Scarcity of Nurses in India

2016 ◽  
Vol 18 (4) ◽  
pp. 509-522 ◽  
Author(s):  
Reema Gill

The human resources for health (HRH), especially nurses, constitute an important part of health systems. It is difficult to ascertain comprehensive information on the availability of health workers globally due to irregular reporting of data from the countries. However, experts have proposed minimum thresholds for achieving certain health-related Millennium Development Goals (MDGs). These thresholds have been used as yardsticks by others for determining HRH shortages in their nations. As per the minimum threshold developed by the World Health Organization (WHO), not enough health workers are available in India, especially in the rural areas. The nurse to population ratio in India is even lower than some of the other developing countries in Asia. Various factors, such as low professional and socio-economic status, gender issues, lack of political will on part of the government and unregulated private sector, have led to scarcity of nurses in numbers as well as qualitatively in India. To overcome the dismal working and social conditions, many Indian nurses are migrating to developed nations, further exacerbating the nursing shortages in the country. Inclusive planning, adequate financing and political commitment on the part of all stakeholders are required for overcoming the shortage of health personnel existing in India.

Author(s):  
Uwera S ◽  
◽  
Nikwigize S ◽  
Bagwaneza T ◽  
Rutayisire E ◽  
...  

COVID-19 is an infectious disease and can be transmitted from humans to humans through infected air droplets during coughing and sneezing or though contact with contaminated hands or surfaces. By March 01st 2021, World Health Organization (WHO) reported 113,820,168 confirmed cases globally, among them 2,851,062 are from the continent of Africa. Rwanda reported 18,850 confirmed cases, and 261 deaths. Healthcare systems have been burdened by the huge number of COVID-19 cases. Home-Based Care (HBC) was introduced as an alternative option to control the pandemic specifically in poor resource countries. Since December 2020, the number of COVID-19 case and death continued to rise in Rwanda. To handle this issue, the government of Rwanda started promoting the home-based care for asymptomatic people or patients with mild symptoms and they would be followed up by trained Community Health Workers (CHW). The increased number of positive cases is attributed to inadequate compliance to COVID-19 Infectious Prevention and Control (IPC) measures, low socio-economic status, inability to self-isolate due to having small and shared living rooms, food insecurity, lack of familiarity to disinfection procedures for home sanitation, inadequate access to water, weak policy regulating HBC, insufficient PPEs for CHWs, CHW fear of getting infected through HBC, low level of community awareness and perception, comorbidities, poor communication during follow up of HBC patients. Overall, we concluded that HBC has been very crucial in management of COVID-19 as it relieved the burden on health facilities, but more improvement on HBC is needed to be properly applicable in poor resource settings.


2018 ◽  
Vol 20 (2) ◽  
pp. 151-163 ◽  
Author(s):  
Sanjay Zodpey ◽  
Anjali Sharma ◽  
Quazi Syed Zahiruddin ◽  
Abhay Gaidhane ◽  
Sunanda Shrikhande

India is a country of 1.32 billion. The World Health Organization recommends, one doctor to serve 1,000 people, across all levels of care. This implies, we need a total of 1.2 million doctors to serve our population. India plans to establish 200 new medical colleges in the next 10 years to meet a projected shortage of 600,000 doctors. However, the information available on allopathic doctors have largely been fragmented and unreliable. A comprehensive search was undertaken to find out the estimates, norms and projections for allopathic doctors provided by the various health committees and experts in India. The Bhore, Sokhey & Mudaliar Committees, Five-year Planning Commission Reports, MCI Vision 2015 document and High-Level Expert Group (HLEG) report on Universal Health Coverage in have yielded estimates, norms and projections for allopathic doctors. The targeted doctor population ratio of 1:1000 could be achieved by 2027 as per HLEG and by 2031 as per MCI Vision 2015. This study emphasizes the estimates and norms of doctors as reported by the Government and allied agencies need strengthening for comprehensiveness and reliability to report information on the allopathic doctors. An important recommendation for the state professional councils is to maintain a live register of health workers.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Erica Sedlander ◽  
Rajiv Rimal ◽  
Michael Long ◽  
Ashita Munjral ◽  
Hagere Yilma ◽  
...  

