scholarly journals Timely Access to Maternal, Neonatal and Child Healthcare for rural communities in Rwanda: Job satisfaction of Community Health Workers delivering Community Based Maternal, Newborn and Child Healthcare

2020 ◽  
Author(s):  
Jean Bosco BIGIRIMANA ◽  
Isaac Luginaah

Abstract Background In Rwanda, although there has been progressing in health care delivery as expressed in the reduction in maternal and child mortality, rates are still high and geographically variable. For the improvement of equitable access to health services for maternal, newborn and child healthcare (MNCH), community-based maternal, newborn and child healthcare (CBMNCH) depends on the use of “community health workers” (CHWs). However, the CHW program faces challenges that disrupt the quality delivery of a full package of services. Yet little is known about the satisfaction of CHWs in delivering CBMNCH. Methods This quantitative cross-sectional study involved a survey of 500 sampled CHWs delivered CBMNCH in three selected rural districts of the southern province, Rwanda. Ordinal regression was used to examine the determinants of CHWs` job satisfaction. Results Multivariate analysis shows that the determinants of job satisfaction were motivation (OR = 8.59, p < 0.001), formal training in CBMNCH (OR = 2.24, p < 0.05), individual supervision (OR = 6.19, p < 0.001), and peer support (OR = 2.66, p < 0.01), knowledge about CBMNCH (OR = 0.51, p < 0.05), access to essential materials (OR = 0.32, p < 0.05), and incentives (OR = 0.53 (p < 0.01). Conclusion The findings indicated that the managers of CHW programs and other stakeholders need to improve the working conditions of CHWs to enhance their job satisfaction, to enable the effective provision of CBMNCH.

2015 ◽  
Vol 5 (2) ◽  
pp. 332-335
Author(s):  
Md Humayun Kabir Talukder ◽  
BH Nazma Yasmeen ◽  
Rumana Nazneen ◽  
Md Zakir Hossain ◽  
Ishrat Jahan Chowdhury

Background : Community Health Workforce (CHW) development has a rich history in South East Asian Region (SEAR). The first Community Health Unit was established in Sri Lanka in 1926 and then practiced over many of the regional countries like, Thailand, Mayanmar and India. Community Health Workers are in the fore front workforce to bring about change through community health programmes to national levels. In Bangladesh, there are also different categories of health workforce serving in the health care delivery system.Objectives : To assess relevance and effectiveness of community health workforce (CHW) development system in Bangladesh.Methods : This cross sectional study was conducted from 1st November 2010-30th April 2011 by purposive sampling technique. Study population were directors, administrators, principals, teachers of different institutes/ organizations and community health workers working in different corners of Bangladesh. Study places were different divisional towns of Bangladesh. Previously developed questionnaire & checklist were used for the collection of data from the institutes/ organizations by data collectors. These data were edited, processed and was analysed by using SPSS soft ware and a small portion by manually. No strong ethical issues were involved in this activity.Results : Study revealed that all the respondents (100%) are in favour of production of CHW in Bangladesh through formal academic institutional or pre service education (61.4%) .Most of the respondents (56.8%) viewed that there are scopes of utilisation of produced CHW in rural areas and most of the respondents (63.6%) also viewed that terminal/marginalized/underprivileged peoples of hard to reach areas at least can be served by CHW. Regarding the competency of produced CHW few of the respondents (43.2%) viewed positively. Most of the respondents (86.4%) viewed that both govt. & non govt. sectors should produce CHW with a very good coordination and co-operation. Study revealed the institutional capacities or situations about physical facilities, ongoing course, audiovisual aids, library, manpower and assessment procedure.Conclusion : Study revealed that there is strong & logical relevance present for the production of CHW in Bangladesh. So the existing Human Resource for Health (HRH) policy is to be revised & revisited as a time felt need to develop more competent CHW for Bangladesh to serve the marginalized, terminal, people of remote, rural & hard to reach areas.Northern International Medical College Journal Vol.5(2) 2014: 332-335


2021 ◽  
Vol 11 (02) ◽  
pp. 1439-1447
Author(s):  
Tania Gayle Robert Lourdes ◽  
◽  
Wan Shakira Rodzlan Hasani ◽  
Muhammad Fadhli Mohd Yusoff ◽  
Hamizatul Akmal Abd Hamid ◽  
...  

