scholarly journals Integrating eye health training into the primary child healthcare programme in Tanzania: a pre-training and post-training study

2020 ◽  
Vol 4 (1) ◽  
pp. e000629
Author(s):  
Aeesha N J Malik ◽  
Mlika Mafwiri ◽  
Clare Gilbert ◽  
Min J Kim ◽  
Joanna Schellenberg

ObjectivesTo evaluate a primary child eye care training module for use in the WHO/UNICEF Integrated Management of Newborn and Childhood Illness (IMNCI) programme by primary healthcare workers.DesignPre-training and post-training study.SettingPrimary healthcare facilities in a semirural district, central Tanzania.Participants54 primary healthcare workers selected by the Ministry of Health were trained during routine IMNCI training. All these healthcare workers were assessed pre-intervention and post-intervention. A subgroup of 40 were also assessed 6 months after the completion of training.InterventionTraining in an IMNCI eye module, developed for child primary healthcare workers with the Tanzania Ministry of Health and eye care experts.Main outcome measuresKnowledge, skills and attitudes were assessed using multiple choice questions, case studies and a self-assessment of skills using a Likert scale before and immediately after training, and 6 months later. A total score was derived. At 6 months, attitudes were assessed in semistructured interviews.Results69% PHWs trained were nurses. The baseline (before training) score was 29.9 (95% CI 27.5 to 32.4) and increased by 11.2 points (95% CI 8.3 to 14) immediately after training, and by 12.4 points (95% CI 9.2 to 15.6) at 6 months post the training. Therefore, the post-training scores increased and there was no evident difference in scores from immediately after training to 6 months later. Self-assessed confidence in skills decreased from 9/18 (95% CI 9 to 10) to 6/18 (95% CI 6 to 7). At 6 months, the module was reported as easy to understand and use, with challenges including difficulties in examining children’s eyes and poor referral systems.ConclusionsThe module increased knowledge of child eye health in primary healthcare workers, which was maintained, and was acceptable. The module has since been included into the national IMNCI health policy in Tanzania.

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Noor Ur Rehman ◽  
Hina Sharif

Purpose:  To assess awareness regarding Primary Eye Care among (primary healthcare workers) PHCWs and also intended to identify its determinants. Study Design: Descriptive cross-sectional study. Place and Duration of Study:  All primary healthcare facilities of Tehsil Kallar Syedan, from October 2019 to December 2019. Methods:  The calculated sample size was 115. Data was collected from primary health care workers (PHCWs). Data was collected through a structured questionnaire with both open-ended and close-ended questions. Questions were made using simple language and were also translated in Urdu. Questionnaire was adapted from two articles and some questions were made after reading the components of National Programme for Prevention and Control of Blindness (Punjab, Pakistan).Chi-square test of independence was used for finding associations. Results:  Fifty-four percent PHCWs had poor awareness regarding primary eye care. Majority of the PHCWs, N = 64 (55.7%) identified just the names of common eye diseases. Cataract was identified with correct treatment by 88% primary healthcare workers. Age, education, designation were significantly associated with awareness of PHCWs. Conclusion:  The study concluded that more than half of PHCWs had low awareness regarding PEC. All of them mentioned that there was a need of improving and refreshing their knowledge related to primary eye care. This will definitely help to reduce pressure on secondary and tertiary healthcare workers. Key Words:  Primary eye care, Primary healthcare workers, Primary healthcare facilities, Pakistan.


2021 ◽  
Vol 6 (4) ◽  
pp. e004360
Author(s):  
Dumisani MacDonald Hompashe ◽  
Ulf-G Gerdtham ◽  
Carmen S Christian ◽  
Anja Smith ◽  
Ronelle Burger

Introduction Universal Health Coverage is not only about access to health services but also about access to high-quality care, since poor experiences may deter patients from accessing care. Evidence shows that quality of care drives health outcomes, yet little is known about non-clinical dimensions of care, and patients’ experience thereof relative to satisfaction with visits. This paper investigates the role of non-clinical dimensions of care in patient satisfaction. Methods Our study describes the interactions of informed and non-informed patients with primary healthcare workers at 39 public healthcare facilities in two metropolitan centres in two South African provinces. Our analysis included 1357 interactions using standardised patients (for informed patients) and patients’ exit interviews (for non-informed patients). The data were combined for three types of visits: contraception, hypertension and tuberculosis. We describe how satisfaction with care was related to patients’ experiences of non-clinical dimensions. Results We show that when real patients (RPs) reported being satisfied (vs dissatisfied) with a visit, it was associated with a 30% increase in the probability that a patient is greeted at the facilities. Likewise, when the RPs reported being satisfied (vs dissatisfied) with the visit, it was correlated with a 15% increase in the prospect that patients are pleased with healthcare workers’ explanations of health conditions. Conclusion Informed patients are better equipped to assess health-systems responsiveness in healthcare provision. Insights into responsiveness could guide broader efforts aimed at targeted education and empowerment of primary healthcare users to strengthen health systems and shape expectations for appropriate care and conduct.


2015 ◽  
Vol 20 (6) ◽  
pp. 766-772 ◽  
Author(s):  
Aminatu Ali AbdulRahman ◽  
Mansur Muhammad Rabiu ◽  
Mahmoud Babanini Alhassan

PLoS ONE ◽  
2013 ◽  
Vol 8 (10) ◽  
pp. e76272 ◽  
Author(s):  
Mareli M. Claassens ◽  
Cari van Schalkwyk ◽  
Elizabeth du Toit ◽  
Eline Roest ◽  
Carl J. Lombard ◽  
...  

