scholarly journals How to attract and retain health workers in rural areas of a fragile state: findings from a labour market survey in Guinea

2021 ◽  
Author(s):  
Sophie Witter ◽  
Christopher H. Herbst ◽  
Marc Smitz ◽  
Mamadou Dioulde Balde ◽  
Ibrahim Magazi ◽  
...  
Keyword(s):  
Working Conditions ◽  
Rural Areas ◽  
Health Workers ◽  
Human Resources For Health ◽  
Health Staff ◽  
Policy Dialogue ◽  
Cross Sectional ◽  
Remote Areas ◽  
Nationally Representative ◽  
Rural Service

AbstractMost countries face challenges attracting and retaining health staff in remote areas but this is especially acute in fragile and shock-prone contexts, like Guinea, where imbalances in staffing are high and financial and governance arrangements to address rural shortfalls are weak.The objective of this study was to understand how health staff could be better motivated to work and remain in rural, under-served areas in Guinea. In order to inform the policy dialogue on strengthening human resources for health, we conducted three nationally representative cross-sectional surveys, adapted from tools used in other fragile contexts.We found that the locational job preferences of health workers in Guinea are particularly influenced by opportunities for training, working conditions, and housing. Most staff are satisfied with their work and with supervision, however, financial aspects and working conditions are considered least satisfactory, and worrying findings include the high proportion of staff favouring emigration, their high tolerance of informal user payments, as well as their limited exposure to rural areas during training.Based on our findings, we highlight measures which could improve rural recruitment and retention in Guinea and similar settings. These include offering upgrading and specialization in return for rural service; providing greater exposure to rural areas during training; increasing recruitment from rural areas; experimenting with fixed term contracts in rural areas; and improving working conditions in rural posts. The development of incentive packages should be accompanied by action to tackle wider issues, such as reforms to training and staff management.

scholarly journals How to attract and retain health workers in rural areas of a fragile state: Findings from a labour market survey in Guinea

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0245569
Author(s):  
Sophie Witter ◽  
Christopher H. Herbst ◽  
Marc Smitz ◽  
Mamadou Dioulde Balde ◽  
Ibrahim Magazi ◽  
...  
Keyword(s):  
Working Conditions ◽  
Rural Areas ◽  
Health Workers ◽  
Human Resources For Health ◽  
Health Staff ◽  
Policy Dialogue ◽  
Cross Sectional ◽  
Remote Areas ◽  
Nationally Representative ◽  
Rural Service

Most countries face challenges attracting and retaining health staff in remote areas but this is especially acute in fragile and shock-prone contexts, like Guinea, where imbalances in staffing are high and financial and governance arrangements to address rural shortfalls are weak. The objective of this study was to understand how health staff could be better motivated to work and remain in rural, under-served areas in Guinea. In order to inform the policy dialogue on strengthening human resources for health, we conducted three nationally representative cross-sectional surveys, adapted from tools used in other fragile contexts. This article focuses on the health worker survey. We found that the locational job preferences of health workers in Guinea are particularly influenced by opportunities for training, working conditions, and housing. Most staff are satisfied with their work and with supervision, however, financial aspects and working conditions are considered least satisfactory, and worrying findings include the high proportion of staff favouring emigration, their high tolerance of informal user payments, as well as their limited exposure to rural areas during training. Based on our findings, we highlight measures which could improve rural recruitment and retention in Guinea and similar settings. These include offering upgrading and specialization in return for rural service; providing greater exposure to rural areas during training; increasing recruitment from rural areas; experimenting with fixed term contracts in rural areas; and improving working conditions in rural posts. The development of incentive packages should be accompanied by action to tackle wider issues, such as reforms to training and staff management.

