scholarly journals Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257851
Author(s):  
Juliet Mwanga-Amumpaire ◽  
Grace Ndeezi ◽  
Karin Källander ◽  
Celestino Obua ◽  
Richard Migisha ◽  
...  

Background Low-level private health facilities (LLPHFs) handle a considerable magnitude of sick children in low-resource countries. We assessed capacity of LLPHFs to manage malaria, pneumonia, diarrhea, and, possible severe bacterial infections (PSBIs) in under-five-year-olds. Methods We conducted a cross-sectional survey in 110 LLPHFs and 129 health workers in Mbarara District, Uganda between May and December 2019. Structured questionnaires and observation forms were used to collect data on availability of treatment guidelines, vital medicines, diagnostics, and equipment; health worker qualifications; and knowledge of management of common childhood infections. Results Amoxicillin was available in 97%, parental ampicillin and gentamicin in 77%, zinc tablets and oral rehydration salts in >90% while artemether-lumefantrine was available in 96% of LLPHF. About 66% of facilities stocked loperamide, a drug contraindicated in the management of diarrhoea in children. Malaria rapid diagnostic tests and microscopes were available in 86% of the facilities, timers/clocks in 57% but only 19% of the facilities had weighing scales and 6% stocked oxygen. Only 4% of the LLPHF had integrated management of childhood illness (IMCI) booklets and algorithm charts for management of common childhood illnesses. Of the 129 health workers, 52% were certificate nurses/midwives and (26% diploma nurses/clinical officers; 57% scored averagely for knowledge on management of common childhood illnesses. More than a quarter (38%) of nursing assistants had low knowledge scores. No notable significant differences existed between rural and urban LLPHFs in most parameters assessed. Conclusion Vital first-line medicines for treatment of common childhood illnesses were available in most of the LLPHFs but majority lacked clinical guidelines and very few had oxygen. Majority of health workers had low to average knowledge on management of the common childhood illnesses. There is need for innovative knowledge raising interventions in LLPHFs including refresher trainings, peer support supervision and provision of job aides.

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Ekaete Tobin ◽  
Vivian Ajekweneh ◽  
Andrew Obi ◽  
Eshan Henshaw

The private health sector has the potential to participate in the COVID-19 pandemic response. The study aimed to assess the health literacy, perceptions, practices, willingness to participate and opportunities for engagement of the private health sector in the COVID-19 response. A cross-sectional survey was carried out among health workers in private health facilities in Edo Central and Edo North Senatorial districts of Edo state between May and June 2020. Data were collected using pre-tested questionnaires and analysis carried out using Statistical Package for Social Science (SPSS). Chi-square test of significance and logistic regression were applied at 5% cut off. A total of 153 health workers participated giving a response rate of 75.0%. Eighty-eight (57.5%) respondents had good knowledge of COVID-19 and 80 (52.3%) held negative perceptions towards COVID-19. Ninety-five (62.1%) respondents believed private health facilities had a role to play in the response particularly in the area of suspected case screening (85.4%). Thirty-one (20.3%) respondents indicated their willingness to participate in the COVID-19 response if their facilities were invited to. Sixty-one (39.9%) and 92 (60.1%) respondents respectively held poor and good practices towards COVID- 19 prevention, with practice significantly associated with educational level (χ2 = 14.10, P < 0.01), profession (χ2 = 15.28, P = 0.01). and previous training in infection prevention and control (IPC) (χ2 = 18.16, P < 0.01). The resources available from the private sector to support the response can be harnessed through engagements with medical directors and health workers in the sector to identify areas of collaboration, address identified gaps in knowledge, improve perception and participation.


