scholarly journals What Happens When Donors Pull Out? Examining Differences in Motivation Between Health Workers Who Recently Had Performance-Based Financing (PBF) Withdrawn With Workers Who Never Received PBF in the Democratic Republic of Congo

2019 ◽  
Vol 8 (11) ◽  
pp. 646-661 ◽  
Author(s):  
Rishma Maini ◽  
Julia Lohmann ◽  
David R. Hotchkiss ◽  
Sandra Mounier-Jack ◽  
Josephine Borghi
Keyword(s):  
Financial Incentives ◽  
Local Community ◽  
Health Workers ◽  
Democratic Republic Of Congo ◽  
Qualitative Interviews ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Pull Out ◽  
Performance Based Financing ◽  
Quality Health

Background: A motivated workforce is necessary to ensure the delivery of high quality health services. In developing countries, performance-based financing (PBF) is often employed to increase motivation by providing financial incentives linked to performance. However, given PBF schemes are usually funded by donors, their long-term financing is not always assured, and the effects of withdrawing PBF on motivation are largely unknown. This cross-sectional study aimed to identify differences in motivation between workers who recently had donor-funded PBF withdrawn, with workers who had not received PBF. Methods: Quantitative data were collected from 485 health workers in 5 provinces using a structured survey containing questions on motivation which were based on an established motivation framework. Confirmatory factor analysis was used to verify dimensions of motivation, and multiple regression to assess differences in motivation scores between workers who had previously received PBF and those who never had. Qualitative interviews were also carried out in Kasai Occidental province with 16 nurses who had previously or never received PBF. Results: The results indicated that workers in facilities where PBF had been removed scored significantly lower on most dimensions of motivation compared to workers who had never received PBF. The removal of the PBF scheme was blamed for an exodus of staff due to the dramatic reduction in income, and negatively impacted on relationships between staff and the local community. Conclusion: Donors and governments unable to sustain PBF or other donor-payments should have clear exit strategies and institute measures to mitigate any adverse effects on motivation following withdrawal.

scholarly journals Factors associated with retention of community health workers in maternal, newborn and child health programme in Simiyu Region, Tanzania

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
David P. Ngilangwa ◽  
George S. Mgomella
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Financial Incentives ◽  
Health Workers ◽  
Medical Practitioner ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Health Programme ◽  
Health Programmes

Background: Attrition of community health workers (CHWs) continues to threaten the full realisation and sustainability of community-based health programmes globally. Aim: This study aimed to understand factors associated with CHWs’ recruitment and their retention. Setting: This study was conducted in five districts of the Simiyu Region, namely, Bariadi, Busega, Itilima, Maswa and Meatu in north-western Tanzania. Methods: In this cross-sectional study design, 341 CHWs who were working with the maternal health programme were randomly selected. Semi-structured questionnaires were administered to all participants. Data were descriptively and inferentially analysed using SPSS version 20. Results: Majority (58.0%) of CHWs were below 35 years. Over half (53.1%) had completed primary education only. Motivation factors for being CHW were aspiration to serve the community and desire for further training to become a qualified medical practitioner. Community recognition and financial incentives were among the key retention reasons for the CHWs. Being married (odds ratio [OR] 5.9, 95% confidence interval [CI] 1.7–20.1) having prior volunteer experience (OR 10.5 95% CI 12.7–40.5) and prior employment OR 21.8 (CI 12.2–38.9) were positively associated with retention of CHWs, while being a female was negatively associated with retention OR 0.4 (CI 0.2–0.8). Conclusions: Both financial and non-financial incentives were critical in contributing to the retention of CHWs. Thus, health programmes should carefully select CHWs by understanding their motives beforehand, and provide them with incentives.

scholarly journals Delay of TB patients in diagnosis in a conflict setting of Mogadishu, Somalia - a cross-sectional study

2021 ◽  
Author(s):  
Naima Said Sheikh ◽  
Abdiwahab Moallim Salad ◽  
Abdi Gele
Keyword(s):  
Detection Rate ◽  
Local Community ◽  
Health Workers ◽  
Cross Sectional Study ◽  
Case Detection ◽  
Sectional Study ◽  
Total Delay ◽  
Cross Sectional ◽  
Case Detection Rate ◽  
Poor Knowledge

