A womenʼs health perspective in primary health care: A nursing and community health worker demonstration project in urban America

In this commentary paper, we highlight the key role that community health workers and family health professionals can perform for the identification and care for women experiencing domestic violence in communities. These workers are part of the primary health-care strategy in the Brazilian public health system, who are available in every municipalities and neighborhoods of the country. Based on our ethnographic research, we argue that identification and care of abused women by these workers and professionals follow a pattern which we described and named “the Chinese whispers model.” We also point gaps in training these workers to deal with complex issues, such as domestic violence, arguing for the need of formal qualification for both community health workers and family health professionals by, for example, incorporating such themes into curricula, further education, and continuing professional development.

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The community health worker. A resource for improved health care delivery.

American Journal of Public Health ◽

10.2105/ajph.64.11.1056 ◽

1974 ◽

Vol 64 (11) ◽

pp. 1056-1061 ◽

Cited By ~ 20

Author(s):

R W Richter ◽

B Bengen ◽

P A Alsup ◽

B Bruun ◽

M M Kilcoyne ◽

...

Keyword(s):

Health Care ◽

Community Health ◽

Health Worker ◽

Community Health Worker ◽

Health Care Delivery ◽

Care Delivery

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Health Worker Perceptions of the Integration of Leprosy Control Services at the Primary Health Care Level in Ibadan, Nigeria

International Quarterly of Community Health Education ◽

10.2190/phlv-8acr-xjwe-410p ◽

2003 ◽

Vol 22 (1) ◽

pp. 111-124 ◽

Cited By ~ 1

Author(s):

Oluseyi R. Olaseinde ◽

William R. Brieger

Keyword(s):

Health Care ◽

Primary Health Care ◽

Local Government ◽

Health Worker ◽

Health Staff ◽

Basic Training ◽

Front Line ◽

Primary Health ◽

Service Training ◽

Leprosy Control

A goal of both the World Health Organization and the Nigerian National Tuberculosis and Leprosy Control (TBL) Program is to integrate leprosy control services into the front line primary health care service system. Traditionally, leprosy services had been handled by one local government officer with little involvement of other health staff, and this limited access and timeliness of services for leprosy patients. Even after the national TBL program was implemented, integration has not been achieved, and this study of 203 front line health workers in the five local government areas that comprise the Ibadan metropolitan area of Oyo State, Nigeria sought to determine the role of health worker knowledge, attitudes, and self-efficacy in fostering or inhibiting leprosy service integration. Leprosy knowledge scores were positively associated with years in service, having lectures on leprosy during basic training, and having attended in-service training (IST) on leprosy. Among the cadres interviewed, Environmental Health Officers (EHOs), who had traditionally managed leprosy services prior to the move for integrated services, had the highest scores. EHOs and those who had leprosy lectures during basic training also had better attitudes toward leprosy than their counterparts. Male health staff and those who had leprosy lectures during basic training also had higher attitude scores concerning integrating leprosy control services with primary care. Finally, the only factor associated with perceived self-efficacy to perform leprosy control services was cadre. Ironically, Community Health Extension workers, who have had little in the way of experience with and training in leprosy control, believed they could handle these responsibilities better than other cadres. The influence of basic and in-service training on enhancing leprosy control knowledge and attitudes is recognized and enhancement of curricula for all cadres on leprosy issues is recommended.

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Community Health and General Practice: The Impact of Different Cultures on the Integration of Primary Care

Australian Journal of Primary Health ◽

10.1071/py01010 ◽

2001 ◽

Vol 7 (1) ◽

pp. 65 ◽

Cited By ~ 1

Author(s):

Hal Swerissen ◽

Jenny Macmillan ◽

Catuscia Biuso ◽

Linda Tilgner

Keyword(s):

Primary Care ◽

Health Care ◽

General Practice ◽

Primary Health Care ◽

Community Health ◽

Community Health Centres ◽

Care Services ◽

Primary Health ◽

Health Centres ◽

The Relationship

This study examined the existing relationship between community health centres and General Practice Divisions in the State of Victoria, including the nature of joint working arrangements and the identification of barriers to greater collaboration. Improved integration of primary health care services has been advocated to improve consumer and population health outcomes and to reduce inappropriate use of acute and extended care services. General practitioners (GPs) and community health centres are two key providers of primary health care with potential for greater integration. The current study conducted telephone interviews with 20 community health centre CEOs and 18 Executive Officers of divisions, which were matched according to catchment boundaries. Results suggest, while some joint planning is occurring, especially on committees, working parties and projects, there is an overall low level of satisfaction with the relationship between community health centres and GPs and GP divisions. Major barriers to greater integration are the financial or business interests of GPs and misunderstanding and differences in perceived roles and ideology between GPs and community health centres. Improved communication, greater contact and referral and follow-up procedures are identified as a means of improving the relationship between GPs, GP divisions and community health centres. Community health centres and general practitioners (GPs) are key providers of primary care (Australian Community Health Association, 1990).

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Access of the LGBTQI+ population from the perspective of community health agents, Brazil

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.770 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M H N Souza ◽

A A Pinho ◽

L Graever ◽

A R Pereira ◽

A M S Santana ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Community Health ◽

Quantitative Research ◽

Health Workers ◽

National Policy ◽

Comprehensive Health Care ◽

Care Network ◽

Primary Health ◽

Comprehensive Health

Abstract Introduction In Brazil, according to the National Policy for Integral Health for Lesbians, Gays, Bisexuals, Transvestites, Transsexuals, Queers, Intersexuals and other identities (LGBTQI+), it is increasingly necessary to guarantee access to the health system, as well as to train qualified professionals. Objective describing the perception of Community Health Agents (CHA) about the approach to and access of LGBTQI+ people to primary health care. Methods Quantitative research conducted in October 2019 with 60 community health workers from the municipality of Rio de Janeiro, Brazil. The research was approved by the Ethics and Research Committees of the participating institutions. Results it was found that 100% of the CHA have already supported LGBTQI+ people, 19.2% identify prejudiced attitudes and delay in service as barriers to accessing the unit, and 19.2% recognize the presence of group activities in the unit. In the view of the CHA interviewed, LGBTQI+ patients could be approached in groups (50%), individually (19.2%) or both (30.8%). Among the strategies to increase the access of those patients, 61.5% are unaware and 38.5% listed possible strategies to be implemented in the unit. The topics of interest for discussion were: approach to reception, sexual identity, prejudice, psychological support, family, diseases, violence, and rights. Conclusions From the perspective of community health agents, the study allowed reflections on how approaching and making access available to LGBTQI+ patients in the primary care network. This evidences stigmas and fragility of professionals in the individual and collective approach to deal with issues regarding guidance sexuality and gender identity of the clientele served. It is important to emphasize permanent education actions among professionals, aiming at a comprehensive health care for the LGBTQI+ population. Key messages Welcoming and qualified listening promote comprehensive health care for the LGBTQI+ population. Improvements in the access of the LGBTQI+ population to the primary health care network decrease morbidity and mortality.

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