Continuing Education Experiences of District Level Health Staff in Nigeria

1993 ◽  
Vol 13 (4) ◽  
pp. 389-403
Author(s):  
Philip C. Onuoha ◽  
William R. Brieger
Keyword(s):  
Health Care ◽  
Continuing Education ◽  
Health Workers ◽  
Health Staff ◽  
Rural Districts ◽  
The Past ◽  
Primary Health ◽  
Self Study ◽  
Reading Materials ◽  
Service Training

Primary health care (PHC) implementation has stimulated the need and interest in developing continuing education (CE) programs in Nigeria. A population study of 144 government (69%) and private (31%) health workers in the Ibarapa District of Oyo State in Nigeria documented their CE opportunities. Only 39 percent had attended an in-service training (IST) program in the past five years. Fewer (32%) had received a supervisory visit within the previous month, and most of these visits contained little of educational relevance according to respondents. Slightly over half (54%) reported attending a staff meeting in the previous month, but 72 percent had attended at least one in the past six months. Like supervisory visits, these meetings were not primarily educational in nature. Only 58 percent engaged in self-study through reading in the past six months, but quality reading materials were scarce, forcing health workers to rely on old texts and popular health magazines. Local government staff and workers with formal health training were most likely to have taken advantage of an IST. Trained workers and males were more likely to have engaged in self-study. New PHC management structures have the potential filling CE gaps and redressing imbalances in CE opportunities in this and other rural districts throughout the country.

Health Worker Perceptions of the Integration of Leprosy Control Services at the Primary Health Care Level in Ibadan, Nigeria

2003 ◽  
Vol 22 (1) ◽  
pp. 111-124 ◽  
Author(s):  
Oluseyi R. Olaseinde ◽  
William R. Brieger
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Local Government ◽  
Health Worker ◽  
Health Staff ◽  
Basic Training ◽  
Front Line ◽  
Primary Health ◽  
Service Training ◽  
Leprosy Control

A goal of both the World Health Organization and the Nigerian National Tuberculosis and Leprosy Control (TBL) Program is to integrate leprosy control services into the front line primary health care service system. Traditionally, leprosy services had been handled by one local government officer with little involvement of other health staff, and this limited access and timeliness of services for leprosy patients. Even after the national TBL program was implemented, integration has not been achieved, and this study of 203 front line health workers in the five local government areas that comprise the Ibadan metropolitan area of Oyo State, Nigeria sought to determine the role of health worker knowledge, attitudes, and self-efficacy in fostering or inhibiting leprosy service integration. Leprosy knowledge scores were positively associated with years in service, having lectures on leprosy during basic training, and having attended in-service training (IST) on leprosy. Among the cadres interviewed, Environmental Health Officers (EHOs), who had traditionally managed leprosy services prior to the move for integrated services, had the highest scores. EHOs and those who had leprosy lectures during basic training also had better attitudes toward leprosy than their counterparts. Male health staff and those who had leprosy lectures during basic training also had higher attitude scores concerning integrating leprosy control services with primary care. Finally, the only factor associated with perceived self-efficacy to perform leprosy control services was cadre. Ironically, Community Health Extension workers, who have had little in the way of experience with and training in leprosy control, believed they could handle these responsibilities better than other cadres. The influence of basic and in-service training on enhancing leprosy control knowledge and attitudes is recognized and enhancement of curricula for all cadres on leprosy issues is recommended.

scholarly journals Acceptability and Potential Effectiveness of eHealth Tools for Training Primary Health Workers From Nigeria at Scale: Mixed Methods, Uncontrolled Before-and-After Study (Preprint)

2020 ◽  
Author(s):  
Joseph Paul Hicks ◽  
Matthew John Allsop ◽  
Godwin O Akaba ◽  
Ramsey M Yalma ◽  
Osasuyi Dirisu ◽  
...  
Keyword(s):  
Health Care ◽  
Technology Acceptance ◽  
Digital Technology ◽  
Health Workers ◽  
Care Delivery ◽  
Digital Health ◽  
Clinical Knowledge ◽  
Potential Effectiveness ◽  
Primary Health ◽  
Service Training

