Care’s Profit

2021 ◽  
pp. 188-209
Author(s):  
Isabelle L Lange ◽  
Sunita Bhadauria ◽  
Sunita Singh ◽  
Loveday Penn-Kekana
Keyword(s):  
Maternal Health ◽  
Patient Care ◽  
Working Conditions ◽  
Health Workers ◽  
Health Sector ◽  
Structural Vulnerability ◽  
Health Providers ◽  
Ethnographic Approach ◽  
Maternity Hospitals ◽  
Labour Room

Using a layered, ethnographic approach focusing on four small non-corporate private maternity hospitals, we turn a critical lens on what it means to work within this self-regulated bubble and examine the ‘creation’ of a cadre of healthcare workers. Our analysis addresses how a space of care and business is generated out of the precarious positions of both women and the health workers who depend on employment there. Clinic owners’ staffing strategies centred on hiring unlicensed labour room staff, trained on the job rather than in accredited institutes, who take care of all aspects of patient care, including deliveries. By exploring narratives surrounding training and overtreatment, this chapter highlights the tensions between the value placed on profit, care, and working conditions in the private maternal health sector, and examines the structural vulnerability of unlicensed health providers working there.

scholarly journals Violence against doctors in Iraq during the time of COVID-19

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0254401
Author(s):  
Riyadh Lafta ◽  
Noor Qusay ◽  
Meighan Mary ◽  
Gilbert Burnham
Keyword(s):  
Patient Care ◽  
Workplace Violence ◽  
Health Workers ◽  
Hospital Environment ◽  
Health Providers ◽  
Security Measures ◽  
Hospital Violence ◽  
Hospital Doctors ◽  
Hospital Productivity ◽  
Violence Against Doctors

Objectives This study assessed patterns in reported violence against doctors working in 11 Baghdad hospitals providing care for patients with COVID-19 and explored characteristics of hospital violence and its impact on health workers. Methods Questionnaires were completed by 505 hospital doctors (38.6% male, 64.4% female) working in 11 Baghdad hospitals. No personal or identifying information was obtained. Findings Of 505 doctors, 446 (87.3%) had experienced hospital violence in the previous 6 months. Doctors reported that patients were responsible for 95 (21.3%) instances of violence, patient family or relatives for 322 (72.4%), police or military personnel for 19 (4.3%), and other sources for 9 (2%). The proportion of violent events reported did not differ between male and female doctors, although characteristics varied. There were 415 of the 505 doctors who reported that violence had increased since the beginning of the pandemic, and many felt the situation would only get worse. COVID-19 has heightened tensions in an already violent health workplace, further increasing risks to patients and health providers. Interpretation During the COVID-19 epidemic in Iraq an already violent hospital environment in Baghdad has only worsened. The physical and emotional toll on health workers is high which further threatens patient care and hospital productivity. While more security measures can be taken, reducing health workplace violence requires other measures such as improved communication, and addressing issues of patient care.

scholarly journals Impact De La Motivation Financière Du Personnel De Santé Sur La Qualité Des Soins Administrés Aux Patients A L’hôpital Général De Référence De Kalemie (RDC)

2021 ◽  
pp. 163-171
Author(s):  
Héman KABEMBA BUKASA ◽  
Gaston ALIMASI YUMA ◽  
David YAMUNYINGA KABINGIE ◽  
KILIMA KUNDA Sylvain ◽  
KITENGIE NSOMBWE LUTHER ◽  
...  
Keyword(s):  
Patient Care ◽  
Working Conditions ◽  
Risk Premium ◽  
Health Personnel ◽  
Health Workers ◽  
National Level ◽  
Essential Element ◽  
Poor Quality ◽  
Qualité Des Soins ◽  
Personnel De Santé