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.

scholarly journals Determinants of COVID-19 preventive behaviours among adults with chronic diseases in the USA: an analysis of the nationally representative COVID-19 impact survey

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044600
Author(s):  
Jessica Y. Islam ◽  
Denise C. Vidot ◽  
Marlene Camacho-Rivera
Keyword(s):  
Chronic Diseases ◽  
Rural Areas ◽  
Prevalence Ratio ◽  
Face Mask ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
High School Degree ◽  
The Usa ◽  
Nationally Representative

BackgroundPreventive behaviours have been recommended to control the spread of SARS-CoV-2. Adults with chronic diseases (CDs) are at higher risk of COVID-19-related mortality compared to the general population. Our objective was to evaluate adherence to COVID-19 preventive behaviours among adults without CDs compared with those with CDs and identify determinants of non-adherence to COVID-19 preventive behaviours.Study designCross-sectional.Setting and participantsWe used data from the nationally representative COVID-19 Impact Survey (n=10 760) conducted in the USA.Primary measuresAdults with CDs were categorised based on a self-reported diagnosis of diabetes, high blood pressure, heart disease/heart attack/stroke, asthma, chronic obstructive pulmonary disease (COPD), bronchitis or emphysema, cystic fibrosis, liver disease, compromised immune system, or cancer (54%).ResultsCompared with adults without CDs, adults with CDs were more likely to adhere to preventive behaviours including wearing a face mask (χ2-p<0.001), social distancing (χ2-p<0.001), washing or sanitising hands (χ2-p<0.001), and avoiding some or all restaurants (χ2-p=0.002) and public or crowded places (χ2-p=0.001). Adults with a high school degree or below [Adjusted prevalence ratio (aPR):1.82, 95% Confidence interval (CI)1.04 to 3.17], household income <US$50 000 (aPR:2.03, 95% CI 1.34 to 2.72), uninsured (aPR:1.65, 95% CI1.09 to 2.52), employed (aPR:1.48, 95% CI 1.02 to 2.17), residing in rural areas (aPR:1.70, 95% CI 1.01 to 2.85) and without any CD (aPR:1.78, 95% CI 1.24 to 2.55) were more likely to not adhere to COVID-19 preventive behaviours.ConclusionAdults with CDs are more likely to adhere to recommended COVID-19 preventive behaviours. Public health messaging targeting specific demographic groups and geographic areas, such as adults without CD or adults living in rural areas, should be prioritised.

scholarly journals COPD awareness in the urban slums and rural areas around Pune city in India

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Deesha Deepak Ghorpade ◽  
Anchala Raghupathy ◽  
Jyoti Deepak Londhe ◽  
Sapna Jitendra Madas ◽  
Nisha Vijay Kale ◽  
...  
Keyword(s):  
Tobacco Smoking ◽  
Rural Areas ◽  
Total Population ◽  
Health Workers ◽  
Urban Slum ◽  
Urban Slums ◽  
Cross Sectional ◽  
Rural Villages ◽  
Disability Adjusted Life ◽  
Life Years

AbstractCOPD is the second leading cause of death and disability adjusted life years (DALYs) in India, yet, it remains poorly recognized. We aimed to study the level of awareness of COPD in urban slums of Pune city in India and its neighboring rural areas. All male and female subjects above the age of 30 years residing in 13 randomly selected slums of Pune city (total population of 3000) and 7 randomly selected neighboring rural villages (total population of 3000) were invited to participate in this cross-sectional community survey. After obtaining written informed consent, 13 trained community health workers (CHWs) administered a questionnaire that captured their level of awareness of COPD. Of the 6000 subjects approached, 5420 residents (mean age ± SD = 48.0 ± 13.5 years; 38% males) consented and answered all questions. The number of people who had ever heard the word COPD was 49/5420 [0.9% (0.6–1.1%); 0.7% (0.5–1.3%) of the urban slum dwellers and 1.15% (0.5–1.3%) of rural residents]. Among those who had never heard the word COPD (n = 5371), when asked what was the name of the disease caused by long-term tobacco smoking, 38% said cancer, 16.7% said asthma, and 4.4% said TB. Among those who had heard the word COPD (n = 49), 6.1% said it was a disease of the heart, and 61% attributed COPD to smoke and dust pollution and 20% to tobacco smoking. The level of awareness of COPD in the Indian community is extremely low, highlighting the need to have nationwide mass awareness programs in India.

