Using Ethical Principles

2021 ◽  
pp. 213-221
Author(s):  
J Patrick Vaughan ◽  
Cesar Victora ◽  
A Mushtaque R Chowdhury

Ethical practice is important for all health workers in public, non-government, and private health services that aim to strengthen primary health care. Four general principles are important: respect for the right of individuals to practice informed choices (autonomy), a fair distribution of benefits and risks (justice), benefits that should far outweigh risks (beneficence), and do no harm or injury (non-maleficence). Local health teams should use these principles together with national guidelines to organise a fair and just approach to district health planning, data collection, and local research studies.

2021 ◽  
pp. 178-198
Author(s):  
J Patrick Vaughan ◽  
Cesar Victora ◽  
A Mushtaque R Chowdhury

This chapter focuses on how local health teams can use epidemiology to help plan for health priorities and identify high-risk groups and to tackle inequalities. Using a systems approach epidemiology can help to strengthen primary health care and improve the delivery of district health services and programmes. These need to be delivered so people have high levels of access to high-quality services and programmes that also achieve high levels of population coverage.


2020 ◽  
Author(s):  
Sangwani Salimu ◽  
Maggie Woo Kinshella ◽  
Marianne Vidler ◽  
Mwai Banda ◽  
Laura Newberry ◽  
...  

Abstract Background Severe respiratory distress is a leading cause of mortality among neonates in Malawi. Despite evidence on the safety, cost effectiveness and efficacy of bubble continuous positive airway pressure (CPAP) in managing the condition, its use in Malawian health facilities is limited and little is known about caregivers' engagement with perspectives of bubble CPAP. The purpose of this study was to explore caregiver perspectives for bubble CPAP at both central and district hospitals and key factors that enable effective caregiver engagement in Malawi. Methods This was a descriptive qualitative study employing secondary analysis of 46 health care worker in-depth interviews. We interviewed the health workers about their thoughts on caregiver perspectives regarding use of bubble CPAP. We implemented the study at a tertiary facility and three district hospitals in southern Malawi. This was a part of a larger study to understand barriers and facilitators to implementing neonatal innovations in resource-constrained hospitals. Interviews were thematically analysed in NVivo 12 software (QSR International, Melbourne, Australia). Health workers were purposively selected to include nurses, clinicians and district health management involved in the use of bubble CPAP.Results Emerging issues included caregiver fears around bubble CPAP equipment as potentially harmful to their new-borns and how inadequate information provided to caregivers exacerbated knowledge gaps and was associated with refusal of care. However, good communication between health care providers and caregivers was associated with acceptance of care. Caregivers’ decision-making was influenced by relatives and peer advocates were helpful in supporting caregivers and alleviating fears or misconceptions about bubble CPAP.Conclusions Since caregivers turn to relatives and peers for support, there is need to ensure that both relatives and peers are counselled on bubble CPAP for improved understanding and uptake. Health workers need to provide simplified, accurate, up-to-date information on the intervention as per caregivers’ level of understanding. Notably, contextualised comprehensible information will help alleviate caregivers’ fear and anxieties about bubble CPAP.


2017 ◽  
Vol 1 (1) ◽  
pp. 53-57
Author(s):  
Rajoo S Chhina ◽  
Rajdeep S Chhina ◽  
Ananat Sidhu ◽  
Amit Bansal

