scholarly journals Who could be One Health Activist at the community level?: A case for India

2020 ◽  
Author(s):  
Sandul Yasobant ◽  
Walter Bruchhausen ◽  
Deepak Saxena ◽  
Farjana Zakir Memon ◽  
Timo Falkenberg
Keyword(s):  
Health System ◽  
Financial Incentives ◽  
One Health ◽  
Health Workers ◽  
Structured Interview ◽  
Communicable Diseases ◽  
Community Level ◽  
System Level ◽  
Cross Sectional

Abstract Background: Community Health Workers (CHWs) are the mainstay of the public health system, serving for decades in low resource countries. Their multi-dimensional work in diverse health care services, including the prevention of communicable diseases and health promotion for non-communicable diseases, are making CHWs the frontline workers in their respective communities in India. As India is heading towards the development of One Health (OH), this study attempted to provide an insight into potential OH activists (OHA) at the community level. Thus, this case study in one of the western cities of India, Ahmedabad, targeted to identify OHA by exploring the motivation to become an OHA in a local setting.Methods: This case study explores two major CHWs i.e. female (Accredited Social Health Activists-ASHA) and male (multipurpose male health worker) on their motivation for becoming an OHA. The data was collected between September 2018 and August 2019 through a mixed design i.e. quantitative data (cross-sectional structured questionnaire) and qualitative data (focus group discussion with a semi-structured interview guide). Results: The motivation of the CHWs for OHA was found to be low. Although most CHWs have received zoonoses training or contributed to zoonoses prevention campaigns, their awareness level was found to be different among male and female health workers. ASHAs were found to be willing to accept the additional new liaison role of OHAs if measures like financial incentives and improved recognition are provided. Conclusion: The high demotivation of CHWs that has been documented on the individual, community, and health system level needs to be urgently addressed in future policies.

scholarly journals Who could be One Health Activist at the community level?: A case for India

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Sandul Yasobant ◽  
Walter Bruchhausen ◽  
Deepak Saxena ◽  
Farjana Zakir Memon ◽  
Timo Falkenberg
Keyword(s):  
Health System ◽  
Work Experience ◽  
Financial Incentives ◽  
One Health ◽  
Health Workers ◽  
Structured Interview ◽  
Communicable Diseases ◽  
Community Level ◽  
System Level

Abstract Background Community health workers (CHWs) are the mainstay of the public health system, serving for decades in low-resource countries. Their multi-dimensional work in various health care services, including the prevention of communicable diseases and health promotion of non-communicable diseases, makes CHWs, the frontline workers in their respective communities in India. As India is heading towards the development of One Health (OH), this study attempted to provide an insight into potential OH activists (OHA) at the community level. Thus, this case study in one of India’s western cities, Ahmedabad, targeted identifying OHA by exploring the feasibility and the motivation of CHWs in a local setting. Methods This case study explores two major CHWs, i.e., female (Accredited Social Health Activists/ASHA) health workers (FHWs) and male (multipurpose) health workers (MHWs), on their experience and motivation for becoming an OHA. The data were collected between September 2018 and August 2019 through a mixed design, i.e., quantitative data (cross-sectional structured questionnaire) followed by qualitative data (focus group discussion with a semi-structured interview guide). Results The motivation of the CHWs for liaisoning as OHA was found to be low; however, the FHWs have a higher mean motivation score [40 (36–43)] as compared to MHWs [37 (35–40)] out of a maximum score of 92. Although most CHWs have received zoonoses training or contributed to zoonoses prevention campaigns, their awareness level was found to be different among male and female health workers. Comparing the female and male health workers to act as OHA, higher motivational score, multidisciplinary collaborative work experience, and way for incentive generation documented among the female health workers. Conclusion ASHAs were willing to accept the additional new liaison role of OHAs if measures like financial incentives and improved recognition are provided. Although this study documented various systemic factors at the individual, community, and health system level, which might, directly and indirectly, impact the acceptance level to act as OHA, they need to be accounted for in the policy regime.

scholarly journals Non-communicable diseases in the Western Area District, Sierra Leone, following the Ebola outbreak

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 795 ◽  
Author(s):  
Ibrahim Baimba Koroma ◽  
Dena Javadi ◽  
Katrina Hann ◽  
Anthony D Harries ◽  
Francis Smart ◽  
...  
Keyword(s):  
Health System ◽  
Sierra Leone ◽  
Ebola Virus ◽  
Health Workers ◽  
Virus Disease ◽  
Secondary Data ◽  
Communicable Diseases ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Western Area