Abstract Objectives Over half of women of reproductive age in India are anemic so the World Health Organization recommends daily iron folic acid (IFA) for all women of reproductive age. The government has distributed free IFA for over four decades but initial uptake and adherence remain inadequate. Objectives 1) to understand the multilevel factors that hinder IFA use and adherence; and 2) to inform a behavioral intervention to increase IFA use to reduce anemia. Methods We conducted this study in four rural villages in the state of Odisha, India. We held 25 key informant interviews with front-line health workers, 16 focus groups with women of reproductive age, husbands, and mothers-in-law (n = 148) and 18 direct observations in health centers, pharmacies and women's groups. We purposively sampled key informants and randomly sampled focus group participants from an enumeration of all eligible residents of each village, and stratified them by sex, age and relation to a woman of reproductive age. We analyzed the data using applied thematic analysis and Nvivo software. Results At the individual level, we found that most people knew that IFA prevents anemia, but they did not recognize its widespread prevalence, believing instead that it was rare in their community. They also believed that taking too many IFA supplements during pregnancy would “make your baby big” causing a painful birth and possibly the need for a cesarean section. At the interpersonal level, mothers-in-law were not supportive of their daughters-in-law taking IFA too often because they themselves did not take them when they were younger. Husbands were more supportive. At the policy level, frontline health workers distribute IFA but are not incentivized to follow up on adherence. Finally, state and national policies are not consistent around which sub-populations should take IFA (e.g., whether all non-pregnant women of reproductive age should take them). Conclusions To address these multilevel barriers to IFA use and adherence, interventions should take a normative approach that includes a woman's social network and targets both descriptive norms (ideas about how many women in the community have anemia and are taking IFA) and injunctive norms around who should be taking IFA (e.g., all women of reproductive age). Funding Sources The Bill and Melinda Gates Foundation. Supporting Tables, Images and/or Graphs


GeoScape ◽  
2020 ◽  
Vol 14 (1) ◽  
pp. 11-23
Author(s):  
Ripan Debnath ◽  
Praghya Parmita Debnath

AbstractPeople in urban and peri-urban areas enjoy better physical access to health facilities compared to those living in rural area. However, healthier natural environment is commonly absent in urban and its adjoining peri-urban areas. Premising on the competitiveness of health determinants outlined by the World Health Organization (WHO), this study has embarked upon comparing healthiness of different communities in a region as well as to ascertain the factor(s) regulating their healthiness related outcome. Relying on presurveyed 1397 household data spreading over an urban, two peri-urban, and eight rural localities in Mymensingh region, Bangladesh, the study has evaluated the communities’ healthiness in views of both the conventional perspective and using a set of health determinants. Illness and disease manifestation as well as socio-economic status of the households were analyzed statistically to get communities’ overall healthiness scenario. Later, comparison among the communities and contribution of different indicators were sought using a combined score index. In this study’s context, it has been found that urban is healthier than rural followed by peri-urban community. Here, rural areas lack education the most that should be improved; peri-urban areas need better income opportunity; and urban area requires better water-supply and waste management facilities to improve their respective health status in a community sense. There is not a commonly accepted health metrics for community’s comprehensive health assessment toward which this study sets a pathway. Besides, using the combined health index developed here, specific interventions required to improve community’s healthiness and minimize the gap among them can easily be identified.