Abstract Introduction: Community health workers (CHW) or volunteers are health workers who are trained but do not possess a professional certificate. They are community members who live and work in that particular community. The Ministry of Health Malaysia had initiated a community-based intervention programme, Healthy Community Empowers the Nation or ‘Komuniti Sihat Pembina Negara’ (KOSPEN) in October 2013. In this programme, CHWs main task is to conduct non-communicable diseases (NCD) risk factor screening. Methods: Data from the “Evaluation of the implementation of KOSPEN programme in Malaysia 2016” was used. It is a cross-sectional study which was carried out in randomly selected KOSPEN localities throughout Malaysia. Logistic regression analysis was applied to determine factors associated with not performing KOSPEN screening activities by the volunteers. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 20. Results: A total of 700 volunteers were included in this study. Most of the volunteers were female (65.7%) and were aged 50-59 years (30.9%), followed by those aged 40-49 (27.1%). Majority had secondary education (65.3%), employed (55.7%.) and were married (80.4%). Multivariate logistic regression showed that volunteers who never attended training (aOR 2.79; 95% CI:1.66, 4.67) and who felt the content of the training module was inadequate (aOR 2.693; 95% CI: 1.46, 4.98) were more likely to not perform screening activities in the community. Conclusion: Attendance of the training should be a pre-requisite to qualify as a volunteer. Improvement to the training module should done to increase comprehensibility of the modules among the volunteers. Keywords: KOSPEN-community health workers-NCD screening-community-based intervention


2020 ◽  
Author(s):  
Yemane Berhane Tesfau ◽  
Alemayehu Bayray Kahsay ◽  
Tesfay Gebregzabher Gebrehiwot ◽  
Araya Abrha Medhanyie ◽  
Hagos Godefay

Abstract Background : In low-income countries like Ethiopia, where families have poor access to or do not utilize the services of formal health care systems, community health workers provide postnatal care services through home visits. However, the extent and effectiveness of home-based postnatal visits by community health workers such as the Ethiopian health extension workers (HEWs) are not well explored. This community -based study aimed to determine the coverage, contents of postnatal home visits and associated factors by health extension workers in Northern Ethiopia. Methods : We conducted a community based cross-sectional study in the rural Districts in Northern Ethiopia from August to September 2018. A total of 705 mothers who gave a live birth in the year preceding the survey were selected using multistage random sampling. A structured questionnaire was applied to collect data by interviewing the mothers. Data were analyzed using SPSS version 22 statistical software. Association of postnatal home visits with possible explanatory variables was investigated using logistic regression. Results : One hundred and two (14.5%) mothers and newborns received PNC home visit within three days after birth from HEW and 170(24.1%) reported postnatal home visits within 42 days. Among the mothers who received postnatal home visits, 6.5% measured their blood pressure, 11.2% measured their temperature, 20% counseled about family planning, 16.5% counseled on newborn danger signs, 11.2% counseled on the skin to skincare of the newborn and 14.1% of their newborns were measured their weight at home. Mothers who received at least one home visit during pregnancy (AOR, 7.49; CI 3.55-15.80), participated in pregnant women forum (AOR, 3.16; CI 1.67-5.99), notified their birth (AOR, 6.16; CI 3.50-10.84) and those members of community health insurance (AOR, 1.87; CI 1.13-3.10) were factors associated with postnatal home visit by a health extension worker. Conclusion : The coverage of postnatal home visits by health extension workers remains low in rural districts of Northern Ethiopia. The existing health systems should consider interventions that improve pregnancy and birth notification strategies and more efforts should be made at improving community-based participation and linkages with community health workers.


2020 ◽  
Author(s):  
Yemane Berhane Tesfau ◽  
Alemayehu Bayray Kahasay ◽  
Tesfay Gebregzabher Gebrehiwot ◽  
Araya Abrha Medhanyie ◽  
Hagos Godefay