Background: Non-communicable diseases (NCDs) are the leading causes of morbidity and mortality in the world. During infectious disease outbreaks, such as the Ebola virus disease outbreak in West Africa from 2014-2015, the health system is often strained, and diagnosis, management and care of NCDs may be compromised. This study assessed numbers and distribution of NCDs in all health facilities in the Western-Area District, Sierra Leone, in the post-Ebola period (June–December 2015) comparing findings with the pre-Ebola (June–December 2013) and Ebola outbreak (June–December 2014) periods. Methods: This was a cross-sectional study using secondary data from routine records of aggregate monthly NCD reports. Data were analysed using Open EPI and comparisons were made between the post-Ebola and pre-Ebola/Ebola periods using the chi-square test. Results: There were 10,011 people reported with NCDs during the three six-month periods, with 6194 (62%) presenting at peripheral health units (PHU). Reported NCDs decreased during Ebola and increased post-Ebola, but did not recover to pre-Ebola levels. Hypertension cases remained fairly constant throughout being mainly managed at PHU. Numbers with diabetes mellitus generally stayed the same except for a significant post-Ebola increase in tertiary hospitals. Small numbers were reported with mental health disorders across all facilities in all time periods. Conclusion: NCD reporting is recovering in the immediate post-Ebola period. Decentralization of NCD care is welcome and is an effective strategy for management as evidenced by hypertension. To be successful, this must be supported by strengthening other elements of the health system such as training of health workers, robust information and referral systems and reliable medicine supply chains.

scholarly journals Non-communicable diseases in the Western Area District, Sierra Leone, following the Ebola outbreak

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 795
Author(s):  
Ibrahim Baimba Koroma ◽  
Dena Javadi ◽  
Katrina Hann ◽  
Anthony D Harries ◽  
Francis Smart ◽  
...  
Keyword(s):  
Health System ◽  
Sierra Leone ◽  
Ebola Virus ◽  
Health Workers ◽  
Virus Disease ◽  
Secondary Data ◽  
Communicable Diseases ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Western Area

Background: Non-communicable diseases (NCDs) are the leading causes of morbidity and mortality in the world. During infectious disease outbreaks, such as the Ebola virus disease outbreak in West Africa from 2014-2015, the health system is often strained, and diagnosis, management and care of NCDs may be compromised. This study assessed numbers and distribution of NCDs in all health facilities in the Western-Area District, Sierra Leone, in the post-Ebola period (June–December 2015) comparing findings with the pre-Ebola (June–December 2013) and Ebola outbreak (June–December 2014) periods. Methods: This was a cross-sectional study using secondary data from routine records of aggregate monthly NCD reports. Data were analysed using Open EPI and comparisons were made between the post-Ebola and pre-Ebola/Ebola periods using the chi square test. Results: There were 10,011 people reported with NCDs during the three six-month periods, with 6194 (62%) presenting at peripheral health units (PHU). Reported NCDs decreased during Ebola and increased post-Ebola, but did not recover to pre-Ebola levels. Hypertension cases remained fairly constant throughout being mainly managed at PHU. Numbers with diabetes mellitus generally stayed the same except for a significant post-Ebola increase in tertiary hospitals. Small numbers were reported with mental health disorders across all facilities in all time periods. Conclusion: NCD reporting is recovering in the immediate post-Ebola period. Decentralization of NCD care is welcome and is an effective strategy for management as evidenced by hypertension. To be successful, this must be supported by strengthening other elements of the health system such as training of health workers, robust information and referral systems and reliable medicine supply chains.

scholarly journals Description of a community paediatric strategy offering a package of services to prevent malnutrition among children in one health district in Mali

2021 ◽  
Author(s):  
Thomas Roederer ◽  
Augusto E. Llosa ◽  
Susan Shepherd ◽  
Isabelle Defourny ◽  
Michel-Olivier Lacharité ◽  
...  
Keyword(s):  
One Health ◽  
Health Workers ◽  
Severe Acute Malnutrition ◽  
Scale Up ◽  
Health Indicators ◽  
Food Distribution ◽  
Acute Malnutrition ◽  
Cross Sectional ◽  
Health Area