2008 ◽  
Vol 8 (2) ◽  
pp. 151-162 ◽  
Author(s):  
João Joaquim Freitas do Amaral ◽  
Cesar Gomes Victora

OBJECTIVES: to analyze the effect of training in Integrated Management of Childhood Illness (IMCI) on the quality of case management by healthcare workers based on a systematic review of the literature. METHODS: the authors searched the databases MEDLINE, LILACS, PAHO and WHOLIS for the search terms Integrated Management of Childhood Illness (IMCI), and analyzed documents published by Pan American Health Organization, World Health Organization and the Brazilian Ministry of Health between January 1993 and July 2006. The quality of the methodology was assessed using the criteria developed by Downs and Black. RESULTS: thirty-five papers were reviewed. Twelve of these validated the IMCI algorithm and found the sensitivity to be high and the specificity to be over 80% for major illnesses. Twenty-three papers assessed the performance of healthcare workers, eight of these with no control group. The present study shows clear evidence of improvement in the performance of healthcare workers employed at healthcare facilities with IMCI. The main methodological weaknesses of the study were lack of control of confounding factors and lack of information regarding statistical power. CONCLUSIONS: the performance of healthcare workers tends to improve at public healthcare facilities when IMCI is introduced.


2019 ◽  
Vol 9 (1) ◽  
pp. 17-26
Author(s):  
Essa Tawfiq ◽  
Sayed Ali Shah Alawi ◽  
Kayhan Natiq

Background: Training courses in integrated management of childhood illness (IMCI) have been conducted for health workers for nearly one and half decades in Afghanistan. The objective of the training courses is to improve quality of care in terms of health workers communication skills and clinical performance when they provide health services for under-5 children in public healthcare facilities. This paper presents our findings on the effects of IMCI training courses on quality of care in public primary healthcare facilities in Afghanistan. Methods: We used a cross-sectional post-intervention design with regression-adjusted difference-in-differences (DiD) analysis, and included 2 groups of health workers (treatment and control). The treatment group were those who have received training in IMCI recently (in the last 12 months), and the control group were those who have never received training in IMCI. The assessment method was direct observation of health workers during patient-provider interaction. We used data, collected over a period of 3 years (2015–2017) from primary healthcare facilities, and investigated training effects on quality of care. The outcome variables were 4 indices of quality care related to history taking, information sharing, counseling/medical advice, and physical examination. Each index was formed as a composite score, composed of several inter-related tasks of quality of care carried out by health workers during patient-provider interaction for under-5 children. Results: Data were collected from 733 primary healthcare facilities with 5818 patients. Quality of care was assessed at the level of patient-provider interaction. Findings from the regression-adjusted DiD multivariate analysis showed significant effects of IMCI training on 2 indices of quality care in 2016, and on 4 indices of quality care in 2017. In 2016 two indices of quality care showed improvement. There was an increase of 8.1% in counseling/medical advice index, and 8.7% in physical examination index. In 2017, there was an increase of 5.7% in history taking index, 8.0% in information sharing index, 10.9% in counseling/medical advice index, and 17.2% in physical examination index. Conclusion: Conducting regular IMCI training courses for health workers can improve quality of care for under-5 children in primary healthcare facilities in Afghanistan. Findings from our study have the potential to influence policy and strategic decisions on IMCI programs in developing countries.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T Vivas ◽  
M Duarte ◽  
A Pitta ◽  
B Christovam

Abstract Background The government investments in quality primary healthcare are the basis to strengthening the health systems and monitoring the public expenditure in this area is a way to assess the effectiveness and efficiency of the public health policies. The Brazil Ministry of Health changed, in 2017, the method of onlending federal resources to states and cities seeking to make the public funds management more flexible. This change, however, suppressed mandatory investments in primary healthcare. This research aims to determine the difference of expenditures on primary healthcare in Salvador, Bahia, Brazil metropolitan area before and after this funding reform, seeking to verify how it can impact the quality of primary healthcare services and programs. Methods This is an ecological time-series study that used data obtained in the Brazil Ministry of Health budget reports. The median and interquartile range of expenditures on primary healthcare (set as the percentage of total public health budget applied in primary care services and programs) of the 13 cities in the Salvador metropolitan area were compared two years before and after the reform. Results The median of expenditures on primary healthcare in Salvador metropolitan area was 25.5% (13,9% - 32,2%) of total public health budget before and 24.8% (20.8% - 30.0%) of total public health budget after the reform (-0.7% difference). Seven cities decreased the expenditures on primary healthcare after the reform, ranging from 1.2% to 10.8% reduction in the primary healthcare budget in five years. Conclusions Expenditures on primary healthcare in Salvador metropolitan area decreased after the 2017 funding reform. Seven of 13 cities reduced the government investments on primary healthcare services and programs in this scenario. Although the overall difference was -0.7%, the budget cuts ranged from 1.2% to 10.8% in the analyzed period and sample. More studies should assess these events in wide areas and with long time ranges. Key messages Public health funding models can impact the primary healthcare settings regardless of the health policy. Reforms in the funding models should consider the possible benefits before implementation. Funding models and methods that require mandatory investments in primary healthcare may be considered over more flexible ones.


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