide effective care in communities.

scholarly journals Influence of Conditional Cash Transfers on the Uptake of Maternal and Child Health Services in Nigeria: Insights From a Mixed-Methods Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Uchenna Ezenwaka ◽  
Ana Manzano ◽  
Chioma Onyedinma ◽  
Pamela Ogbozor ◽  
Uju Agbawodikeizu ◽  
...  
Keyword(s):  
Child Health ◽  
Health Services ◽  
Health System ◽  
Pregnant Women ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Unintended Consequences ◽  
Data Set ◽  
Financial Barriers ◽  
And Child Health

Background: Increasing access to maternal and child health (MCH) services is crucial to achieving universal health coverage (UHC) among pregnant women and children under-five (CU5). The Nigerian government between 2012 and 2015 implemented an innovative MCH programme to reduce maternal and CU5 mortality by reducing financial barriers of access to essential health services. The study explores how the implementation of a financial incentive through conditional cash transfer (CCT) influenced the uptake of MCH services in the programme.Methods: The study used a descriptive exploratory approach in Anambra state, southeast Nigeria. Data was collected through qualitative [in-depth interviews (IDIs), focus group discussions (FGDs)] and quantitative (service utilization data pre- and post-programme) methods. Twenty-six IDIs were conducted with respondents who were purposively selected to include frontline health workers (n = 13), National and State policymakers and programme managers (n = 13). A total of sixteen FGDs were conducted with service users and their family members, village health workers, and ward development committee members from four rural communities. We drew majorly upon Skinner's reinforcement theory which focuses on human behavior in our interpretation of the influence of CCT in the uptake of MCH services. Manual content analysis was used in data analysis to pull together core themes running through the entire data set.Results: The CCTs contributed to increasing facility attendance and utilization of MCH services by reducing the financial barrier to accessing healthcare among pregnant women. However, there were unintended consequences of CCT which included a reduction in birth spacing intervals, and a reduction of trust in the health system when the CCT was suddenly withdrawn by the government.Conclusion: CCT improved the utilization of MCH, but the sudden withdrawal of the CCT led to the opposite effect because people were discouraged due to lack of trust in government to keep using the MCH services. Understanding the intended and unintended outcomes of CCT will help to build sustainable structures in policy designs to mitigate sudden programme withdrawal and its subsequent effects on target beneficiaries and the health system at large.

scholarly journals Role of an international non-governmental organisation in strengthening health systems in fragile-state context: Evaluation results from South Sudan

2015 ◽  
Vol 3 (2) ◽  
Author(s):  
Alfonso C. Rosales ◽  
Elizabeth Walumbe ◽  
Frank W.J. Anderson ◽  
Juli A. Hedrick ◽  
Dennis T. Cherian ◽  
...  
Keyword(s):  
Child Health ◽  
Health Services ◽  
Health System ◽  
Health Workforce ◽  
South Sudan ◽  
Health System Strengthening ◽  
Local Health ◽  
Fragile State ◽  
State Context ◽  
And Child Health

World Vision implemented the community-based Maternal and Child Health Transformation (MaCHT) Project from September 2010 to September 2014 in fragile-state South Sudan. To document and measure health-related activities executed by an international nongovernmentalo rganisation to sustainably strengthen the capacity of the health system in delivering essential health services to pregnant women and children under two years of age, including new-borns and infants. A range of mixed methods, including in-depth interviews, focus group discussions, observation, and uncontrolled cross-sectional before-and-after surveys using Henderson’s method were carried out. The unit of analysis was mothers of children under two years of age, and community health workers (CHWs). An estimated 39 000 children under age two were attended to by CHWs. Coverage of essential maternal and childhealth care (MCH) increased in all single interventions, ranging from a minimum of 5% points to a maximum of 49% points during the implementation period. The capacity of the health system to deliver essential MCH services improved by building the supply and performance of the health workforce through task-shifting and in-service training. Likewise, operational linkages between community structures and local health services were strengthened. In conclusion, this program supported health system strengthening, mainly in the areas of service delivery, health workforce, and medical products, vaccines, and technologies. The project also informed policy at district and national levels and repositioned the maternal, neonatal, and child health (MNCH) agenda to further scale up these activities. An evaluation of a four year USAID-funded child survival project implemented by an international non-governmental organisation (NGO) in fragile-state context showed progress and challenges in health system strengthening for maternal health practices and community case management of diarrhoea, pneumonia, and malaria in children under five.

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