‘Let me move to another level’: career advancement desires and opportunities for community health nurses in Ghana

2021 ◽  
pp. 175797592110274
Author(s):  
Meghan Bellerose ◽  
Koku Awoonor-Williams ◽  
Soumya Alva ◽  
Sophia Magalona ◽  
Emma Sacks
Keyword(s):  
Health System ◽  
Community Health ◽  
Work Experience ◽  
Career Advancement ◽  
Program Planning ◽  
Sub Saharan Africa ◽  
System Capacity ◽  
Future Health ◽  
Community Health Nurses ◽  
Continued Education

Career advancement and continued education are critical components of health worker motivation and retention. Continuous advancement also builds health system capacity by ensuring that leaders are those with experience and strong performance records. To understand more about the satisfaction, desires, and career opportunities available to community health nurses (CHNs) in Ghana, we conducted 29 in-depth interviews and four focus group discussions across five predominantly rural districts. Interview transcripts and summary notes were coded in NVivo based on pre-defined and emergent codes using thematic content analysis. Frustration with existing opportunities for career advancement and continued education emerged as key themes. Overall, the CHNs desired greater opportunities for career development, as most aspired to return to school to pursue higher-level health positions. While workshops were available to improve CHNs knowledge and skills, they were infrequent and irregular. CHNs wanted greater recognition for their work experience in the form of respect from leaders within the Ghana Health System and credit towards future degree programs. CHNs are part of a rapidly expanding cadre of salaried community-based workers in sub-Saharan Africa, and information about their experiences and needs can be used to shape future health policy and program planning.

scholarly journals Description of a Multi-faceted COVID-19 Pandemic Physician Workforce Plan at a Multi-site Academic Health System

2021 ◽  
Author(s):  
Sachin R. Pendharkar ◽  
Evan Minty ◽  
Caley B. Shukalek ◽  
Brendan Kerr ◽  
Paul MacMullan ◽  
...  
Keyword(s):  
Health System ◽  
Acute Care ◽  
Care Physician ◽  
System Capacity ◽  
Medical Emergency ◽  
Physician Workforce ◽  
Future Health ◽  
Academic Health ◽  
Response Planning ◽  
Implementation Period

Abstract Background The evolving COVID-19 pandemic has and continues to present a threat to health system capacity. Rapidly expanding an existing acute care physician workforce is critical to pandemic response planning in large urban academic health systems. Intervention The Medical Emergency-Pandemic Operations Command (MEOC)—a multi-specialty team of physicians, operational leaders, and support staff within an academic Department of Medicine in Calgary, Canada—partnered with its provincial health system to rapidly develop a comprehensive, scalable pandemic physician workforce plan for non-ventilated inpatients with COVID-19 across multiple hospitals. The MEOC Pandemic Plan comprised seven components, each with unique structure and processes. Methods In this manuscript, we describe MEOC’s Pandemic Plan that was designed and implemented from March to May 2020 and re-escalated in October 2020. We report on the plan’s structure and process, early implementation outcomes, and unforeseen challenges. Data sources included MEOC documents, health system, public health, and physician engagement implementation data. Key Results From March 5 to October 26, 2020, 427 patients were admitted to COVID-19 units in Calgary hospitals. In the initial implementation period (March–May 2020), MEOC communications reached over 2500 physicians, leading to 1446 physicians volunteering to provide care on COVID-19 units. Of these, 234 physicians signed up for hospital shifts, and 227 physicians received in-person personal protective equipment simulation training. Ninety-three physicians were deployed on COVID-19 units at four large acute care hospitals. The resurgence of cases in September 2020 has prompted re-escalation including re-activation of COVID-19 units. Conclusions MEOC leveraged an academic health system partnership to rapidly design, implement, and refine a comprehensive, scalable COVID-19 acute care physician workforce plan whose components are readily applicable across jurisdictions or healthcare crises. This description may guide other institutions responding to COVID-19 and future health emergencies.

