scholarly journals Frontline healthcare workers’ experiences in implementing the TB-DM collaborative framework in Northern Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rita Suhuyini Salifu ◽  
Khumbulani W. Hlongwana
Keyword(s):  
Health Policy ◽  
Healthcare Workers ◽  
Theoretical Framework ◽  
World Health ◽  
Health Concern ◽  
Northern Ghana ◽  
Lead Author ◽  
Street Level ◽  
Frontline Healthcare Workers ◽  
Street Level Bureaucracy

Abstract Background Over the past decade, global health policy has increased its focus on measures to halt further increase in tuberculosis (TB) incidence and management of diabetes mellitus (DM). However, the vertical management of these two diseases have not achieved much in addressing the adverse effects of the rising tuberculosis-diabetes co-epidemic. This necessitated the World Health Organisation and the International Union Against Tuberculosis and Lung Disease to develop a framework to manage this dual disease burden. TB-DM co-epidemic is a public health concern in Ghana, adversely threatening the country’s fragile health systems. Since frontline healthcare workers are critical in health policy implementation, this study used Lipsky’s theoretical framework of street-level bureaucracy to explore their experiences in implementing the collaborative framework at the health facility level in Ghana. Methods This qualitative study was conducted between July to September 2019 using an exploratory design. Data was generated using a semi-structured interview guide designed to elicit information on knowledge of TB-DM comorbidity as well as systems for co-management. Twenty-three in-depth interviews were conducted among purposively selected frontline healthcare workers (doctors, nurses, TB task- shifting officers, TB institutional coordinators and hospital managers) from three health facilities in the Northern Region of Ghana. The lead author also conducted observations and document reviews, in order to fully address the study objectives. Thematic analysis was guided by the Lipsky’s theoretical framework of street level bureaucracy. Results The findings revealed three main themes and six sub-themes. Main themes were Prioritisation of TB/HIV co-infection while negating TB-DM comorbidity, Poor working conditions, and Coping mechanisms, whereas sub-themes were Low knowledge and awareness of TB-DM comorbidity, Limited awareness of the collaborative framework, High workload in TB & DM Clinics, Multiple roles, Inadequate training, and Space shortage. Conclusions Frontline healthcare workers had limited knowledge of TB-DM comorbidity and the collaborative framework, which, in turn adversely affected the effectiveness in implementing the framework. The effective implementation of the framework begins with raising awareness about the framework through in service training amongst the frontline healthcare workers. Additionally, an integrated screening tool to detect both TB and DM would help achieve early detection of TB-DM comorbidity.

scholarly journals COVID-19, SARS-CoV-2: Impact on healthcare workers in the pandemic’s initial months: Rapid review

2021 ◽  
Vol 5 (1) ◽  
pp. 1-15
Author(s):  
Rachel Malone
Keyword(s):  
Healthcare Workers ◽  
Well Being ◽  
World Health Organisation ◽  
Skin Lesions ◽  
World Health ◽  
Rapid Review ◽  
Protective Equipment ◽  
Family Balance ◽  
Work Family ◽  
Frontline Healthcare Workers

On March 11, 2020 the World Health Organisation declared the SARS-CoV-2 viral outbreak a pandemic. This rapid review aimed to identify the pandemic's impact on frontline healthcare workers during the viral outbreak's initial months. Database searches December 1, 2019 to August 29, 2020 retrieved 18 relevant studies. Findings showed that healthcare workers internationally were negatively impacted by the pandemic. Compared to non-frontline healthcare workers a significantly greater proportion of frontline healthcare workers experienced: burnout, stress, and stressors regarding: childcare, job interference with work-family balance and difficulty getting off-duty time. Compared to male physicians, a significantly greater proportion of female physicians scored low for psychological well-being. Mean scores for stress were significantly higher among females and young healthcare workers (22 to 35 years).  Mean scores for anxiety were significantly higher for: nurses compared to technicians, healthcare workers reporting extreme lack of protective equipment and those aged > 30 years. The prevalence of depression among frontline healthcare workers across studies in this review ranged from 9% to 51%. The prevalence of sleep issues ranged from 24% to 60% with some reporting nightmares. However, these studies lack homogeneity. Healthcare workers experienced fear of: contracting the virus (89.8%), spreading it to family (91.3%) and fear of an uncontrollable epidemic (86.8%). Over 90% reported skin lesions due to prolonged use of personal protective equipment. Many lost their lives to the SARS-CoV-2 virus. One prominent impact of the SARS-CoV-2 pandemic is the reported loss of healthcare worker's lives and this paper wishes to pay them tribute.

scholarly journals THE PSYCHOLOGICAL IMPACT OF COVID-19 ON FRONTLINE HEALTHCARE WORKERS IN MOROCCO

