scholarly journals Why do health workers give anti-malarials to patients with negative rapid test results? A qualitative study at rural health facilities in western Uganda

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Robin Altaras ◽  
Anthony Nuwa ◽  
Bosco Agaba ◽  
Elizabeth Streat ◽  
James K. Tibenderana ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Rural Health ◽  
Health Workers ◽  
Rapid Test ◽  
Health Facilities ◽  
Test Results ◽  
Western Uganda

Factors Influencing Choice of Delivery Place among Mothers in Rukungiri and Kanungu Districts, South Western Uganda: A Cross Sectional Study

2020 ◽  
Author(s):  
Richard Mugambe ◽  
Habib Yakubu ◽  
Solomon Wafula ◽  
Tonny Ssekamatte ◽  
Simon Kasasa ◽  
...  
Keyword(s):  
Health Facility ◽  
Rural Areas ◽  
Health Workers ◽  
Public Health Facility ◽  
Facility Delivery ◽  
Health Facilities ◽  
Public Facility ◽  
Cross Sectional ◽  
Western Uganda ◽  
Delivery Place

Abstract Background: Child birth in health facilities is generally associated with lower risk of maternal and neonatal mortality. However, in Uganda, little is known about factors that influence use of health facilities for delivery especially in rural areas. In this study, we examined the determinants of mothers’ decision of the choice of child delivery place in Western Uganda.Methods: Cross-sectional data was collected from 894 randomly-sampled mothers within the catchment of two private hospitals in Rukungiri and Kanungu districts. Data was collected on the place of delivery for the most recent child, mothers’ sociodemographic characteristics, health facility water, sanitation and hygiene (WASH) status. Modified Poisson regression was used to estimate prevalence ratios (PRs) for the determinants of mothers’ choice of delivery place as well as determinants for the choice of private versus public facility for delivery at 95% confidence intervals. Results: Majority of mothers (90.2%) delivered in health facilities. Non-facility deliveries were attributed to fast progression of labour (77.3%), lack of transport (31.8%) and high cost of hospital delivery (12.5%). Being engaged in business as an occupation [APR = 1.06, 95% CI (1.01 – 1.11)] and belonging to the highest wealth quintile [APR = 1.09, 95% CI (1.02 – 1.17)] favoured facility delivery while higher parity of 3 – 4 [APR = 0.93, 95% CI (0.88 – 0.99)] was inversely associated with facility delivery as compared to parity of 1-2. Choice of private facility over public facility was influenced by how mothers valued factors such as high skilled health workers [APR = 1.15, 95% CI (1.05 – 1.26)], higher quality of WASH services [APR = 1.11, 95% CI (1.04 – 1.17)], cost of the delivery [APR = 0.85, 95% CI (0.78 – 0.92)] and availability of caesarean services [APR = 1.13, 95% CI (1.08 – 1.19)].Conclusion: Utilization of health facility child delivery services was high. Health facility delivery service utilization was influenced by engaging in business, belonging to wealthiest quintile and being multiparous. Choice of private versus public health facility for child delivery was influenced by health facility WASH status, cost of services, and availability of skilled workforce and caesarean services.

scholarly journals Geographic location of health facility and immunization program performance in Hoima district, western Uganda: a health facility level assessment

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nicholas Kwikiriza Magambo ◽  
Francis Bajunirwe ◽  
Fred Bagenda
Keyword(s):  
Health Facility ◽  
Urban Areas ◽  
Health Workers ◽  
Geographic Location ◽  
Health Facilities ◽  
Urban Setting ◽  
World Health ◽  
Program Performance ◽  
Immunization Program ◽  
Western Uganda