2021 ◽  
Author(s):  
Xiaolin Liu ◽  
Hongjin Zhu

Abstract Background Mental health workers may face more obstacles in humanistic care during the COVID-19 pandemic, we aimed to explore the humanistic care ability of mental health workers and its potential influencing factors.Method(s) An online cross-sectional survey was conducted among 262 mental health workers working in Chongqing, China from December 1 to 31, 2020. Self-administered questionnaires were used to collect data from the participants. Results Mental health workers’ humanistic care ability score was 186.47 ± 21.34, and most of the them (79.8%) were at a low level. Psychological capital and personality traits were significant influencing factors of humanistic care ability and its sub-dimensions.Conclusion(s) Research has found that the humanistic care ability of mental health workers is at a low level, and psychological capital and personality traits are significant factors influencing the humanistic care ability and its sub-dimensions. Interventions to improve psychological capital of mental health workers or to promote the change of personality traits that they want are recommended, thereby promoting humanistic practice.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040908
Author(s):  
Deogratius Bintabara ◽  
Dorothy Ngajilo

ObjectiveThis study assessed the readiness of health facilities to provide outpatient management of non-communicable diseases using a nationally representative sample of health facilities from Tanzania as an example of a low-resource country.DesignFacility-based cross-sectional survey.SettingThis study analysed data collected from public and private-owned dispensaries/clinics, health centres and hospitals during the 2014–2015 Tanzania Service Provision Assessment survey.Primary outcome measuresThree outcome variables are included in this study, namely readiness of facilities to provide outpatient management for diabetes, hypertension and chronic respiratory diseases. These were composite variables measured based on availability of indicators identified in the WHO-Service Availability and Readiness Assessment manual. These indicators were grouped into three domains, viz staff training and guidelines, basic diagnostic equipment and basic medicines. Readiness was measured by assessing the presence of required indicators in each of these domains.ResultsOut of 1188 health facilities assessed, 52.1%, 64.8% and 60.9% reported providing services related to diabetes, hypertension and chronic respiratory diseases, respectively. A few facilities reported having treatment guidelines (33.2%) or staff trained to provide non-communicable disease services (10.4%). The availability of basic diagnostic equipment and medicines for these diseases was significantly lower in public lower level facilities than in their private counterparts (p<0.05). Facilities located in urban settings as well as higher level (health centre and hospitals) and publicly owned facilities were significantly associated with increased service readiness index for providing outpatient management of non-communicable diseases.ConclusionA fair distribution of resources through the ‘push’ system of refresher training, treatment guidelines, medicines and diagnostic equipment from higher authorities or other agencies may be one way of strengthening the readiness of lower level and public facilities to cope with the increasing burden of non-communicable diseases in low-resource countries such as Tanzania.


2020 ◽  
Author(s):  
Keith Kakame ◽  
Noel Namuhani ◽  
Andrew Kazibwe ◽  
Felix Bongomin ◽  
Joseph Baluku ◽  
...  

Abstract BackgroundThe incidence of tuberculosis (TB) is high in Uganda; yet, TB case detection is low. A recent national TB prevalence survey revealed that only 16% of presumptive TB patients seeking care at health facilities were offered sputum microscopy or chest-X ray (CXR). The objective of this study was to determine the magnitude of, and patient factors associated with missed opportunities in TB investigation at public health facilities of Wakiso District in Uganda.MethodsA facility-based cross-sectional survey was conducted at 10 high volume public health facilities offering comprehensive TB services in Wakiso, Uganda, among adults (≥18 years) with at least one symptom suggestive of TB predefined according to World Health Organisation criteria. Using exit interviews, data on demographics, TB symptoms, and clinical data relevant to TB were collected. A missed opportunity in TB investigation was defined as a patient with symptoms suggestive of TB who did not have sputum and/or CXR evaluation to rule out TB. Poisson regression analysis was performed to determine factors associated with missed opportunities in TB investigation using STATA 14.ResultsTwo hundred forty seven presumptive TB patients were recruited into this study exiting at antiretroviral therapy (ART) clinics (n=132) or general outpatient clinics (n=115) at public health facilities. Majority of participants were females (161/247, 65.2%) and the mean +SD age was 35.1 + 11.5 years. Sputum and/or CXR were not requested from 138 (55.9%) patients with symptoms suggestive of TB disease. Patients who did not inform health workers about TB related symptoms were more likely to miss a TB investigation (adjusted prevalence ratio: 1.68, 95%CI; 1.36-2.08, P<0.001). Conclusion; A large proportion of patients with symptoms suggestive of TB did not have sputum and/ or CXR requested for investigation. Patients who did not inform health workers about their TB related symptoms were more likely to miss having sputum and/ or CXR requested. We recommend studies to explore barriers and facilitators of disclosure of TB symptoms to enable formulation of effective interventions to empower people to improve likelihood of disclosing TB related symptoms.