ABSTRACT Manpower is the most crucial resource toward delivery of health planning. Health manpower refers to people who are trained to promote health, to prevent and to cure diseases, and to rehabilitate the sick. The aim of manpower planning is to make available the right kind of personnel in the right number with appropriate skills at the right place at the right time doing the right job. Various types of health resources are doctors, nurses, pharmacists, lab technicians, radiographer health assistants, health workers, auxiliary nurse midwife (ANM), accredited social health activists (ASHAs), anganwadi workers, trained dais, and so on. Currently, developing countries including India lag behind suggested norms of required health manpower. Presently, India produces 30,000 doctors, 18,000 specialists, 30,000 Ayurveda, Yoga and naturopathy, Unani, Siddha, and Homeopathy (AYUSH) graduates, 54,000 nurses, 15,000 ANMs, and 36,000 pharmacists annually. This production is not equal across the states, leading to unequal distribution of doctors. Such a skewed distribution results in large gaps in demand and availability. Various reasons for this are skewed production of health manpower, uneven human resource deployment and distribution, disconnected education and training, lack of job satisfaction, professional isolation, and lack of rural experience. The 12th Plan should aim to expand facilities for medical, nursing, and paramedical education; create new skilled health worker categories; enable AYUSH graduates to provide essential health care by upgrading their skills in modern medicine through bridge courses; establish a management system for human resource in health to actualize improved methods for recruitment, retention, and performance; put in place incentive-based structures; create career tracks for professional advancement based on competence; and, finally, build an independent and professional regulatory environment. How to cite this article Chhina RS, Chhina RS, Sidhu A, Bansal A. Health Manpower Planning. Curr Trends Diagn Treat 2017;1(1):53-57.


Author(s):  
Sangwani Salimu ◽  
Maggie Kinshella ◽  
Marianne Marianne ◽  
Mwai Banda ◽  
Laura Newberry ◽  
...  

Abstract Background Severe respiratory distress is a leading cause of mortality among neonates in Malawi. Despite evidence on the safety, cost effectiveness and efficacy of bubble continuous positive airway pressure (CPAP) in managing the condition, its use in Malawian health facilities is limited and little is known about health workers engagement with perspectives of bubble CPAP. The purpose of this study was to explore caregiver perspectives for bubble CPAP at both central and district hospitals and key factors that enable effective caregiver engagement in Malawi. Methods This was a descriptive qualitative study employing secondary analysis of 46 health care worker in-depth interviews. We interviewed the health workers about their thoughts on caregiver perspectives regarding use of bubble CPAP. We implemented the study at a tertiary facility and three district hospitals in southern Malawi. This was a part of a larger study to understand barriers and facilitators to implementing neonatal innovations in resource-constrained hospitals. Interviews were thematically analysed in NVivo 12 software (QSR International, Melbourne, Australia). Health workers were purposively selected to include nurses, clinicians and district health management involved in the use of bubble CPAP. Results Emerging issues included caregiver fears around bubble CPAP equipment as potentially harmful to their new-borns and how inadequate information provided to caregivers exacerbated knowledge gaps and was associated with refusal of care. However, good communication between health care providers and caregivers was associated with acceptance of care. Caregivers’ decision-making was influenced by relatives and peer advocates were helpful in supporting caregivers and alleviating fears or misconceptions about bubble CPAP. Conclusions Since caregivers turn to relatives and peers for support, there is need to ensure that both relatives and peers are counselled on bubble CPAP for improved understanding and uptake. Health workers need to provide simplified, accurate, up-to-date information on the intervention as per caregivers’ level of understanding. Notably, contextualised comprehensible information will help alleviate caregivers’ fear and anxieties about bubble CPAP. Key words : bubble CPAP, neonates, caregiver, perspectives, peers, Malawi


2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Abaseen Khan Afghan ◽  
Masoom Kassi ◽  
Pashtoon Murtaza Kasi ◽  
Adil Ayub ◽  
Niamatullah Kakar ◽  
...  

Cutaneous leishmaniasis (CL) is a rising epidemic in Pakistan. It is a major public health problem in the country especially alongside regions bordering the neighboring Afghanistan and cities that have had the maximum influx of refugees. The purpose of our paper is to highlight the diverse clinical manifestations of the disease seen along with the geographic areas affected, where the hosts are particularly susceptible. This would also be helpful in presenting the broad spectrum of the disease for training of health care workers and help in surveillance of CL in the region. The increased clinical diversity and the spectrum of phenotypic manifestations noted underscore the fact that the diagnosis of CL should be not only considered when dealing with common skin lesions, but also highly suspected by dermatologists and even primary care physicians even when encountering uncommon pathologies. Hence, we would strongly advocate that since most of these patients present to local health care centers and hospitals, primary care practitioners and even lady health workers (LHWs) should be trained in identification of at least the common presentations of CL.