Abstract Background Globally, immunization coverage for childhood vaccines is below the immunization target of achieving at least 90% coverage with the pentavalent vaccine. In Uganda, a recent survey shows 80% of districts had poor immunization program performance. However, there is significant variation in performance within and between districts. We hypothesized that geographic location of a health facility may influence performance of its immunization programs. Therefore, the purpose of this study was to examine whether geographical location of a health facility within a district is associated with performance of the immunization program in Hoima district, western Uganda. Methods We conducted a cross sectional study using a mixed methods approach. The main study unit was a health center and we also interviewed health workers in-charge of the facilities and reviewed their health facility records. We reviewed the Uganda Health Management Information System (HMIS) 105 reports of six months to obtain data on immunization program performance. Performance was categorized using World Health Organization’s Reach Every District (RED) criteria and classified as poor if a facility fell in category 3 or 4 and good if 1 or 2. We also conducted key informant interviews with immunization focal persons in the district. We examined the association between dependent and independent variables using Fisher’s exact test. Results We collected data at 49 health facilities. Most of these facilities (55.1%) had poor immunization program performance. Proximal location to the central district headquarters was significantly associated with poor immunization program performance (p < 0.05). Attitudes of health workers in the more urban areas, differences in strategies for outreach site selection and community mobilization in the rural and urban areas were suggested as possible explanations. Conclusions Proximal location to the urban setting near district headquarters was strongly associated with poor immunization program performance. To be able to reach larger numbers of children for vaccination, interventions to improve performance should target health facilities in urban settings.

scholarly journals Obstacles for Iranian rural population to participate in health education programmes: a qualitative study

2019 ◽  
Vol 7 (1) ◽  
pp. e000020 ◽  
Author(s):  
Yousef Hamidzadeh ◽  
Mina Hashemiparast ◽  
Hadi Hassankhani ◽  
Hamid Allahverdipour
Keyword(s):  
Health Education ◽  
Qualitative Study ◽  
Rural Health ◽  
Health Information ◽  
Information Seeking ◽  
Health Workers ◽  
Local Health ◽  
Community Based Education ◽  
Rural Settings ◽  
Data Saturation

ObjectiveTo explore the obstacles of community participation in rural health education programmes from the viewpoints of Iranian rural inhabitants.DesignThis was a qualitative study with conventional content analysis approach which was carried out March to October 2016.SettingData collected using semistructured interviews that were digitally recorded, transcribed and analysed until data saturation. MAXQDA 10 software was used to manage the textual data.ParticipantParticipants were twenty-two seven clients from a rural community in Ardabil, Iran who were receiving health services from health centres.ResultThe main obstacles to participate in health education programmes in rural settings were ‘Lack of trust to the rural health workers’, ‘Adherence to neighbourhood social networks in seeking health information’ and ‘Lack of understanding on the importance of health education’.ConclusionRural health education programmes in Iran are encountered with a variety of obstacles. We need to enhancing mutual trust between the rural health workers and villagers, and developing community-based education programmes to promote health information seeking behaviours among villagers. The finding of this study will be a referential evidence for the qualitative improvement of local health education programmes for rural inhabitants.

scholarly journals “They have been neglected for a long time”: a qualitative study on the role and recognition of rural health motivators in the Shiselweni region, Eswatini

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Caroline Walker ◽  
Doris Burtscher ◽  
John Myeni ◽  
Bernhard Kerschberger ◽  
Bernadette Schausberger ◽  
...  
Keyword(s):  
Rural Communities ◽  
Qualitative Study ◽  
Rural Health ◽  
Health Workers ◽  
Influencing Factor ◽  
Limiting Factors ◽  
Positive Health ◽  
Community Stakeholders ◽  
Public Health Challenges

Abstract Background Community health workers (CHWs) are increasingly engaged to address human resource shortages and fill primary healthcare gaps. In Eswatini, a cadre of CHWs called Rural Health Motivators (RHM) was introduced in 1976 to respond to key public health challenges. However, the emergence of health needs, particularly HIV/TB, has been met with inadequate programme amendments, and the role of RHMs has become marginalised following the addition of other CHWs supported by non-governmental organisations. This study was implemented to understand the role of RHMs in decentralised HIV/TB activities. In this paper, we explore the findings in relation to the recognition of RHMs and the programme. Methods This exploratory qualitative study utilised individual in-depth interviews, group and focus group discussions, participatory methods (utilising a game format) and observations. Participants were purposively selected and comprised RHM programme implementers, community stakeholders and local and non-governmental personnel. Data collection took place between August and September 2019. Interviews were conducted in English or siSwati and transcribed. SiSwati interviews were translated directly into English. All interviews were audio-recorded, manually coded and thematically analysed. Data was validated through methodical triangulation. Results Suboptimal organisational structure and support, primarily insufficient training and supervision for activities were factors identified through interviews and observation activities. Significant confusion of the RHM role was observed, with community expectations beyond formally endorsed tasks. Community participants expressed dissatisfaction with receiving health information only, preferring physical assistance in the form of goods. Additionally, gender emerged as a significant influencing factor on the acceptability of health messages and the engagement of RHMs with community members. Expectations and structurally limiting factors shape the extent to which RHMs are recognised as integral to the health system, at all social and organisational levels. Conclusions Findings highlight the lack of recognition of RHMs and the programme at both community and national levels. This, along with historical neglect, has hindered the capacity of RHMs to successfully contribute to positive health outcomes for rural communities. Renewed attention and support mechanisms for this cadre are needed. Clarification of the RHM role in line with current health challenges and clearer role parameters is essential.