2021 ◽  
Vol 9 (09) ◽  
pp. 678-689
Author(s):  
I. Hanine ◽  
◽  
I. Hmamouchi ◽  
S. Belbachir ◽  
M. Chtibi ◽  
...  
Keyword(s):  
Perceived Stress ◽  
Healthcare Workers ◽  
Health Workers ◽  
Psychological Impact ◽  
Medical Personnel ◽  
Severity Index ◽  
University Hospital ◽  
World Health ◽  
Frontline Healthcare Workers ◽  
The Impact

Introduction: On March 11th 2020, the World Health Organization declared the infection of the virus severe acute respiratory syndrome coronavirus 2 or SARS-COV-2 a pandemic. The virus, which was first discovered in China in Wuhan province in December 2019, has affected more than 100 million people and more than two million deaths in more than 200 countries.Along with other epidemics and pandemics, the existence of this virus has led to psychiatric disorders in people in or without direct contact with the disease, especially frontline healthcare workers. Objective: To assess the impact of the virus on medical personnel working in Morocco, in particular stress, depression and sleep disorders. Methodology: To explore this topic, we used an anonymity questionnaire based on, in addition to individual status and conditions, scales assessing stress, depression and sleep.The questionnaire was sent via social networks to health personnel working in Morocco in the various hospitals and departments treating patients infected with this virus.The CES-D (Center of Epidemiological Studies - Depression) scales for depression, the PSS-10 (Cohens Perceived Stress Scale) for perceived stress and ISI (C. Morins Insomnia Severity Index) for disorders of sleep, were chosen given their frequent use in a number of studies on the same topic. Results: After sorting our responsesrigorously, we were able to collect 376 responses, of which 53.5% were women, with an average age of 28.45 years, 23.9% were nurses, 14.4% general practitioners, 19, 7% of internal doctors 37.2% of residents or specialists and 4.8% occupied other functions such as medical transport. 66% of our candidates were at the level of the different university hospital centers of Morocco.Our candidates respectively occupied 39.1% 28.2% 29% and 25.8% triage positions, observation of suspected cases, the COVID sector and resuscitation.Regarding our results, it was observed that 71% of our participants presented moderate stress, 44.9% had a risk of developing depression and 53.7 had insomnia of varying severity.The female sex, the lack of medical, surgical and psychiatric history influence the occurrence of the three abnormalities studied, it should also be noted that these last three maintain a relationship of influences between them. Conclusion: The exploration of stress, depression and insomnia revealed an impact of the state of health on the daily life of front-line health workers in Morocco.

scholarly journals Nurses Experiences and Challenges during COVID 19: Mixed Method Approach

2020 ◽  
pp. 81-87
Author(s):  
Mohammed S. Alshmemri ◽  
Pushpamala Ramaiah
Keyword(s):  
Mixed Method ◽  
Healthcare Workers ◽  
World Health ◽  
Post Traumatic Stress ◽  
Welfare Programs ◽  
Healthcare Resources ◽  
Work Related ◽  
Healthcare Needs ◽  
Depth Analysis ◽  
Frontline Healthcare Workers

Background: World health organization announced COVID-19 as a pandemic crisis in march 2020. As of WHO statistics 2020 September, the incidence appears to be accelerating globally, with the soaring of new cases since the last one week. Even though worldwide incidence and further deaths have decreased in recent weeks across a few nations, the panic situation has caused unprecedented stress among frontline healthcare workers. Nurses fall into the category of full-blown anxiety responses syndrome to undergo burnout post-traumatic stress disorder. Purpose: This research aimed to explore the perceptions of frontline healthcare workers (Nurses)’ and their opinion about healthcare resources while caring for COVID-19 patients. Methodology: The study adopted a mixed-method where the quantitative data collected using a google document questionnaire related to healthcare resources followed by a qualitative method of online individual interview method to explore the in-depth analysis of nurses’ perceptions of caring for coronaviruses infected patients. Results: The results revealed the nurses’ concerns about the everyday routine of delivering care to COVID-19 patients, including a moderate level of resilience in healthcare resources authorities. The barriers faced by nurses in the journey of a pandemic crisis were also discussed in this study that could also render substantial support in establishing policies and guidelines to meet the needed population’s healthcare needs. Conclusions: Health care workers, including nurses, tend to experience work-related stress that could be alleviated by the appropriate staffing, equipment and supplies, training programs, and staff welfare programs.

scholarly journals COVID-19 Pandemic and Comparative Health Policy Learning in Iran