BBackground. The TB case detection rate in Somalia is 42%, which is much lower than the WHO target of detecting 70% of new TB cases. Understanding the factors contributing to the delay of TB patients in the diagnosis, and reducing the time between the onset of TB symptoms to diagnosis, is a prerequisite to increase the case detection rate and to ultimately bring the TB epidemic in Somalia under control. The aim of this study is to examine the duration of delay, and factors associated with the delay among patients in TB management centers in Mogadishu, Somalia. Methods. An institution-based, cross-sectional study was conducted in TB management clinics providing directly observed treatments (DOTS) programs in Mogadishu. A total of 276 patients were interviewed using a structured questionnaire from June-October 2018. We analyzed data using descriptive statistics and different logistic regression models. Results. Approximately 78% of study participants were male. Nearly a third (36.5%) came from a household of nine individuals or more, while 73% were unemployed. The median patient and provider delays were 50 days and one day, respectively. The median total delay was 55 days, with an inter-quartile range of 119 days. Patients who had a poor knowledge of the symptoms of TB had 3.16 times higher odds of delay over 50 days than their counterparts. Furthermore, a poor knowledge of the symptoms of TB (aOR 4.22, CI 2.13-8.40), not making ones own decisions in seeking TB treatment (aOR 2.43, CI 1.22-4.86) and a poor understanding of the fact that TB can be treated with biomedical treatment, as opposed to traditional treatment (aOR 2.07, CI 1.02-4.16), were predictors of a patient delay over 120 days. Conclusions. The duration in the delay of TB patients under diagnosis in Mogadishu is one of the highest reported in developing countries, exceeding two years in some patients. Training local community health workers to detect suspected TB cases, and referring the cases of prolonged cough over three weeks for TB care centers for diagnosis, is imperative to help break the transmission and reduce the infectious pool in the population of Mogadishu. This may not only increase the community awareness of TB disease, but it may also facilitate the early referral of TB patients to diagnostic and treatment care centers.

Implementation status of antimicrobial stewardship programs in hospitals: A quantitative analysis study in Ho Chi Minh city, Vietnam

MedPharmRes ◽  
2020 ◽  
Vol 4 (2) ◽  
pp. 34-39
Author(s):  
Thi-Hai-Yen Nguyen ◽  
Truong Van Dat ◽  
Phuong-Thao Huynh ◽  
Chi-Thuong Tang ◽  
Vinh-Chau Van Nguyen ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Health Workers ◽  
Cross Sectional Study ◽  
Ho Chi Minh City ◽  
Multi Drug Resistance ◽  
Cross Sectional ◽  
Clostridioides Difficile ◽  
The Status ◽  
Specific Assessment ◽  
Implementation Status

Vietnam has one of the highest multi drug resistance in Asia. Although, despite many efforts to implement the Antimicrobial Stewardship Programs (the ASP) since 2016, studies that on the implementation policy are very lacking of this program are limited. For that reason, we conducted this cross-sectional study to analyze the viewpoint of health workers (HWs) on the implementation of the ASP at some hospitals in Ho Chi Minh City (HCMC). An assessment of 234 HWs showed that the implementation of the ASP in HCMC hospitals was above average (62.7/100.0). A barrier to the implementation consisted of the deficiency in finances, guidelines for diagnosis, and specific interventions for some common infections, such as distributing current antibiogram and monitoring rate of Clostridioides difficile infections. These were the widely recognized problems in initially implementing the ASP. Although most HWs are aware of the importance of implementing the ASP (79.1%), the specific assessment has not been recorded clearly due to the numerous neutral responses. Despite the support of the leadership, the implementation still faces many difficulties and limitations, especially in 3rd and 4th class hospitals. Besides, there was a lack of wide dissemination of information on the ASP at each unit. To generalize the status of the ASP implementation, researchers should conduct qualitative and quantitative studies with a larger scale.

