“Contract to Volunteer”: South African Community Health Worker Mobilization for Better Labor Protection

2017 ◽  
Vol 27 (4) ◽  
pp. 648-666 ◽  
Author(s):  
Zara Trafford ◽  
Alison Swartz ◽  
Christopher J. Colvin
Keyword(s):  
Community Health ◽  
South African ◽  
Health Workers ◽  
Labor Rights ◽  
Future Research ◽  
Local Health ◽  
Decent Work ◽  
National Union ◽  
African Community ◽  
Run Up

In this paper, we explore the increasing activity around labor rights for South African community health workers (CHWs). Contextualizing this activity within broader policy and legal developments, we track the emergence of sporadic mobilizations for decent work (supported by local health activist organizations) and subsequently, the formation of a CHW union. The National Union of Care Workers of South Africa (NUCWOSA) was inaugurated in 2016, hoping to secure formal and secure employment through government and the consequent labor and occupational health protections. Various tensions were observed during fieldwork in the run up to NUCWOSA's formation and raise important questions about representation, legitimacy, and hierarchies of power. We close by offering suggestions for future research in this developing space.

scholarly journals Automated Respiratory Rate Counter to Assess Children for Symptoms of Pneumonia: Protocol for Cross-Sectional Usability and Acceptability Studies in Ethiopia and Nepal (Preprint)

2019 ◽  
Author(s):  
Kevin Baker ◽  
Alice Maurel ◽  
Charlotte Ward ◽  
Dawit Getachew ◽  
Tedila Habte ◽  
...  
Keyword(s):  
Respiratory Rate ◽  
Community Health ◽  
Respiratory Infection ◽  
Acute Respiratory Infection ◽  
Health Workers ◽  
World Health ◽  
Future Research ◽  
Cross Sectional ◽  
Diagnostic Aid ◽  
Semistructured Interviews

BACKGROUND Manually counting a child’s respiratory rate (RR) for 60 seconds using an acute respiratory infection timer is the World Health Organization (WHO) recommended method for detecting fast breathing as a sign of pneumonia. However, counting the RR is challenging and misclassification of an observed rate is common, often leading to inappropriate treatment. To address this gap, the acute respiratory infection diagnostic aid (ARIDA) project was initiated in response to a call for better pneumonia diagnostic aids and aimed to identify and assess automated RR counters for classifying fast breathing pneumonia when used by front-line health workers in resource-limited community settings and health facilities. The Children’s Automated Respiration Monitor (ChARM), an automated RR diagnostic aid using accelerometer technology developed by Koninklijke Philips NV, and the Rad-G, a multimodal RR diagnostic and pulse oximeter developed by Masimo, were the two devices tested in these studies conducted in the Southern Nations, Nationalities, and Peoples’ Region in Ethiopia and in the Karnali region in Nepal. OBJECTIVE In these studies, we aimed to understand the usability of two new automated RR diagnostic aids for community health workers (CHWs; health extension workers [Ethiopia] and female community health volunteers [Nepal]) and their acceptability to CHWs in Ethiopia and Nepal, first-level health facility workers (FLHFWs) in Ethiopia only, and caregivers in both Ethiopia and Nepal. METHODS This was a prospective, cross-sectional study with a mixed methods design. CHWs and FLHFWs were trained to use both devices and provided with refresher training on all WHO requirements to assess fast breathing. Immediately after training, CHWs were observed using ARIDA on two children. Routine pneumonia case management consultations for children aged 5 years and younger and the device used for these consultations between the first and second consultations were recorded by CHWs in their patient log books. CHWs were observed a second time after 2 months. Semistructured interviews were also conducted with CHWs, FLHFWs, and caregivers. The proportion of consultations with children aged 5 years and younger where CHWs using an ARIDA and adhered to all WHO requirements to assess fast breathing and device manufacturer instructions for use after 2 months will be calculated. Qualitative data from semistructured interviews will be analyzed using a thematic framework approach. RESULTS The ARIDA project was funded in November 2015, and data collection was conducted between April and December 2018. Data analysis is currently under way and the first results are expected to be submitted for publication in 2020. CONCLUSIONS This is the first time the usability and acceptability of automated RR counters in low-resource settings have been evaluated. Outcomes will be relevant for policy makers and are important for future research of this new class of diagnostic aids for the management of children with suspected pneumonia. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/14405

scholarly journals Automated Respiratory Rate Counter to Assess Children for Symptoms of Pneumonia: Protocol for Cross-Sectional Usability and Acceptability Studies in Ethiopia and Nepal

10.2196/14405 ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. e14405 ◽  
Author(s):  
Kevin Baker ◽  
Alice Maurel ◽  
Charlotte Ward ◽  
Dawit Getachew ◽  
Tedila Habte ◽  
...  
Keyword(s):  
Respiratory Rate ◽  
Community Health ◽  
Respiratory Infection ◽  
Acute Respiratory Infection ◽  
Health Workers ◽  
World Health ◽  
Future Research ◽  
Cross Sectional ◽  
Diagnostic Aid ◽  
Semistructured Interviews

