scholarly journals Exploring the lived experiences of pregnant women and community health care providers during the pandemic of COVID-19 in Bangladesh through a phenomenological analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sadika Akhter ◽  
Feroza Akhter Kumkum ◽  
Farzana Bashar ◽  
Aminur Rahman

Abstract Background Like many countries, the government of Bangladesh also imposed stay-at-home orders to restrict the spread of severe acute respiratory syndrome coronavirus-2 (COVID-19) in March, 2020. Epidemiological studies were undertaken to estimate the early possible unforeseen effects on maternal mortality due to the disruption of services during the lockdown. Little is known about the constraints faced by the pregnant women and community health workers in accessing and providing basic obstetric services during the pandemic in the country. This study was conducted to explore the lived experience of pregnant women and community health care providers from two southern districts of Bangladesh during the pandemic of COVID-19. Methods The study participants were recruited through purposive sampling and non-structured in-depth interviews were conducted. Data was collected over the telephone from April to June, 2020. The data collected was analyzed through a phenomenological approach. Results Our analysis shows that community health care providers are working under tremendous strains of work load, fear of getting infected and physical and mental fatigue in a widely disrupted health system. Despite the fear of getting infected, the health workers are reluctant to wear personal protective suits because of gender norms. Similarly, the lived experience of pregnant women shows that they are feeling helpless; the joyful event of pregnancy has suddenly turned into a constant fear and stress. They are living in a limbo of hope and despair with a belief that only God could save their lives. Conclusion The results of the study present the vulnerability of pregnant women and health workers during the pandemic. It recognizes the challenges and constraints, emphasizing the crucial need for government and non-government organizations to improve maternal and newborn health services to protect the pregnant women and health workers as they face predicted waves of the pandemic in the future.

Author(s):  
Rogério Meireles Pinto ◽  
Rahbel Rahman ◽  
Margareth Santos Zanchetta ◽  
W. Galhego-Garcia

Abstract Background Narrative medicine (NM) encourages health care providers to draw on their personal experiences to establish therapeutic alliances with patients of prevention and care services. NM medicine practiced by nurses and physicians has been well documented, yet there is little understanding of how community health workers (CHWs) apply NM concepts in their day-to-day practices from patient perspectives. Objective To document how CHWs apply specific NM concepts in Brazil’s Family Health Strategy (FHS), the key component of Brazil’s Unified Health System. Design We used a semi-structured interview, grounded in Charon’s (2001) framework, including four types of NM relationships: provider–patient, provider–colleague, provider–society, and provider–self. A hybrid approach of thematic analysis was used to analyze data from 27 patients. Key Results Sample: 18 females; 13 White, 12 “Pardo” (mixed races), 12 Black. We found: (1) provider–patient relationship—CHWs offered health education through compassion, empathy, trustworthiness, patience, attentiveness, jargon-free communication, and altruism; (2) provider–colleague relationship—CHWs lacked credibility as perceived by physicians, impacting their effectiveness negatively; (3) provider–society relationship—CHWs mobilized patients civically and politically to advocate for and address emerging health care and prevention needs; (4) provider–self relationship—patients identified possible low self-esteem among CHWs and a need to engage in self-care practices to abate exhaustion from intense labor and lack of resources. Conclusion This study adds to patient perspectives on how CHWs apply NM concepts to build and sustain four types of relationships. Findings suggest the need to improve provider–colleague relationships by ongoing training to foster cooperation among FHS team members. More generous organizational supports (wellness initiatives and supervision) may facilitate the provider–self relationship. Public education on CHWs’ roles is needed to enhance the professional and societal credibility of their roles and responsibilities. Future research should investigate how CHWs’ personality traits may influence their ability to apply NM.