BACKGROUND The in-service training of frontline health workers (FHWs) in primary health care facilities plays an important role in improving the standard of health care delivery. However, it is often expensive and requires FHWs to leave their posts in rural areas to attend courses in urban centers. This study reports the implementation of a digital health tool for providing video training (VTR) on maternal, newborn, and child health (MNCH) care to provide in-service training at scale without interrupting health services. The VTR intervention was supported by satellite communications technology and existing 3G mobile networks. OBJECTIVE This study aims to determine the feasibility and acceptability of these digital health tools and their potential effectiveness in improving clinical knowledge, attitudes, and practices related to MNCH care. METHODS A mixed methods design, including an uncontrolled pre- and postquantitative evaluation, was adopted. From October 2017 to May 2018, a VTR mobile intervention was delivered to FHWs in 3 states of Nigeria. We examined changes in workers’ knowledge and confidence in delivering MNCH services through a pre- and posttest survey. Stakeholders’ experiences with the intervention were explored through semistructured interviews that drew on the technology acceptance model to frame contextual factors that shaped the intervention’s acceptability and usability in the work environment. RESULTS In total, 328 FHWs completed both pre- and posttests. FHWs achieved a mean pretest score of 51% (95% CI 48%-54%) and mean posttest score of 69% (95% CI 66%-72%), reflecting, after adjusting for key covariates, a mean increase between the pre- and posttest of 17 percentage points (95% CI 15-19; <i>P</i>&lt;.001). Variation was identified in pre- and posttest scores by the sex and location of participants alongside topic-specific areas where scores were lowest. Stakeholder interviews suggested a wide acceptance of VTR Mobile (delivered via digital technology) as an important tool for enhancing the quality of training, reinforcing knowledge, and improving health outcomes. CONCLUSIONS This study found that VTR supported through a digital technology approach is a feasible and acceptable approach for supporting improvements in clinical knowledge, attitudes, and reported practices in MNCH. The determinants of technology acceptance included ease of use, perceived usefulness, access to technology and training contents, and the cost-effectiveness of VTR, whereas barriers to the adoption of VTR were poor electricity supply, poor internet connection, and FHWs’ workload. The evaluation also identified the mechanisms of the impact of delivering VTR Mobile at scale on the micro (individual), meso (organizational), and macro (policy) levels of the health system. Future research is required to explore the translation of this digital health approach for the VTR of FHWs and its impact across low-resource settings to ameliorate the financial and time costs of training and support high-quality MNCH care delivery. CLINICALTRIAL ISRCTN Registry 32105372; https://www.isrctn.com/ISRCTN32105372

scholarly journals Pandemic, Primary Health Workers and work trajectories: A Memoing Representational Study

2021 ◽  
Author(s):  
K Rajasekharan Nayar ◽  
Ujjwala Gupta ◽  
Bindhya Vijayan ◽  
Sunitha S B ◽  
Kapila VS ◽  
...  
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Health Workers ◽  
Effective Control ◽  
Health Staff ◽  
Health Coverage ◽  
Positive Health ◽  
Primary Health ◽  
Tier System ◽  
Health Centres

