scholarly journals The Burden of COVID-19 Infection in a Rural Tamil Nadu Community

2021 ◽  
Author(s):  
Rita Isaac ◽  
Biswajit Paul ◽  
Madelon Finkel ◽  
Mahesh Moorthy ◽  
Seshasailam Venkateswaran ◽  
...  
Keyword(s):  
Community Health ◽  
Tamil Nadu ◽  
Health Workers ◽  
Extended Family ◽  
Community Health Center ◽  
Vulnerable Groups ◽  
Severe Illness ◽  
Suspected Case ◽  
Antibody Testing ◽  
The Impact

Abstract Background: There are almost 11 million cases of COVID-19 in India. Transmission rates vary from region to region, and are influenced by many factors including population susceptibility, travel and uptake of preventive measures. To date there have been relatively few studies examining the impact of the pandemic in poor, rural regions of India. We report on a study examining COVID-19 burden in a rural community in Tamil Nadu.Methods: The study was undertaken in a population of approximately 130000 people, served by the Rural Unit of Health and Social Affairs (RUHSA), a community health center of CMC, Vellore. We established and evaluated a COVID-19 PCR-testing programme for symptomatic patients – testing was offered to 350 individuals, and household members of test-positive cases were offered antibody testing. We also undertook two COVID-19 seroprevalence surveys in the same community, amongst 701 randomly-selected individuals. Results: There were 182 positive tests in the symptomatic population (52.0%). Factors associated with test-positivity were older age, male gender, higher socioeconomic status (SES, as determined by occupation, education and housing), a history of diabetes, contact with a confirmed/suspected case and attending a gathering (such as a religious ceremony, festival or extended family gathering). Amongst test-positive cases, 3 (1.6%) died and 16 (8.8%) suffered a severe illness. Amongst 129 household contacts 40 (31.0 %) tested positive. The two seroprevalence surveys showed positivity rates of 2.2% (July/Aug 2020) and 22.0% (Nov 2020). 40 tested positive (31.0%, 95% CI: 23.02 -38.98). Our estimated infection-to-case ratio was 31.7.Conclusions: A simple approach using community health workers and a community-based testing clinic can readily identify significant numbers of COVID-19 infections in Indian rural population. There appear, however, to be low rates of death and severe illness, although vulnerable groups may be under-represented in our sample. It’s vital these poor, rural populations aren’t overlooked in ongoing pandemic monitoring and vaccine roll-out in India.

scholarly journals The burden of COVID-19 infection in a rural Tamil Nadu community

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
R. Isaac ◽  
B. Paul ◽  
M. Finkel ◽  
M. Moorthy ◽  
S. Venkateswaran ◽  
...  
Keyword(s):  
Community Health ◽  
Tamil Nadu ◽  
Health Workers ◽  
Extended Family ◽  
Vulnerable Groups ◽  
Severe Illness ◽  
Suspected Case ◽  
Lower Income ◽  
Antibody Testing ◽  
The Impact

Abstract Background There have been over 30 million cases of COVID-19 in India and over 430,000 deaths. Transmission rates vary from region to region, and are influenced by many factors including population susceptibility, travel and uptake of preventive measures. To date there have been relatively few studies examining the impact of the pandemic in lower income, rural regions of India. We report on a study examining COVID-19 burden in a rural community in Tamil Nadu. Methods The study was undertaken in a population of approximately 130,000 people, served by the Rural Unit of Health and Social Affairs (RUHSA), a community health center of CMC, Vellore. We established and evaluated a COVID-19 PCR-testing programme for symptomatic patients—testing was offered to 350 individuals, and household members of test-positive cases were offered antibody testing. We also undertook two COVID-19 seroprevalence surveys in the same community, amongst 701 randomly-selected individuals. Results There were 182 positive tests in the symptomatic population (52.0%). Factors associated with test-positivity were older age, male gender, higher socioeconomic status (SES, as determined by occupation, education and housing), a history of diabetes, contact with a confirmed/suspected case and attending a gathering (such as a religious ceremony, festival or extended family gathering). Amongst test-positive cases, 3 (1.6%) died and 16 (8.8%) suffered a severe illness. Amongst 129 household contacts 40 (31.0%) tested positive. The two seroprevalence surveys showed positivity rates of 2.2% (July/Aug 2020) and 22.0% (Nov 2020). 40 tested positive (31.0%, 95% CI: 23.02 − 38.98). Our estimated infection-to-case ratio was 31.7. Conclusions A simple approach using community health workers and a community-based testing clinic can readily identify significant numbers of COVID-19 infections in Indian rural population. There appear, however, to be low rates of death and severe illness, although vulnerable groups may be under-represented in our sample. It’s vital these lower income, rural populations aren’t overlooked in ongoing pandemic monitoring and vaccine roll-out in India.