2021 ◽  
Author(s):  
Xiaolin Liu ◽  
Hongjin Zhu

Abstract Background Mental health workers may face more obstacles in humanistic care during the COVID-19 pandemic, we aimed to explore the humanistic care ability of mental health workers and its potential influencing factors.Method(s) An online cross-sectional survey was conducted among 262 mental health workers working in Chongqing, China from December 1 to 31, 2020. Self-administered questionnaires were used to collect data from the participants. Results Mental health workers’ humanistic care ability score was 186.47 ± 21.34, and most of the them (79.8%) were at a low level. Psychological capital and personality traits were significant influencing factors of humanistic care ability and its sub-dimensions.Conclusion(s) Research has found that the humanistic care ability of mental health workers is at a low level, and psychological capital and personality traits are significant factors influencing the humanistic care ability and its sub-dimensions. Interventions to improve psychological capital of mental health workers or to promote the change of personality traits that they want are recommended, thereby promoting humanistic practice.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Keith Twirire Kakame ◽  
Noel Namuhani ◽  
Andrew Kazibwe ◽  
Felix Bongomin ◽  
Joseph Baruch Baluku ◽  
...  

Abstract Background The incidence of tuberculosis (TB) is high in Uganda; yet, TB case detection is low. The population-based survey on the prevalence of TB in Uganda revealed that only 16% of presumptive TB patients seeking care at health facilities were offered sputum microscopy or chest-X ray (CXR). This study aimed to determine the magnitude of, and patient factors associated with missed opportunities in TB investigation at public health facilities of Wakiso District in Uganda. Methods A facility-based cross-sectional survey was conducted at 10 high volume public health facilities offering comprehensive TB services in Wakiso, Uganda, among adults (≥18 years) with at least one symptom suggestive of TB predefined according to the World Health Organisation criteria. Using exit interviews, data on demographics, TB symptoms, and clinical data relevant to TB diagnosis were collected. A missed opportunity in TB investigation was defined as a patient with symptoms suggestive of TB who did not have sputum and/or CXR evaluation to rule out TB. Poisson regression analysis was performed to determine factors associated with missed opportunities in TB investigation. Results Two hundred forty-seven (247) patients with presumptive TB exiting at antiretroviral therapy (ART) clinics (n = 132) or general outpatient clinics (n = 115) at public health facilities were recruited into this study. Majority of participants were female (161/247, 65.2%) with a mean + SD age of 35.1 + 11.5 years. Overall, 138 (55.9%) patients with symptoms suggestive of TB disease did not have sputum and/or CXR examinations. Patients who did not inform health workers about their TB related symptoms were more likely to miss a TB investigation (adjusted prevalence ratio (aPR): 1.68, 95%CI; 1.36–2.08, P < 0.001). However, patients who reported duration of cough of 2 weeks or more were less likely to be missed for TB screening (aPR; 0.69, 95%CI; 0.56–0.86, p < 0.001). Conclusion There are substantial missed opportunities for TB diagnosis in Wakiso District. While it is important that patients should be empowered to report symptoms, health workers need to proactively implement the WHO TB symptom screen tool and complete the subsequent steps in the TB diagnostic cascade.