2013 ◽  
Vol 3 (2) ◽  
pp. 154-159
Author(s):  
Janet Perkins ◽  
Aminata Bargo ◽  
Cecilia Capello ◽  
Carlo Santarelli

Assuring the provision of person-centred care is critical in maternal and newborn health (MNH). As a component of the national strategy to improve MNH, Burkina Faso Ministry of Health, supported by Enfants du Monde, La Fondation pour le Développement Communautaire/Burkina Faso and UNFPA, is implementing the World Health Organization’s (WHO) framework for Working with Individuals, Families and Communities (IFC) to improve MNH. As a first step in district implementation, participatory community assessments were conducted. These assessments consistently revealed that poor interactions with healthcare providers posed one important barrier preventing women from seeking MNH services. In order to address this barrier, healthcare providers were trained to improve their interpersonal skills and in counselling women. During 2011-12 a total of 175 personnel were trained over a 5-day course developed using a WHO manual. The course was met with enthusiasm as providers expressed their need and desire for such training. Immediate post-test results revealed an impressive increase in knowledge and anecdotal evidence suggests that training has influenced provider’s behaviours in their interactions with women. In addition, health care providers are taking concrete action to build the capabilities of women to experience pregnancy and birth safely by engaging directly with communities.  While early findings are promising, an evaluation will be necessary to measure how the training has influenced practices, whether this translates into a shift of perceptions at community level and ultimately its contribution toward promoting person-centred care in Burkina Faso.


2009 ◽  
Vol 3 (10) ◽  
pp. 783-788 ◽  
Author(s):  
Elizabeth M. Kiefer ◽  
Theresa Shao ◽  
Olveen Carrasquillo ◽  
Pamela Nabeta ◽  
Carlos Seas

Background: Expansion of the health care workforce in Peru to combat tuberculosis (TB) includes both professional health care providers (HCPs) such as doctors and nurses, and non-professional HCPs such as community health workers (CHWs). We describe the knowledge and attitudes of these HCPs, and identify modifiable barriers to appropriate anti-tuberculosis treatment.  Methodology: We surveyed HCPs practicing in 30 clinical settings (hospitals, community health centers, and health posts) in the San Juan de Lurigancho district of Eastern Lima, Peru. Multiple-choice questions were used to assess knowledge of TB. A five-item Likert scale was created to assess attitudes toward the community, patients, and clinics. Linear regression was used to identify predictors of mean knowledge score, and analysis of variance was used to test differences in HCP score.  Results: Of the 73 HCPs surveyed, 15% were professionals (doctors or nurses). The remaining 85% were health technicians, community health workers (CHWs) or students. The mean knowledge score was 10.0 ± 1.9 (maximum 14) with professional HCPs scoring higher than other HCPs (11.7 ± 1.1 vs. 9.7 ± 1.9), p < .01). Knowledge gaps included identification of patients at high risk for TB, assessment of treatment outcomes, and consequences of treatment failure. The most commonly cited modifiable barriers were structural, including laboratory facilities and staffing of TB clinics, with 52.1% and 62.5% of HCPs, respectively, citing these as problematic.  Conclusions: Efforts to improve knowledge of TB HCPs in Peru should focus on the specific gaps we have identified. Further research is needed to evaluate whether these knowledge gaps correlate with TB control.     


2007 ◽  
pp. 155-170 ◽  
Author(s):  
Norm Archer

Health care is an industry with a diverse set of stakeholders: governments, private health care providers, medical practitioners (physicians, nurses, researchers, etc.), home health care providers and workers, and last but not least, clients/patients and their families. Overlapping and interacting environments include hospitals, clinics, long-term care facilities, primary care providers, homes, and so forth, involving acute, emergency, chronic, primary, and outpatient care. Patient transitions between these environments are often unnecessarily dif?cult due to an inability by providers to access pre-existing patient records. Mobile/wireless solutions can play an important role in supporting health care by providing applications that access health care records and reduce paperwork for clinical physicians, nurses, and other workers, community health care practitioners and their patients, or mobile chronically ill patients such as diabetics. This chapter makes the case for mobile health care and its solutions in the non-acute community health care environment, where critical issues include usability, adoption, interoperability, change management, risk mitigation, security and privacy, and return on investment. A proposed community health care application demonstrates how these issues are addressed.


Author(s):  
Seyede Sakine Hasani Ziabari ◽  
Sareh Shakerian

Background: Effective supervision strategies help to address the challenges unique to community health workers (CHWs) or Behvarz and improve poor practices. Current research is comparing situation of two supervisors group on performance of CHWs in Lahijan city.Methods: This study was done through a quasi-experimental method in which with census it was considered through pre and post-test after education, then the statistical society was divided through systematic random sampling method and was supervised by two supervisor groups (health care providers and headquarters experts) and their situation were compared using the standard performance checklist in 10 primary healthcare fields for a four month period.Results: Education section showed that 120 CHWs of statistical society, 56 CHWs of capability (in pre-test) answered 70% of questions correctly and in post-test 83 CHWs have answered to 70% of questions correctly and totally it shows 34% of enhancement. Result of in performance section showed that 63% CHWs under supervision of health care providers could have performance higher than 70% in 10 fields. Also result showed that 73% CHWs supervised by headquarter experts could have performance higher than 70% in 10 fields.Conclusions: The effect of the education and supervision on the performance increased although with little difference in the two groups of observers. It can be concluded that the only field that is fully specialized after the implementation of Health Reform Plan is the field of pregnant mothers who provide services to this highly specialized group through midwives. 


