Obstetric neonatal emergency simulation workshops in remote and regional South India: a qualitative evaluation

Abstract Background Healthcare facilities in remote locations with poor access to a referral centre have a high likelihood of health workers needing to manage emergencies with limited support. Obstetric and neonatal clinical training opportunities to manage childbirth emergencies are scant in these locations, especially in low- and middle-income countries. Objectives This study aimed to explore the factors, which influenced healthcare worker experience of attending birth emergencies in remote and regional areas of South India, and the perceived impact of attending the Obstetric and Neonatal Emergency Simulation (ONE-Sim) workshop on these factors. Design Qualitative descriptive study using pre- and post-workshop qualitative surveys. Settings Primary healthcare facilities in remote/regional settings in three states of South India. Participants A total of 125 healthcare workers attended the workshops, with 85 participants completing the pre- and post-workshop surveys included in this study. Participants consisted of medical and nursing staff and other health professionals involved in care at childbirth. Methods ONE-Sim workshops (with a learner-centred approach) were conducted across three different locations for interprofessional teams caring for birthing women and their newborns, using simulation equipment and immersive scenarios. Thematic analysis was employed to the free-text responses obtained from the surveys consisting of open-ended questions. Results Participants identified their relationship with the patient, the support provided by other health professionals, identifying their gaps in knowledge and experience, and the scarcity of resources as factors that influenced their experience of birth emergencies. Following the workshops, participant learning centred on improving team and personal performance and approaching future emergencies with greater confidence. Conclusions Challenges experienced by healthcare workers across sites in remote and regional South India were generally around patient experience, senior health professional support and resources. The technical and interpersonal skills introduced through the ONE-Sim workshop may help to address some of these factors in practice.

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How primary healthcare workers obtain information during consultations to aid safe prescribing in low-income and lower middle-income countries: a systematic review

BMJ Global Health ◽

10.1136/bmjgh-2019-002094 ◽

2020 ◽

Vol 5 (4) ◽

pp. e002094 ◽

Cited By ~ 1

Author(s):

Chris Smith ◽

Michelle Helena van Velthoven ◽

Nguyen Duc Truong ◽

Nguyen Hai Nam ◽

Vũ Phan Anh ◽

...

Keyword(s):

Low Income ◽

Primary Healthcare ◽

Healthcare Workers ◽

Health Workers ◽

Internet Access ◽

Sources Of Information ◽

Quality Of Reporting ◽

Middle Income ◽

Middle Income Countries ◽

Registration Number

BackgroundWe systematically reviewed the evidence on how primary healthcare workers obtain information during consultations to support decision-making for prescribing in low and lower middle-income countries.MethodsWe searched electronic databases, consulted the Healthcare Information For All network, hand searched reference lists, ran citation searches of included studies and emailed authors of identified papers. Two reviewers extracted data and appraised quality with relevant tools.ResultsOf 60 497 records found, 23 studies met our inclusion criteria. Fourteen studies were observational and nine were interventional. Frequently mentioned sources of information were books, leaflets, guidelines, aids and the internet. These sources were sometimes out of date and health workers reported being confused which to use. Internet access varied and even when it was available, use was limited by technical issues. Of the five electronic tools that were assessed, four had positive outcomes. Tools assisted prescribers with medicine selection and dosage calculations, which increased prescribing accuracy. The quality of reporting varied but was overall low.DiscussionStudies indicated a lack of up-to-date and relevant medicine information in low and lower middle-income settings. Internet-based sources appeared to be useful when it is possible to download content for offline use and to update when there is internet access. Electronic tools showed promise, but their accuracy needs to be validated and they should focus on giving actionable advice to guide prescribers.PROSPERO registration numberCRD42018091088.

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No time for change? Impact of contextual factors on the effect of training primary care healthcare workers in Kyrgyzstan and Vietnam on how to manage asthma in children - A FRESH AIR implementation study

BMC Health Services Research ◽

10.1186/s12913-020-05984-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Jesper Kjærgaard ◽

◽

Thomas Nørrelykke Nissen ◽

Elvira Isaeva ◽

Nguyen Nhat Quynh ◽

...