Author(s):  
Yuni Kurniati Yuni Kurniati

ABSTRACT [World Health Organization ( WHO ) , diarrhea is the number one cause of infant mortality worldwid. In Indonesia , toddler diarrhea is the number two killer after ARI ( Acute Respiratory Infection ) . Research purposes to determine the factors associated with the incidence of diarrhea in infants in the Free Health Center Palembang in 2012 . Sampling is done by sampling rondom method , data analysis, univariate and  =abivariate statistical chi - square test with a significance level of  0.05 . The results from 378 respondents who have children who suffer from diarrhea 213 ( 56.3 % ) . Age of toddlers at high risk of diarrhea, 121 ( 63.4 % ) . Higher education totaled 121 ( 47.3 % ) . High economic status who had diarrhea 56 ( 46.3 % ) . test results obtained chi - square with toddler age p value = 0.008 p value = maternal education and economic status of families 0,000 p value  = 0.05 .a  = 0.009 smaller  So that the hypothesis stating no statistically significant association between toddler age , education and economic status with the incidence of diarrhea in infants statistically proven. Expected for health workers to improve education about prevention of diarrhea in an effort to reduce the incidence of diarrhea in Indonesia.                                      ABSTRAK World Healt Organization (WHO), diare adalah penyebab nomor satu kematian balita di seluruh dunia. Di Indonesia, diare adalah pembunuh balita nomor dua setelah ISPA (Infeksi Saluran Pernapasan Akut). Tujuan penelitian untuk mengetahui faktor-faktor yang berhubungan dengan kejadian diare pada balita di Puskesmas Merdeka Palembang tahun 2012. Pengambilan sampel ini dilakukan dengan metode rondom sampling, analisa data dilakukan secara univariat dan bivariat dengan uji statistik chi-square  dengan tingkat kemaknaan a = 0,05. Hasil penelitian dari 378 responden yg memiliki balita yg terkena diare 213 (56,3%),. Umur balita yang beresiko tinggi  terkena diare 121 (63,4%). Pendidikan tinggi berjumlah 121 (47,3%). Status ekonomi tinggi yang terkena diare 56 (46,3%). Hasil uji ­chi-square dengan didapatkan umur balita p value = 0,008 pendidikan ibu p value = 0,000 dan status ekonomi keluarga p value = 0,009 lebih kecil   a = 0,05. Sehingga hipotesis menyatakan ada hubungan bermakna antara umur balita, pendidikan dan status ekonomi dengan kejadian diare pada balita terbukti secara statistik. Diharapkan bagi tenaga kesehatan untuk meningkatkan penyuluhan tentang pencegahan diare dalam upaya menurunkan angka kejadian diare di Indonesia.    


2021 ◽  
Vol 1 (2) ◽  
pp. 134-145
Author(s):  
Nur Afni

COVID-19 discovered a global pandemic that gave rise to the emergence of various groups, especially the public. Inaugurated by the World Health Organization as a global pandemic, the management of COVID-19 is a challenge for countries with limited energy sources and health care systems. Citizens' understanding continues to grow along with the number of positive problems and deaths due to COVID-19 which continues to grow in a relatively short time. The ability of each country to adapt to the existing conditions during efficient and anticipatory implementation varies greatly. The policy finds an early ground that must be tested in order to be able to tackle these cases successfully. Anticipatory policy decisions related to efforts to prevent the spread of COVID-19, take action against infected patients, protect health workers, and control public awareness are carefully considered. For this reason, the Government is trying to schedule a New Normal policy so that the economic impact of the pandemic does not create a sustainable crisis. This policy is linked to planning where the Government has established programs, as well as major projects in the 2020-2024 National Medium-Term Development Plan (RPJMN). The government needs to review the medium-term plan considering that in 2020 all programs that are trying to focus on taking action against Covid-19. The government has 3 alternatives in the medium term, whether it is always quality, making moderate improvements, or changing it with a new plan with assumptions made from the Covid-19 pandemic and the consequences that accompany it.