scholarly journals Adherence to malaria rapid diagnostic test results and a qualitative study on Health Workers perception about the test in Agona East District of Ghana

2020 ◽  
Author(s):  
Selina Ansah-Koi
Keyword(s):  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Health Workers ◽  
Health Planning ◽  
National Level ◽  
Health Facilities ◽  
Health Centers ◽  
Quantitative Aspect ◽  
Test Results ◽  
Negative Test

Abstract Background Ghana has adopted the policy of diagnostically testing for malaria before treatment. The Rapid Diagnostic Test (RDT) is used to diagnose malaria especially in lower health facilities like Health Centers (HC) and Community-based Health Planning Services (CHPS) Compounds without microscopy. Studies have shown that clinicians do not always adhere to negative malaria test results of the RDT and prescribe anti-malarials. Methods Quantitative aspect focused on how malaria is diagnosed and adherence to negative rapid diagnostic test results using the consulting room register and patients’ folder of six health facilities within the period of July to September 2015. In-depth interviews using purposive sampling was conducted for 14 health workers at Health Centers and CHPS compounds to find out their perceptions about malaria RDT and reasons for adherence or non-adherence to test results.Results Of the six health facilities in the Agona East District, 3.87% (14/362) were presumptively diagnosed with malaria whiles 96.10% (348/362) were diagnosed with malaria using RDT.For those tested with RDT, 15.25% tested negative and 84.75% tested positive. Of those who tested negative, 20.75% were given anti-malarials and 79.25% did not receive anti-malarials. Health workers perceived the Malaria RDT kit as easy to use and also as making work easier. Testing is done mainly because it is a policy. Conclusion The malaria testing rate in the Agona East District is higher than that at the National level. Health Centers compared to CHPS compounds are likely to treat for malaria in cases of a negative test result. There is also high adherence to negative test results. Health workers perceive the RDT as a useful tool which has made malaria diagnosis easy.

scholarly journals A Qualitative Study of the Development and Utilization of Health Facility-based Immunization Microplans in Uganda.

2021 ◽  
Author(s):  
David Kaawa-Mafigiri ◽  
Constance Iradukunda ◽  
Catherine Atumanya ◽  
Michael Odie ◽  
Arielle Mancuso ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health Facility ◽  
Planning Process ◽  
Health Workers ◽  
Immunization Coverage ◽  
Health Facilities ◽  
Optimal Development ◽  
Limited Knowledge ◽  
Catchment Areas ◽  
Development And Utilization

Abstract Background: In 2006, Uganda adopted the Reaching Every District strategy with the goal of attaining at least 80% coverage for routine immunizations in every district. The development and utilization of health facility/district immunization microplans is the key to the strategy. A number of reports have shown sub-optimal development and use of microplans in Uganda. This study explores factors associated with sub-optimal development and use of microplans in two districts in Uganda to pinpoint challenges encountered during the microplanning process.Methods: A qualitative study was conducted comparing two districts, Kapchorwa with low immunization coverage and Luwero with high immunization coverage. Data were collected through multilevel observation of health facilities, planning sessions and planning meetings; records review of microplans, micromaps, and meeting minutes; 57 interviews with health workers at the Ministry level and lower cadre health facility workers. Data were analyzed using NVivo 8 qualitative text analysis software. Transcripts were coded, memos and display matrices were developed to examine the process of developing and utilization of microplans, including experiences of health workers (implementers). Results: Three key findings emerged from this study. First, there are significant knowledge gaps about the microplanning process among health workers at all levels (community and district health facility and nationally). Limited knowledge about communities and program catchment areas greatly hinders the planning process by limiting the ability to identify hard-to-reach areas as well as prioritize areas according to need. Secondly, the microplanning tool is bulky and complex. Finally, microplanning is being implemented in the context of already over-tasked health personnel who have to conduct several other activities as part of their daily routines.Conclusions: In order to achieve quality improvement of the Reaching Every District campaign, the microplanning process should be revised. Health workers’ misunderstanding and limited knowledge about the microplanning process, especially at peripheral health facilities, coupled with the complex, bulky nature of the microplanning tool reduces the effectiveness of microplanning in improving routine immunization in Uganda. The study reveals the need to reduce the complexity of the tool and identify ways to train and support workers in the use of the revised tool, including support in incorporating the microplanning process into their busy schedules.