2020 ◽  
Author(s):  
Sangwani Salimu ◽  
Maggie Kinshella ◽  
Marianne Marianne ◽  
Mwai Banda ◽  
Laura Newberry ◽  
...  

Abstract Background Severe respiratory distress is a leading cause of mortality among neonates in Malawi. Despite evidence on the safety, cost effectiveness and efficacy of bubble continuous positive airway pressure (CPAP) in managing the condition, its use in Malawian health facilities is limited and little is known about health workers engagement with perspectives of bubble CPAP. The purpose of this study was to explore caregiver perspectives for bubble CPAP at both central and district hospitals and key factors that enable effective caregiver engagement in Malawi. Methods This was a descriptive qualitative study employing secondary analysis of 46 health care worker in-depth interviews. We interviewed the health workers about their thoughts on caregiver perspectives regarding use of bubble CPAP. We implemented the study at a tertiary facility and three district hospitals in southern Malawi. This was a part of a larger study to understand barriers and facilitators to implementing neonatal innovations in resource-constrained hospitals. Interviews were thematically analysed in NVivo 12 software (QSR International, Melbourne, Australia). Health workers were purposively selected to include nurses, clinicians and district health management involved in the use of bubble CPAP. Results Emerging issues included caregiver fears around bubble CPAP equipment as potentially harmful to their new-borns and how inadequate information provided to caregivers exacerbated knowledge gaps and was associated with refusal of care. However, good communication between health care providers and caregivers was associated with acceptance of care. Caregivers’ decision-making was influenced by relatives and peer advocates were helpful in supporting caregivers and alleviating fears or misconceptions about bubble CPAP. ConclusionsSince caregivers turn to relatives and peers for support, there is need to ensure that both relatives and peers are counselled on bubble CPAP for improved understanding and uptake. Health workers need to provide simplified, accurate, up-to-date information on the intervention as per caregivers’ level of understanding. Notably, contextualised comprehensible information will help alleviate caregivers’ fear and anxieties about bubble CPAP. Key words : bubble CPAP, neonates, caregiver, perspectives, peers, Malawi


2020 ◽  
Vol 5 (1) ◽  
pp. 39
Author(s):  
Do Thi Nhuong ◽  
Chu Tuan Anh

Medical staff holds a pivotal role in the Vietnamese health system, and is crucial to the efficiency and quality of health care services in Vietnam. It is their professional and dedicated work that is a permanent basis to guarantee protection of and care for people’s health in the provision of health care services to people in all regions, including remote areas, borders and islands. The continuous growth in the quantity and quality of health workers in Vietnam has affirmed the right leadership of the Communist Party of Vietnam in building this health workforce over the years.


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255390
Author(s):  
Zewdie Birhanu ◽  
Fira Abamecha ◽  
Nimona Berhanu ◽  
Tadesse Dukessa ◽  
Mesfin Beharu ◽  
...  