Abstract Background : In low-income countries like Ethiopia, where families have poor access to or do not utilize services of formal health care systems, community health workers provide postnatal care services through home visits. However, the extent and effectiveness of home-based postnatal visits by community health workers such as the Ethiopian health extension workers (HEWs) are not well explored. This community -based study aimed to determine the coverage, contents of postnatal home visits and associated factors by health extension workers in Northern Ethiopia.Methods : We conducted a community based cross-sectional study in the rural Districts in Northern Ethiopia from August to September 2018. A total of 705 mothers who gave a live birth in the year preceding the survey were selected using multistage random sampling. A structured questionnaire was applied to collect data by interviewing mothers. Data were analyzed using SPSS version 22 statistical software. Association of postnatal home visits with possible explanatory variables was investigated using logistic regression.Results : One hundred two (14.5%) mothers and newborns received PNC home visit within three days after birth from HEW and 170(24.1%) reported postnatal home visits within 42 days. Among the mothers who received postnatal home visits, 6.5% measured their blood pressure, 11.2% measured their temperature, 20% counseled about family planning, 16.5% counseled on newborn danger signs, 11.2% counseled on the skin to skincare of the newborn and 14.1% of their newborns were measured their weight at home. Mothers who received at least one home visit during pregnancy (AOR, 7.58; CI 3.59-15.98), participated in pregnant women forum (AOR, 3.21; CI 1.70-6.05), notified their birth (AOR, 6.15; CI 3.50-10.80) and those member of community health insurance (AOR, 1.88; CI 1.14-3.12) were significantly associated factors with postnatal home visit by a health extension worker.Conclusion : The coverage of postnatal home visits by health extension workers remains low in rural districts of Northern Ethiopia. Existing health systems should consider interventions that improve pregnancy and birth notification strategies and more efforts should be made at improving community-based participation and linkages with community health workers.


2012 ◽  
Vol 38 (6) ◽  
pp. 822-834 ◽  
Author(s):  
Padmini Balagopal ◽  
N. Kamalamma ◽  
Thakor G. Patel ◽  
Ranjita Misra ◽  
Ranjita Misra ◽  
...  

2020 ◽  
Author(s):  
Preety R Rajbangshi ◽  
Devaki Nambiar ◽  
Aradhana Srivast

Abstract Introduction:. It is well acknowledged that India’s Community Health workers known as Accredited Social Health Activists (ASHA) are the bedrock of its health system. Many ASHAs are currently working in fragile and conflict-affected settings. No efforts have yet been made to understand the challenges and vulnerabilities of these female workers. This paper seeks to address this gap by bringing attention to the situation of ASHAs working in the fragile and conflict settings and how conflict impacts them and their work. Methods: Qualitative fieldwork was undertaken in four conflict-affected villages in two conflict-affected districts -Kokrajhar and Karbi Anglong of Assam state situated in the North-East region of India. Detailed account of four ASHAs from the majority (Bodo or Karbi) and minority (Adivasi or Koch) communities serving roughly 4000 people is presented. Data transliterated into English were analysed by authors by developing a codebook using grounded theory and thematic organisation of codes. Results: ASHAs reported facing challenges in ensuring access to health services during and immediately after outbreaks of conflict. They experienced difficulty in arranging transport and breakdown of services at remote health facilities. Their physical safety and security were at risk during episodes of conflict. ASHAs reported hostile attitudes of the communities they served due to the breakdown of social relations, trauma due to displacement, and loss of family members, particularly their husbands. Conclusion: Conflict must be recognised as an important context within which community health workers operate, with greater policy focus and research devoted to understanding and addressing the barriers they face as workers and as persons affected by conflict.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Zoe L Zwecker ◽  
Susan Spratt ◽  
Benjamin A Goldstien ◽  
Bradi B Granger

Introduction: Diabetes is a chronic condition that affects 34.2 million Americans. Long-lasting or undiagnosed diabetes increases the risk of developing cardiovascular disease (CVD). Geographic Information Systems (GIS) inform healthcare delivery interventions to target patients, clinicians, health systems and communities at highest risk. A gap remains in how data and GIS are applied and leveraged in the context of value-based care delivery systems. This spatial analysis demonstrates the application of a generalizable methodology for allocating resources such as AHA Field Teams, community health workers (CHWs), and educational tools to areas most burdened by diabetes and CVD. Methods: The automated geocoding infrastructure from the Duke Medicine electronic data warehouse was developed to standardize and scale geocoding addresses for a population of people with type 2 diabetes from the Southeastern Diabetes Initiative (SEDI) in 2017. While maintaining accuracy and assuring that patients’ protected health information was secure, we used geocoded data and public data (public health data, census tract data, and information on the built environment) to assess risk and identify accessible resources. Results and Discussion: Using this method to understand racial distribution, level of education, and income,we identified high risk communities in Durham County. We correlated geospatial patterns of health risk, illness burden, and determined accessible resources for diabetes and CVD.We calculated a resource ratio of one CHW to 100 patient-population and identified a central hub for fixed resource access. Using neighborhood boundaries, we identified a community where the burden of diabetes reached 17%, 60% of inhabitants were African American, median income was $55,945, and just 17.7% had a bachelor’s degree. Understanding risk using these social determinants (Figure 1) supports the intentional allocation of resources and hiring of CHWs.


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