Keyword(s):

Primary Care ◽

Healthcare Workers ◽

Health Workers ◽

Clinical Performance ◽

Contextual Factors ◽

Middle Income ◽

Middle Income Countries ◽

Primary Care Health ◽

Care Health ◽

Asthma In Children

Abstract Background Training is a common and cost-effective way of trying to improve quality of care in low- and middle-income countries but studies of contextual factors for the successful translation of increased knowledge into clinical change are lacking, especially in primary care. The purpose of this study was to assess the impact of contextual factors on the effect of training rural healthcare workers in Kyrgyzstan and Vietnam on their knowledge and clinical performance in managing pediatric patients with respiratory symptoms. Methods Primary care health workers in Kyrgyzstan and Vietnam underwent a one-day training session on asthma in children under five. The effect of training was measured on knowledge and clinical performance using a validated questionnaire, and by direct clinical observations. Results Eighty-one healthcare workers participated in the training. Their knowledge increased by 1.1 Cohen’s d (CI: 0.7 to 1.4) in Kyrgyzstan where baseline performance was lower and 1.5 Cohen’s d (CI: 0.5 to 2.5) in Vietnam. Consultations were performed by different types of health care workers in Kyrgyzstan and there was a 79.1% (CI 73.9 to 84.3%) increase in consultations where at least one core symptom of respiratory illness was asked. Only medical doctors participated in Vietnam, where the increase was 25.0% (CI 15.1 to 34.9%). Clinical examination improved significantly after training in Kyrgyzstan. In Vietnam, the number of actions performed generally declined. The most pronounced difference in contextual factors was consultation time, which was median 15 min in Kyrgyzstan and 2 min in Vietnam. Discussion and conclusion The effects on knowledge of training primary care health workers in lower middle-income countries in diagnosis and management of asthma in children under five only translated into changes in clinical performance where consultation time allowed for changes to clinical practice, emphasizing the importance of considering contextual factors in order to succeed in behavioral change after training.

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A qualitative study of barriers and facilitators to adequate environmental health conditions and infection control for healthcare workers in Malawi

H2Open Journal ◽

10.2166/h2oj.2022.139 ◽

2022 ◽

Author(s):

Raymond Tu ◽

Hayley Elling ◽

Nikki Behnke ◽

Jennifer Mmodzi Tseka ◽

Holystone Kafanikhale ◽

...

Keyword(s):

Environmental Health ◽

Healthcare Workers ◽

Barriers And Facilitators ◽

Infection Prevention And Control ◽

Structured Interviews ◽

Middle Income ◽

Healthcare Facilities ◽

Management Procedures ◽

Water Provision ◽

Healthcare Associated

Abstract The burden of healthcare-associated infections (HAIs) is greater in low- and middle-income countries than in high-income countries. Inadequate environmental health (EH) conditions and work systems contribute to HAIs in countries like Malawi. We collected qualitative data from 48 semi-structured interviews with healthcare workers (HCWs) from 45 healthcare facilities (HCFs) across Malawi and conducted a thematic analysis. The facilitators of infection prevention and control (IPC) practices in HCFs included disinfection practices, patient education, and waste management procedures. HCWs reported barriers such as lack of IPC training, bottlenecks in maintenance and repair, hand hygiene infrastructure, water provision, and personal protective equipment. This is one of the most comprehensive assessments to date of IPC practices and environmental conditions in Malawian HCFs in relation to HCWs. A comprehensive understanding of barriers and facilitators to IPC practices will help decision-makers craft better interventions and policies to support HCWs to protect themselves and their patients.

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Low back pain among nurses working in a clinical settings of Africa: A systematic review and meta-analysis of a 19 years of studies

10.1101/507053 ◽

2018 ◽

Cited By ~ 1

Author(s):

Ayele Semachew ◽

Yinager Workineh ◽

Emiru Ayalew ◽

Worku Animaw ◽

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Prevalence Rate ◽

Healthcare Workers ◽

Health Workers ◽

Meta Analysis ◽

P Value ◽

Low Back ◽

Healthcare Facilities

Introduction: Because of the nature of the work, healthcare providers are prone to develop different musculoskeletal problems including low back pain and hospital healthcare workers are groups of healthcare workers who suffered a lot from it. The incidence varies between countries and professions. The situation is somewhat worsen among the frontline healthcare provider in many healthcare facilities. Nurses in Africa are arguably the most important frontline health care workers available in most African healthcare facilities, performing a broad range of tasks and working in settings where no other health workers, including physicians, are available. This situation is considerably important in the causation of work load. Nursing is listed among the highly risky profession for the development of low back pain and has been ranked with in the top tenth professions which have a great risk of having susceptible to low back pain. Objective: The aim of this systematic review and meta-analysis was to ascertain whether LBP is of a significant concern among nurses in African healthcare facilities. Methods: A comprehensive literature search of different data bases with no date limit was conducted from September to November 2018 using the PRISMA guideline. The quality of the included studies were assessed using a 12-item rating system. Subgroup and sensitivity analysis were performed. Cochran's Q and the I2 test were used to assess heterogeneity. The presence of publication bias was evaluated by using Egger's test and visual inspection of the symmetry in funnel plots. Result: During the period 2000–2018, nineteen studies with a sample size of 6110 have been carried out. Among them, the lowest and the highest prevalence were found to be 44.1% and 82.7%. Both the highest and the lowest prevalence of low back pain were reported from a studies done in Nigeria. The estimation of the prevalence rate of low back pain among nurses using the random effects model was found to be 64.07% (95% CI: 58.68–69.46; P-value < 0.0001). Heterogeneity of the reviewed studies was I2 = 94.2% and heterogeneity Chi-squared = 310.06 (d.f = 18), P-value < 0.0001. The subgroup analyses showed that the highest prevalence of LBP among nurses was from west African region with prevalence rates of 68.46% (95% CI: 54.94– 81.97; P-value <0.0001) and followed by north Africa region with prevalence rate of 67.95% (95% CI: 55.96–79.94; P value <0.0001) had the higher prevalence of LBP as compared to their south African counterparts, 59% (95% CI: 51–66.9; P-value <0.0001). Conclusion: Even though the overall prevalence of the present study is lower when compared to the western and Asian studies, it indicated that the prevalence of low back pain among nurses is on the move.