Background Successful health care and clinical services essentially depend on patients’ realization of ones’ rights, and health workers’ and facilities’ fulfillments and protections of these rights. However, little is documented about how patients and health workers perceive patients’ rights during care-seeking practices. Methods A qualitative study was conducted in four hospitals in Ethiopia through 8 focus group discussions with patients and 14 individual interviews with diverse groups of patients, caretakers, and 14 interviews with health workers. Participants were recruited through a purposive sampling method to meet the saturation of ideas about patients’ rights. The sampled patients, caretakers, and professionals were enlisted from various departments in the hospitals. The data analysis was assisted by ATLAS.ti 7.1.4 Results The study identified three major categories of healthcare rights (clinical, socio-cultural, and organizational), incorporating supporting elements of education, engagement, and empowerment. Study participants reported detailed rights the patients would have during hospital visits which included the right to timely access to care and treatment, adequate medications) with full respect, dignity, and without any discrimination. Patients widely perceived that they had the right to tell their illness history and know their illness in the language they can understand. It was also widely agreed that patients have the right to be educated and guided to make informed choices of services, procedures, and medications. Additionally, patients reported that they had the right to be accompanied by caretakers together with the right to use facilities and resources and get instructions on how to utilize these resources, the right to be protected from exposure to infections and unsafe conditions in hospitals, right to get a diet of their preference, and right to referral for further care. Nevertheless, there was a common concern among patients and caretakers that these rights were mostly non-existent in practice which were due to barriers related to patients (fear of consequence; a sense of dependency, feeling of powerlessness, perceptions of low medical literacy), health workers (negligence, lack of awareness and recognition of patient rights, undermining patients), and facilities’ readiness and support, including lack of guiding framework. Conclusions Perceived patients’ rights in the context of hospital visits were profoundly numerous, ranging from the right to access clinical and non-clinical services that are humanely respectful, fulfilling socio-cultural contexts, and in a manner that is organizationally coordinated. Nonetheless, the rights were not largely realized and fulfilled. Engaging, educating, and empowering patients, caretakers, and health care providers supported with policy framework could help to move towards patient-centered and right-based healthcare whereby patients’ rights are protected and fulfilled in such resource-limited settings.


2021 ◽  
Author(s):  
Rafael Harun ◽  
Walton-Roberts Margaret

Abstract Background: The World Health Organization adopted the Global Strategy on Human Resources for Health Workforce 2030 in May 2016. It sets specific milestones for improving health workforce planning in member countries, such as developing a health workforce registry by 2020 and ensuring workforce self-sufficiency by halving dependency on foreign-trained health professionals. Canada falls short in achieving these milestones due to the absence of such a registry and a poor understanding of immigrants in the health workforce, particularly nursing and healthcare support occupations. This paper provides a multiscale (Canada, Ontario, and Ontario’s Local Health Integration Networks) overview of immigrant participation in nursing and health care support occupations, discusses associated enumeration challenges, and the implications for health workforce planning focusing on immigrants.Methods: Descriptive data analysis was performed on Canadian Institute for Health Information dataset for 2010 to 2020, and 2016 Canadian Census and other relevant data sources. Results: The distribution of nurses in Canada, Ontario, and Ontario’s Local Health Integration Networks reveal a growth in Nurse Practitioners and Registered/Licensed Practical Nurses, and contraction in the share of Registered Nurses. Immigrant entry into the profession was primarily through the practical nurse cadre. Mid-sized communities registered the highest growth in the share of internationally educated nurses. Data also pointed towards the underutilization of immigrants in regulated nursing and health occupations. Conclusion: Immigrants comprise an important share of Canada’s nursing and health care support workforce. Immigrant pathways for entering nursing occupations are complex and difficult to accurately enumerate. This paper recommends the creation of an integrated health workforce dataset, including information about immigrant health workers, for both effective national workforce planning and for assessing Canada’s role in global health workforce distribution and utilization.


2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Lilian Bulage ◽  
Juliet Sekandi ◽  
Omar Kigenyi ◽  
Ezekiel Mupere

Quality of care plays an important role in the status of tuberculosis (TB) control, by influencing timely diagnosis, treatment adherence, and treatment completion. In this study, we aimed at establishing the quality of TB service care in Kamuli district health care centres using Donabedian structure, process, and outcomes model of health care. A cross-sectional study was conducted in 8 health care facilities, among 20 health care workers and 392 patients. Data was obtained using face-to-face interviews, an observation guide, a check list, and record review of the TB unit and laboratory registers. Data entry and analysis were done using EPI INFO 2008 and STATA 10 versions, respectively. A high number 150 (87.21%) of TB patients were not aware of all the signs to stop TB medication, and 100 (25.51%) patients received laboratory results after a period of 3–5 working days. The major challenges faced by health workers were poor attitude of fellow health workers, patients defaulting treatment, and fear of being infected with TB. One of the worst performance indicators was low percentage of cure. Comprehensive strengthening of the health system focusing on quality of support supervisions, patient follow up, promoting infection control measures, and increasing health staffing levels at health facilities is crucial.


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