scholarly journals Geographic location of health facility and immunization program performance in Hoima district, western Uganda: A health facility level assessment

2020 ◽  
Author(s):  
Nicholas Magambo Kwikiriza ◽  
Francis Bajunirwe ◽  
Fred Bagenda
Keyword(s):  
Health Facility ◽  
Urban Areas ◽  
Health Workers ◽  
Geographic Location ◽  
Health Facilities ◽  
Urban Setting ◽  
World Health ◽  
Program Performance ◽  
Immunization Program ◽  
Western Uganda

Abstract Background: Globally immunization coverage for childhood vaccines is below the immunization target of achieving at least 90% coverage with the pentavalent vaccine. In Uganda, a recent survey shows 80% of districts had poor immunization program performance. However, there is significant variation in performance within and between districts. We hypothesized that geographic location of health facility may influence performance of their immunization programs. Therefore, the purpose of this study was to examine whether geographical location of health facility within a district is associated with performance of the immunization program in Hoima district, western Uganda.Methods: We conducted a cross sectional study using a mixed methods approach. The study unit was a health center and we interviewed health workers in-charge of the facilities and reviewed their health facility records. We reviewed the Uganda Health Management Information System (HMIS) 105 reports of six months to obtain data on immunization program performance. Performance was categorized using World Health Organization’s Reach Every District (RED) criteria and classified as poor if a facility fell in category 3 or 4 and good if 1 or 2. We also conducted key informant interviews with immunization focal persons in the district. We examined the association between dependent and independent variables using Fisher’s exact test. Results: We collected data at 49 health facilities. Most of the health units (55.1%) had poor immunization program performance. Proximal location to the central district headquarters was significantly associated with poor immunization program performance (p<0.05). Attitudes of health workers in the more urban areas, differences in strategies for outreach site selection and community mobilization in the rural and urban areas were suggested as possible explanations.Conclusions: Proximal location to the urban setting near district headquarters was strongly associated with poor immunization program performance. To be able to reach larger numbers of children for vaccination, interventions to improve performance should target health facilities in urban settings.

Evaluation of the impact of a simple hand-washing and water-treatment intervention in rural health facilities on hygiene knowledge and reported behaviours of health workers and their clients, Nyanza Province, Kenya, 2008

2014 ◽  
Vol 143 (4) ◽  
pp. 873-880 ◽  
Author(s):  
N. SREENIVASAN ◽  
S. A. GOTESTRAND ◽  
S. OMBEKI ◽  
G. OLUOCH ◽  
T. K. FISCHER ◽  
...  
Keyword(s):  
Drinking Water ◽  
Water Treatment ◽  
Rural Health ◽  
Health Workers ◽  
Health Facilities ◽  
Hand Washing ◽  
Treatment Intervention ◽  
Treatment Procedure ◽  
Western Kenya ◽  
The Impact

SUMMARYMany clinics in rural western Kenya lack access to safe water and hand-washing facilities. To address this problem, in 2005 a programme was initiated to install water stations for hand washing and drinking water in 109 health facilities, train health workers on water treatment and hygiene, and motivate clients to adopt these practices. In 2008, we evaluated this intervention's impact by conducting observations at facilities, and interviewing staff and clients about water treatment and hygiene. Of 30 randomly selected facilities, 97% had water stations in use. Chlorine residuals were detectable in at least one container at 59% of facilities. Of 164 interviewed staff, 79% knew the recommended water-treatment procedure. Of 298 clients, 45% had received training on water treatment at a facility; of these, 68% knew the recommended water-treatment procedure. Use of water stations, water treatment, and client training were sustained in some facilities for up to 3 years.

Sign in / Sign up

Export Citation Format

Share Document