scholarly journals Exploring the knowledge, attitudes, practices and lived experiences of frontline health workers in the times of COVID-19 : a qualitative study from Bangladesh

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e051893
Author(s):  
Samiun Nazrin Bente Kamal Tune ◽  
Bushra Zarin Islam ◽  
Mir Raihanul Islam ◽  
Zarin Tasnim ◽  
Syed Masud Ahmed
Keyword(s):  
Qualitative Study ◽  
Lived Experiences ◽  
Health Workers ◽  
Early Stage ◽  
Emotional Health ◽  
Structured Interview ◽  
Common Source ◽  
Snowball Sampling ◽  
Community Healthcare ◽  
Frontline Health Workers

ObjectiveThis study explored Frontline Health Workers’ (FLWs) knowledge, attitude and practice (KAP) on COVID-19 and their lived experiences, in both their personal and work lives, at the early stage of the pandemic in Bangladesh.Design, setting and participantsThis was a qualitative study conducted through telephone interviews in May 2020. A total of 41 FLWs including physicians, nurses, paramedics, community healthcare workers and hospital support staff from 34 public and private facilities of both urban and rural parts of Bangladesh participated in the interview. A purposive sampling technique supplemented by a snowball sampling method was followed to select the participants. The in-depth interviews followed a semi-structured interview guide, and we applied the thematic analysis method for the qualitative data analysis.FindingsExcept physicians, the FLWs did not receive any institutional training on COVID-19, including its prevention and management, in most instances. Also, they had no training in the use of personal protective equipment (PPE). Their common source of knowledge was the different websites or social media platforms. The FLWs were at risk while delivering services because patients were found to hide histories and not maintaining safety rules, including physical distancing. Moreover, inadequate supply of PPE, fear of getting infected, risk to family members and ostracisation by the neighbours were mentioned to be quite common by them. This situation eventually led to the development of mental stress and anxiety; however, they tried to cope up with this dire situation and attend to the call of humanity.ConclusionThe uncertain work environment during the COVID-19 pandemic simultaneously affected FLWs’ physical and emotional health in Bangladesh. However, they showed professional devotion in overcoming such obstacles and continued to deliver essential services. This could be further facilitated by a quick and targeted training package on COVID-19, and the provision of supplies for delivering services with appropriate safety precautions.

scholarly journals Communication between mothers and health workers is important for quality of newborn care: a qualitative study in neonatal units in district hospitals in South Africa

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Christiane Horwood ◽  
Lyn Haskins ◽  
Silondile Luthuli ◽  
Neil McKerrow
Keyword(s):  
South Africa ◽  
Qualitative Study ◽  
Health Workers ◽  
Newborn Care ◽  
Well Being ◽  
Structured Interview ◽  
Observation Data ◽  
Good Communication ◽  
District Hospitals

Abstract Background There is a high global burden of neonatal mortality, with many newborn babies dying of preventable and treatable conditions, particularly in low and middle-income countries. Improving quality of newborn care could save the lives of many thousands of babies. Quality of care (QoC) is a complex and multifaceted construct that is difficult to measure, but patients’ experiences of care are an important component in any measurement of QoC. We report the findings of a qualitative study exploring observations and experiences of health workers (HWs) and mothers of babies in neonatal units in South Africa. Methods A qualitative case study approach was adopted to explore care of newborn babies admitted to neonatal units in district hospitals. Observation data were collected by a registered nurse during working hours over a continuous five-day period. Doctors and nurses working in the neonatal unit and mothers of babies admitted during the observation period were interviewed using a semi-structured interview guide. All interviews were audio recorded. Observation data were transcribed from hand written notes. Audiotapes of interviews were transcribed verbatim and, where necessary, translated into English. A thematic content analysis was used to analyse the data. Results Observations and interviews were conducted in seven participating hospitals between November 2015 and May 2016. Our findings highlight the importance of information sharing between HWs and mothers of babies, contrasting the positive communication reported by many mothers which led to them feeling empowered and participating actively in the care of their babies, with incidents of poor communication. Poor communication, rudeness and disrespectful behaviour of HWs was frequently described by mothers, and led to mothers feeling anxious, unwilling to ask questions and excluded from their baby’s care. In some cases poor communication and misunderstandings led to serious mismanagement of babies with HWs delaying or withholding care, or to mothers putting their babies at risk by not following instructions. Conclusion Good communication between mothers and HWs is critical for building mothers’ confidence, promoting bonding and participation of mothers in the care of their baby and may have long term benefits for the health and well-being of the mother and her baby.