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Mask-associated de novo headache in healthcare workers during the Covid-19 pandemic.

10.1101/2020.08.07.20167957 ◽

2020 ◽

Author(s):

Jose M Ramirez-Moreno ◽

David Ceberino ◽

Alberto Gonzalez ◽

Belen Rebollo ◽

Pablo Macias ◽

...

Keyword(s):

Health Care ◽

Health Professionals ◽

Healthcare Workers ◽

Social Impact ◽

De Novo ◽

Health Workers ◽

Online Questionnaire ◽

Related Factors ◽

Cross Sectional ◽

The Impact

Introduction: The pandemic caused by the new coronavirus (COVID-19) has led to changes in the development of health care activities by health professionals. We analysed whether there is an association between the appearance of de novo headache according to the type of mask used, the related factors, as well as the impact of the headache on health professionals. Method: cross-sectional study in a tertiary hospital in Extremadura, Spain. We administered an online questionnaire to healthcare workers during the period of maximum incidence of COVID-19 in our setting. Results: n=306, 244 women (79.7%), with an average age of 43 years (range 23-65). Of the total, 129 (42.2%) were physicians, 112 (36.6%) nurses and 65 (21.2%) other health workers. 208 (79.7%) used surgical masks and 53 (20.3%) used filtering masks. Of all those surveyed, 158 (51.6%) presented de novo headache. The occurrence of headache was independently associated with the use of a filtering mask, OR 2.14 (IC95% 1.07-4.32), being a nurse OR 2.09 (IC95% 1.18-3.72) or another health worker OR 6.94 (IC95% 3.01-16.04) or having a history of asthma OR 0.29 (IC95% 0.09-0.89). Depending on the type of mask used there were differences in headache intensity. And the impact of headache in the subjects who used a filtering mask was worse in the all aspects evaluated. Conclusions: The appearance of de novo headache is associated with the use of filtering masks and is more frequent in certain health care workers, causing a greater occupational, family, personal and social impact.

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Components of compulsory service program for health professionals in low- and middle-income countries: a scoping review

Perspectives in Public Health ◽

10.1177/1757913919839432 ◽

2019 ◽

Vol 140 (1) ◽

pp. 54-61

Author(s):

CT Antonio ◽

JP Guevarra ◽

PN Medina ◽

MD Avelino ◽

AG Agbon ◽

...

Keyword(s):

Scoping Review ◽

Health Professionals ◽

Rural Areas ◽

Health Workers ◽

Active Management ◽

Future Research ◽

Service Program ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Aims:The global health landscape has been characterized by shortfalls and imbalances in human resources for health (HRH), with more health workers concentrated in urban than rural areas. To address this maldistribution, some countries resorted to the implementation of a compulsory service policy for HRH. However, there is no comprehensive documentation describing the different components of such policies. This scoping review aims to determine the components for compulsory service for selected health professionals in low- and middle-income countries (LMICs).Methods:A search was conducted in MEDLINE, PLoS, Scopus, and ProQuest Central, using keywords for ‘compulsory service’, ‘return service’, ‘mandatory service’, ‘physician’, ‘dentist’, ‘nurse’, ‘midwife’, ‘physical therapist’, ‘occupational therapist’, and identified LMICs. A total of 6757 records were retrieved and assessed, from which 41 relevant records were included in the study.Results and conclusions:Common elements of a compulsory service program are the following: a comprehensive master plan, clearly articulated program goals, appropriate education and training, transparent recruitment and placement, strong institutional and system support, competitive benefits and incentives, and active management of exit from the program. Results presented in this article can serve to inform LMICs on policy, guide program development and management, and direct future research in the area of HRH to address challenges in maldistribution.

