scholarly journals Men perspectives on attending antenatal care visits together with their pregnant partners in Misungwi district, rural Tanzania: a qualitative study

2020 ◽  
Author(s):  
Maendeleo Boniphace ◽  
Dismas Matovelo ◽  
Rose Laisser ◽  
Hadija Swai ◽  
Victoria Yohana ◽  
...  
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Community Health ◽  
Community Health Workers ◽  
Research Team ◽  
English Language ◽  
Health Workers ◽  
Cultural Beliefs ◽  
National Language ◽  
Rural Tanzania

Abstract Background: Mens’ attendance, together with their pregnant partners at facility-based antenatal care (ANC) visits is important, yet remains uncommon in parts of rural Tanzania. This study examined perspectives of men on attending with their pregnant partners in Misungwi District, Tanzania.Methods: Individual interviews (n=6) and focus group discussions (5) were conducted using semi-structured questionnaires with fathers, expectant fathers and other key informants (health providers, volunteer community health workers, Village leaders). The interviewers were researchers trained on how to conduct interviews prior field visits. The questions were asked using Tanzania National language ( Swahili).Transcripts were recorded, transcribed in Swahili Language and later on it was translated in English language. The research team conducted thematic analysis using English language by grouping related codes into themes. The main themes were obtained upon agreement with the research team. Results: Two key system/societal-level themes were identified: (1) males who attended facility-based ANC visits and experienced lack of being given ANC feedback from health care workers and partners and hence men felt excluded from visit services; and (2) traditional cultural beliefs and gender roles strongly influenced the choice not to attend visits. This resulted into men being hidden pregnancy details (secrecy) from their partners in the community. Conclusion: To maximize gender equity in maternal and health requires involvement of men at ANC visits in Misungwi. This can be achieved by addressing core traditional and systemic barriers including use of community health workers. Improved communication between partners and health care providers through provision of ANC feedback and male involvement in examination room is warranted to promote access to ANC.

Promotoras Voice Their Challenges in Fulfilling Their Role as Community Health Workers

2020 ◽  
pp. 152483992092118
Author(s):  
Pamela Orpinas ◽  
Rebecca A. Matthew ◽  
Luis R. Alvarez-Hernandez ◽  
Alejandra Calva ◽  
J. Maria Bermúdez
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Participatory Research ◽  
English Language ◽  
Health Workers ◽  
Cultural Beliefs ◽  
Community Based Participatory Research ◽  
Well Being ◽  
Emotional Impact ◽  
Community Based

Promotoras de salud (Spanish for female community health workers) are integral to efforts to enhance the health and well-being of Latinx individuals, families, and communities. The purpose of this study was to describe the challenges that promotoras face and the proposed solutions from the perspective of the promotoras themselves. Five promotoras who worked for a year as volunteers in a community-based participatory research study, Lazos Hispanos, participated in two group interviews. Eight challenges emerged—balancing their new work with their family commitments, handling their perceived imbalance of power with men, managing the emotional impact of hearing participants’ problems, facing and handling the barriers imposed by having limited English language skills, feeling discouraged by the perception of ethnocentric beliefs and discrimination from some providers, feeling disheartened by the cultural beliefs of some Latinx participants, handling the lack of transportation for themselves and for the participants, and managing the burden of data collection for the research aspect of the program. The explanation of these challenges and the practical solutions they proposed are embedded in their intersecting identities. The solutions are a valuable addition to the practice of health promotion and community-based participatory research, particularly within Latinx communities.

Bringing Community Health Workers into the Mainstream of U.S. Health Care

2015 ◽  
Vol 5 (2) ◽  
Author(s):  
Mary Pittman ◽  
Anne Sunderland ◽  
Andrew Broderick ◽  
Kevin Barnett
Keyword(s):  
Health Care ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers

scholarly journals Brazil’s Community Health Workers Practicing Narrative Medicine: Patients’ Perspectives

2021 ◽  
Author(s):  
Rogério Meireles Pinto ◽  
Rahbel Rahman ◽  
Margareth Santos Zanchetta ◽  
W. Galhego-Garcia
Keyword(s):  
Health Care ◽  
Community Health ◽  
Community Health Workers ◽  
Health Care Providers ◽  
Health Workers ◽  
Hybrid Approach ◽  
Narrative Medicine ◽  
Structured Interview ◽  
Patient Perspectives ◽  
Care Providers

Abstract Background Narrative medicine (NM) encourages health care providers to draw on their personal experiences to establish therapeutic alliances with patients of prevention and care services. NM medicine practiced by nurses and physicians has been well documented, yet there is little understanding of how community health workers (CHWs) apply NM concepts in their day-to-day practices from patient perspectives. Objective To document how CHWs apply specific NM concepts in Brazil’s Family Health Strategy (FHS), the key component of Brazil’s Unified Health System. Design We used a semi-structured interview, grounded in Charon’s (2001) framework, including four types of NM relationships: provider–patient, provider–colleague, provider–society, and provider–self. A hybrid approach of thematic analysis was used to analyze data from 27 patients. Key Results Sample: 18 females; 13 White, 12 “Pardo” (mixed races), 12 Black. We found: (1) provider–patient relationship—CHWs offered health education through compassion, empathy, trustworthiness, patience, attentiveness, jargon-free communication, and altruism; (2) provider–colleague relationship—CHWs lacked credibility as perceived by physicians, impacting their effectiveness negatively; (3) provider–society relationship—CHWs mobilized patients civically and politically to advocate for and address emerging health care and prevention needs; (4) provider–self relationship—patients identified possible low self-esteem among CHWs and a need to engage in self-care practices to abate exhaustion from intense labor and lack of resources. Conclusion This study adds to patient perspectives on how CHWs apply NM concepts to build and sustain four types of relationships. Findings suggest the need to improve provider–colleague relationships by ongoing training to foster cooperation among FHS team members. More generous organizational supports (wellness initiatives and supervision) may facilitate the provider–self relationship. Public education on CHWs’ roles is needed to enhance the professional and societal credibility of their roles and responsibilities. Future research should investigate how CHWs’ personality traits may influence their ability to apply NM.

