scholarly journals Challenges in Providing Health Care Services During COVID-19 Pandemic: Exploration of Providers’ Perspectives in Nepal.

Author(s):  
Rajendra Karkee ◽  
Prajjwal Pyakurel ◽  
Deepak Paudel ◽  
Parineeta Thapa ◽  
Jiba Nath Dhamala ◽  
...  

Abstract IntroductionThe rapid increase of COVID-19 cases since the beginning of May 2020, imposition of lockdown, and preparation activities to detect, manage and treat COVID-19 in public hospitals have impacted on the provision of non-COVID health care services resulting in increased morbidity and mortality in Nepal. This study aims to explore challenges in providing non-COVID as well as COVID-19 health care services through public hospitals in Eastern Nepal.MethodsA qualitative study with 25 key informants from three public hospitals in Eastern Nepal was conducted. Key informants were health care workers (HCWs) and managers of the hospitals. A thematic analysis was carried out to identify challenges in providing non-COVID and COVID-19 health care services.ResultsWe identified four themes: weak implementation; weak co-ordination and management; low accountability of HCWs and staff; and risk of infection and stigma as the challenges to provide COVID-19 health care services. We identified three themes: maintaining safety measures in hospitals, managing patients, and fear of infection as the challenges in provision of non-COVID health care services. Inadequate resources and HCWs, lengthy procurement process, and poor jobs specification were the main reasons for weak implementation. HCWs stated weak hospital administration while managers and focal persons complained of low accountability of HCWs and staff to manage COVID-19 health care services.ConclusionIn addition to inadequate resources; the risk of infection of COVID-19, maintaining safety measures in hospitals, ensuring clear leadership and governance, and preparing motivated and accountable HCWs and staff to get ‘work done’ are unique challenges observed in the study hospitals; and consequently need to be addressed.

2019 ◽  
Vol 9 (2) ◽  
pp. 226-242 ◽  
Author(s):  
Jatin Pandey ◽  
Manjari Singh ◽  
Biju Varkkey ◽  
Dileep Mavalankar

The health of people in a nation is a potential indicator of its development. Over and above that, the job performance of people involved in the delivery and facilitation of health care services within a nation reflects the actual health conditions in it. In developing countries, where a large chunk of the population lives in rural areas, the job performance of grass-roots health care workers gains significant importance in order to ensure effective and efficient delivery of health care services to the masses and marginalized communities. The present study takes the case of Accredited Social Health Activists (ASHAs) in difficult rural areas of India to identify factors that affect their job performance and suggests interventions through which it could be enhanced. Fifty-five ASHAs were interviewed and five focused group discussions (FGDs) were conducted. Additionally, triangulation was done by interviewing other stakeholders, while studying relevant documents. Through content analysis of these interviews and documents, this study identifies the demands, resources and stressors that affect the job performance of these important intermediaries in the health care supply chain (in the Indian context). The study also suggests policy-level decisions that could help in enhancing job performance of ASHAs by managing demands, increasing resources and reducing stressors. Key Messages We have developed a model that delineates the demands, resources and stressors that affect job performance of women workers in rural India. We have studied Accredited Social Health Activists (ASHAs) who are part of community health care sector. However, our findings are applicable to a wider set of similar job roles. We have studied the nuances of factors affecting job performance for a category of community health care workers who are not full-time employees, have received minimal training and work in close proximity of their residence in a closely knit society. We have looked at job performance of ASHAs who are women community health workers, with low educational qualifications, based in rural setting of a developing country. We have recommended policy implications that would aid in enhancing the performance of ASHAs and thus improve the health care situation in rural India.


2007 ◽  
Vol 36 (1) ◽  
pp. 95-106 ◽  
Author(s):  
James F. Oehmke ◽  
Satoshi Tsukamoto ◽  
Lori A. Post

The search for engines to power rural economic growth has gone beyond the traditional boundaries of the food and fiber sector to industries such as tourism and to schemes such as attracting metropolitan workers to commuter communities with rural amenities. A group that has been somewhat overlooked is retirees, who may wish to trade in urban or suburban lifestyles for a more peaceful rural retirement. An industry that has been neglected is the health care industry, which is the most rapidly growing industry nationally and of particular interest to retirees and aging populations. This paper examines the importance of rural health care services in attracting migrants age 65+ to rural counties in Michigan. Results indicate that the number of health care workers has a positive effect on net in-migration, and that this effect is large and statistically significant for the 70+ age group. Implications for rural development strategies are discussed.