Background Manually counting a child’s respiratory rate (RR) for 60 seconds using an acute respiratory infection timer is the World Health Organization (WHO) recommended method for detecting fast breathing as a sign of pneumonia. However, counting the RR is challenging and misclassification of an observed rate is common, often leading to inappropriate treatment. To address this gap, the acute respiratory infection diagnostic aid (ARIDA) project was initiated in response to a call for better pneumonia diagnostic aids and aimed to identify and assess automated RR counters for classifying fast breathing pneumonia when used by front-line health workers in resource-limited community settings and health facilities. The Children’s Automated Respiration Monitor (ChARM), an automated RR diagnostic aid using accelerometer technology developed by Koninklijke Philips NV, and the Rad-G, a multimodal RR diagnostic and pulse oximeter developed by Masimo, were the two devices tested in these studies conducted in the Southern Nations, Nationalities, and Peoples’ Region in Ethiopia and in the Karnali region in Nepal. Objective In these studies, we aimed to understand the usability of two new automated RR diagnostic aids for community health workers (CHWs; health extension workers [Ethiopia] and female community health volunteers [Nepal]) and their acceptability to CHWs in Ethiopia and Nepal, first-level health facility workers (FLHFWs) in Ethiopia only, and caregivers in both Ethiopia and Nepal. Methods This was a prospective, cross-sectional study with a mixed methods design. CHWs and FLHFWs were trained to use both devices and provided with refresher training on all WHO requirements to assess fast breathing. Immediately after training, CHWs were observed using ARIDA on two children. Routine pneumonia case management consultations for children aged 5 years and younger and the device used for these consultations between the first and second consultations were recorded by CHWs in their patient log books. CHWs were observed a second time after 2 months. Semistructured interviews were also conducted with CHWs, FLHFWs, and caregivers. The proportion of consultations with children aged 5 years and younger where CHWs using an ARIDA and adhered to all WHO requirements to assess fast breathing and device manufacturer instructions for use after 2 months will be calculated. Qualitative data from semistructured interviews will be analyzed using a thematic framework approach. Results The ARIDA project was funded in November 2015, and data collection was conducted between April and December 2018. Data analysis is currently under way and the first results are expected to be submitted for publication in 2020. Conclusions This is the first time the usability and acceptability of automated RR counters in low-resource settings have been evaluated. Outcomes will be relevant for policy makers and are important for future research of this new class of diagnostic aids for the management of children with suspected pneumonia. International Registered Report Identifier (IRRID) DERR1-10.2196/14405

scholarly journals HUBUNGAN MOTIVASI KADER POSYANDU DENGAN UPAYA PENINGKATAN KUNJUNGAN BALITA DI WILAYAH KERJA PUSKESMAS PAMATANG SILIMAHUTA

2019 ◽  
Vol 2 (1) ◽  
pp. 1-6
Author(s):  
Maria M U Girsang ◽  
Siti Marlina
Keyword(s):  
Community Health ◽  
Health Center ◽  
Health Workers ◽  
Community Health Center ◽  
P Value ◽  
Local Health ◽  
Children Under Five ◽  
Under Five ◽  
Work Area ◽  
Integrated Service

Motivation is defined as strength, encouragement, needs, enthusiasm, pressure, or psychological mechanisms that encourage someone or a group of people to achieve certain achievements in accordance with what people want. Integrated service post is one form of health services organized by the community for the community with technical support from local health workers. The purpose of this study was to determine the relationship between the motivation of integrated service postcadres and efforts to increase children under five year visits in the area in the Pamatang Silimahuta Community Health Center work area. The sample was 73 respondents using random sampling techniques. The design of this study used analytic survey research, using the Cross Sectional approach and data collected from respondents using questionnaire sheets. The results showed a relationship between integrated service post cadre motivation and efforts to increase children under five year visits in the Pamatang Silimahuta Community Health Center work area with p value = 0.007 smaller than 0.05. It was suggested to the relevant parties to give awards to cadres so that it could motivate integrated service postcadres to be more active so that it can increase children under five year visit to the integrated service post.

scholarly journals Community health workers at the dawn of a new era: 3. Programme governance

2021 ◽  
Vol 19 (S3) ◽  
Author(s):  
Simon Lewin ◽  
Uta Lehmann ◽  
Henry B. Perry
Keyword(s):  
Health System ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Critical Role ◽  
Decision Makers ◽  
Local Health ◽  
New Era ◽  
Wide Range ◽  
Health Related

Abstract Background Community health workers (CHWs) can play a critical role in primary healthcare and are seen widely as important to achieving the health-related Sustainable Development Goals (SDGs). The COVID-19 pandemic has emphasized the key role of CHWs. Improving how CHW programmes are governed is increasingly recognized as important for achieving universal access to healthcare and other health-related goals. This paper, the third in a series on “Community Health Workers at the Dawn of a New Era”, aims to raise critical questions that decision-makers need to consider for governing CHW programmes, illustrate the options for governance using examples of national CHW programmes, and set out a research agenda for understanding how CHW programmes are governed and how this can be improved. Methods We draw from a review of the literature as well as from the knowledge and experience of those involved in the planning and management of CHW programmes. Results Governing comprises the processes and structures through which individuals, groups, programmes, and organizations exercise rights, resolve differences, and express interests. Because CHW programmes are located between the formal health system and communities, and because they involve a wide range of stakeholders, their governance is complex. In addition, these programmes frequently fall outside of the governance structures of the formal health system or are poorly integrated with it, making governing these programmes more challenging. We discuss the following important questions that decision-makers need to consider in relation to governing CHW programmes: (1) How and where within political structures are policies made for CHW programmes? (2) Who implements decisions regarding CHW programmes and at what levels of government? (3) What laws and regulations are needed to support the programme? (4) How should the programme be adapted across different settings or groups within the country or region? Conclusion The most appropriate and acceptable models for governing CHW programmes depend on communities, on local health systems, and on the political system in which the programme is located. Stakeholders in each setting need to consider what systems are currently in place and how they might be adapted to local needs and systems.

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