scholarly journals Perceptions of health workers on the referral of women with obstetric complications: a qualitative study in rural Sierra Leone

2020 ◽  
Author(s):  
R. Proos ◽  
H. Mathéron ◽  
J. Vas Nunes ◽  
A. Falama ◽  
P. Serry-Kamal ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Maternal Mortality ◽  
Sierra Leone ◽  
Health Care Workers ◽  
Health Workers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Obstetric Complications ◽  
Care Workers

Abstract BackgroundSierra Leone has one of the highest maternal mortality ratios in the world. Timely and well-coordinated referrals are necessary to reduce delays in providing adequate care for women with obstetric complications. This study describes the perspectives of health workers in rural facilities in Sierra Leone concerning the referral of women with obstetric complications.MethodsWe conducted semi-structured group interviews with health care workers in nine peripheral health units in rural Sierra Leone regarding the referral of women with obstetric complications. Themes discussed were based on an interview guide. The data was analysed by systematic text condensation.ResultsPerspectives were grouped according to the following themes identified: 1) communication between health care workers; 2) underlying influences on decision-making; 3) women’s compliance to referral; 4) logistic constraints.ConclusionSeveral factors in rural Sierra Leone are perceived to complicate timely and adequate referral of women in need of emergency obstetric care. Notable among these factors are fear among women for being referred and fear among health care workers for having maternal deaths or severe obstetric complications at their own facilities. Furthermore, the decision-making of health care workers concerning referral is negatively influenced by an atmosphere of hierarchy between health care workers. Such factors must be considered in efforts to reduce maternal mortality.

scholarly journals Perspectives of health workers on the referral of women with obstetric complications: a qualitative study in rural Sierra Leone

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e041746
Author(s):  
Ryan Proos ◽  
Hanna Mathéron ◽  
Jonathan Vas Nunes ◽  
Abdul Falama ◽  
Patricia Sery Kamal ◽  
...  
Keyword(s):  
Decision Making ◽  
Maternal Mortality ◽  
Sierra Leone ◽  
Rural Areas ◽  
Healthcare Workers ◽  
Health Workers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Obstetric Complications ◽  
Structured Interviews

ObjectivesSierra Leone has one of the highest maternal mortality ratios in the world. Timely and well-coordinated referrals are necessary to reduce delays in providing adequate care for women with obstetric complications. This study describes factors affecting timely and adequate referral of women with obstetric complications in rural areas of Sierra Leone as viewed by health workers in rural health facilities.DesignQualitative research with semi-structured interviews using open-ended questions. Data were analysed by systematic text condensation.SettingInterviews were held in nine peripheral health units in rural Sierra Leone.Participants19 health workers including nurses, midwives and clinical health officers participated in nine interviews.ResultsFrom the interviews, four major themes describing possible factors of delay in referral of women in need of emergency obstetric care emerged: (1) communication between healthcare workers; (2) underlying influences on decision-making; (3) women’s compliance to referral and (4) logistic constraints.Several factors in rural Sierra Leone are perceived to complicate timely and adequate referral of women in need of emergency obstetric care. Notable among these factors are fear among women for being referred and fear among healthcare workers for having maternal deaths or severe obstetric complications occurring at their own facilities. Furthermore, decision-making of healthcare workers whether to refer a woman or not is negatively influenced by a hierarchical culture with high power distance between healthcare workers.ConclusionFactors identified that complicate timely and adequate referral of women in need of emergency obstetric care must be considered in efforts to reduce maternal mortality. Possible interventions that may reduce delay in referral include increased communication by mobile phones between health workers for advice and feedback regarding referrals, involvement of influential stakeholders to increase women’s compliance to referral, and consistent use of standardised management protocols.

scholarly journals Health care workers experiences in emergency obstetric care following implementation of an in-service training program: case of 2 Referral Hospitals in Botswana

2021 ◽  
Vol 21 (1) ◽  
pp. 51-58
Author(s):  
Ludo Nkhwalume ◽  
Yohana Mashalla
Keyword(s):  
Health Care ◽  
Maternal Mortality ◽  
Health Care Workers ◽  
Community Involvement ◽  
Negative Attitude ◽  
Emergency Obstetric Care ◽  
Theory Approach ◽  
Care Workers ◽  
Referral Hospitals ◽  
Service Training