2015 ◽  
Vol 18 (1) ◽  
Author(s):  
Kudra Khamis ◽  
Bernard Njau

Background: Quality of care is a complex issue influenced by many factors. It is fundamental in assessing health care delivery in health facilities in developing countries. Health care workers’ perceptions help policy makers and planners to identify bottlenecks in the system to improve utilisation and sustainability of health care services in the population. The objective of this study was to explore health care workers’ perception about the quality of health care delivered at the outpatient department in Mwananyamala Hospital in Dar es Salaam, Tanzania.  Methods: A cross-sectional qualitative study was conducted from April to May 2013.  Results: Health care workers’ mentioned extrinsic as well as intrinsic factors, which may influence the quality of health care services. Extrinsic factors included poor physical infrastructure, unavailability of medical equipment and/or essential drugs and poor staffing levels. Intrinsic factors mentioned were motivation for health care workers and workplace training opportunities.Conclusion: Multiple factors influencing perceived quality of health care Mwananyamala hospital have been identified to include physical infrastructure, availability of medical equipment and essential medicines, staffing levels, remuneration and promotion.


2022 ◽  
Vol 75 (1) ◽  
Author(s):  
Luciano Garcia Lourenção ◽  
Jacqueline Flores de Oliveira ◽  
Francisco Rosemiro Guimarães Ximenes Neto ◽  
Carlos Leonardo Figueiredo Cunha ◽  
Sandra Verónica Valenzuela-Suazo ◽  
...  

ABSTRACT Objective: Assess levels of career commitment and career entrenchment among Primary Health Care workers. Methods: This Cross-sectional study addressed 393 workers using the Brazilian versions of the Career Commitment Measure (CCM) and Career Entrenchment Measure (CEM). Results: Levels of Career commitment [75.5-77.5] were higher (p<0.001) than Career Entrenchment [66.7-69.2]. Identity levels [82.7-85.5] were higher (p<0.001) than Investment levels [60.4-65.0]. Career resilience levels [75.1-79.2] were higher (p<0.001) than Emotional costs [69.0-72.1]. Planning levels [64.2-67.1] were lower (p<0.001) than levels of limitedness of career alternatives [68.1-71.0]. Conclusion: The highest scores were obtained in Career commitment, showing the workers’ identification and positive relationship with their careers, that is, these workers remain in Primary Health Care services because they identify themselves with their professions.


Author(s):  
Enwereji Ezinne E. ◽  
Ezeama Martina C. ◽  
Enwereji Kelechi O.

Background: The need for nursing students to care and support patients especially those living positively with HIV and AIDS as well as those with terminal diseases should not be underestimated. By training, nursing students are expected to interact cordially with patients and other health care professionals but most times, the reverse is the case. Inter-professional and interpersonal education prepare nursing students on clinical posting to provide quality health care services to all patients irrespective of their ages and health conditions. Therefore, creating healthy work environment by encouraging team work, integrating treatment and prevention services to promote good health is imperative in ensuring patients’ safety, and enhanced inter-professional relationship.Methods: A two-day pre-clinical seminar which centered on professionalism, teamwork, interpersonal and inter-professional relationships, as well as effective communication to guarantee healthy work environments was carried out. The pre-clinical seminar was also used to prepare 186 nursing students on their expected roles during the twelve weeks’ clinical posting in health institutions. At the end of the students’ posting, two days post-clinical seminar aimed to harness students’ experiences, views and performances, as well as the teachers’ observations during the clinical posting was conducted. Thereafter, all comments on performances, observations, experiences and other remarks from the teachers and students were grouped together and analyzed qualitatively and quantitatively.Results: A good proportion of the students 142 (76.3%) established good interpersonal relationship with the patients who are HIV positive while 135 (72.6%) had effective inter-professional interaction with health care workers. Also 135 (72.6%) had good team work relationship with other health care professionals. There were better health care services to clients as evidenced by 95 (51.1%) of students who shared case managements with the health care workers and 122 (65.6%) of the students who used mobilization and advocacy to identify pressing challenges like inter-professional conflicts, poor uptake of messages about treatment and referrals as well as malnutrition among children. A respectable number of the students, 144 (77.4%) collaborated with colleagues to provide nutrition to malnourished children to improve their nutritional status, while 75 (40.3%) assisted in resolving some inter-professional conflicts.Conclusions: Students’ initiatives in management of cases, inter-professional and interpersonal learning experiences during clinical postings increased students’ understanding of teamwork and professionalism as well as promoted friendlier environments that guaranteed better health care services to patients.