scholarly journals Career Intentions and Dropout Causes Among Medical Students in Kazakhstan

Medicina ◽  
2013 ◽  
Vol 49 (6) ◽  
pp. 45
Author(s):  
Kamila Faizullina ◽  
Galina Kausova ◽  
Zhanna Kalmataeva ◽  
Ardak Nurbakyt ◽  
Saule Buzdaeva
Keyword(s):  
Medical Students ◽  
Human Resources ◽  
Rural Areas ◽  
Urban Areas ◽  
Human Resources For Health ◽  
Medical Schools ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Unequal Distribution ◽  
Survey Tool

Background and Objective. The number of new entrants to higher medical schools of Kazakhstan increased by 1.6 times from 2007 to 2012. However, it is not known how it will affect the shortage of human resources for health. Additionally, human resources for health in rural areas of Kazakhstan are 4 times scarcer than in urban areas. The aim of the present study was to investigate the intentions of students toward their professional future and readiness to work in rural areas, as well as to determine the causes for dropping out from medical schools. Material and Methods. A cross-sectional survey was conducted in 2 medical universities in Almaty during the academic year 2011–2012. The study sample included medical students and interns. In total, 2388 students participated in the survey. The survey tool was an anonymous questionnaire. Results. The students of the first years of studies compared with those of later years of studies were more optimistic about the profession and had more intentions to work in the medical field. Only 8% of the students reported a wish to work in rural localities. On the other hand, 4% of the students did not plan to pursue the profession. On the average, every third medical student dropped out on his/her own request. Conclusions. Associations between intentions to work according to the profession and the year of studies, faculty, and residence area before enrolling in a medical school were documented. The majority of the students who came from rural areas preferred to stay and look for work in a city, which might contribute to an unequal distribution of physicians across the country.

scholarly journals Study of Working Experience in Remote Rural Areas after Medical Graduation

2015 ◽  
Vol 12 (2) ◽  
pp. 121-125
Author(s):  
KR Thapa ◽  
BK Shrestha ◽  
MD Bhattarai
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Sampling Method ◽  
Postgraduate Training ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Remote Areas ◽  
Convenience Sampling ◽  
A Priority

Background Posting of doctors in remote rural areas has always been a priority for Government; however data are scarce in the country about experience of doctors of working in remote areas after medical graduation.Objective A questionnaire survey of doctors was planned to analyze their experience of working after graduation in remote rural areas in various parts of the country.Method The cross-sectional survey was done by convenience sampling method. A one-page questionnaire with one partially closed-end and five open-end type questions was distributed to the doctors who had worked in remote rural areas after graduation under various governments’ postings.Result Two-third of participants had their home in urban areas and 89.8% had stayed for 1 to 5 years. About half of the participants had difficulty in getting the posting in the remote areas of their choice. Most participants indicated provision of opportunities for Residential (postgraduate) Training as their reasons of going to remote areas as well as their suggestions to encourage young graduates to go there. Similarly most also suggested appropriate career, salary and incentives to encourage doctors to go to work in remote areas. About 85% of participants pointed out the major problem faced while posted in remote areas as difficulty in handling varied situations with no guidance or seniors available around.Conclusion The notable points indicated by the participants are centered on the opportunity for Residential Training and difficulties faced without such training. Residential Training is a priority to be considered while planning the health policy for optimum health care of people.Kathmandu University Medical Journal Vol.12(2) 2014: 121-125

scholarly journals PREVALENCE OF CARBONATED SOFT DRINK CONSUMPTION AND ASSOCIATED FACTORS AMONG MALAYSIAN ADOLESCENTS: A NATIONWIDE CROSS-SECTIONAL STUDY 2017