More than 65 per cent of the population in India lives in rural areas with the highest overall burden of disease. The Indian rural health care system is composed of the three-tier system comprising Sub-Centres, Primary Health Centres, and Community Health Centres with a considerable shortfall in health facilities at different levels - 18 per cent at Sub centre level, 22 per cent at PHC level and 30 per cent at CHC level. The real facts and figures of the epidemic in rural areas are not known yet except for broad distribution patterns. The course of events with respect to preventive strategies to control COVID-19 especially the experiences in states like Kerala which has comparatively well-developed health infrastructure are important as a lesson for managing future emergencies. In the present study, the responses and experiences of the frontline health workers including ASHA workers toward the pandemic are documented. We followed a Memoing approach largely similar to in-depth interviews- based on conversations with primary level health workers including ASHA workers and Junior Health Staff. The conversations which lasted for about one hour and in some cases more were presented by the respondents as experiential representations and memoranda on which reflective notes were prepared by the authors who conversed with the staff. The conversations mainly echoed the complaints, concerns and criticisms of the staff regarding the program and the severe limitations that they faced in COVID control. Based on the narratives as well as representations, we could identify interlinked dominant and minor specific-context related issues which are important for equity-based universal health coverage. Firstly, training of primary health workers in Primary Emergency Health care is important in order to counter unpleasant human interactions and also for maintaining security. The training is also important to counter misinformation which is hampering positive health actions. Secondly, it is important to reinvigorate the medical loop and preventive protocols in health programs to strengthen the health service system at the grassroots level especially enhance the trust between the workers and the people. COVID 19 pandemic is an opportunity to recognize and reinforce the role of primary care workers and formulate gender-sensitive and effective control strategies.

scholarly journals Can public sector community health workers deliver a nurturing care intervention in South Africa? The Amagugu Asakhula feasibility study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sonja Klingberg ◽  
Esther M. F. van Sluijs ◽  
Stephanie T. Jong ◽  
Catherine E. Draper
Keyword(s):  
South Africa ◽  
Health Care ◽  
Public Sector ◽  
Health Workers ◽  
Care Facility ◽  
Health Care Facility ◽  
Preschool Age ◽  
Primary Health Care Facility ◽  
Community Based ◽  
Primary Health

Abstract Background Nurturing care interventions have the potential to promote health and development in early childhood. Amagugu Asakhula was designed to promote developmentally important dietary and movement behaviours among children of preschool age (3–5 years) in South Africa. An initial formative study in Cape Town found the intervention to be feasible and acceptable when delivered by community health workers (CHWs) linked to a community-based organisation. This study evaluated the delivery of the Amagugu Asakhula intervention by CHWs linked to a public sector primary health care facility in Soweto, as this mode of delivery could have more potential for sustainability and scalability. Methods A qualitative design was utilised to assess feasibility, acceptability, adoption, appropriateness, implementation, fidelity and context. CHWs (n = 14) delivered the intervention to caregivers (n = 23) of preschool-age children in Soweto over 6 weeks. Following the completion of the intervention, focus group discussions were held with CHWs and caregivers. Further data were obtained through observations, study records and key informant interviews (n = 5). Data were analysed using deductive thematic analysis guided by a process evaluation framework. Results The delivery of the Amagugu Asakhula intervention through CHWs linked to a primary health care facility in Soweto was not found to be feasible due to contextual challenges such as late payment of salaries influencing CHW performance and willingness to deliver the intervention. CHWs expressed dissatisfaction with their general working conditions and were thus reluctant to take on new tasks. Despite barriers to successful delivery, the intervention was well received by both CHWs and caregivers and was considered a good fit with the CHWs’ scope of work. Conclusions Based on these findings, delivery of the Amagugu Asakhula intervention is not recommended through public sector CHWs in South Africa. This feasibility study informs the optimisation of implementation and supports further testing of the intervention’s effectiveness when delivered by CHWs linked to community-based organisations. The present study further demonstrates how implementation challenges can be identified through qualitative feasibility studies and subsequently addressed prior to large-scale trials, avoiding the wasting of research and resources.

scholarly journals Continuing Education in Health: interprofessional practices in the field of Collective Health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A P N Fornereto ◽  
M N Ogata ◽  
T A Santos ◽  
A B C Franceschini ◽  
MCRLR Pinto ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Continuing Education ◽  
Technical Assistance ◽  
Health Management ◽  
Multidisciplinary Teams ◽  
Target Area ◽  
Clinic Management ◽  
Primary Health ◽  
Health Support