2019 ◽  
Author(s):  
Rizqy Amelia Zein ◽  
Nuzulul Kusuma Putri ◽  
Ilham Akhsanu Ridlo

Our research attempted to investigate whether justice, trust in health care services, the confidence level of the health system and institutions, political party support and evaluation of health care services post- Jaminan Kesehatan Nasional (JKN) affected policy acceptability in our health workers (N=95) and laypeople (N=308) sample. We performed a two-level linear mixed-effects model to test our hypothesis that trust, perceived justice, confidence in healthcare services, and national health system evaluation could impact policy acceptability in our health workers and laypeople sample. We calculated the effect sizes by comparing level-2 variances and residuals of the null model and the random-intercept model. Our findings suggested that health care workers with high concern on justice would be more likely to hold negative acceptability to JKN. The findings implied that health workers tend to associate JKN with unfairness. On the other hand, JKN acceptability in laypeople sample was found to be positively associated with the evaluation of health care service post-JKN, while justice or political party support did not affect JKN acceptability. It might indicate that laypeople motives for joining JKN scheme could be essentially pragmatic. We administered our questionnaire using an online platform and circulated it through social media and IMS, so that this research poses a problem of self-selection bias, which potentially leads to biased estimates. We also oversampled female participants, especially in laypeople samples. Aiming at a universal health coverage in 2019, JKN will cover almost 300 million Indonesians and be one of the biggest single-payer national health insurance scheme in the world. Our research might offer insight into how health workers and laypeople respond to the policy.


2021 ◽  
Vol 3 (2) ◽  
pp. 444-453
Author(s):  
Arturo Cervantes Trejo ◽  
Sophie Domenge Treuille ◽  
Isaac Castañeda Alcántara

AbstractThe Institute for Security and Social Services for State Workers (ISSSTE) is a large public provider of health care services that serve around 13.2 million Mexican government workers and their families. To attain process efficiencies, cost reductions, and improvement of the quality of diagnostic and imaging services, ISSSTE was set out in 2019 to create a digital filmless medical image and report management system. A large-scale clinical information system (CIS), including radiology information system (RIS), picture archiving and communication system (PACS), and clinical data warehouse (CDW) components, was implemented at ISSSTE’s network of forty secondary- and tertiary-level public hospitals, applying global HL-7 and Digital Imaging and Communications in Medicine (DICOM) standards. In just 5 months, 40 hospitals had their endoscopy, radiology, and pathology services functionally interconnected within a national CIS and RIS/PACS on secure private local area networks (LANs) and a secure national wide area network (WAN). More than 2 million yearly studies and reports are now in digital form in a CDW, securely stored and always available. Benefits include increased productivity, reduced turnaround times, reduced need for duplicate exams, and reduced costs. Functional IT solutions allow ISSSTE hospitals to leave behind the use of radiographic film and printed medical reports with important cost reductions, as well as social and environmental impacts, leading to direct improvement in the quality of health care services rendered.


Author(s):  
Elijah Marangu ◽  
Fethi Mansouri ◽  
Natisha Sands ◽  
David Ndetei ◽  
Peterson Muriithi ◽  
...  

Abstract Aim To assess mental health literacy of health workers in primary health care services in Kenya. Background Mental illness is common in Kenya, yet there are fewer than 500 specialist mental health workers to serve Kenya’s population of over 50 million. The World Health Organization recommends the integration of mental health care into primary health care services to improve access to and equity of this care, especially in low and middle-income countries. An important step to integrating mental health care into primary health care services is to determine mental health literacy levels of the primary health care workforce. Method A cross-sectional survey using Jorm’s Mental Health Literacy Instrument (adapted for the Kenyan context) was administered to 310 primary health care workers in four counties of Kenya. Results Of the 310 questionnaires distributed, 212 (68.3%) were returned. Of the respondents, 13% had a formal mental health qualification, while only 8.7% had received relevant continuing professional development in the five years preceding the survey. Just over one third (35.6%) of primary health care workers could correctly identify depression, with even fewer recognising schizophrenia (15.7%). Conclusions This study provides preliminary information about mental health literacy among primary health care workers in Kenya. The majority of respondents had low mental health literacy as indicated by their inability to identify common mental disorders. While identifying gaps in primary health care workers’ mental health knowledge, these data highlight opportunities for capacity building that can enhance mental health care in Kenya and similar low and middle-income countries.


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