scholarly journals Biopsychopharmacosocial approach to assess impact of social distancing and isolation on mental health in older adults

2020 ◽  
Vol 25 (5) ◽  
pp. 231-238 ◽  
Author(s):  
Edward Baker ◽  
Louise L Clark
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Community Health ◽  
Health Professionals ◽  
Assessment Model ◽  
Vulnerable Groups ◽  
Severe Illness ◽  
Social Distancing ◽  
Health And Social Care ◽  
The Impact

It is impossible to predict or comprehend the impact of the ongoing COVID-19 pandemic. The UK Government's advice for vulnerable people, including older adults, to move towards self-isolation and social distancing is likely to reduce rates of transmission, the risk of severe illness and the impact on the acute health services. Although justified and necessary, this process of isolation is likely to have a negative impact on the mental health of these vulnerable groups, especially older people. It will become increasingly important for community health professionals to assess subtle changes in older persons' mental health, as the duration of this period of isolation remains unclear. The biopsychopharmacosocial model provides one method of assessing mental health and planning health and social care needs. This article hopes to guide community health professionals through the specifics of this assessment model in relation to the growing COVID-19 pandemic.

scholarly journals COVID-19 among Health Workers in Germany and Malaysia

2020 ◽  
Vol 17 (13) ◽  
pp. 4881 ◽  
Author(s):  
Albert Nienhaus ◽  
Rozita Hod
Keyword(s):  
Mortality Rate ◽  
Social Welfare ◽  
Health Workers ◽  
Case Reports ◽  
Severe Illness ◽  
Suspected Case ◽  
Work Related ◽  
Infection Protection Act ◽  
The Government ◽  
The Impact

We report on the suspected case reports filed for SARS-CoV-2 infections and COVID-19 illnesses among health and social welfare workers in Germany. In addition, we report about COVID-19 in health workers in Malaysia. Claims for occupational diseases caused by SARS-CoV-2 are recorded separately in a database of the Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW). This database is analyzed according to its content as of May 22, 2020. In addition, the notifiable cases of SARS-CoV-2 infections from personnel in medical institutions (e.g., clinics and doctor’s office) and social welfare institutions (e.g., nursing homes, shelters and refugee camps) following the German Infection Protection Act are analyzed. The report from Malaysia is based on personal experience and publications of the government. In Germany at present, 4398 suspected case reports for the diagnosis of SARS-CoV-2 infections among health and social workers have been filed. This figure is four times the number of all reported infections normally received per year. The majority of claims, regardless of being a confirmed infection, concerned nurses (n = 6927, 63.9%). The mortality rate for workers infected with SARS-CoV-2 is 0.2% to 0.5%. Doctors are affected by severe illness more frequently than other occupational groups (8.1% vs. 4.1%). In Malaysia, work-related infection of health workers (HW) occurred mainly when COVID-19 was not suspected in patients and no adequate personal protective equipment (PPE) was worn. Although knowledge on the spread of SARS-CoV-2 infections among workers remains limited, the impact appears to be substantial. This is supported by the mortality rate among infected workers. Occupational health check-ups carried out at the present time should be systematically analyzed in order to gain more information on the epidemiology of COVID-19 among HW. Since the supply and use of PPE improved, the infection risk of HW in Malaysia seems to have decreased.

scholarly journals Community Health Workers as a Strategy to Tackle Psychosocial Suffering Due to Physical Distancing: A Randomized Controlled Trial

2021 ◽  
Vol 18 (6) ◽  
pp. 3097
Author(s):  
Dorien Vanden Bossche ◽  
Susan Lagaert ◽  
Sara Willems ◽  
Peter Decat
Keyword(s):  
Randomized Controlled Trial ◽  
Community Health ◽  
Health Workers ◽  
Psychosocial Support ◽  
Controlled Trial ◽  
Intervention Group ◽  
Psychosocial Health ◽  
Control Group ◽  
Randomized Controlled ◽  
The Impact

Background: During the COVID-19 pandemic, many primary care professionals were overburdened and experienced difficulties reaching vulnerable patients and meeting the increased need for psychosocial support. This randomized controlled trial (RCT) tested whether a primary healthcare (PHC) based community health worker (CHW) intervention could tackle psychosocial suffering due to physical distancing measures in patients with limited social networks. Methods: CHWs provided 8 weeks of tailored psychosocial support to the intervention group. Control group patients received ‘care as usual’. The impact on feelings of emotional support, social isolation, social participation, anxiety and fear of COVID-19 were measured longitudinally using a face-to-face survey to determine their mean change from baseline. Self-rated change in psychosocial health at 8 weeks was determined. Results: We failed to find a significant effect of the intervention on the prespecified psychosocial health measures. However, the intervention did lead to significant improvement in self-rated change in psychosocial health. Conclusions: This study confirms partially the existing evidence on the effectiveness of CHW interventions as a strategy to address mental health in PHC in a COVID context. Further research is needed to elaborate the implementation of CHWs in PHC to reach vulnerable populations during and after health crises.