Non-compliance to Mass Drug Administration Associated with the Low Perception of the Community Members About their Susceptibility to Lymphatic Filariasis in Ankobra, Ghana

2020 ◽  
Vol 20 (2) ◽  
pp. 167-174
Author(s):  
Ilo Dicko ◽  
Yaya Ibrahim Coulibaly ◽  
Modibo Sangaré ◽  
Bismark Sarfo ◽  
Priscillia Awo Nortey
Keyword(s):  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Health Workers ◽  
Compliance Rate ◽  
Cross Sectional Study ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Improve Compliance ◽  
Degree Of Association

Background: Lymphatic filariasis (LF) is a parasitic disease that has been targeted for elimination through the Mass Drug Administration (MDA.) Although the MDA started in the Ankobra community in Ghana in 2000, LF prevalence as reported in 2014 was relatively high (4.5%). Non-compliance to the MDA has been associated with the persistent LF prevalence in endemic regions. Objective: This study determined the factors associated with the non-compliance to the MDA among patients living in the Ankobra community, Ghana. Methods: A cross-sectional study using a one-stage cluster sampling method was used to collect data between June and July, 2017 in Ankobra. Questionnaires were used to collect data from health workers, the MDA drug distributors and study participants in Ankobra. Data analysis was performed using STATA 14. Logistic regression was used to measure the degree of association between the dependent (non-compliance) and independent variables. Non-compliance rate was defined as the percentage of individuals who self-reported that they did not actually swallow the drugs provided during the MDA. Results: The MDA coverage and non-compliance rates were 73.5% (147/200) and 33.33% (49/147) respectively. The main reason for non-compliance was fear of drug adverse events (75.51%, 37/49). Thought of “not being susceptible to LF” was significantly associated with the non-compliance (aOR= 2.83, [CI= 1.15, 6.98]). Conclusion: Health education about the susceptibility of residents getting LF disease in endemic community must be intensified to improve compliance to MDA medication ingestion and thus meet the Global Elimination of Lymphatic Filariasis by 2020.

scholarly journals Tired, Worried and Burned Out, but Still Resilient: A Cross-Sectional Study of Mental Health Workers in the UK during the COVID-19 Pandemic

2021 ◽  
Vol 18 (9) ◽  
pp. 4457
Author(s):  
Sofia Pappa ◽  
Joshua Barnett ◽  
Ines Berges ◽  
Nikolaos Sakkas
Keyword(s):  
Mental Health ◽  
Emotional Exhaustion ◽  
Organizational Support ◽  
Sleep Problems ◽  
Health Workers ◽  
Maslach Burnout Inventory ◽  
Cross Sectional Study ◽  
Mental Health Workers ◽  
Sectional Study ◽  
Cross Sectional

The burden of the COVID-19 pandemic on health systems and the physical and mental health of healthcare workers (HCWs) has been substantial. This cross-sectional study aims to assess the effects of COVID-19 on the psychological wellbeing of mental health workers who provide care to a vulnerable patient population that have been particularly affected during this crisis. A total of 387 HCWs from across a large urban mental health service completed a self-administered questionnaire consisting of socio-demographic, lifestyle and work-based information and validated psychometric scales. Depression and anxiety were measured using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7), respectively; sleep problems with the Athens Insomnia Scale (AIS); burnout with the Maslach Burnout Inventory (MBI); and resilience with the Resilience Scale-14 (RS-14). Multivariable logistic regression analysis was performed to determine potential mediating factors. Prevalence of burnout was notable, with 52% recording moderate/severe in Emotional Exhaustion, 19.5% moderate/severe in Depersonalisation, and 55.5% low/moderate Personal Accomplishment. Over half of all respondents (52%) experienced sleep problems; the presence of depressive symptoms was a significant predictor of insomnia. An increase in potentially harmful lifestyle changes, such as smoking, alcohol consumption and overeating was also observed. However, high Resilience was reported by 70% of the samples and the importance of this is highlighted. Female gender was associated with increased levels of depression and emotional exhaustion while those with a history of mental health conditions were most at risk of affective symptoms, insomnia, and burnout. Overall, our study revealed considerable levels of psychological distress and maladaptive coping strategies but also resilience and satisfaction with organizational support provided. Findings can inform tailored interventions in order to mitigate vulnerability and prevent long-term psychological sequelae.