2019 ◽  
Author(s):  
Eveline Muika Kabongo ◽  
Ferdinand Mukumbang ◽  
Peter N/A Delobelle ◽  
Edward N/A Nicol

Abstract Introduction Despite the growing global application of mobile health (mHealth) technology in maternal and child health, the contextual factors and mechanisms by which interventional outcomes are generated have not been subjected to extensive review. In this study, we sought to identify context, mechanisms and outcome elements from implementation and evaluation studies of mHealth interventions to formulate theories or models explicating how mHealth interventions work (or not) both for health care providers and for pregnant women and new mothers.Method An electronic search of six online databases (Medline, Pubmed, Google Scholar, Scopus, Academic Search Premier and Health Systems Evidence) was performed. Using appropriate MeSH terms and selection procedure, 32 articles were considered for analysis. A theory-driven approach, narrative synthesis, was applied to synthesise the data. Thematic content analysis was used to delineate the elements of the intervention, including its context, actors, mechanism and outcomes. Retroduction was applied to link these elements using a realist evaluation heuristic to form generative theories.Results Mechanisms that promote the implementation of mHealth by community health workers/health care providers include motivation, perceived skill and knowledge improvement, improved self-efficacy, improved confidence, improved relationship between community health workers and clients, perceived support of community health workers, perceived ease of use and usefulness of mHealth, For pregnant women and new mothers, mechanisms that trigger the uptake of mHealth and use of maternal and child health services included: perceived service satisfaction, perceived knowledge acquisition, support and confidence, improved self-efficacy, encouragement, empowerment and motivation. Information overload was identified as a potential negative mechanism for the uptake of maternal and child health services.Conclusion The models developed in this study provide a detailed understanding of the implementation and uptake of mHealth interventions and how they improve maternal and child health services in low and middle income countries. These models provide a foundation for the ‘white box’ or theory-driven evaluation of mHealth intervention and can improve the rollout and implementation where required.


Author(s):  
Norm Archer

Health care is an industry with a diverse set of stakeholders: governments, private health care providers, medical practitioners (physicians, nurses, researchers, etc.), home health care providers and workers, and last but not least, clients/patients and their families. Overlapping and interacting environments include hospitals, clinics, long-term care facilities, primary care providers, homes, and so forth, involving acute, emergency, chronic, primary, and outpatient care. Patient transitions between these environments are often unnecessarily difficult due to an inability by providers to access pre-existing patient records. Mobile/wireless solutions can play an important role in supporting health care by providing applications that access health care records and reduce paperwork for clinical physicians, nurses, and other workers, community health care practitioners and their patients, or mobile chronically ill patients such as diabetics. This chapter makes the case for mobile health care and its solutions in the non-acute community health care environment, where critical issues include usability, adoption, interoperability, change management, risk mitigation, security and privacy, and return on investment. A proposed community health care application demonstrates how these issues are addressed.


1997 ◽  
Vol 24 (4) ◽  
pp. 510-522 ◽  
Author(s):  
Mary Beth Love ◽  
Kristen Gardner ◽  
Vicki Legion

Community health workers (CHWs) are community members who serve as frontline health care professionals. They generally work with the underserved and are indigenous to the community in which they work—ethnically, linguistically, socioeconomically, and experientially. This article presents the results of a survey of 197 systematically selected health care providers in eight Bay Area counties. The authors found that 25% of the health care providers in these eight counties hire CHWs. The hiring projections indicate that opportunities are expanding for these frontline professionals; the majority of growth is in public health departments and community-based organizations. The majority of CHWs are women (66%) of color (77%) with a high school degree or less (58%). A total of 44% earn an annual salary of $20,00 to $25,000; 30% make more than $25,001. AIDS and maternal and child health are the two major content foci of CHW work.


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