scholarly journals Factor Affecting the Utilization of Family Planning Program Services

2021 ◽  
Vol 2 (2) ◽  
pp. 41-50
Author(s):  
Melda Andriani ◽  
Megawati Megawati ◽  
Asriwati Asriwati ◽  
Lucia Lastiur
Keyword(s):  
Family Planning ◽  
Community Health ◽  
Health Center ◽  
Mixed Methods Research ◽  
Quantitative Methods ◽  
Family Planning Program ◽  
Health Workers ◽  
Community Health Center ◽  
Planning Program

Family planning to spacing or planning the number and distance of pregnancies using contraception. Data on active family planning participants based on the type of contraception at the Pasie Raya Community Health Center in 2019 was 39.4%, there was no increase in the coverage of active KB participants based on the type of contraception in 2018 of 49.4%. The aim is to find out what are the factors that influence the use of family planning program services for women in the working area of ​​the Pasie Raya Community Health Center. This type of research is a combination research (mixed methods research) combining or combining quantitative methods and qualitative methods with Accidental Sampling sampling techniques on 90 samples and 5 informants. Quantitative data were analyzed using univariate, bivariate and multivariate logistic regression tests. The results of the study showed the influence of knowledge, information sources, culture, family support and support from health workers on the utilization of family planning program services. Based on the multivariate analysis, the support variable for health workers is the dominant variable, while the results of the qualitative analysis on key informants and supporters can be concluded that women have taken advantage of the Kb service program, but most of the women do not understand and understand the benefits that are obtained from the family planning program. The conclusion from the health workers is very important in the utilization of family planning program services. It is recommended that the Health Office conduct more evaluations of family planning services at the Puskesmas. It is necessary to improve the quality of Kb services by including health workers in training.

scholarly journals Community Health Workers as a Strategy to Tackle Psychosocial Suffering due to Physical Distancing: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Dorien Vanden Bossche ◽  
Susan Lagaert ◽  
Sara Willems ◽  
Peter Decat
Keyword(s):  
Randomized Controlled Trial ◽  
Community Health ◽  
Health Workers ◽  
Psychosocial Support ◽  
Controlled Trial ◽  
Intervention Group ◽  
Psychosocial Health ◽  
Control Group ◽  
Randomized Controlled ◽  
The Impact

Background: During the COVID-19 pandemic some family physicians were overburdened and experienced difficulties reaching vulnerable patients and meeting the increased need for psycho-social support. This randomized controlled trial (RCT) tested whether a primary healthcare (PHC) based community health worker (CHW) intervention could tackle psychosocial suffering due to physical distancing measures in patients with limited social networks. Methods: CHWs provided 8 weeks of tailored psychosocial support to the intervention group. Control group patients received ‘care as usual’. The impact on feelings of emotional support, social isolation, social participation, anxiety and fear of COVID-19 were measured longitudinally using a face-to-face survey to determine their mean change from baseline. Self-rated change in psychosocial health at 8 weeks was determined. Results: We failed to find a significant effect of the intervention on the prespecified psychosocial health measures. However, the intervention did lead to significant improvement in self-rated change in psychosocial health. Conclusions: This study confirms partially the existing evidence on the effectiveness of CHW in-terventions as a strategy to address mental health in PHC in a COVID context. Further research is needed to elaborate the implementation of CHWs in PHC to reach vulnerable populations during and after health crises.

scholarly journals Kompetensi Bidan Puskesmas dalam Meningkatkan Pelayanan Antenatal (Studi Kasus di Puskesmas Tambak Rejo, Surabaya)

2019 ◽  
Vol 7 (1) ◽  
pp. 1-8
Author(s):  
Andy Asmara
Keyword(s):  
Community Health ◽  
Health Center ◽  
Community Health Centers ◽  
Health Workers ◽  
Perinatal Care ◽  
Community Health Center ◽  
Community Empowerment ◽  
District Health ◽  
Soft Skill ◽  
Birth Attendance