scholarly journals Minimum acceptable diet among children aged 6–23 months in South Kivu, Democratic Republic of Congo: a community-based cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Richard Mbusa Kambale ◽  
Gaylord Amani Ngaboyeka ◽  
Joe Bwija Kasengi ◽  
Sarah Niyitegeka ◽  
Boss Rutakaza Cinkenye ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Feeding Practices ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Republic Of Congo ◽  
Wide Range ◽  
South Kivu

Abstract Background Suboptimal child nutrition remains the main factor underlying child undernutrition in Democratic Republic of Congo (DRC). This study aimed to assess the prevalence of minimum acceptable diet and associated factors among children aged 6–23 months old. Methods Community-based cross-sectional study including 742 mothers with children aged 6–23 months old was conducted in 2 Health Zones of South Kivu, Eastern DRC. WHO indicators of Infant and Young Child Feeding (IYCF) regarding complementary feeding practices were used. Logistic regression analysis was used to quantify the association between sociodemographic indicators and adequate minimum acceptable diet for both univariate and multivariate analysis. Results Overall, 33% of infants had minimum acceptable diet. After controlling for a wide range of covariates, residence urban area (AOR 2.39; 95% CI 1.43, 3.85), attendance postnatal care (AOR 1.68; 95% CI 1.12, 2.97), education status of mother (AOR 1.83; 95% CI 1.20, 2.77) and household socioeconomic status (AOR 1.72; 95% CI 1.14, 2.59) were factors positively associated with minimum acceptable diet. Conclusion Actions targeting these factors are expected to improve infant feeding practices in South Kivu.

scholarly journals Competency of health workers in detecting and managing gestational hypertension, pre-eclampsia, severe pre-eclampsia and eclampsia during antenatal check-ups in primary care health facilities in Bangladesh: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e046638
Author(s):  
Sk Masum Billah ◽  
Abdullah Nurus Salam Khan ◽  
S M Rokonuzzaman ◽  
Nafisa Lira Huq ◽  
Marufa Aziz Khan ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Workers ◽  
Gestational Hypertension ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Hypertensive Disorders Of Pregnancy ◽  
Cross Sectional ◽  
Hypertensive Disorders ◽  
Care Facilities

Study objectiveTo evaluate the competency of trained health workers in detecting and managing hypertensive disorders of pregnancy during routine antenatal check-ups (ANCs) at primary care facilities in Bangladesh.Study design and settingsCross-sectional study; conducted in 26 primary care facilities.Outcome measuresAccurate diagnosis of the hypertensive disorders of pregnancy.MethodIn total 1560 ANC consultations provided by primary health workers, known as Family Welfare Visitors (FWVs), were observed using a structured checklist between October 2017 and February 2018. All consultations were reassessed by study physicians for validation.ResultOf the ‘true’ cases of gestational hypertension (n=32), pre-eclampsia (n=29) and severe pre-eclampsia (n=16), only 3%, 7% and 25%, respectively, were correctly diagnosed by FWVs. Per cent agreement for the diagnosed cases of any hypertensive disorders of pregnancy was 9% and kappa statistics was 0.50 (p value 0.0125). For identification of any hypertensive disorders by FWVs, sensitivity and positive predictive values were 14% and 50%, respectively. There was a moderate positive correlation between the blood pressure measurements taken by FWVs and study physicians. Only 27% of those who had ‘some protein’ in urine were correctly identified by FWVs. Women diagnosed with any of the hypertensive disorders of pregnancy by FWVs were more likely to be counselled on at least one danger sign of pre-eclampsia (severe headache, blurring of vision and upper abdominal pain) than those without any such diagnosis (41% vs 19%, p value 0.008). All four cases of severe pre-eclampsia diagnosed by FWVs were given a loading dose of intramuscular magnesium sulphate and three among them were referred to a higher facility.ConclusionThe FWVs should be appropriately trained on risk assessment of pregnant women with particular emphasis on accurately assessing the diagnostic criteria of hypertensive disorders of pregnancy and its management.