AbstractBackgroundWe present results from an intervention case study, the Soins Preventifs de l’Enfant (SPE) project, in Konséguéla health area, Mali. The intervention involved a network of community health workers providing a comprehensive preventive/therapeutic package, ultimately aiming at reducing under 24-month mortality. Associated costs were documented to assess the feasibility of replication and scale-up.MethodsSPE program monitoring data were obtained from booklets specific to the program between 2010 and 2014. Data included sex, age, vaccination status, anthropometric measurements, Ready-To-Use-Supplementary Food distribution, morbidities reported by the mother between visits, hospitalizations over 18 months of follow-up. Cross-sectional surveys in the district of Koutiala, of which Konséguéla is one health area, were conducted yearly between 2010 and 2014 for comparison, using difference-in-difference approach. Ethical approval was granted from the Malian Ethical Committee.ResultsGlobal and Severe Acute Malnutrition prevalences decreased over time in Konséguéla as well as in the rest of the district, but the difference between areas was not significant. Children reaching 24 months were 20% less stunted in Konséguéla than children the same age outside (p<0.001). Mortality rates significantly decreased more in Konséguéla, while vaccination coverage for all antigens significantly increased in the meantime. The package cost approximately USD 95 per child per year; 56% of which was for the RUSF.ConclusionThe results of this case study suggest a sustained impact of a community based, comprehensive health package on major child health indicators. Most notably, while improvements in acute malnutrition were found in the district as a whole, those in the intervention area were more pronounced. Trends for other indicators suggest additional benefits.

scholarly journals Prevalence and factors associated with Metabolic Syndrome in elderly users of the Unified Health System

2014 ◽  
Vol 17 (4) ◽  
pp. 805-817 ◽  
Author(s):  
Edna Cunha Vieira ◽  
Maria do Rosário Gondim Peixoto ◽  
Erika Aparecida da Silveira
Keyword(s):  
Metabolic Syndrome ◽  
Health System ◽  
Health Workers ◽  
The Elderly ◽  
World Health ◽  
Fat Percentage ◽  
Cross Sectional ◽  
Factors Associated ◽  
Unified Health System ◽  
The Metabolic Syndrome

OBJECTIVE: To evaluate the prevalence and factors associated with metabolic syndrome in the elderly. METHODS: Cross-sectional study, with 133 individuals randomly selected in the Unified Health System in Goiania, Goiás. The following variables were researched: anthropometric (BMI, waist circumference, fat percentage by Dual X-ray absorptiometry), sociodemographic (gender, age, color, income, marital status and years of schooling), lifestyle (physical activity, smoking and risk alcohol consumption) and food intake (risk and protective foods). The metabolic syndrome was assessed according to harmonized criteria proposed by the World Health Organization (WHO). The combinations were tested by Poisson regression for confounding factors. RESULTS: The prevalence of metabolic syndrome was 58.65% (95%CI 49.8 - 67.1), with 60.5% (95%CI 49.01 - 71.18) for females and 55.7% (95%CI 41.33 - 69.53) for males. Hypertension was the most prevalent component of the syndrome in both men, with 80.8% (95%CI 64.5 - 90.4), and women, with 85.2% (95%CI 75.5 - 92.1). After the multivariate analysis, only the excess of weight measured by body mass index (prevalence ratio = 1.66; p < 0.01) remained associated with the metabolic syndrome. CONCLUSIONS: The prevalence of metabolic syndrome in this sample was high, indicating the need for systematic actions by health workers in the control of risk factors through prevention strategies and comprehensive care to the elderly.

scholarly journals Benefits and Challenges of Policy Options in Rationing the Hospital Radiology Services: A Case Study

2020 ◽  
Author(s):  
Hasan Jafari ◽  
Mohammad Ranjbar ◽  
Hamideh Mahjoub ◽  
Hamed Ghoshoni ◽  
Mohammad Baghi ◽  
...  
Keyword(s):  
Health System ◽  
Supply And Demand ◽  
Knowledge Network ◽  
System Level ◽  
Radiology Department ◽  
Policy Options ◽  
Policy Makers ◽  
Rationing Policy ◽  
Care Costs

Objective: In many countries, limiting the financial and budgetary resources is a challenge in the health system. One of the most costly parts of the health system is undoubtedly the radiology department of hospitals. Therefore, this study aimed to determine the benefits and challenges of the policies proposed for rationing hospital radiology services. Information sources and selected methods for study: In this narrative or literature review study, Persian (SID, Magiran, Barkat Knowledge network system, Irandoc), and Latin (Google Scholar, PubMed, Scopus, ISI web of sciences) databases were searched. The applied keywords were radiology, rationing, distribution, priority setting, resource allocation, and policy brief. In the initial search, 145 articles were studied. Subsequently, after reviewing the titles and abstracts, 65 studies were selected and investigated. Finally, 44 related studies were thoroughly investigated. The inclusion criteria covered the studies in Persian or English. The exclusion criteria included the studies that did not have full texts. Our search included the studies conducted from 1/1/2000 to 1/1/ 2017. Results: The present study examined the benefits and challenges of radiology services rationing. Policy options were presented at 3 levels of provider, organizational, and system. The provider level consisted of training clinical and non-clinical personnel to use and maintain the medical equipment and requiring the physicians to use clinical guidelines. The organization level included reviewing imaging tariffs, entering insurance in controlling supply and demand for radiology services, and assessing equipment by the Institute for Health Technology Assessment. The system level contained assignment of radiological services to the private sector. Conclusion: As health care costs are rising and resources are increasingly constrained by ever-increasing demands, policy makers and officials can use the proposed solutions with regard to contextual conditions to design a rationing model. Services at the macro level of the health system and operationalization of the rationing process reduce the gap between supply and demand of the health services.  