Background: Maternal mortality rate remains a challenge in many developing countries. Objectives: This study explored experiences of Health Care Workers on Emergency Obstetrics Care (EMOC) in-service training and its effect on maternal mortality. Methods: Descriptive qualitative study design was conducted using in-depth interviews and focus group discussions. Par- ticipants were EMOC trained midwives and doctors purposively selected from the 2 referral hospitals in the country. Data were transcribed verbatim, coded, and analysed using Grounded Theory approach. Results: Four themes emerged including training, EMOC implementation, maternal death factors and EMOC prioritisation. The duration of training was viewed inadequate but responsiveness to and confidence in managing obstetric emergencies improved post EMOC training. Staff shortage, HCWs non-adherence and negative attitude to EMOC guidelines; delays in instituting interventions, inadequate community involvement, minimal or no health talk to women and their partners and communities on sexual reproductive matters and non-prioritisation of EMOC by authorities were concerns raised. Conclusion: Strengthening health education at health facility levels, stakeholders’ involvement; and prioritising EMOC in-service training are necessary in reducing the national maternal mortality. Keywords: Maternal mortality; health care workers; EMOC, in-service training.

scholarly journals Health care workers experiences in emergency obstetric care following implementation of an in-service training program: case of 2 Referral Hospitals in Botswana

2021 ◽  
Vol 21 ◽  
pp. 51-58
Author(s):  
Ludo Nkhwalume ◽  
Yohana Mashalla
Keyword(s):  
Health Care ◽  
Maternal Mortality ◽  
Health Care Workers ◽  
Community Involvement ◽  
Negative Attitude ◽  
Emergency Obstetric Care ◽  
Theory Approach ◽  
Care Workers ◽  
Referral Hospitals ◽  
Service Training

Background: Maternal mortality rate remains a challenge in many developing countries. Objectives: This study explored experiences of Health Care Workers on Emergency Obstetrics Care (EMOC) in-service training and its effect on maternal mortality. Methods: Descriptive qualitative study design was conducted using in-depth interviews and focus group discussions. Par- ticipants were EMOC trained midwives and doctors purposively selected from the 2 referral hospitals in the country. Data were transcribed verbatim, coded, and analysed using Grounded Theory approach. Results: Four themes emerged including training, EMOC implementation, maternal death factors and EMOC prioritisation. The duration of training was viewed inadequate but responsiveness to and confidence in managing obstetric emergencies improved post EMOC training. Staff shortage, HCWs non-adherence and negative attitude to EMOC guidelines; delays in instituting interventions, inadequate community involvement, minimal or no health talk to women and their partners and communities on sexual reproductive matters and non-prioritisation of EMOC by authorities were concerns raised. Conclusion: Strengthening health education at health facility levels, stakeholders’ involvement; and prioritising EMOC in-service training are necessary in reducing the national maternal mortality. Keywords: Maternal mortality; health care workers; EMOC, in-service training.

scholarly journals NSI: A major occupational hazards among the health care workers in Nepal

2013 ◽  
Vol 3 (1) ◽  
pp. 22-25 ◽  
Author(s):  
Jaita Mondal
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Body Fluid ◽  
Occupational Safety ◽  
Assessment Tool ◽  
Health Workers ◽  
Needle Stick Injury ◽  
Safety And Health ◽  
Care Workers ◽  
B Virus

A percutaneous piercing wound as in needle stick injury is a typically set by a needle point, but possibly also by other sharp instruments or objects. These events are of concern because of the risk to transmit blood-borne diseases through the passage of the hepatitis B virus (HBV), the hepatitis C virus (HCV), and the Human Immunodeficiency Virus (HIV), the virus which causes AIDS. The present study was done to determine the risk status regarding NSI among health care workers of Private Hospitals, Pokhara, Nepal. Samples were selected through purposive sampling. Self administered questionnaire & risk assessment tool were used to collect data. Study revealed that majority of health care workers were females (93%) with mean age of 22.66 years (±3.1). Sixty eight percent had got NSI, among them 41% had NSI more than 2times in life. Maximum NSI cases happened either by recapping of the needle (18%) or during disposal of sharps (16%) or while transferring a body fluid (blood) to a specimen bottle (15%). The study concludes that majority of health workers had NSI more than two times which denotes NSI is a major occupational hazard. Cases happened either by recapping of the needle or during disposal of sharps or while transferring a body fluid to a specimen bottle. DOI: http://dx.doi.org/10.3126/ijosh.v3i1.9098   International Journal of Occupational Safety and Health, Vol 3 No 1 (2013) 22-25

scholarly journals Measuring the Quality of Rural-Based, Government Health Care Workers in Nepal