Factors Impacting Sustainability of Community Health Worker Programming in rural Uganda: A Qualitative Study

2020 ◽  
Author(s):  
Scholastic Ashaba ◽  
Manasseh Tumuhimbise ◽  
Esther Beebwa ◽  
Francis Oriokot ◽  
Jennifer L Brenner ◽  
...  
Keyword(s):  
Health Promotion ◽  
Health System ◽  
Community Health ◽  
Health Worker ◽  
Child Mortality ◽  
Community Health Worker ◽  
Sub Saharan Africa ◽  
Team Approach ◽  
Sub Saharan ◽  
And Training

Abstract Background Despite significant global progress towards decreased child mortality over the past decades, over 5 million children died before reaching their fifth birthday in 2018. Additionally, the number of women dying during pregnancy and childbirth was 295, 000 in 2017. Majority of these deaths occurred in sub Saharan Africa yet these deaths are preventable with known interventions. A huge global investment has been made in initiating community health work (CHW) programs which play a critical role in health promotion with increasing scale up in sub Saharan Africa. The government of Uganda continues to identify maternal, newborn and child health (MNCH) programming as a priority and national policies continue to encourage community-based approaches for health promotion through the Village Health Team approach to reduce maternal and child mortality. However, sustaining of CHWs programs remains a challenge and less is known about if and how these CHW networks can be maintained. Methods A sustainability-focused qualitative evaluation was conducted five years following a district-wide comprehensive MNCH intervention that involved selection and training of a large CHW network (n =2626) in 2 rural districts in southwest Uganda. Focus Group discussions (FGDs) and in-depth interviews (IDIs) were conducted to gain insights into the factors affecting CHW program sustainability. Interviews were digitally recorded then translated and transcribed directly into English. Data was managed using NVivo software (version 12, QSR International, Burlington Mass.). Thematic content analysis was done to identify themes relevant to sustainability. Results Enablers and barriers to CHW sustainability identified by study participants included health system effectiveness (availability of supplies, medicines and services and availability of facility health providers), community health worker program factors (CHW selection and training, CHW recognition and incentives, CHW supervision and CHW refresher trainings), community attitudes and beliefs, and stakeholder engagement (alignment with district priorities and programs and local government involvement). Conclusion Effectiveness of health systems and human resources were major factors in sustainability for this community health intervention. Sustainability could be strengthened through increased community member involvement during implementation and improved support for general health system effective functioning.

scholarly journals Descriptive Study of Community Health Education Jobs in the U.S.A., May – December 1998

2003 ◽  
Vol 1 (4) ◽  
pp. 47-78
Author(s):  
Larry Wu
Keyword(s):  
Health Education ◽  
Community Health ◽  
Work Experience ◽  
Word Processing ◽  
Program Planning ◽  
Target Population ◽  
Full Time ◽  
Health Educators ◽  
Community Health Education ◽  
Education Professionals

The purpose of this study was to explore the community health education jobs in the USA and to provide relevant workforce information to community health education professionals and students. Two hundred fifty community health education announcements out of 908 were randomly selected from the Heath Education Professional Resources (HEPR) Job Bank for the periods May to December of 1998. Job information such as job searching methods, working environments, job qualifications, job descriptions, salaries, and benefits of community health education professionals were characterized. RESULTS: October had the highest number of job announcements during eighth-month period. There were more job announcements from the Northeast and West. Many of the job announcements were obtained through CareerPath® and America’s Job Bank®. There were at least 137 different job titles. The majority of institutions hiring health educators were either non-profit or government. About two-thirds were public organizations. The majority of the positions (86%) required applicants to have either a baccalaureate or master’s degree. There were diverse job qualifications. College majors other than health education or community health were acceptable. Work experience in descending order were: program planning and evaluation, program management, working with diverse populations, community organization and coordination, and working with multicultural populations in descending order. One to five years of working experience was required for the job positions. Target population and target issues were diverse. Almost half of the health educators served general health issues in their community. Computer skills, particularly word processing and Internet skills, were required. The capacity for working independently and self-motivation were significant factors in the hiring for most of the employers. Communication skills were required in 80% of the job announcements. Other required skills included program assessment, planning, implementation, evaluation, and teaching. For full-time employees, the median salary was $36,000. Other employee compensation information is also reported.