Abstract Family Health Support Centres (NASFs, in Portuguese) aim to develop interprofessional practices anchored in the assumptions of Primary Health Care, guided by the criteria of shared care specific professional interventions, management processes, interdisciplinarity, intersectoriality, Continuing Education in Health and health promotion. This health management methodology (Matrix Support) still represents a challenge to workers and managers, as it switches the logic of clinical thought from individual-centred, ambulatory and disciplinary care to collective, territory and interdisciplinary care. This study might illustrate and allow sharing of experiences about a work management format for multidisciplinary teams in Primary Health Care. A partnership between the University and the state health department was established in order to elaborate a collaborative, educational and supportive action. We formed a group of workers in the target area (24 municipalities and 18 teams) who had a focus on Continuing Education in Health using Institutional Analysis as theoretical reference. The main goal of the action was to provide spaces to share experiences and learning in the perspective of Continuing Education in Health. How does Continuing Education in Health support interprofessional practices in the field of Collective Health? Among the main results, we list: reflection about organisation practices of multiprofessional work, reflection about care practices and clinic management in the technical-assistance and pedagogic perspectives of Matrix Support; encouragement to improve the services offered in this level of care and their relationship with other points of the network. This experience showed us the importance of three main aspects: Continuing Education in Health, as a strategy of critical analysis about work and workers; the partnership and integration between teaching and service; and interprofessional formation processes (necessary to NASF and Collective Health). Key messages Continuing Education in Health is a strategy to deal with challenges and possibilities of interprofessional practices in the field of Collective Health. Enabling experiences and providing spaces for health professionals to share experience and learning.

Childhood Mental Disorders in Primary Health Care: Results of Observations in Four Developing Countries

PEDIATRICS ◽  
1981 ◽  
Vol 68 (5) ◽  
pp. 677-683
Author(s):  
R. Giel ◽  
M. V. de Arango ◽  
C. E. Climent ◽  
T. W. Harding ◽  
H. H. A. Ibrahim ◽  
...  
Keyword(s):  
Health Care ◽  
Developing Countries ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Health Workers ◽  
Health Care Facilities ◽  
Primary Health ◽  
Care Facilities ◽  
Research Procedure ◽  
Primary Health Care Facilities

To ascertain the frequency of mental disorders in Sudan, Philippines, India, and Colombia, 925 children attending primary health care facilities were studied. Rates of between 12% and 29% were found in the four study areas. The range of mental disorders diagnosed was similar to that encountered in industrialized countries. The research procedure involved a two-stage screening in which a ten-item "reporting questionnaire" constituted the first stage. The study has shown that mental disorders are common among children attending primary health care facilities in four developing countries and that accompanying adults (usually the mothers) readily recognize and report common psychologic and behavioral symptoms when these are solicited by means of a simple set of questions. Despite this, the primary health workers themselves recognized only between 10% and 22% of the cases of mental disorder. The results have been used to design appropriate brief training courses in childhood mental disorders for primary health workers in the countries participating in the study.

Community midwifery: a primary health care approach to care during pregnancy for Aboriginal and Torres Strait Islander women

2021 ◽  
Vol 27 (1) ◽  
pp. 57
Author(s):  
Ailsa Munns
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Torres Strait Islander ◽  
Service Providers ◽  
Early Years ◽  
Health Staff ◽  
Liaison Officer ◽  
Primary Health ◽  
Comprehensive Primary Health Care ◽  
Torres Strait