scholarly journals Connecting communities to primary care: a qualitative study on the roles, motivations and lived experiences of community health workers in the Philippines

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Eunice Mallari ◽  
Gideon Lasco ◽  
Don Jervis Sayman ◽  
Arianna Maever L. Amit ◽  
Dina Balabanova ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Community Health ◽  
Community Health Workers ◽  
Financial Incentives ◽  
Lived Experiences ◽  
Health Workers ◽  
The Philippines ◽  
Community Members ◽  
Cross Sectional ◽  
The Impact

Abstract Background Community health workers (CHWs) are an important cadre of the primary health care (PHC) workforce in many low- and middle-income countries (LMICs). The Philippines was an early adopter of the CHW model for the delivery of PHC, launching the Barangay (village) Health Worker (BHW) programme in the early 1980s, yet little is known about the factors that motivate and sustain BHWs’ largely voluntary involvement. This study aims to address this gap by examining the lived experiences and roles of BHWs in urban and rural sites in the Philippines. Methods This cross-sectional qualitative study draws on 23 semi-structured interviews held with BHWs from barangays in Valenzuela City (urban) and Quezon province (rural). A mixed inductive/ deductive approach was taken to generate themes, which were interpreted according to a theoretical framework of community mobilisation to understand how characteristics of the social context in which the BHW programme operates act as facilitators or barriers for community members to volunteer as BHWs. Results Interviewees identified a range of motivating factors to seek and sustain their BHW roles, including a variety of financial and non-financial incentives, gaining technical knowledge and skill, improving the health and wellbeing of community members, and increasing one’s social position. Furthermore, ensuring BHWs have adequate support and resources (e.g. allowances, medicine stocks) to execute their duties, and can contribute to decisions on their role in delivering community health services could increase both community participation and the overall impact of the BHW programme. Conclusions These findings underscore the importance of the symbolic, material and relational factors that influence community members to participate in CHW programmes. The lessons drawn could help to improve the impact and sustainability of similar programmes in other parts of the Philippines and that are currently being developed or strengthened in other LMICs.

scholarly journals Determinants of Disparity between Antenatal Bookings and Institutional Deliveries in Port Harcourt, Southern Nigeria

2020 ◽  
pp. 21-30
Author(s):  
Terhemen Kasso ◽  
Ojimah Chibianotu ◽  
Rosemary Ogu
Keyword(s):  
Qualitative Study ◽  
Antenatal Care ◽  
Health Workers ◽  
Structured Interview ◽  
Cost Of Care ◽  
Skilled Birth Attendants ◽  
Mortality And Morbidity ◽  
Birth Attendants ◽  
Port Harcourt ◽  
Depth Interviews

Aim: To determine the reasons why women deliver outside institutions where they register for antenatal care. Study Design: Qualitative study. Place and Duration of Study: Antenatal clinic of the University of Port Harcourt Teaching Hospital in February 2018. Methodology: A qualitative study using in-depth interviews (IDIs) was conducted in Port Harcourt, Nigeria to collect information on various reasons why women do not deliver where they received antenatal care (ANC) or with skilled birth attendants (SBAs). This was done using structured interview guides. Specifically, we asked 30 pregnant women to elucidate the circumstances that lead women to deliver in places other than where they had received antenatal care, and recommendations to enhance the number of women delivering with skilled birth attendants. All in-depth interviews were audio-taped, transcribed and content-analyzed. Results: Thirty IDIs were carried out. The women were all pregnant; aged 20 to 43 years old with mean age of 32.9 ± 5.5 years. The broad themes that emerged from their responses: Cost/financial reasons relating to inability to afford the cost of care in the hospitals, personal reasons such as fear of Caesarean section, and hospital-related reasons such as health workers’ strike action. Conclusion:  Evidence from our study indicates that pregnant women’s non-use of skilled birth attendants during childbirth even when they received antenatal care in the hospital is mainly due to financial, personal and hospital-related reasons. These factors are modifiable and should be targeted to increase delivery with skilled attendants, a key strategy for the reduction of maternal and neonatal mortality and morbidity.