2020 ◽  
Vol 23 (4) ◽  
pp. 220-234 ◽  
Author(s):  
Azam Raoofi ◽  
Amirhossein Takian ◽  
Ali Akbari Sari ◽  
Alireza Olyaeemanesh ◽  
Hajar Haghighi ◽  
...  
Keyword(s):  
Health Policy ◽  
Policy Learning ◽  
World Health ◽  
Health Concern ◽  
Double Burden ◽  
Global Pandemic ◽  
Professional Advocacy ◽  
Before And After ◽  
Novel Coronavirus ◽  
Health Organization

Background: On March 11, 2020, the World Health Organization (WHO) declared the novel coronavirus disease (COVID-19) a global pandemic. Starting in December 2019 from China, the first cases were officially announced on February 19 in Qom city, Iran. As of April 3, 2020, 206 countries have reported a total of 932166 cases with 46764 deaths. Along with China, USA, Italy, Spain, and Germany, Iran has been suffering the hardest burden of COVID-19 outbreak. Worse still, countries like Iran are struggling with the double burden of political sanctions to provide lifesaving medical equipment and medicines to combat the emergency. Methods: Using systematic document content analysis and through the lenses of health policy triangle, this article aims to compare the policies and strategies that Iran is adopting, with the experience and recommendations of China and WHO to combat COVID-19. Results: Iran has formulated contextual-based policies to combat COVID-19 outbreak before and after virus entrance. Insufficient whole-government, whole-society approach in managing the outbreak, inadequate lifesaving and protective equipment, and delayed decisive governance are the biggest challenges in policy making to combat COVID-19. COVID-19 policies are a public health concern and require professional advocacy attempts through appropriate inter-sectoral collaboration and whole-government coalitions. Conclusion: COVID-19 is an unfolding outbreak; hence, policy learning is crucial to formulate appropriate policies and implement them accordingly. Iran has made many efforts to defeat the outbreak, but more coherent, timely and efficient action is required, now, more than ever, to save lives and slow the spread of this pandemic.

Application of solid-phase immune electron microscopy to study physical and stability characteristics of enterically transmitted non-a, non-b hepatitis virus

1988 ◽  
Vol 46 ◽  
pp. 80-81
Author(s):  
Charles D. Humphrey ◽  
E. H. Cook ◽  
Karen A. McCaustland ◽  
Daniel W. Bradley
Keyword(s):  
Electron Microscopy ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Solid Phase ◽  
Etiologic Agent ◽  
World Health ◽  
Health Concern ◽  
Morphological Identification ◽  
Immune Electron Microscopy

Enterically transmitted non-A, non-B hepatitis (ET-NANBH) is a type of hepatitis which is increasingly becoming a significant world health concern. As with hepatitis A virus (HAV), spread is by the fecal-oral mode of transmission. Until recently, the etiologic agent had not been isolated and identified. We have succeeded in the isolation and preliminary characterization of this virus and demonstrating that this agent can cause hepatic disease and seroconversion in experimental primates. Our characterization of this virus was facilitated by immune (IEM) and solid phase immune electron microscopic (SPIEM) methodologies.Many immune electron microscopy methodologies have been used for morphological identification and characterization of viruses. We have previously reported a highly effective solid phase immune electron microscopy procedure which facilitated identification of hepatitis A virus (HAV) in crude cell culture extracts. More recently we have reported utilization of the method for identification of an etiologic agent responsible for (ET-NANBH).

European Recommendations for the Management of Healthcare Workers Occupationally Exposed to Hepatitis

2018 ◽  
Vol 2 (1) ◽  
pp. 49
Author(s):  
Enis Uruci
Keyword(s):  
Occupational Exposure ◽  
Hepatitis B ◽  
Healthcare Workers ◽  
Antiviral Treatment ◽  
World Health ◽  
Antibody Concentration ◽  
Post Exposure Prophylaxis ◽  
Transferase Activity ◽  
Mediterranean Countries