2021 ◽  
Author(s):  
Bizuhan Gelaw Birhanu ◽  
Johanna Mmabojalwa Mathibe-Neke

Abstract Background: During 2019, neonatal conditions in Ethiopia accounted for 56% of under-5 deaths, with 33 neonatal deaths occurring for every 1,000 live births. More than 80% of all newborns deaths are caused by preventable and treatable conditions with available interventions. In Ethiopia, mortality rates for newborn babies have remained stubbornly high over the decades. Methods: A cross-sectional survey design was employed. Interviewer-administered questionnaires were administered to 221 health workers and health extension workers in 142 health facilities from April to July 2017. Data was entered in the EpiData 3.1, exported to SPSS and STATA for analysis. Results: Out of the ten quality of newborn care variables, 8.7 [95%CI: 6.03-11.303], the highest mean was achieved by primary hospitals, followed by urban health centres with a 6.4 mean [95%CI:5.168-7.601]. However, nearly half of the rural health centres were providing quality of newborn care at the mean of 5.7 [95%CI: 5.152-6.18], and below half was provided by health posts, 4.5 [95%CI: 3.867-5.116]. From the seven emergency newborn care signal functions, primary hospitals had a higher mean score, 6.3 [95%CI: 6.007-7.325] and rural health centres had a lowest mean score, 2.3 [95%CI: 2.043-2.623]. The availability of essential equipment is also significantly associated with the quality of neonatal care provision in the health facilities (p < 0.05). Overall, the effectiveness of the neonatal healthcare services has a significant association with the health facilitates readiness score [95%CI: 0.134-0.768]. Conclusion: The quality of newborn care was high at the higher-level health facilities and lower in the lower level health facilities such as rural health centres and health posts; where these facilities are designed to provide the newborn care services to the majority of the rural communities. In addition, the provision of emergency newborn care signal functions were critically low in rural health centres where these are a referral receiving health facilities from health posts. Thus, the rural health centres and health posts should be targeted to improve their readiness to provide the quality of services for newborns as per their expected level of care.


2021 ◽  
Vol 62 (2) ◽  
Author(s):  
Phạm Văn Dậu ◽  
Phạm Cẩm Kỳ ◽  
Bùi Thị Hương

Objective: To assess knowledge and practices on safe motherhood of mothers giving birth at public health facilities of Ninh Binh province in 2019. Subjects: Health workers working at public health facilities of the province. Rearch method: Descriptive cross-sectional survey. Results:When asked about the danger signs of mothers after giving birth that need to be monitored, the highest percentage is prolonged bleeding (94.3%), the lowest is prolonged abdominal pain (70.7%). In full body examination, the percentage of health workers who  practiced correctly was found the lowest for cardiopulmonary examination (49.0%), breast examination (58.0%), and the highest for blood pressure measurement (91.7%). Conclusion: The rate of health workers having correct knowledge on safe motherhood was not high. The rate of health workers having correct practice on prenatal check-up steps and asking steps ranged from 68.2% to 94.3%.


Author(s):  
Kahler W. Stone ◽  
Kristina W. Kintziger ◽  
Meredith A. Jagger ◽  
Jennifer A. Horney

While the health impacts of the COVID-19 pandemic on frontline health care workers have been well described, the effects of the COVID-19 response on the U.S. public health workforce, which has been impacted by the prolonged public health response to the pandemic, has not been adequately characterized. A cross-sectional survey of public health professionals was conducted to assess mental and physical health, risk and protective factors for burnout, and short- and long-term career decisions during the pandemic response. The survey was completed online using the Qualtrics survey platform. Descriptive statistics and prevalence ratios (95% confidence intervals) were calculated. Among responses received from 23 August and 11 September 2020, 66.2% of public health workers reported burnout. Those with more work experience (1–4 vs. <1 years: prevalence ratio (PR) = 1.90, 95% confidence interval (CI) = 1.08−3.36; 5–9 vs. <1 years: PR = 1.89, CI = 1.07−3.34) or working in academic settings (vs. practice: PR = 1.31, CI = 1.08–1.58) were most likely to report burnout. As of September 2020, 23.6% fewer respondents planned to remain in the U.S. public health workforce for three or more years compared to their retrospectively reported January 2020 plans. A large-scale public health emergency response places unsustainable burdens on an already underfunded and understaffed public health workforce. Pandemic-related burnout threatens the U.S. public health workforce’s future when many challenges related to the ongoing COVID-19 response remain unaddressed.


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