Introduction: Motivation (financial and / or non-financial) remains the essential element that allows health personnel to carry out their work with objectivity, ethics and strict respect of profession rules. The aim of this study was to help improve the provision of care by health workers. Methods: This was a prospective cohort descriptive and analytical study carried out among health personnel at the Kalemie General Referral Hospital (DRC) from October 2016 to June 2017, i.e. eight months. Results: Out of 102 health personnel questioned, 49 (or 48%) are satisfied with their financial situation. Only 21 health personnel (20.6%) receive full compensation made up of risk premiums and salary from the national level. The large gap in risk premium between nurses and doctors remains an obstacle to real harmony in service delivery. Salaries do not allow the staff questioned to meet monthly needs and there is frustration and violation of ethical and deontological rules. In the majority of cases, patient care was continuous and honest, hours of care respected, and regularity of service respected. This performance is justified by professional experience, dedication to patients and the expectations of improving the living and working conditions of health personnel. On the other hand, the care was not comprehensive and the reception of patients was of poor quality. Conclusion: The results of this study show an urgent need to organize and improve the working conditions of health personnel, which will enable them to carry out patient care activities with professionalism, ethics and respect of deontological rules. The considerable impact is to avoid the uncontrolled movements of strikes.

Humanized Childbirth and Cultural Humility: Designing an Online Course for Maternal Health Providers in Limited-Resource Settings

2015 ◽  
Vol 5 (4) ◽  
pp. 188-199 ◽  
Author(s):  
Amita Sreenivas ◽  
Susanna Cohen ◽  
Laura Magaña-Valladares ◽  
Dilys Walker
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health Care Professionals ◽  
Role Models ◽  
Professional Training ◽  
Health Workers ◽  
Cultural Humility ◽  
Online Course ◽  
Disrespect And Abuse ◽  
Health Providers

This article reviews the implications of disrespect and abuse in maternal health services, the growing movement to humanize childbirth and promote cultural humility, and one strategy to build an online course to address this issue among maternal health workers in Mexico. Reports of disrespect and abuse have been widely reported by women seeking health services, including maternity care, across the globe. Evidence indicates offenders are often health care professionals who do not consider their behavior inappropriate and believe they are acting in the interests of both mother and baby. These same providers are often overworked, underpaid, and have few role models who humanize childbirth and demonstrate cultural humility. Strategies which aim to foster competencies in humanized childbirth and cultural humility among health providers are lacking in current health professional training programs. Using the case of Mexico, the authors describe the template and justification for an online course for novice to expert health professionals to build competencies in humanized childbirth and cultural humility. Recommendations for future work are discussed.

scholarly journals Barriers to access in maternal healthcare services in the Northern Bangladesh

2017 ◽  
Vol 6 (2) ◽  
pp. 23-36 ◽  
Author(s):  
Bijoy Krishna Banik
Keyword(s):  
Maternal Health ◽  
Urban Areas ◽  
Health Workers ◽  
Health Sector ◽  
Emergency Obstetric Care ◽  
Healthcare Services ◽  
Northern Region ◽  
Early Marriage ◽  
Primary Data ◽  
Health Staff

Poor women, in both rural and urban areas in the northern region of Bangladesh, experience high maternal mortality rate (MMR), and compared to other regions, this group also has a low proportion of receiving antenatal care (ANC) and of births assisted by the skilled health personnel. One of the prime factors for this situation is the lack of the poor mothers’ access to maternal health care (MHC) services. Finding out physical, social and organisational access barriers to MHC services and exploring how these barriers caused three delays in healthcare seeking behaviour were therefore the main objectives of the paper. The study used both primary and secondary data to meet its objectives. The primary data was collected from October to December in 2010 interviewing 160 mothers who were pregnant or delivered at least one baby during the last ten years and the heads of seven relevant health centres, administering eight focus group discussions and observing the field. An assortment of articles, reports, theses and books were consulted in complementing and substantiating the argument. The study found social (early marriage, perception of pregnancy and childbirth, high financial cost) and organizational (lack of female health staff, lack of a guiding principle in the health sector, in/exclusion errors in benefit distribution, low quality services) barriers more acute than physical (distance and waiting time) barriers. As concluded, all these barriers seem to have caused delays in seeking healthcare, reaching facility centres at the right time and receiving adequate services. The findings of the current study suggest that rescheduling official time of the service centre, recruiting and posting female health workers, following a guiding path and providing emergency obstetric care at free of costs are the feasible ways of getting better maternal health situation in the study areas.South East Asia Journal of Public Health Vol.6(2) 2016: 23-36

scholarly journals Determining the efficacy of national strategies aimed at addressing the challenges facing health personnel working in rural areas in KwaZulu-Natal, South Africa