Comprehensive primary health care is integral to meaningful client-centred care, with nurses and midwives central to partnership approaches with individuals, families and communities. A primary health model of antenatal care is needed for Aboriginal and Torres Strait Islander women in rural and remote areas, where complex social determinants of health impact on pregnancy outcomes, early years and lifelong health. Staff experiences from a community midwifery-led antenatal program in a remote Western Australian setting were explored, with the aim of investigating program impacts from health service providers’ perspectives. Interviews with 19 providers, including community midwives, child health nurses, program managers, a liaison officer, doctors and community agency staff, examined elements comprising a culturally safe community antenatal program for Aboriginal and Torres Strait Islander women, exploring program benefits and challenges. Thematic analysis derived five themes: Organisational and Accessibility Factors; Culturally Appropriate Support; Staff Availability and Competencies; Collaboration; and Sustainability. The ability of program staff to work in culturally safe partnerships with clients in collaboration with community agencies was essential to building meaningful and sustainable antenatal strategies. Midwifery primary health care competencies were viewed as a strong enabling factor, with potential to reduce health disparities in accordance with Australian Government and research recommendations.

scholarly journals Reasons for students’ poor clinical competencies in the Primary Health Care: Clinical nursing, diagnosis treatment and care programme

2010 ◽  
Vol 15 (1) ◽  
Author(s):  
Nomasonto B. Magobe ◽  
Sonya Beukes ◽  
Ann Müller
Keyword(s):  
South Africa ◽  
Health Care ◽  
Primary Health Care ◽  
Care Service ◽  
Health Care Service ◽  
Health Staff ◽  
Care Programme ◽  
Clinical Competencies ◽  
Primary Health ◽  
Comprehensive Primary Health Care

‘No member of [health] staff should undertake tasks unless they are competent to do so’ is stated in the Comprehensive Primary Health Care Service Package for South Africa (Department of Health 2001)document. In South Africa, primary clinical nurses (PCNs), traditionally known as primary health care nurses (PHCNs), function as ‘frontline providers’ of clinical primary health care (PHC) services within public PHC facilities, which is their extended role. This extended role of registered nurses(set out in section 38A of the Nursing Act 50 of 1978, as amended) demands high clinical competency training by nursing schools and universities.The objectives of the study were to explore and describe the perceptions of both clinical instructors and students, in terms of the reasons for poor clinical competencies. Results established that two main challenges contributed to students’ poor clinical competencies: challenges within the PHC clinical field and challenges within the learning programme (University).OpsommingDie primêre kliniese verpleegkundiges, tradisioneel bekend as primêre gesondheidsorg verpleegkundiges, funksioneer in Suid-Afrika as eerste-linie verskaffers van kliniese primêre gesondheidsorg (PGS) dienste binne die publieke PGS fasiliteite. Dit is hulle uitgebreide rol. Hierdie uitgebreide rol van die verpleegkundige (soos deur Wet op Verpleging,No 50 van 1978, artikel 38A voorgeskryf), vereis opleiding in kliniese vaardighede van hoë gehalte deur verpleegskole en universiteite.Die doelwitte van die navorsing was om die persepsies van beide kliniese dosente en leerders,met betrekking tot die redes vir swak kliniese vaardighede, repektiewelik te verken en te beskryf.Twee temas is deur die resultate as uitdagings (hoof redes) vir die swak vaardighede van leerders aangetoon, naamlik uitdagings in die PGS kliniese praktyk en die uitdagings in die leerprogram (universiteit).

scholarly journals The provision of Primary Health Care in two rural districts of the Eastern Cape Province with particular reference to human resources and accessibility - Part 2: The results and recommendations

Curationis ◽  
1998 ◽  
Vol 21 (2) ◽  
Author(s):  
M. Thipanyana ◽  
T.R. Mavundla
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Phase Iii ◽  
Eastern Cape Province ◽  
Eastern Cape ◽  
Problem Statement ◽  
Rural Districts ◽  
Primary Health ◽  
Community People ◽  
Professional Nurses

Part 1 of this article dealt with the introduction, problem statement and the research methods. This article details the results and the recommendations with the aim of improving the provision of primary health care in rural districts of the Eastern Cape Province. This article is dealt with in three phases: phase I gives the results of interviews of community people, phase II deals with the results of the questionnaire administered to professional nurses and phase III entails the recommendations.

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