Exposure prevention is the primary strategy to reduce the risk of occupational bloodborne pathogen infections in healthcare workers (HCW). HCWs should be made aware of the medicolegal and clinical relevance of reporting an exposure, and have ready access to expert consultants to receive appropriate counselling, treatment and follow-up. Vaccination against hepatitis B virus (HBV), and demonstration of immunisation before employment are strongly recommended. HCWs with postvaccinal anti-HBs levels, 1-2 months after vaccine completion, .or=10 mIU/mL are considered as responders. Responders are protected against HBV infection: booster doses of vaccine or periodic antibody concentration testing are not recommended. Alternative strategies to overcome non-response should be adopted. Isolated anti-HBc positive HCWs should be tested for anti-HBcIgM and HBV-DNA: if negative, anti-HBs response to vaccination can distinguish between infection (anti-HBs .or=50 mIU/ml 30 days after 1st vaccination: anamnestic response) and false positive results(anti-HBs .or=10 mUI/ml 30 days after 3rd vaccination: primary response); true positive subjects have resistance to re-infection. and do not need vaccination The management of an occupational exposure to HBV differs according to the susceptibility of the exposed HCW and the serostatus of the source. When indicated, post-exposure prophylaxis with HBV vaccine, hepatitis B immunoglobulin or both must be started as soon as possible (within 1-7 days). In the absence of prophylaxis against hepatitis C virus (HCV) infection, follow-up management of HCV exposures depends on whether antiviral treatment during the acute phase is chosen. Test the HCW for HCV-Ab at baseline and after 6 months; up to 12 for HIV-HCV co-infected sources. If treatment is recommended, perform ALT (amino alanine transferase) activity at baseline and monthly for 4 months after exposure, and qualitative HCV-RNA when an increase is detected. Introduction Bloodborne pathogens such as hepatitis B (HBV) and C virus (HCV) represent an important hazard for healthcare workers (HCWs) (1). In the general population, HCV prevalence varies geographically from about 0.5% in northern countries to 2% in Mediterranean countries, with some 5 million chronic carriers estimated in Europe; while HBV prevalence ranges from 0.3% to 3%. The World Health Organization (WHO) estimates that each year in Europe 304 000 HCWs are exposed to at least one percutaneous injury with a sharp object contaminated with HBV, 149 000 are exposed to HCV and 22 000 to HIV. The probability of acquiring a bloodborne infection following an occupational exposure has been estimated to be on average.

Psychosocial Impact of Covid-19 Pandemic on Frontline Healthcare Workers in Pakistan: A Cross-Sectional Study

2020 ◽  
Author(s):  
Quratul-Ain Zafar
Keyword(s):  
Data Collection ◽  
Emotional Distress ◽  
Healthcare Workers ◽  
Cross Sectional Study ◽  
Psychosocial Impact ◽  
Control Group ◽  
Study Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Frontline Healthcare Workers

Objective: The purpose of this study was to evaluate the impact of the COVID-19 pandemic on frontline healthcare workers in Pakistan in terms of psychological factors emotional distress, insomnia, and burnout. Study Design: Observational cross-sectional study. Place and Duration of Study: This study was conducted at different hospitals across Pakistan and data collection was carried out from 15th June 2020 till 15th August 2020. Material and Methods: This was a questionnaire-based study aiming to compare the levels of burnout and emotional distress between frontline COVID-19 and non-COVID-19 healthcare workers. Any physician, nurse, and other healthcare workers were recruited from emergency care units and Covid-19 care units (target group), and non-COVID-19 care units (control group). Participation was voluntary and participants had to complete self-reported questionnaires and scales. A mixed-mode data collection was carried out, either in paper or web-based form to ensure maximum participation. Results: The independent t-test showed a statistically significant difference between the two groups regarding depression, stress, and insomnia. The study group showed higher scores for these factors than the control group. Chi-square test of association revealed significant scores of burnout and professional fulfillment in both groups. There was a higher prevalence of burnout in the study group than in the control group. Conclusion: This study concludes that there was a significant psychosocial impact of the Covid-19 pandemic in the frontline healthcare workers measured in terms of emotional distress, insomnia, and burnout.

viewpoint TIME TO RESTART: PROTOCOL OF RESUMPTION OF ACTIVITIES OF A DERMATOLOGICAL CLINIC OF A LEVEL II HOSPITAL IN THE COVID-19 ERA. (Preprint)

2020 ◽  
Author(s):  
Federico Diotallevi ◽  
Anna Campanati ◽  
Giulia Radi ◽  
Oriana Simonetti ◽  
Emanuela Martina ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
World Health ◽  
New Wave ◽  
Staff Members ◽  
Level Ii ◽  
The World ◽  
Health Organization ◽  
Spread Of Infection ◽  
Hospital Wards ◽  
Medical And Healthcare

UNSTRUCTURED Two months have passed since the World Health Organization (WHO) declared the pandemic of the Coronavirus Disease 19 (COVID-19), caused by the SARS CoV-2 virus, on March 11, 2020. Medical and healthcare workers have continued to be on the frontline to defeat this disease, however, continual changes are being made to their working habits which are proving to be difficult. Since the beginning of the pandemic, a major reorganisation of all hospital wards, including dermatological wards, has been carried out in order to make medical and nursing staff available in COVID wards and to prevent the spread of infection. These strategies, which were also adopted in our clinic, proved to be effective, as no staff members or patients were infected by the virus. Now, thanks to the global decrease in SARS-CovV2 infections, it is necessary to make dermatological wards accessible to patients again, but it is also essential to adopt specific protocols to avoid a new wave of infections.

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