scholarly journals Nurses’ Feelings and Perspectives of the COVID-19 Pandemic: A Qualitative Study in a Developing Country

2021 ◽  
Vol 9 (G) ◽  
pp. 71-80
Author(s):  
Restuning Widiasih ◽  
Ermiati Ermiati ◽  
Etika Emaliyawati ◽  
Sri Hendrawati ◽  
Raini Diah Susanti ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health Workers ◽  
Social Stigma ◽  
Structured Interview ◽  
Health Awareness ◽  
Referral Hospitals ◽  
Qualitative Descriptive ◽  
The Government ◽  
Perceptions And Expectations ◽  
And Behavior

BACKGROUND: Nurses’ duties and responsibilities related to the risk of transmitting COVID-19. Studies that explore nurses’ feelings and perspectives in providing health services at COVID-19 referral hospitals, especially in developing countries like Indonesia, are limited. AIM: This study aims to explore nurses’ feelings, perceptions, and expectations of the COVID-19 pandemic. METHODS: This qualitative study applied the qualitative descriptive design that involved 17 nurses from different hospitals in Indonesia. The semi-structured interview gathered their views of COVID-19, and the comparative analysis for interviews technique was chosen to analyze the data. RESULTS: Three themes emerged from the data analysis. The themes were nurses’ express psychological responses in facing the COVID-19 pandemic such as fear, surrender, panic, and calmness. Other two themes included the COVID 19 pandemic enhances nurses’ health awareness and behavior, and the government protect nurses from the COVID-19 transmission and social stigma. CONCLUSION: The feelings reported dominantly by the nurse, in addition to information about health awareness, behavior, the government’s actions, and their expectations. Mental health assistance would be useful to prevent depression in nurses, and the government’s comprehensive approaches in dealing with the COVID-19 pandemic would increase the protection and productivity of health workers, including nurses.

scholarly journals South Sudanese or Australian or Both or Caught in Between? A Qualitative Study Examining Identity Among South Sudanese Refugees Living in Sydney, Australia.

2021 ◽  
Author(s):  
Geraldine Vaughan ◽  
Tafadzwa Nyanhanda ◽  
Sabitra Kaphle ◽  
Jenny Kelly ◽  
Lal Rawal ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Lived Experiences ◽  
Early Years ◽  
Structural Factors ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Making Sense ◽  
South Sudanese ◽  
Sudanese Refugees

Abstract Background: The majority of the current South Sudanese population in Australia arrived as refugees in the early 2000s, facing challenges related to dislocation, navigating a new culture while honouring their own own. Much of the research on the South Sudanese experience has been conducted in the early years after arrival, with resettlement stressors likely to influence narratives of identity as new immigrants.This study aimed to understand the lived experiences of identity among South Sudanese who are long-term residents of Australia after fleeing their birth country, migration, and re-building their lives.Methods: The qualitative study was underpinned by a phenomenological framework that characterised the experiences of study participants. Purposive and snowball sampling was used to recruit Sydney-residing adults who arrived in Australia through its humanitarian refugee program 10 or more years ago and were born in South Sudan. Semi-structured interviews explored how participants identified themselves in Australia, changes in their experiences over time, their social and general life situation in Australia, and perceptions (self and other) of South Sudanese people in Australia.Results: The 26 participants from refugee backgrounds all had similar experiences of dislocation, most arriving in Australia 10-19 years ago with family members. Most participants were in employment and had attained (sometimes multiple) educational qualifications.Participants described a multiplicity of interconnected domains that governed the negotiating and making sense of identity. Three key themes were identified: mutable identities - dependent on context; Identity in relation to children; and the influence of limited opportunities. These themes were mediated by other interwoven personal and structural factors that shaped experience and perception. Expressions of hope, pride and achievement were threaded through several of the interviews, particularly in relation to their children. There was also frustration related to employment challenges and discrimination that limited identity reconstruction.Conclusions: Our exploration of long-term lived experiences for South Sudanese migrants highlights the evolving and often conflicting factors that shape domains of integration and identity construction. The deeper, more nuanced understandings of bicultural identity within a strengths-based framework calls for better partnerships and services to support strengthened community and acculturalisation.

