Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana: A Randomized Cluster Trial

Abstract Background: Decentralization has dominated the agenda for the reforms of the organization of service delivery in Lower and Middle-Income Countries (LMICs). Decentralization faces a formidable challenge of fiscal decentralization in primary healthcare facilities. Of now, LMICs are implementing fiscal decentralization reforms to empower health facilities and their Health Facility Governing Committees (HFGCs). Given the paucity of the impact of fiscal decentralization, this study was conducted to assess the functionality of HFGCs and their associative factors in primary health care facilities implementing fiscal decentralization through Direct Health Facility Financing (DHFF) in Tanzania.Methods: A cross-sectional design was employed to gather both qualitative and quantitative data. The study was conducted in 32 selected primary health facilities implementing DHFF in Tanzania. Probability and nonprobability sampling procedures were employed, in which a multistage sampling procedure was used to select 280 respondents. Data were collected through a structured questionnaire, in-depth interviews and focus group discussions. Descriptive analysis was employed to determine the functionality of HFGCs and binary logistic regression was employed to determine associated factors for the functionality of HFGC. Qualitative analysis was done through thematic analysis.Result: HFGC functionality under DHFF has been found to be good by 78.57%. Specifically, HFGCs have been found to have good functionality in mobilizing communities to join Community Health Funds 87.14%, participating in the procurement process 85%, discussing community health challenges 81.43% and planning and budgeting 80%. The functionality of HFGCs has been found to be associated with the planning and budgeting aspects p-value of 0.0011, procurement aspects p-value 0.0331, availability of information reports p-value 0.0007 and Contesting for HFGC position p-value 0.0187.Conclusion: The study has revealed that fiscal decentralization through DHFF significantly improves the functionality of HFGCs. Therefore, the study recommends more effort be put into facilitating the availability of finances to the health facilities.

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Impact of Covid-19 on the Outcomes of Basic Immunization in Health Facilities

Jurnal Profesi Medika Jurnal Kedokteran dan Kesehatan ◽

10.33533/jpm.v14i2.2170 ◽

2020 ◽

Vol 14 (2) ◽

Author(s):

Retno Setyo Iswati ◽

Indria Nuraini

Keyword(s):

Significant Relationship ◽

Immunization Coverage ◽

Health Facilities ◽

Children's Health ◽

Independent Practice ◽

Chi Square ◽

Primary Health ◽

Chi Square Test ◽

Primary Health Facilities ◽

The Impact

The purpose of this study was to determine the impact of Covid 19 on basic immunization coverage, oriented to the number of Covid 19 cases mapped in the red, yellow, and green. This research provides the advantage of making a policy to improve children's health during a pandemic, particularly in preventing diseases that can be anticipated by immunization, such as tuberculosis, diphtheria, hepatitis, tetanus, meningitis, polio, and measles. This research can also be used as a basic for immunization in health facilities while still implementing health protocols. This study's results can be implemented in primary health facilities such as the Puskesmas, Posyandu, Poskesdes, or Midwife Independent Practice. This study's results indicate that immunization coverage <95% is mostly found in the red zone area of Pentabio 1 and 2 immunization, as well as measles. Chi-square test found that there was no significant relationship with basic immunization coverage.

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Improving Tanzanian childbirth service quality

International Journal of Health Care Quality Assurance ◽

10.1108/ijhcqa-10-2015-0122 ◽

2018 ◽

Vol 31 (3) ◽

pp. 190-202 ◽

Cited By ~ 3

Author(s):

Jennie Jaribu ◽

Suzanne Penfold ◽

Cathy Green ◽

Fatuma Manzi ◽

Joanna Schellenberg

Keyword(s):

Health Facility ◽

Low Income ◽

Healthcare Providers ◽

Health Facilities ◽

Rural District ◽

Local Data ◽

Content Type ◽

Primary Health ◽

Primary Health Facilities ◽

Childbirth Care

Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

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The relationship between leadership style and health worker motivation, job satisfaction and teamwork in Uganda

Journal of Healthcare Leadership ◽

10.2147/jhl.s147885 ◽

2018 ◽

Vol Volume 10 ◽

pp. 21-32 ◽

Cited By ~ 8

Author(s):

Conrad Musinguzi ◽

Leticia Namale ◽

Elizeus Rutebemberwa ◽

Aruna Dahal ◽

Patricia Nahirya-Ntege ◽

...