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The Study of the Awareness of Healthcare Workers on Organizational Aspects of Vaccination

Archive of Clinical Medicine ◽

10.21802/acm.2021.1.4 ◽

2021 ◽

Vol 27 (1) ◽

Author(s):

Kateryna Bulavinova ◽

Oryna Detsyk ◽

Zoya Tsikhon

Keyword(s):

Medical Care ◽

Health Professionals ◽

Primary Care Physicians ◽

Healthcare Workers ◽

Health Workers ◽

Medical Personnel ◽

Cold Chain ◽

Health Care Managers ◽

Knowledge And Beliefs ◽

Care Managers

Aim. To analyze the awareness of healthcare workers on the organization of vaccination. Materials and Methods. In 2018 – 2019 sociological survey was conducted among 1384 healthcare workers from 4 Ukrainian regions: 353 primary care physicians, 233 specialized medical care doctors, 88 healthcare managers, 700 nurses, and 10 others. Results. Gaps in the knowledge and beliefs of health professionals associated with the organization of vaccination were founded: less than half of the surveyed health workers understand that vaccination is carried out with any certified vaccine, regardless of the country of origin; a significant part of respondents tend to prescribe drugs not recommended by international guidelines (53.6%), antihistamines (15.9%) and anti-inflammatory (8.0%) drugs before vaccination; do not know about the possibility of doing several vaccinations in one visit (47.3%) and that the cold chain breach affects the effectiveness of the vaccine (52.4%). It was found that the most knowledgeable about the organization of immunoprophylaxis of the population are the health care managers and medical personnel who have passed special training on vaccination vs the least informed specialized medical care doctors. Conclusions. It is necessary to develop a set of scientifically based measures to improve the awareness of health professionals about the organization of vaccination in order to improve the coverage of the population with immunoprophylaxis.

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An IoT Based Health Monitoring System to Tackle COVID-19 in a Contagious Ward of Hospital

International Journal of Advanced Medical Sciences and Technology - Regular Issue ◽

10.35940/ijamst.c3022.081421 ◽

2021 ◽

Vol 1 (4) ◽

pp. 11-18

Author(s):

Sk. Shariful Alam* ◽

◽

Md. Shakibul Islam ◽

Md. Mustahsin Farhan Chowdhury ◽

Tanim Ahmed ◽

...

Keyword(s):

Health Monitoring ◽

Health Professionals ◽

Healthcare Workers ◽

Autonomous Robots ◽

Health Workers ◽

Health Monitoring System ◽

Novel Coronavirus ◽

Isolation Ward ◽

Specific Health ◽

Health Parameters

l: l: Email:l: Email:l: Regarding the highly contiguous novel coronavirus disease (COVID-19), it is unsafe for health professionals, being involved in a hospital isolation ward. The healthcare workers, stationed in a contagious ward provide relentless monitoring of specific health parameters of those patients. The rate of contagion proportionately depends on the time spent by the health workers in an isolation ward. This challenging task is fairly manageable by employing promising Internet-of-Things (IoT) based autonomous robots (i.e. smart bots) thus reducing the hazards of contamination to health workers. In this research paper, we introduce a smart bot that can periodically measure the health parameters of COVID-19 patients, for instance, body temperature, oxygen saturation levels, blood pressure, respiration rate, heart rate, blood glucose level, etc. The proposed smart bot will transfer from one patient to another in a structured pattern and autonomously collect, forward, store the data of the patients for further analysis. The goal of the work is to involve a significantly inferior number of health workers in contagious wards to control contagion, thus creating stress-free environs for health workers. Moreover, smart bots will offer health professionals to pay attention to non-COVID-19 patients and make things easier for regular health check-ups of individuals in need.

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“Covid Just Amplified the Cracks of the System”: Working as a Frontline Health Worker during the COVID-19 Pandemic

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph181910178 ◽

2021 ◽

Vol 18 (19) ◽

pp. 10178

Author(s):

Karen Willis ◽

Paulina Ezer ◽

Sophie Lewis ◽

Marie Bismark ◽

Natasha Smallwood

Keyword(s):

Healthcare Workers ◽

Health Workers ◽

Qualitative Content Analysis ◽

Health And Safety ◽

Free Text ◽

Safety Issues ◽

Health Workforce Retention ◽

Workforce Retention ◽

Workplace Challenges ◽

The Right

The COVID-19 pandemic has intensified existing workplace stresses and created new challenges for people working on the healthcare frontline, including rapid workplace changes and increasing uncertainty at work, along with fear of contracting the virus. The purpose of this study is to examine the workplace challenges described by Australian frontline health workers during the pandemic. Drawing on a national online anonymous survey of 9518 healthcare workers, we analysed free-text responses to the question: “What did you find to be the main challenges that you faced during the pandemic?” A qualitative content analysis was undertaken. We identified five key themes relating to participant experiences of workplace challenges. These were: Work-life imbalance; Following orders or caring for patients; Unpredictability, disruption, and inconsistency at work; The right to be safe at work; and (Un)preparedness in the workplace. We argue that working during the COVID-19 pandemic illuminated existing occupational health and safety issues that have serious implications for job satisfaction, health workforce retention, and ultimately, patient care.

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