scholarly journals Inequalities in Private Tutoring of English: A Phenomenological Qualitative Study Based on Bangladeshi Higher Secondary Students

2021 ◽  
Author(s):  
Monjurul Islam ◽  
Shams Hoque ◽  
Kazi Enamul Hoque
Keyword(s):  
Qualitative Study ◽  
Secondary Students ◽  
Lived Experiences ◽  
Structured Interview ◽  
Phenomenological Analysis ◽  
Private Tutoring ◽  
Financial Capability ◽  
One To One ◽  
Negative Impacts ◽  
Insight Into

This phenomenological qualitative study analyzes the lived experiences of eleven Bangladeshi higher secondary students in mainstream schools to provide insight into their thoughts, feelings, beliefs, values, and assumptions of private tutoring in English (PT-E). The study also focused on PT-E that contribute to inequalities between students who have access to private tutoring and those who do not. Each participant participated in a one-to-one in-depth semi-structured interview. Using phenomenological analysis, 321 significant statements and three themes emerged. The data show that unequal practice, discrimination due to financial capability, and social psyche for PT-E that influences students to widen the negative impacts of PT-E between students, particularly those who do not have an access in private tutoring of English (PT-E).

scholarly journals Toward Designs of Workplace Stress Management Mobile Apps for Frontline Health Workers During the COVID-19 Pandemic and Beyond: Design Implications for a Mixed Methods Qualitative Study (Preprint)

2021 ◽  
Author(s):  
Beenish Moalla Chaudhry ◽  
Ashraful Islam ◽  
Monica Matthieu
Keyword(s):  
Mixed Methods ◽  
Qualitative Study ◽  
Coping Strategies ◽  
Stress Management ◽  
Health Workers ◽  
Mobile Apps ◽  
Workplace Stressors ◽  
Frontline Health Workers ◽  
Google Search ◽  
The Impact

BACKGROUND In recent years, mobile apps have been developed to prevent burnout, promote anxiety management, and provide health education to workers in various workplace settings. However, there remains a paucity of such apps for frontline health workers (FHWs), even though FHWs are the most susceptible to stress due to the nature of their jobs. OBJECTIVE The goal of this study was to provide suggestions for designing stress management apps to address workplace stressors of FHWs based on the understanding of their needs from FHWs’ own perspectives and theories of stress. METHODS A mixed methods qualitative study was conducted. Using a variety of search strings, we first collected 41 relevant web-based news articles published between December 2019 and May 2020 through the Google search engine. We then conducted a cross-sectional survey with 20 FHWs. Two researchers independently conducted qualitative analysis of all the collected data using a deductive followed by an inductive approach. RESULTS Prevailing uncertainty and fear of contracting the infection was causing stress among FHWs. Moral injury associated with seeing patients die from lack of care and lack of experience in handling various circumstances were other sources of stress. FHWs mentioned 4 coping strategies. Quick coping strategies such as walking away from stressful situations, entertainment, and exercise were the most common ways to mitigate the impact of stress at work. Peer support and counseling services were other popular methods. Building resilience and driving oneself forward using internal motivation were also meaningful ways of overcoming stressful situations. Time constraints and limited management support prevented FHWs from engaging in stress management activities. CONCLUSIONS Our study identified stressors, coping strategies, and challenges with applying coping strategies that can guide the design of stress management apps for FHWs. Given that the pandemic is ongoing and health care crises continue, FHWs remain a vulnerable population in need of attention.