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.

scholarly journals Combating non-communicable diseases in rural Lucknow: Are the skills and knowledge of female health workers adequate?

2020 ◽  
Vol 7 (9) ◽  
pp. 3480
Author(s):  
Arunima Saini ◽  
Monika Agarwal
Keyword(s):  
Health Workers ◽  
Uttar Pradesh ◽  
Cross Sectional Study ◽  
Communicable Diseases ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Grass Root ◽  
Grass Root Level ◽  
The Government ◽  
Essential Knowledge

Background: India is facing the surging trend of non-communicable diseases (NCD). Forecasting the burden for NCDs, the Government of India (GOI) initiated a program in 2010 across the country, i.e., National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke. The GOI has envisaged the female health workers (FHW) for the last mile delivery of health services under the programme. Available literature shows that FHWs lack essential knowledge regarding chronic diseases. This study attempts to fill these gaps by studying knowledge and skills regarding NCDs among FHWs in rural Lucknow. Objectives were to explore the knowledge about NCDs among ASHAs and ANMs in rural Lucknow and to assess of skills related to NCD screening among ANMs in rural Lucknow.Methods: It was a cross-sectional study conducted among FHWs of Lucknow, Uttar Pradesh from June 2019 to August 2019.Results: Among the FHWs, knowledge about NCDs was found to be higher for those with the age more than 40 years, with the education of higher secondary and above and also amongst those who had received previous training for NCDs.Conclusions: Majority of the respondents were found to have poor knowledge regarding NCDs. Additionally, older age, training and higher education are found to be associated with good knowledge; there is a need of training of grass root level workers for them to correctly identify the symptoms and risk factors of various NCDs.

scholarly journals FAKTOR-FAKTOR YANG MEMPENGARUHI PEMANFAATAN POSBINDU PTM OLEH MASYARAKAT DI WILAYAH KERJA PUSKESMAS MARTAPURA 2

2020 ◽  
Vol 7 (1) ◽  
pp. 1
Author(s):  
Eka Supriyatna ◽  
Endang Pertiwiwati ◽  
Herry Setiawan
Keyword(s):  
Health Service ◽  
Family Support ◽  
Peer Support ◽  
Health Workers ◽  
Communicable Diseases ◽  
Utilization Rate ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Non Communicable Diseases