scholarly journals Knowledge and attitudes of tuberculosis management in San Juan de Lurigancho district of Lima, Peru

2009 ◽  
Vol 3 (10) ◽  
pp. 783-788 ◽  
Author(s):  
Elizabeth M. Kiefer ◽  
Theresa Shao ◽  
Olveen Carrasquillo ◽  
Pamela Nabeta ◽  
Carlos Seas
Keyword(s):  
Health Care ◽  
Community Health ◽  
Community Health Workers ◽  
Health Care Providers ◽  
Health Workers ◽  
Knowledge Score ◽  
San Juan ◽  
Care Providers ◽  
Knowledge Gaps ◽  
Knowledge And Attitudes

Background: Expansion of the health care workforce in Peru to combat tuberculosis (TB) includes both professional health care providers (HCPs) such as doctors and nurses, and non-professional HCPs such as community health workers (CHWs). We describe the knowledge and attitudes of these HCPs, and identify modifiable barriers to appropriate anti-tuberculosis treatment.  Methodology: We surveyed HCPs practicing in 30 clinical settings (hospitals, community health centers, and health posts) in the San Juan de Lurigancho district of Eastern Lima, Peru. Multiple-choice questions were used to assess knowledge of TB. A five-item Likert scale was created to assess attitudes toward the community, patients, and clinics. Linear regression was used to identify predictors of mean knowledge score, and analysis of variance was used to test differences in HCP score.  Results: Of the 73 HCPs surveyed, 15% were professionals (doctors or nurses). The remaining 85% were health technicians, community health workers (CHWs) or students. The mean knowledge score was 10.0 ± 1.9 (maximum 14) with professional HCPs scoring higher than other HCPs (11.7 ± 1.1 vs. 9.7 ± 1.9), p < .01). Knowledge gaps included identification of patients at high risk for TB, assessment of treatment outcomes, and consequences of treatment failure. The most commonly cited modifiable barriers were structural, including laboratory facilities and staffing of TB clinics, with 52.1% and 62.5% of HCPs, respectively, citing these as problematic.  Conclusions: Efforts to improve knowledge of TB HCPs in Peru should focus on the specific gaps we have identified. Further research is needed to evaluate whether these knowledge gaps correlate with TB control.     

Authors’ Commentary: Domestic Violence Against Women, Public Policies and Community Health Workers in Brazilian Primary Health Care

2019 ◽  
Vol 40 (3) ◽  
pp. 237-239
Author(s):  
Marcos Signorelli ◽  
Angela Taft ◽  
Pedro Paulo Gomes Pereira
Keyword(s):  
Health Care ◽  
Domestic Violence ◽  
Primary Health Care ◽  
Community Health ◽  
Community Health Workers ◽  
Health Professionals ◽  
Health Workers ◽  
Family Health ◽  
Further Education ◽  
Primary Health

In this commentary paper, we highlight the key role that community health workers and family health professionals can perform for the identification and care for women experiencing domestic violence in communities. These workers are part of the primary health-care strategy in the Brazilian public health system, who are available in every municipalities and neighborhoods of the country. Based on our ethnographic research, we argue that identification and care of abused women by these workers and professionals follow a pattern which we described and named “the Chinese whispers model.” We also point gaps in training these workers to deal with complex issues, such as domestic violence, arguing for the need of formal qualification for both community health workers and family health professionals by, for example, incorporating such themes into curricula, further education, and continuing professional development.

Improving use of maternal care services among married adolescent girls: an intervention study in rural India

2020 ◽  
pp. 1-20
Author(s):  
Ashok Dyalchand ◽  
Rohini Prabha Pande ◽  
Gopal Kulkarni ◽  
Manisha Khale
Keyword(s):  
Antenatal Care ◽  
Community Health ◽  
Community Health Workers ◽  
Adolescent Girls ◽  
Maternal Care ◽  
Health Workers ◽  
Care Delivery ◽  
Scale Up ◽  
Care Services ◽  
Study Sites

Abstract This study examined the effect of the Safe Adolescent Transition and Health Initiative (SATHI) programme on the use of maternal care services among rural, pregnant adolescents in India. This was an intensive community-based, multi-site intervention project conducted in Maharashtra state between 2008 and 2011. Its aims were to improve the reproductive health of married adolescent girls and avert the adverse consequences of early motherhood. It had a quasi-experimental, case-control, pre-post design to enable rigorous evaluation. This study used cross-sectional data from 644 married girls aged under 19 years at baseline and 802 at endline to assess the maternal care outcomes of antenatal care, delivery and postnatal services and nutrition during pregnancy. Difference-in-differences analysis showed that all outcomes improved significantly in the study sites between baseline and endline, and the improvement in study sites was significantly larger than in the control sites. Multivariate analysis showed a statistically significant dose–response effect of intervention participation for antenatal care, pregnancy nutrition and postnatal care. Study participation was not statistically significantly associated with higher rates of safe or institutional delivery. The analysis suggests that training and supporting community health workers to work with married adolescent girls using interpersonal communication and interacting frequently with them and their families and communities can significantly improve the use of maternal care services among this population. With almost a million community health workers and 200,000 auxiliary nurse midwives at the community level providing primary level care in India, this intervention offers a proven strategy to replicate and scale-up to reach large numbers of married adolescent girls who do not currently use maternal care services.

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