scholarly journals Health workers’ perspectives of a mobile health tool to improve diagnosis and management of paediatric acute respiratory illnesses in Uganda: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049708
Author(s):  
Laura Elizabeth Ellington ◽  
Irene Najjingo ◽  
Margaret Rosenfeld ◽  
James W Stout ◽  
Stephanie A Farquhar ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Focus Groups ◽  
Mobile Health ◽  
Health Workers ◽  
Respiratory Illnesses ◽  
Individual Level ◽  
Frontline Health Workers ◽  
Primary Care Health ◽  
Care Health

ObjectivesMobile health tools have potential to improve the diagnosis and management of acute lower respiratory illnesses (ALRI), a leading cause of paediatric mortality worldwide. The objectives were to evaluate health workers’ perceptions of acceptability, usability and feasibility of Acute Lower Respiratory Illness Treatment and Evaluation (ALRITE), a novel mobile health tool to help frontline health workers diagnose, treat and provide education about ALRI in children <5 years.DesignA qualitative study including semistructured interviews with health facility administrators and focus groups with primary care health workers.SettingTwo federally funded Ugandan primary care health facilities, one peri-urban and one rural.ParticipantsWe enrolled 3 health administrators and 28 health workers (clinical officers and nurses).InterventionThe ALRITE smartphone application was developed to help frontline health workers adhere to ALRI guidelines and differentiate wheezing illnesses from pneumonia in children under 5 years of age. ALRITE contains a simple decision tree, a partially automated respiratory rate counter, educational videos and an adapted respiratory assessment score to determine bronchodilator responsiveness. We performed a demonstration of ALRITE for participants at the beginning of interviews and focus groups. No participant had used ALRITE prior.ResultsThemes impacting the potential implementation of ALRITE were organised using individual-level, clinic-level and health-system level determinants. Individual-level determinants were acceptability and perceived benefit, usability, provider needs and provider–patient relationship. Clinic-level determinants were limited resources and integration within the health centre. Systems-level determinants included medication shortages and stakeholder engagement.ConclusionsIncorporation of these themes will ready ALRITE for field testing. Early engagement of end users provides insights critical to the development of tailored mHealth decision support tools.

scholarly journals Health Workers’ Perceptions and Expectations of the Role of the Pharmacist in Emergency Units: A Qualitative Study in Kupang, Indonesia

Pharmacy ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 31
Author(s):  
Laila Safitrih ◽  
Dyah Perwitasari ◽  
Nelci Ndoen ◽  
Keri Dandan
Keyword(s):  
Qualitative Study ◽  
Human Error ◽  
Health Workers ◽  
Positive Impact ◽  
Structured Interview ◽  
Medication Administration ◽  
Pharmacy Services ◽  
Ensure Patient Safety ◽  
Emergency Units ◽  
Perceptions And Expectations

Background. An essential way to ensure patient safety in the hospital is by applying pharmacy services in emergency units. This strategy was implemented in Indonesia several years ago, with the aim of ensuring that adequate pharmacy services are given to patients in hospitals. To achieve this, pharmacists are required to cooperate with other health workers via inter-professional teamwork. This study intended to identify the perceptions and expectations of health workers with respect to pharmacy services in emergency units. Methods. This was a qualitative study, using a phenomenological approach with a semi-structured interview technique to obtain data. This study was performed at the Prof. Dr. W.Z. Johannes Hospital Kupang from June to September 2018. The results of the interviews were thematically analyzed using QSR NVivo software 11. Results. The themes identified in this study included: (1) The positive impact of pharmacists in service; (2) Badan Penyelenggara Jaminan Sosial (BPJS) influence; (3) Acceptance of health workers; (4) Medication administration information; and (5) Expectations of health workers. Various perceptions were conveyed by participants regarding the emergency unit services in the hospital’s pharmaceutical department. Data obtained proved that the existence of a pharmacist increased the efficiency of time for services and prevented human error. Conclusion. Pharmacists and policy-makers play a significant role in providing appropriate pharmaceutical services in emergency units. Pharmacists also need to improve their quality of practice in accordance with their competence. They must review the patient medical history and physician’s prescriptions, educate the patients and other health workers, so that the workload and service time will be reduced.

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