2019 ◽  
Vol 22 (3) ◽  
Author(s):  
Asep Hermawan

Equal distributions of physicians, nurses and midwives are the successful key to achieve the 12 public health indicators set by the World Health Organization. This study is to measure physicians, nurses and midwives inequality in Indonesia, 2013. Data for health workforce are obtained from routine data by the Board for Development and Empowerment of Human Resources for Health, 2013, and population data from Appendix 1 Books Code and Region Administration Data by Province, districs/cities and all Indonesian Sub-district, Ministry of Internal Affairs. Ratio per Population, Gini Index and Lorenz’s curve were used to analyze the inequality distribution of health workers. The fi ndings showed the ratio of midwives and nurses/100,000 population had met The National Medium Term Development Plan 2010-2014 target. However, the doctors were still far from the target. Analysis by Gini Index indicated the distribution of midwives is better than other health workers. The Nusa Tenggara Region has the highest inequality compared to other regions for doctors, nurses and midwives. By administrative, municipital are more equitable to all types of health workers. Regarding the status of underdeveloped areas, remote borders and islands (DTPK), The Non-DTPK areas are more evenly distributed compared to the DTPK. Ratio per population some health workers are suffi cient though are not distributed well. The distribution of health personnel should not merely use the ratio per population. The other distribution index such as the Gini Index and other distribution measures will provide better policy options.   Abstrak Distribusi dokter, perawat dan bidan yang merata merupakan salah satu kunci sukses untuk mencapai 12 indikator kesehatan masyarakat yang ditetapkan World Health Organization. Tujuan penelitian ini adalah menggambarkan pemerataan tenaga dokter, perawat dan bidan di Indonesia pada 2013. Sumber data tenaga kesehatan (dokter perawat dan bidan) diperoleh dari data rutin Badan Pengembangan dan Pendayagunaan Sumber Daya Manusia Kesehatan (BPPSDMK) 2013. Data jumlah penduduk diperoleh dari Lampiran 1 Buku Induk Kode dan Data Wilayah Administrasi Pemerintahan per Provinsi, Kabupaten/Kota dan Kecamatan Seluruh Indonesia milik Kementerian Dalam Negeri. Untuk menilai inequality distribusi tenaga kesehatan menggunakan rasio/populasi, Gini Index dan Kurva Lorenz. Hasil penelitian menunjukkan bahwa rasio bidan dan perawat/100.000 penduduk sudah memenuhi target RPJMN 2010-2014, sedangkan dokter masih jauh dari target. Analisis dengan Gini Index menunjukkan bahwa distribusi bidan lebih dibandingkan tenaga kesehatan lainnya. Regional Nusa Tenggara memiliki inequality tenaga yang tertinggi dibandingkan regional lainnya baik untuk dokter, perawat, dan bidan. Secara administratif, kota cenderung lebih merata untuk semua jenis tenaga kesehatan. Berdasarkan status daerah tertinggal, perbatasan dan kepulauan (DTPK), daerah non DTPK cenderung lebih merata dibandingkan DTPK. Walaupun secara rasio per populasi sebagian tenaga kesehatan sudah mencukupi namun tidak terdistribusi dengan baik. Penilaian distribusi tenaga kesehatan seharusnya tidak hanya menggunakan rasio tenaga per populasi saja, penggunaan ukuran indeks distribusi lain seperti Gini Index dan ukuran distribusi lain akan dapat memberi opsi kebijakan lebih baik. 


2018 ◽  
Vol 3 (3) ◽  
pp. 97 ◽  
Author(s):  
Ahmed Fahal ◽  
Suliman Suliman ◽  
Roderick Hay

Mycetoma is a chronic infection, newly designated by the World Health Organization (WHO) as a neglected tropical disease, which is endemic in tropical and subtropical regions. It follows implantation of infectious organisms, either fungi (eumycetomas) or filamentous bacteria (actinomycetomas) into subcutaneous tissue, from where infection spreads to involve skin, bone and subcutaneous sites, leading to both health related and socioeconomic problems. In common with other NTDs, mycetoma is most often seen in rural areas amongst the poorest of people who have less access to health care. The organisms form small microcolonies that are discharged onto the skin surface via sinus tracts, or that can burrow into other adjacent tissues including bone. This paper describes the clinical features of mycetoma, as early recognition is a key to early diagnosis and the institution of appropriate treatment including surgery. Because these lesions are mostly painless and the majority of infected individuals present late and with advanced disease, simplifying early recognition is an important public health goal.


2021 ◽  
Author(s):  
Adetoro A. Adegoke ◽  
Godwin Y. Afenyadu ◽  
Fatima L. Adamu ◽  
Sally Findley

Inadequate number of health workers in rural areas is a major concern in many countries. It causes underutilization, prevents equitable access of health services, and is a barrier to universal health coverage. To increase the number and improve retention of health workers in rural areas, the World Health Organization (WHO) issued global recommendations to improve the rural retention of the health workforce. This paper presents the experiences of adopting and implementing the WHO recommendations in four states in Northern Nigeria. It highlights the results, challenges and lessons learnt with the implementation. We used an implementation research approach and evaluated the implementation at three stages: the pilot; full implementation; and immediate post exit. A total of 477 midwives were recruited and deployed to rural health facilities over a period of four years. Of these, 196 (41%) were in Jigawa, 126 (26.4%) in Yobe, 78 (16.4%) in Zamfara and 77 (16.1%) in Katsina. Midwives’ retention rates increased gradually over the four years. In three (Jigawa, Katsina and Zamfara) of the four states, midwives’ retention rates increased from 69.2% in Jigawa in 2013 to 98% in 2016; from 53.3% in Katsina in 2013 to 100% retention in 2016. Zamfara made the most progress with a poor retention rate of 42.8% in 2013 to 100% retention rate in 2016. In Yobe state, the retention rate of 47% in 2013 gradually increased to 100% in 2015. This however slightly dropped to 90% in 2016 as a result of the deteriorating security situation in 2015. Other effects of the initiative included: heightened determination of states to increase the production of indigenous midwives; reversal of policy directives that banned the recruitment of health workers including midwives; and to provide incentives such as safe and comfortable accommodation.