2010 ◽  
Author(s):  
Stephen Knoble ◽  
Anil Pandit ◽  
Bibek Koirala ◽  
Laxmi Ghimire
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Clinical Training ◽  
Health Workers ◽  
Clinical Skills ◽  
Clinical Teacher ◽  
Government Health ◽  
Care Workers ◽  
Key Skills ◽  
Significant Difference

A representative, cross-sectional clinical skills assessment of 163 mid-level, rural-based, government health care workers was conducted in four districts of Nepal in June 2007. All Health Assistants and Auxiliary Healthcare Workers within the target districts were scored using checklists of standardized key skills in clinical encounters with model patients or clinical models. Participant scores were reported as a mean percentage in adult medicine 28(%), pediatric medicine 56(%), maternity medicine 35(%), orthopedic medicine 45(%), clinical procedures 59(%), and management 46(%). This was measured against the government’s 60(%) standard on clinical skills. There was little significant difference between categories of health workers by district of posting or years of experience. There was a minor difference in skills by level of facility - workers in higher level facilities scored better across the domains. Reasons for poor performance in clinical skills were attributed to a lack of clinical in-service training programs, training only focusing on prevention and public health, and poor on-sight supervision. Poor pre-service schooling factors included heavy theory concentration in pathophysiology and inadequate clinical exposure opportunities. Recommendations for the improvement of clinical skills and decision-making include the institution of in-service competency-based training with a high emphasis on real patient exposure. Pre-service recommendations include implementation of a national certification program and an expansion of the current government clinical training sites and clinical teacher development programs.

scholarly journals Closing delivery gaps in the treatment of tuberculosis infection: Lessons from implementation research in Peru

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247411
Author(s):  
Courtney M. Yuen ◽  
Ana Karina Millones ◽  
Daniela Puma ◽  
Judith Jimenez ◽  
Jerome T. Galea ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Implementation Research ◽  
Health Workers ◽  
Preventive Treatment ◽  
Interferon Gamma Release Assay ◽  
Household Contacts ◽  
Care Cascade ◽  
Care Workers ◽  
Treatment Support

Background Targeted testing and treatment of TB infection to prevent disease is a pillar of TB elimination. Despite recent global commitments to greatly expand access to preventive treatment for TB infection, there remains a lack of research on how best to expand preventive treatment programs in settings with high TB burdens. Methods We conducted implementation research in Lima, Peru, around a multifaceted intervention to deliver TB preventive treatment to close contacts of all ages, health care workers, and people in congregate settings. Key interventions included use of the interferon gamma release assay (IGRA), specialist support for generalist physicians at primary-level health facilities, and treatment support by community health workers. We applied a convergent mixed methods approach to evaluate feasibility and acceptability based on a care cascade framework. Findings During April 2019-January 2020, we enrolled 1,002 household contacts, 148 non-household contacts, 107 residents and staff of congregate settings, and 357 health care workers. Cumulative completion of the TB preventive care cascade was 34% for contacts <5 years old, 28% for contacts 5–19 years old, 18% for contacts ≥20 years old, 0% for people in congregate settings, and 4% of health care workers. IGRA testing was acceptable to adults exposed to TB. Preventive treatment was acceptable to contacts, but less acceptable to physicians, who frequently had doubts about prescribing preventive treatment for adults. Community-based treatment support was both acceptable and feasible, and periodic home-visits or calls were identified as facilitators of adherence. Conclusions We attempted to close the gap in TB preventive treatment in Peru by expanding preventive services to adult contacts and other risk groups. While suboptimal, care cascade completion for adult contacts was consistent with what has been observed in high-income settings. The major losses in the care cascade occurred in completing evaluations and having doctors prescribe preventive treatment.