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Grace Mburu ◽  
Gavin George
Keyword(s):  
Community Service ◽  
Working Conditions ◽  
Rural Areas ◽  
Health Personnel ◽  
Health Workers ◽  
Health Care Service ◽  
Health Sector ◽  
Medical Doctors ◽  
Kwazulu Natal ◽  
Working And Living Conditions

Background: Shortages of Human Resources for Health (HRH) in rural areas are often driven by poor working and living conditions, inadequate salaries and benefits, lack of training and career development opportunities amongst others. The South African government has adopted a human resource strategy for the health sector in 2011 aimed at addressing these challenges.Aim: This study reviews the challenges faced by health personnel against government strategies aimed at attracting and retaining health personnel in these underserved areas.Setting: The study was conducted in six primary health care service sites in the Hlabisa sub-district of Umkhanyakude, located in northern KwaZulu-Natal, South Africa.Methods: The study population comprised 25 health workers including 11 professional nurses, 4 staff nurses and 10 doctors (4 medical doctors, 3 foreign medical doctors and 3 doctors undertaking community service). Qualitative data were collected from semi-structured interviews and analysed using thematic analysis.Results: Government initiatives including the rural allowance, deployment of foreign medical doctors and the presence of health personnel undertaking their community service in rural areas are positively viewed by health personnel working in rural health facilities. However, poor living and working conditions, together with inadequate personal development opportunities, remain unresolved challenges. It is these challenges that will continue to dissuade experienced health personnel from remaining in these underserved areas.Conclusion: South Africa’s HRH strategy for the Health Sector 2012/13–2015/16 had highlighted the key challenges raised by respondents and identified strategies aimed at addressing these challenges. Implementation of these strategies is key to improving both living and working conditions, and providing health personnel with opportunities for further development will require inter-ministerial collaboration if the HRH 2030 objectives are to be realised.

Eliminating Hepatitis B from Bangladesh by the Year 2030

2020 ◽  
Vol 38 (3) ◽  
pp. 145-149
Author(s):  
Md Golam Mustafa ◽  
Md Shahinul Alam ◽  
Md Golam Azam ◽  
Md Mahabubul Alam ◽  
Md Saiful Islam ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Health Workers ◽  
Health Sector ◽  
Public Health Problem ◽  
Integrated System ◽  
Hbv Infection ◽  
Diagnosis And Treatment ◽  
Major Public Health Problem ◽  
Medical Institutions ◽  
The Government

Worldwide, hepatitis B virus (HBV) infection is still a major public health problem. Bangladesh having a large burden of HBV infection, should be a major contributor towards it’s elimination by 2030. The country has been making progress in reducing incidence of HBV infection during the past decades. The progresses are mainly due to large vaccination coverage among children and large coverage of timely birthdose vaccine for prevention of mother-to-child transmission of HBV. However, Bangladesh still faces challenges in achieving target of reduction in mortality from HBV. On the basis of targets of the WHO’s Global health sector strategy on viral hepatitis 2016–2021, we highlight priorities for action towards HBV elimination. To attain the target of reduced mortality we propose that, the service coverage targets of diagnosis and treatment should be prioritized along with vaccination. Firstly, improvements are needed in the diagnostic and treatment abilities of medical institutions and health workers. Secondly, the government needs to reduce the costs of health care. Thirdly, better coordination is needed across existing national program and resources to establish an integrated system for prevention, screening, diagnosis and treatment of HBV infection. In this way, we can make progress towards achieving the target of eliminating HBV from Bangladesh by 2030 J Bangladesh Coll Phys Surg 2020; 38(3): 145-149

Self-assessment by medical workers of the degree of influence of working conditions on the development of occupational diseases

2019 ◽  
pp. 463-467 ◽  
Author(s):  
N. N. Petrukhin ◽  
O. N. Andreenko ◽  
I. V. Boyko ◽  
S. V. Grebenkov
Keyword(s):  
Health Care ◽  
Working Conditions ◽  
Occupational Diseases ◽  
Health Workers ◽  
Medical Personnel ◽  
Long Term Memory ◽  
Self Assessment ◽  
Medical Institutions ◽  
Care Workers ◽  
The Impact