Keyword(s):

Job Satisfaction ◽

Health Worker ◽

Leadership Style ◽

Health Worker Motivation ◽

Worker Motivation ◽

The Relationship

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How to do (or not to do)… Measuring health worker motivation in surveys in low- and middle-income countries

Health Policy and Planning ◽

10.1093/heapol/czx153 ◽

2017 ◽

Vol 33 (2) ◽

pp. 192-203 ◽

Cited By ~ 12

Author(s):

J Borghi ◽

J Lohmann ◽

E Dale ◽

F Meheus ◽

J Goudge ◽

...

Keyword(s):

Health Worker ◽

Low Income ◽

Health Workers ◽

Poor Quality ◽

Validity And Reliability ◽

High Quality Research ◽

Quality Health Care ◽

Middle Income ◽

Health Worker Motivation ◽

Worker Motivation

Abstract A health system’s ability to deliver quality health care depends on the availability of motivated health workers, which are insufficient in many low income settings. Increasing policy and researcher attention is directed towards understanding what drives health worker motivation and how different policy interventions affect motivation, as motivation is key to performance and quality of care outcomes. As a result, there is growing interest among researchers in measuring motivation within health worker surveys. However, there is currently limited guidance on how to conceptualize and approach measurement and how to validate or analyse motivation data collected from health worker surveys, resulting in inconsistent and sometimes poor quality measures. This paper begins by discussing how motivation can be conceptualized, then sets out the steps in developing questions to measure motivation within health worker surveys and in ensuring data quality through validity and reliability tests. The paper also discusses analysis of the resulting motivation measure/s. This paper aims to promote high quality research that will generate policy relevant and useful evidence.

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Determinants and consequences of health worker motivation in hospitals in Jordan and Georgia

Social Science & Medicine ◽

10.1016/s0277-9536(03)00203-x ◽

2004 ◽

Vol 58 (2) ◽

pp. 343-355 ◽

Cited By ~ 107

Author(s):

Lynne Miller Franco ◽

Sara Bennett ◽

Ruth Kanfer ◽

Patrick Stubblebine

Keyword(s):

Health Worker ◽

Health Worker Motivation ◽

Worker Motivation

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Heterogeneity in Average Cost per Patient with type 2 Diabetes at Primary Health Facilities in Mexico: Comparing Comprehensive Diabetes Management Medical Offices with General Practice

10.21203/rs.3.rs-53303/v1 ◽

2020 ◽

Author(s):

M. Arantxa Colchero ◽

Rousellinne Gómez ◽

Ruy López-Ridaura ◽

Daniel López-Hernández ◽

Iyari Sánchez-Díaz ◽

...

Keyword(s):

General Practice ◽

Diabetes Care ◽

Diabetes Management ◽

Unit Cost ◽

Health Facilities ◽

Patient Knowledge ◽

Factors Associated ◽

Unit Costs ◽

Primary Health ◽

Primary Health Facilities

Abstract Background. Despite the high health and financial burden imposed by diabetes in Mexico, few studies have estimated the cost per patient treated. The objective of this study was to estimate the average annual cost per patient (unit cost) with diabetes among 60 primary health facilities in Mexico comparing comprehensive diabetes management medical offices (MIDE) and those from general practice (Non-MIDE). Methods. We described the variation in unit costs across these two types of medical offices and explored factors associated. Unit costs were the sum of staff, medications, laboratory tests, and equipment. We show descriptive statistics to analyze the heterogeneity of unit costs, and the distribution of total costs by input and the distribution of staff costs by personnel all by medical office. We estimated a multivariate linear regression model to explore factors associated with the unit costs. Results. Unit costs vary from $267.2 USD in Non-MIDE offices to $410.6 for MIDE. Unit costs were negatively associated with scale, Non-MIDE offices, medical competence, patient knowledge of diabetes and positively associated with comorbidities. Conclusions. Results from this study might help design more efficient programs for diabetes care in primary health facilities to reduce the burden of diabetes in the system. Investing in staff training and educational interventions to increase patient knowledge of diabetes could be promising interventions to reduce diabetes care costs in primary care settings.

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