ABSTRAKPos Pembinaan Terpadu Penyakit Tidak Menular (Posbindu PTM) merupakan usaha pemerintah dalam menanggulangi penyakit tidak menular. Rendahnya angka pemanfaatan Posbindu oleh masyarakat dalam memanfaatkan pelayanan posbindu dilihat dari data kunjungan Posbindu PTM tiga bulan terakhir tahun 2018 untuk kunjungan lama yaitu pada bulan Oktober 365 kunjungan, kemudian bulan November menurun ke angka 348 kunjungan dan pada Bulan Desember mengalami penurunan sebanyak 297 kunjungan. Secara teoritis, seseorang dikatakan memanfaatkan suatu pelayanan kesehatan jika mendatangi pelayanan kesehatan itu teratur dalam tiga bulan terakhir tanpa menyebabkan terganggunya kegiatan harian. Tujuan dari penelitian adalah menjelaskan hubungan faktor-faktor yang mempengaruhi pemanfaatan Posbindu PTM oleh masyarakat di Wilayah Kerja UPT Puskesmas Martapura 2. Penelitian ini menggunakan desain cross sectional dengan teknik purposive sampling pada 85 orang masyarakat di wilayah kerja UPT Puskesmas Martapura 2. Penelitian ini dilaksanakan pada periode Bulan Maret-April tahun 2019. Pada penelitian ini menggunakan Uji chi square analisis menunjukkan nilai p-value <0,05 yaitu pendidikan (p-value= 0,029), pekerjaan (p-value= 0,022) PR= 4,295 (95% CI 1,315-14,036), dukungan keluarga (p-value= 0,001) PR=7,714 (95% CI 2,698-22,057) , dukungan petugas kesehatan (p-value= 0,001) PR= 8,273 (95% CI 2,795-24,488), dukungan kader kesehatan (p-value= 0,001) PR= 7,071 (95% CI 2,227-22,454), dan dukungan teman sebaya (p-value= 0,001) PR= 5,844 (95% CI 2,114-16,151). Hal ini menunjukkan bahwa pendidikan, pekerjaan, dukungan keluarga, dukungan petugas kesehatan, dukungan kader kesehatan dan dukungan teman sebaya memiliki hubungan pada pemanfaatan Posbindu PTM.Kata-kata kunci: posbindu, pemanfaatan, penyakit tidak menularABSTRACTIntegrated Post Training of Non-Communicable Diseases (Posbindu PTM) is a government effort in tackling non-communicable diseases. The low utilization rate of Posbindu by the community in utilizing posbindu services can be seen from the PTM Posbindu visit data for the last three months of 2018 for long visits namely in October 365 visits, then in November it decreased to 348 visits and in December it decreased by 297 visits. Theoretically, a person is said to utilize a health service if attending the health service regularly in the last three months without causing disruption to daily activities. The purpose of this research is to explain the relationship between the factors that influence the utilization of Posbindu PTM by the community in the Work Area of Martapura Public Health Center 2.1,315-14,036), family support (p-value= 0.001) PR= 7,714 (95% CI2,698-22,057), support of health workers (p-value 0.001) PR= 8.273 (95% CI 2,795-24,488), support for health cadres (p-value= 0.001) PR= 7.071 (95% CI 2,227-22,454), and peer support (p-value= 0.001) PR= 5.844 (95% CI2,114-16,151. This shows that education, employment, family support, health worker support, health cadre support and peer support have a relationship to the use of Posbindu PTM.Keywords : posbindu, utilization, non-communicable diseases

scholarly journals KNOWLEDGE, ATTITUDE, AND PRACTICES OF NON-COMMUNICABLE DISEASES: COMPARISON BETWEEN ORANG ASLI AND MALAY FROM RURAL AREA IN NEGERI SEMBILAN, MALAYSIA: A COMPARATIVE STUDY

2020 ◽  
Vol 20 (2) ◽  
pp. 131-140
Author(s):  
Muslimah Ithnin ◽  
Norsham Juliana ◽  
Nadeeya ‘Ayn Umaisara Mohamad Nor ◽  
Nadia Mohd Effendy ◽  
Mohd Dzulkhairi Mohd Rani
Keyword(s):  
Blood Pressure ◽  
Good Practice ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Communicable Diseases ◽  
Cross Sectional ◽  
Orang Asli ◽  
Non Communicable Diseases ◽  
Glucose Levels ◽  
Significant Difference

The study evaluates the prevalence, knowledge, attitude, and practices of non-communicable diseases (NCDs) among adult Orang Asli and Malay ethnicity in Negeri Sembilan, Malaysia. This cross-sectional study involving 634 respondents aged 18 years and above of Orang Asli (51.3%) and Malays (48.7%) from the rural villages. Structured interview questionnaire for disease history and KAP level conducted. Weight, height, waist circumference, blood pressure, and blood glucose levels then measured. Prevalence of NCDs was higher among Malays compared to Orang Asli with hypertension (35.0% vs 14.8%), hypercholesterolemia (31.1% vs 5.2%), and diabetes mellitus (16.2% vs 4.3%), respectively. Malays also had a higher percentage of being abdominal obese (70.6% vs 59.7%) and increased blood pressure (54.4% vs 29.8%). Multivariate analysis indicates hypercholesterolemia [OR=6.035 (95%CI: 3.150,11.561)], abdominal obesity [aOR= 1.807 (95%CI: 1.065, 3.067)], and increased in blood pressure [aOR= 2.359 (95%C1: 1.619,3.437)] have a significant relation with Malay ethnicity. For Orang Asli, 51.7% had poor knowledge, 72.3% had a good attitude, and 16.0% had a good practice. Knowledge and attitude scores were significantly less among Orang Asli with no significant difference for practice compared to the Malays. The prevalence of NCDs among the Malays is alarmingly high, with an increasing trend among Orang Asli, which needs immediate attention. The NCDs and obesity were significant among Malays but also showed a worrying trend in the Orang Asli as the good practice on a healthy life-style was low in both ethnicities. Thus, proper education and promotion regarding NCDs needed for diseases screening and prevention.

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