scholarly journals Community Health Workers as Influential Health System Actors and not "Just Another Pair Of Hands"

2020 ◽  
Author(s):  
Sumit Kane ◽  
Anjali Radkar ◽  
Mukta Gadgil ◽  
Barbara McPake
Keyword(s):  
Health System ◽  
Community Health ◽  
Community Health Workers ◽  
Health Systems ◽  
Work Experience ◽  
Health Workers ◽  
Human Resources For Health ◽  
Research Question ◽  
Large Body ◽  
Optimal Strategies

Background: Over the last 20 years, community health workers (CHWs) have become a mainstay of human resources for health in many low- and middle-income countries (LMICs). A large body of research chronicles CHWs’ experience of their work. In this study we focus on 2 narratives that stand out in the literature. The first is the idea that social, economic and health system contexts intersect to undermine CHWs’ experience of their work, and that a key factor underpinning this experience is that LMIC health systems tend to view CHWs as just an ‘extra pair of hands’ to be called upon to provide ‘technical fixes.’ In this study we show the dynamic and evolving nature of CHW programmes and CHW identities and the need, therefore, for new understandings. Methods: A qualitative case study was carried out of the Indian CHW program (CHWs are called accredited social health activists: ASHAs). It aimed to answer the research question: How do ASHAs experience being CHWs, and what shapes their experience and performance? In depth interviews were conducted with 32 purposively selected ASHAs and key informants. Analysis was focused on interpreting and on developing analytical accounts of ASHAs’ experiences of being CHWs; it was iterative and occurred throughout the research. Interviews were transcribed verbatim and transcripts were analysed using a framework approach (with Nvivo 11). Results: CHWs resent being treated as just another pair of hands at the beck and call of formal health workers. The experience of being a CHW is evolving, and many are accumulating substantial social capital over time – emerging as influential social actors in the communities they serve. CHWs are covertly and overtly acting to subvert the structural forces that undermine their performance and work experience. Conclusion: CHWs have the potential to be influential actors in the communities they serve and in frontline health services. Health systems and health researchers need to be cognizant of and consciously engage with this emerging global social dynamic around CHWs. Such an approach can help guide the development of optimal strategies to support CHWs to fulfil their role in achieving health and social development goals.

scholarly journals Predicted COVID-19 fatality rates based on age, sex, comorbidities and health system capacity

2020 ◽  
Vol 5 (9) ◽  
pp. e003094 ◽  
Author(s):  
Selene Ghisolfi ◽  
Ingvild Almås ◽  
Justin C Sandefur ◽  
Tillman von Carnap ◽  
Jesse Heitner ◽  
...  
Keyword(s):  
Health System ◽  
High Income ◽  
Sub Saharan Africa ◽  
System Capacity ◽  
Asia Pacific ◽  
Fatality Rate ◽  
Middle Income ◽  
Middle Income Countries ◽  
Sub Saharan ◽  
Low And Middle Income

Early reports suggest the fatality rate from COVID-19 varies greatly across countries, but non-random testing and incomplete vital registration systems render it impossible to directly estimate the infection fatality rate (IFR) in many low- and middle-income countries. To fill this gap, we estimate the adjustments required to extrapolate estimates of the IFR from high-income to lower-income regions. Accounting for differences in the distribution of age, sex and relevant comorbidities yields substantial differences in the predicted IFR across 21 world regions, ranging from 0.11% in Western Sub-Saharan Africa to 1.07% for high-income Asia Pacific. However, these predictions must be treated as lower bounds in low- and middle-income countries as they are grounded in fatality rates from countries with advanced health systems. To adjust for health system capacity, we incorporate regional differences in the relative odds of infection fatality from childhood respiratory syncytial virus. This adjustment greatly diminishes but does not entirely erase the demography-based advantage predicted in the lowest income settings, with regional estimates of the predicted COVID-19 IFR ranging from 0.37% in Western Sub-Saharan Africa to 1.45% for Eastern Europe.