Author(s):  
Tirta Anggraini Tirta Anggraini

ABSTRACT According to the World Health Organization (WHO), maternal nutritional status at the time of growth and during pregnancy can affect fetal growth and development. Based on (IDHS) survey of 2007 AKI Indonesia at 228 per 100,000 live births, although this figure is still the highest in Asia. Social health center in Palembang in 2011 the number of pregnant women with good nutritional status of 67 men (97.1%). factors that influence the nutritional status of pregnant women is the temperature of the environment, economic status, habits and views of women to food, age, education, and health status. The purpose of this study is a known relationship education and economic status with nutritional status of pregnant women in the third trimester of Social Health Center Palembang in 2012. This study uses analytic survey with cross sectional approach. The population in this study were all third trimester pregnant women who visit the health center Social Palembang in May 2012, with a sample of 30 respondents. Sampling in this study with non-random methods with techniques Accidental Sampling. Data analysis carried out univariate and bivariate statistics with Chi-Square test with significance level α = 0.05. The results showed than 30 respondents there (73.3%) of respondents that good nutritional status, higher education (76.7%), and high economic status (70.0%). The results of this study showed no significant association education and economic status with nutritional status of pregnant women in the third trimester of Social Health Center Palembang in 2012. From the results of this study, researchers hope to improve the health care workers, especially health services in Antenatal Care services pay more attention to maternal risk of poor nutritional status.   ABSTRAK Menurut World Health Organization (WHO), status gizi ibu hamil pada waktu pertumbuhan dan selama hamil dapat mempengaruhi pertumbuhan dan perkembangan janin. Berdasarkan (SDKI) survei terakhir tahun 2007 AKI Indonesia sebesar 228 per 100.000 Kelahiran Hidup, meskipun demikian angka tersebut masih tertinggi di Asia.  Di Puskesmas Sosial Palembang tahun 2011 jumlah ibu hamil yang berstatus gizi baik sebesar 67 orang (97,1%). faktor-faktor yang mempengaruhi status gizi ibu hamil adalah suhu lingkungan, status ekonomi, kebiasaan dan pandangan wanita terhadap makanan, usia, pendidikan, dan status kesehatan. Tujuan penelitian ini adalah diketahuinya hubungan pendidikan dan status ekonomi dengan status gizi ibu hamil trimester III di Puskesmas Sosial Palembang tahun 2012. Penelitian ini menggunakan metode survey analitik dengan pendekatan cross sectional. Populasi pada penelitian ini adalah semua ibu hamil trimester III yang berkunjung di Puskesmas Sosial Palembang pada bulan Mei tahun 2012, dengan jumlah sampel 30 responden. Pengambilan sampel pada penelitian ini dengan metode non random dengan teknik Accidental Sampling. Analisa data dilakukan secara univariat dan bivariat dengan uji statistik Chi-Square dengan tingkat kemaknaan α = 0,05. Hasil penelitian menunjukkan dari 30 responden terdapat (73,3%) responden yang berstatus gizi baik, pendidikan tinggi (76,7%), dan status ekonomi tinggi (70,0%). Hasil penelitian ini menunjukkan ada hubungan yang bermakna pendidikan dan status ekonomi dengan status gizi ibu hamil trimester III di Puskesmas Sosial Palembang tahun 2012. Dari hasil penelitian ini, peneliti berharap petugas pelayanan kesehatan dapat meningkatkan pelayanan kesehatan terutama dalam pelayanan Antenatal Care lebih memperhatikan kehamilan ibu yang berisiko status gizi buruk.


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