The daily facts indicated that an individual is the key factor to achieve organization’s success. Every organization with its best performance is always related to its human resources’ balanced competency. The midwife has role, function, and competencies to provide maternal services for women. The midwife’s role is not only a doer, but also an organizer, an educator, and a researcher. Therefore, the midwife is expected to focus on prevention and health promotion aspect with basis of partnership, and community empowerment collaboration with other health workers in order to be readily prepare the health services for anyone who is in need.This was qualitative research method with case study approach. The informant was the midwives of Tambakrejo Community Health Center of Surabaya. According to the data of antenatal care attendance, trained birth attendance, and perinatal care, there were 859 pregnant women, 581 persons on phase of K1 (67.64%), and 551 persons on phase of K4 (64.14%). The birth attendances by trained birth attendants are 513 people (62.56%), while perinatal care recorded 570 people attending the health service (69.51%). The data indicated the performance by the midwives of Tambakrejo Community Health Center categorized in the lowest position among 63 community health centers in Surabaya. The result showed poor soft skill competency and poor hard skill competency on midwives. In conclusion, poor soft skill competency including personal competence and social competence should be trained and developed by obstetrics and gynecology specialist of Soewandhi Public Hospital of Surabaya. The study suggested Surabaya District Health Office needs to conduct training of technology information and computer in order to increase the service quality and to solved the problem related to hard skill competencies on technology and computer skill. 

scholarly journals A mixed-methods evaluation of the impact of a person-centered family planning intervention for community health workers on family planning outcomes in India

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nadia Diamond-Smith ◽  
Claire McDonell ◽  
Ananta Basudev Sahu ◽  
Kali Prasad Roy ◽  
Katie Giessler
Keyword(s):  
Mixed Methods ◽  
Family Planning ◽  
Community Health ◽  
San Francisco ◽  
Health Workers ◽  
Qualitative Interviews ◽  
Centered Care ◽  
The University ◽  
Care Worker ◽  
The Impact

Abstract Background Person-centered quality for family planning has been gaining increased attention, yet few interventions have focused on this, or measured associations between person-centered quality for family planning and family planning outcomes (uptake, continuation, etc.). In India, the first point of contact for family planning is often the community health care worker, in this case, Accredited Social Health Activists (ASHAs). Methods In this study, we evaluate a training on person-centered family planning as an add-on to a training on family planning provision for urban ASHAs in Varanasi, India in 2019 using mixed methods. We first validate a scale to measure person-centered family planning in a community health worker population and find it to be valid. Higher person-centered family planning scores are associated with family planning uptake. Results Comparing women who saw intervention compared to control ASHAs, we find that the intervention had no impact on overall person-centered family planning scores. Women in the intervention arm were more likely to report that their ASHA had a strong preference about what method they choose, suggesting that the training increased provider pressure. However, qualitative interviews with ASHAs suggest that they value person-centered care for their interactions and absorbed the messages from the intervention. Conclusions More research is needed on how to intervene to change behaviors related to person-centered family planning. Trial registration This study received IRB approval from the University of California, San Francisco (IRB # 15–25,950) and was retrospectively registered at clinicaltrials.gov (NCT04206527).

scholarly journals Connecting communities to primary care: a qualitative study on the roles, motivations and lived experiences of community health workers in the Philippines

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Eunice Mallari ◽  
Gideon Lasco ◽  
Don Jervis Sayman ◽  
Arianna Maever L. Amit ◽  
Dina Balabanova ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Community Health ◽  
Community Health Workers ◽  
Financial Incentives ◽  
Lived Experiences ◽  
Health Workers ◽  
The Philippines ◽  
Community Members ◽  
Cross Sectional ◽  
The Impact

Abstract Background Community health workers (CHWs) are an important cadre of the primary health care (PHC) workforce in many low- and middle-income countries (LMICs). The Philippines was an early adopter of the CHW model for the delivery of PHC, launching the Barangay (village) Health Worker (BHW) programme in the early 1980s, yet little is known about the factors that motivate and sustain BHWs’ largely voluntary involvement. This study aims to address this gap by examining the lived experiences and roles of BHWs in urban and rural sites in the Philippines. Methods This cross-sectional qualitative study draws on 23 semi-structured interviews held with BHWs from barangays in Valenzuela City (urban) and Quezon province (rural). A mixed inductive/ deductive approach was taken to generate themes, which were interpreted according to a theoretical framework of community mobilisation to understand how characteristics of the social context in which the BHW programme operates act as facilitators or barriers for community members to volunteer as BHWs. Results Interviewees identified a range of motivating factors to seek and sustain their BHW roles, including a variety of financial and non-financial incentives, gaining technical knowledge and skill, improving the health and wellbeing of community members, and increasing one’s social position. Furthermore, ensuring BHWs have adequate support and resources (e.g. allowances, medicine stocks) to execute their duties, and can contribute to decisions on their role in delivering community health services could increase both community participation and the overall impact of the BHW programme. Conclusions These findings underscore the importance of the symbolic, material and relational factors that influence community members to participate in CHW programmes. The lessons drawn could help to improve the impact and sustainability of similar programmes in other parts of the Philippines and that are currently being developed or strengthened in other LMICs.

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