2020 ◽  
Vol 20 (3) ◽  
pp. 156-162
Author(s):  
Ruhaya Salleh ◽  
Rashidah Ambak ◽  
S. Maria Awaluddin ◽  
Mohamad Hasnan Ahmad ◽  
Noor Safiza Mohamad Noor ◽  
...  
Keyword(s):  
Rural Areas ◽  
Fast Food ◽  
Associated Factors ◽  
Soft Drink ◽  
Cross Sectional Study ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Soft Drink Consumption ◽  
Nationally Representative ◽  
Malaysian Adolescents

Carbonated soft drinks (CSD) consumption is one of the contributing factors to weight gain, dental caries and non-communicable diseases among adolescents. This study aims to determine CSD consumption among Malaysian adolescents and their associated factors. The Adolescent Health Survey 2017, was a nationally representative survey sampled school-going adolescents aged 13 to 17 years. Findings reported that 36.9% of adolescents reported CSD consumption at least once daily in the past 30 days, and the prevalence was higher than a similar study conducted in 2012. Boys, schools in rural areas, lower secondary schoolers, not physically active, consuming fast food, having food insecurity, and truancy problem reported significantly higher odds of consuming CSD compared to their counterparts. By ethnicity, Bumiputera Sarawak adolescents showed the highest odds of consuming CSD and followed by Bumiputera Sabah. Thus, interventions to limit CSD consumption among Malaysian adolescents should consider the factors highlighted in this study.

scholarly journals Interventions in increasing availability of skilled healthcare providers in rural areas: A Case Study of Bihar (India)

2021 ◽  
Vol 24 ◽  
pp. 853-864
Author(s):  
Dilip Kumar
Keyword(s):  
Rural Health ◽  
Rural Areas ◽  
Service Providers ◽  
State Level ◽  
The State ◽  
Health Facilities ◽  
Working Environment ◽  
Health Staff ◽  
Personal Support ◽  
Rural Service

Population of rural areas face distinct health challenges due to economic conditions, cultural/behavioural factors, and health provider shortages that combine to impose striking disparities in health outcomes among them. The process of recruitment takes about four to six months for Recruitment of Medical officers and paramedics. The number of applicants is quite limited because of dearth of doctors and paramedics in the State. It was felt that the health staffs incentives will help to increase the turnover of health staffs to some extent in the rural and remote areas. Monitoring cell has been constituted at the state level. The trainings are being monitored at regular intervals of time. The motivational level of health staff at all levels seems to be low. Continuous communication and feedback by state level programme officers is needed on regular basis. Placement of the suitable trained personnel is needed at those health facilities where sufficient infrastructure is available. Since 2010-11, there has been a continuous focus on the capacity building of the existing manpower in  the  state.  Trainings  as  per  GOI  guidelines  on  Immunization,  IMNCI,  EmOC,  LSAS,  SBA  and Minilap/MVA etc. have been taken up with full strength. In addition, the State wide training on immunization for Medical Officers, IPC skills for breast feeding and basic training in neonatal resuscitation also has been taken up at various levels. More than four-fifth of the total staffs in the health facilities were agreed on all the educational interventions for retention of health staffs in rural areas. For the regulatory interventions such as enhanced scope of practice, different types of health workers; multi skilling of alternate service providers, compulsory rural service which may be mandatory for obtaining license to practice or can be a prerequisite for entry into specialization and subsidized education in return of assured services were agreed by four-fifth of the total staffs. For the interventions related to professional and personal support such as better living conditions (water, sanitation, electricity, telecommunications, schools, etc.), safe and supportive working environment, outreach activities to facilitate cooperation between health workforce from better served and underserved areas; use of tele-health, designing career development programmes linked with rural service: more senior posts in rural areas and professional networks for rural areas such as rural health professional associations, rural health journals, etc. about 88 percent of the HR categories of Staffs were agreed in the health facilities

Factors Influencing Choice of Delivery Place among Mothers in Rukungiri and Kanungu Districts, South Western Uganda: A Cross Sectional Study