scholarly journals Predicted COVID-19 fatality rates based on age, sex, comorbidities, and health system capacity

2020 ◽  
Author(s):  
Selene Ghisolfi ◽  
Ingvild Ingvild Almas ◽  
Justin Sandefur ◽  
Tillman von Carnap ◽  
Jesse Heitner ◽  
...  
Keyword(s):  
Health System ◽  
Regional Differences ◽  
Sub Saharan Africa ◽  
System Capacity ◽  
Asia Pacific ◽  
Fatality Rate ◽  
Middle Income ◽  
Middle Income Countries ◽  
Regional Estimates ◽  
Sub Saharan

Early reports suggest the fatality rate from COVID-19 varies greatly across countries, but non-random testing and incomplete vital registration systems render it impossible to directly estimate the infection fatality rate (IFR) in many low- and middle-income countries. To fill this gap, we estimate the adjustments required to extrapolate estimates of the IFR from high- to lower-income regions. Accounting for differences in the distribution of age, sex, and relevant comorbidities yields substantial differences in the predicted IFR across 21 world regions, ranging from 0.11% in Western Sub-Saharan Africa to 0.95% for High Income Asia Pacific. However, these predictions must be treated as lower bounds, as they are grounded in fatality rates from countries with advanced health systems. In order to adjust for health system capacity, we incorporate regional differences in the relative odds of infection fatality from childhood influenza. This adjustment greatly diminishes, but does not entirely erase, the demography-based advantage predicted in the lowest income settings, with regional estimates of the predicted COVID-19 IFR ranging from 0.43% in Western Sub-Saharan Africa to 1.74% for Eastern Europe.

scholarly journals Female Community Health Workers and Health System Navigation in a Conflict Zone: The Case of Afghanistan

2021 ◽  
Vol 9 ◽  
Author(s):  
Ateeb Ahmad Parray ◽  
Sambit Dash ◽  
Md. Imtiaz Khalil Ullah ◽  
Zuhrat Mahfuza Inam ◽  
Sophia Kaufman
Keyword(s):  
Health System ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Program Planning ◽  
Health Sector ◽  
Social Infrastructure ◽  
Conflict Zone ◽  
The Social ◽  
Healthcare Program

Afghanistan ranked 171st among 188 countries in the Gender Inequality Index of 2011 and has only 16% of its women participating in the labor force. The country has been mired in violence for decades which has resulted in the destruction of the social infrastructure including the health sector. Recently, Afghanistan has deployed community health workers (CHW) who make up majority of the health workforce in the remote areas of this country. This paper aims to bring the plight of the CHWs to the forefront of discussion and shed light on the challenges they face as they attempt to bring basic healthcare to people living in a conflict zone. The paper discusses the motivations of Afghani women to become CHWs, their status in the community and within the health system, the threatening situations under which they operate, and the challenges they face as working women in a deeply patriarchal society within a conflict zone. The paper argues that female CHWs should be provided proper accreditation for their work, should be allowed and encouraged to progress in their careers, and should be instilled at the heart of healthcare program planning because they have the field experience to make the most effective and community oriented programmatic decisions.

Educating tomorrow's community health nurses for today's Canadian standards

2005 ◽  
Author(s):  
Ruta Valaitis ◽  
Patricia Gibson ◽  
Donna Meagher-Stewart ◽  
Christina Rajsic ◽  
Patrica Seaman ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Nurses
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