scholarly journals Misconceptions about COVID-19 among older Rohingya (forcefully displaced Myanmar nationals) adults in Bangladesh: findings from a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e050427
Author(s):  
Sabuj Kanti Mistry ◽  
A R M Mehrab Ali ◽  
Uday Narayan Yadav ◽  
Saruna Ghimire ◽  
Md. Belal Hossain ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Health Workers ◽  
Multiple Linear Regression Model ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Factors Associated ◽  
Cumulative Score ◽  
Low Health Literacy ◽  
Communication Frequency

ObjectivesDue to low health literacy and adverse situation in the camps, there are possibilities of misconceptions related to COVID-19 among the older Rohingya (forcefully displaced Myanmar nationals or FDMNs) adults in Bangladesh. The present research aimed to assess the level of misconceptions and the factors associated with it among the older FDMNs in Bangladesh.DesignCross-sectional.SettingA selected Rohingya camp situated in Cox’s Bazar, a southeastern district of Bangladesh.ParticipantsInformation was collected from 416 conveniently selected FDMNs who were aged 60 years and above.Primary and secondary outcome measuresThe primary outcome was misconceptions related to the spread, prevention and treatment of COVID-19. Information on 14 different locally relevant misconceptions was gathered, each was scored as one, and obtained a cumulative score, ranging from 0 to 14, with a higher score indicating a higher level of misconceptions. A multiple linear regression model explored the factors associated with misconceptions.ResultsThe participants had an average of five misconceptions. The most prevalent misconceptions were: everyone should wear personal protective equipment when outside (84.6%) and its prevention by nutritious food (62.5%) and drinking water (59.3%). Other notable misconceptions included the spread of COVID-19 through mosquito bites (42%) and its transmissions only to the non/less religious person (31.4%). In regression analyses, memory or concentration problems, communication frequency with social networks, pre-existing conditions and receiving information from health workers were significantly associated with higher COVID-19 misconceptions. These misconceptions were less likely among those overwhelmed by COVID-19, having COVID-19 diagnosed friends or family members and receiving information from friends and family.ConclusionsOverall, we found that misconceptions were prevalent among the older FDMNs in Bangladesh. The associations have important implications for programmes to prevent and manage COVID-19 in these settings. Health workers need to be adequately trained to provide clear communication and counter misconceptions.

scholarly journals Conflict styles observed in doctors and nurses in health care organization

2011 ◽  
Vol 64 (5-6) ◽  
pp. 262-266 ◽  
Author(s):  
Branislava Brestovacki ◽  
Dragana Milutinovic ◽  
Tomislav Cigic ◽  
Vera Grujic ◽  
Dragana Simin
Keyword(s):  
Health Care ◽  
Health Workers ◽  
Health Care Organization ◽  
Cross Sectional Study ◽  
Care Organization ◽  
Cross Sectional ◽  
Conflict Styles ◽  
Five Dimensions ◽  
Significant Difference ◽  
Doctors And Nurses

Introduction. Health care workers often come into conflict situations while performing their daily activities. People behave differently when they come into conflicts and they are usually not aware of their own reactions. The aim of this paper was to establish the presence of conflict styles among health workers and the differences in relation to demographic characteristics (education, working experience, managerial position). Material and Methods. The research was done as a cross-sectional study and through surveys. The conflict handling questionnaire was used as the research instrument. The questionnaire contained 30 statements arranged in five dimensions of conflict styles. The sample included one hundred nurses and fifty-five doctors. Results. The research showed that accommodating was the most often used conflict style. There was no significant difference in styles of managerial and non-managerial staff, but there was a significant difference in the styles adopted by doctors and nurses. It should be noted that nurses used avoiding and accommodating conflict styles much more often. Conclusion. It is important to increase the awareness of conflict existence and the possibility of solving the problem constructively in order to achieve more efficient duty performance.

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