2020 ◽  
Author(s):  
Richard Mugambe ◽  
Habib Yakubu ◽  
Solomon Wafula ◽  
Tonny Ssekamatte ◽  
Simon Kasasa ◽  
...  
Keyword(s):  
Health Facility ◽  
Rural Areas ◽  
Health Workers ◽  
Public Health Facility ◽  
Facility Delivery ◽  
Health Facilities ◽  
Public Facility ◽  
Cross Sectional ◽  
Western Uganda ◽  
Delivery Place

Abstract Background: Child birth in health facilities is generally associated with lower risk of maternal and neonatal mortality. However, in Uganda, little is known about factors that influence use of health facilities for delivery especially in rural areas. In this study, we examined the determinants of mothers’ decision of the choice of child delivery place in Western Uganda.Methods: Cross-sectional data was collected from 894 randomly-sampled mothers within the catchment of two private hospitals in Rukungiri and Kanungu districts. Data was collected on the place of delivery for the most recent child, mothers’ sociodemographic characteristics, health facility water, sanitation and hygiene (WASH) status. Modified Poisson regression was used to estimate prevalence ratios (PRs) for the determinants of mothers’ choice of delivery place as well as determinants for the choice of private versus public facility for delivery at 95% confidence intervals. Results: Majority of mothers (90.2%) delivered in health facilities. Non-facility deliveries were attributed to fast progression of labour (77.3%), lack of transport (31.8%) and high cost of hospital delivery (12.5%). Being engaged in business as an occupation [APR = 1.06, 95% CI (1.01 – 1.11)] and belonging to the highest wealth quintile [APR = 1.09, 95% CI (1.02 – 1.17)] favoured facility delivery while higher parity of 3 – 4 [APR = 0.93, 95% CI (0.88 – 0.99)] was inversely associated with facility delivery as compared to parity of 1-2. Choice of private facility over public facility was influenced by how mothers valued factors such as high skilled health workers [APR = 1.15, 95% CI (1.05 – 1.26)], higher quality of WASH services [APR = 1.11, 95% CI (1.04 – 1.17)], cost of the delivery [APR = 0.85, 95% CI (0.78 – 0.92)] and availability of caesarean services [APR = 1.13, 95% CI (1.08 – 1.19)].Conclusion: Utilization of health facility child delivery services was high. Health facility delivery service utilization was influenced by engaging in business, belonging to wealthiest quintile and being multiparous. Choice of private versus public health facility for child delivery was influenced by health facility WASH status, cost of services, and availability of skilled workforce and caesarean services.

scholarly journals Retention and Task Shifting in Human Resources for Health through Data Mining

2017 ◽  
Vol 10 (5) ◽  
pp. 29
Author(s):  
Cheng-Kun Wang
Keyword(s):  
Data Mining ◽  
Literature Review ◽  
Human Resources ◽  
Rural Areas ◽  
Health Workers ◽  
Human Resources For Health ◽  
Task Shifting ◽  
Good Tool ◽  
Medical Manpower ◽  
And Task

Human resources for health (HRH) are the backbone of the healthcare system, but a shortage of medical manpower and the misdistribution of human resources are critical problems in the rural areas of many countries till 2017. The shortage of medical manpower is a big issue between 2004 and 2013. Data mining of bibliometrics is a good tool to find the solutions for shortage of medical manpower. By analyzing 118,092 citations in 2,000 articles published in the SSCI and SCI databases addressing HRH from 2004 to 2013, we plotted the networks among authors in the field. We combine quantitative bibliometrics and a qualitative literature review to determine the important articles and to realize the relationships between important topics in this field. We find that retention and task shifting are the hot topics in HRH field between 2004 and 2013, and find out the solutions for these issues through literature review in later papers. The solution to the HRH shortage is to determine the motivations of health workers and to provide incentives to maintain their retention. Task shifting is another solution to the HRH crisis.

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