Prevalence and causes of unreported needle stick injuries among health care workers: a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Razieh Behzadmehr ◽  
Abbas Balouchi ◽  
Mehran Hesaraki ◽  
Farshid Alazmani Noodeh ◽  
Hosein Rafiemanesh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Workers ◽  
Health Workers ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Needle Stick ◽  
Care Workers ◽  
Needle Stick Injuries

Abstract Objectives Health care workers (HCWs) are exposed to needle needles daily. Despite individual studies, there is no statistics on the prevalence of unreported needle stick injuries (NSIs) have been reported. This study was performed to determine the prevalence and causes of unreported NSIs among HCWs. Content In present systematic review and meta-analysis study, three international databases (Web of Science, Scopus, PubMed) were searched from January 1, 2000 to December 31, 2018. The random model was used to determine the prevalence of unreported needle stick among HCWs. Summary and outlook Forty-one studies performed on 19,635 health care workers entered the final stage. Based-on random effect model, pooled prevalence of unreported needle stick injuries was 59.9% (95% CI: 52.0, 67.7; I2=98.9%). The most common cause of unreported NSIs was: They were not worried about NSIs (n=12). The high prevalence of unreported needle sticks injuries indicates the urgency and necessity of paying attention to strategies to improve reporting among health workers.

Risking Lives to Save Others During COVID-19: A Focus on Public Health Care Workers in Bangladesh and Egypt

2021 ◽  
pp. 002073142110637
Author(s):  
Shahjahan Bhuiyan
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Workers ◽  
Health Workers ◽  
Public Health Care ◽  
Altruistic Behavior ◽  
Ongoing Research ◽  
Health Crisis ◽  
Street Level ◽  
Care Workers

The coronavirus (COVID-19) pandemic has been spreading around the world, causing a major public health crisis that has already claimed hundreds of thousands of lives. Street-level bureaucrats­—health workers, teachers, street cleaners, police officers­, and so forth—are at the forefront in fighting against the pandemic. Of these, public health care workers, due to the nature of their involvement, should know and understand why they are risking their lives to save others during this pandemic. Based on the preliminary data gleaned from interviews with public health care workers in Bangladesh and Egypt, this ongoing research suggests they are risking their lives for reasons such as altruistic behavior, service to profession, adherence to bureaucratic accountability, and a desire to help mankind. The findings contribute to the existing literature about street-level bureaucratic behavior in atypical times such as these of the pandemic. This study is unique in that it comprehends that public health care workers of two culturally and geographically distinct countries are risking their lives for the same public-spirited cause.

scholarly journals Organizational and Individual Innovation Decisions in an Interorganizational System: Social Influence and Decision-Making Authority

2020 ◽  
Vol 70 (4) ◽  
pp. 497-521
Author(s):  
Jiawei Sophia Fu ◽  
Michelle Shumate ◽  
Noshir Contractor
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Social Norms ◽  
Social Influence ◽  
Health Care Workers ◽  
Social Information Processing ◽  
Innovation Adoption ◽  
Decision Makers ◽  
Care Workers ◽  
Interorganizational System

Abstract This study examines the processes of complex innovation adoption in an interorganizational system. It distinguishes the innovation adoption mechanisms of organizational-decision-makers (ODMs), who make authority adoption decisions on behalf of an organization, from individual-decision-makers (IDMs), who make optional innovation decisions in their own work practice. Drawing on the Theory of Reasoned Action and Social Information Processing Theory, we propose and test a theoretical model of interorganizational social influence. We surveyed government health-care workers, whose advice networks mostly span organizational boundaries, across 1,849 state health agencies in Bihar, India. The collective attitudes of coworkers and advice network members influence health-care workers’ attitudes and perceptions of social norms toward four types of innovations. However, individuals’ decision-making authority moderates these relationships; advisors’ attitudes have a greater influence on ODMs, while perceptions of social norms only influence IDMs. Notably, heterogeneity of advisors’ and coworkers’ attitudes negatively influence IDMs’ evaluations of innovations but not ODMs’.

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