Introduction. The activities of health workers are associated with the impact of many harmful factors that lead to loss of health. Compared with other professional groups, health care workers are ill longer and harder, which may be due to polymorbidity pathology.The aim of the study based on the survey data to study the representation of health workers about working conditions and to identify their impact on the formation of occupational diseases.Materials and methods. In order to get a real idea of the attitude of medical workers to their working conditions in 2018, an anonymous survey was conducted of 1129 doctors and 776 employees of secondary and junior medical personnel working in health care institutions in St. Petersburg, Moscow, Krasnoyarsk, Vologda and Orel.Results. Research of working conditions and health of physicians allowed to establish that work in medical institutions imposes considerable requirements to an organism of working, its physical condition and endurance, volume of operational and long-term memory, ability to resist to mental, moral and ethical overloads.Conclusions: The most important method of combating the development of occupational diseases is their prevention. Organizational and preventive measures should be aimed primarily at monitoring the working conditions and health of medical staff .

The Impact of Social Mobilization on Health Service Delivery and Health Outcomes

2018 ◽  
Author(s):  
Xavier Giné ◽  
Salma Khalid ◽  
Mansuri Ghazala
Keyword(s):  
Health Services ◽  
Service Delivery ◽  
Health Outcomes ◽  
Health Workers ◽  
Health Service Delivery ◽  
Health Providers ◽  
Child Health Outcomes ◽  
Rural Pakistan ◽  
Post Natal Care ◽  
The Impact

This chapter uses a randomized community development programme in rural Pakistan to assess the impact of citizen engagement on public service delivery and maternal and child health outcomes. The programme had a strong emphasis on organizing women, who also identified health services as a development priority at baseline. At midline, we find that the mobilization effort alone had a significant impact on the performance of village-based health providers. We detect economically large improvements in pregnancy and well-baby visits by female health workers, as well as increased utilization of pre- and post-natal care by pregnant women. In contrast, the quality of supra-village health services did not improve, underscoring the importance of community enforcement and monitoring capacity for improving service delivery.

scholarly journals Working conditions and health status of 6,317 front line public health workers across five provinces in China during the COVID-19 epidemic: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jinghua Li ◽  
Jingdong Xu ◽  
Huan Zhou ◽  
Hua You ◽  
Xiaohui Wang ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Health Status ◽  
Health Outcomes ◽  
Working Conditions ◽  
Health Workers ◽  
Front Line ◽  
Cross Sectional ◽  
Self Rated Health ◽  
Public Health Workers

ABSTRACT Background Public health workers at the Chinese Centre for Disease Control and Prevention (China CDC) and primary health care institutes (PHIs) were among the main workers who implemented prevention, control, and containment measures. However, their efforts and health status have not been well documented. We aimed to investigate the working conditions and health status of front line public health workers in China during the COVID-19 epidemic. Methods Between 18 February and 1 March 2020, we conducted an online cross-sectional survey of 2,313 CDC workers and 4,004 PHI workers in five provinces across China experiencing different scales of COVID-19 epidemic. We surveyed all participants about their work conditions, roles, burdens, perceptions, mental health, and self-rated health using a self-constructed questionnaire and standardised measurements (i.e., Patient Health Questionnaire and General Anxiety Disorder scale). To examine the independent associations between working conditions and health outcomes, we used multivariate regression models controlling for potential confounders. Results The prevalence of depression, anxiety, and poor self-rated health was 21.3, 19.0, and 9.8%, respectively, among public health workers (27.1, 20.6, and 15.0% among CDC workers and 17.5, 17.9, and 6.8% among PHI workers). The majority (71.6%) made immense efforts in both field and non-field work. Nearly 20.0% have worked all night for more than 3 days, and 45.3% had worked throughout the Chinese New Year holiday. Three risk factors and two protective factors were found to be independently associated with all three health outcomes in our final multivariate models: working all night for >3 days (multivariate odds ratio [ORm]=1.67~1.75, p<0.001), concerns about infection at work (ORm=1.46~1.89, p<0.001), perceived troubles at work (ORm=1.10~1.28, p<0.001), initiating COVID-19 prevention work after January 23 (ORm=0.78~0.82, p=0.002~0.008), and ability to persist for > 1 month at the current work intensity (ORm=0.44~0.55, p<0.001). Conclusions Chinese public health workers made immense efforts and personal sacrifices to control the COVID-19 epidemic and faced the risk of mental health problems. Efforts are needed to improve the working conditions and health status of public health workers and thus maintain their morale and effectiveness during the fight against COVID-19.

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