scholarly journals Review of: 'Increasing access to health workers in remote and rural areas through improved retention: global policy recommendations: Global policy recommendations'

2010 ◽  
Author(s):  
Jose Manuel Lopez-Abuin
Keyword(s):  
Rural Areas ◽  
Health Workers ◽  
Policy Recommendations ◽  
Global Policy ◽  
Access To Health

scholarly journals Utilization of Maternity Waiting Home (MWH) to Improve Access to Health Services: Systematic Literature Review

2020 ◽  
Vol 7 (3) ◽  
pp. 368-375
Author(s):  
Nuraina Nuraina
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Health Workers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Access To Health Services ◽  
Care Services ◽  
Access To Health ◽  
Maternity Waiting Home ◽  
Improve Access

Maternity waiting home (MWH) is a home built in the compound or near to health facilities that provides standard medical and emergency obstetric care services. MWH is considered to be a key strategy to "bridge the geographical gap" in obstetric care between rural areas with poor access to equipped facilities, and urban areas where the services are available. This study aimed to systematically review the utilization of MWH to improve access to health service. The method of finding articles in this study was in the period 2014 to 2018, free full text, human species, and scholarly journals which were then identified using an electronic database from Pubmed, Proquest and Onesearch. Three articles were carried out with thematic analysis to identify the main points. Factors associated with the utilization of MWH included (1) Distance; (2) Complication during pregnancy; and (3) Income. Barrier in the utilization of MWH were (1) Inadequate number of room and postpartum bed; (2) Lack of water and sanitation facilities; and (3) Unavailable electricity. Partnership between health workers in rural facilities, stronger role of stakeholders, and a broader health system, were expected to increase the utilization of MWH.

scholarly journals Increasing access to health workers in rural and remote areas: what do stakeholders’ value and find feasible and acceptable?

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Onyema Ajuebor ◽  
Mathieu Boniol ◽  
Michelle McIsaac ◽  
Chukwuemeka Onyedike ◽  
Elie A. Akl
Keyword(s):  
Rural Areas ◽  
Health Workers ◽  
World Health ◽  
Policy Options ◽  
Rural And Remote ◽  
Outcome Indicators ◽  
Recruitment And Retention ◽  
Remote Areas ◽  
Access To Health ◽  
Rural And Remote Areas

Abstract Background The primary aim of this study is to assess stakeholders’ views of the acceptability and feasibility of policy options and outcome indicators presented in the 2010 World Health Organization (WHO) global policy recommendations on increasing access to health workers in remote and rural areas through improved retention. Methods A survey on the acceptability, feasibility of recruitment and retention policy options, and the importance of their outcome indicators was developed. It followed a cross-sectional approach targeting health workers in rural and remote settings as well as policy- and decision-makers involved in the development of recruitment and retention policies for such areas. Respondents were asked their perception of the importance of the policy outcomes of interest, as well as the acceptability and feasibility of the 2010 WHO guidelines’ policy options using a 9-point Likert scale. Results In total, 336 participants completed the survey. Almost a third worked in government; most participants worked in community settings and were involved in the administration and management of rural health workers. Almost all 19 outcomes of interests assessed were valued as important or critical. For the 16 guideline policy options, most were perceived to be "definitely acceptable" and "definitely feasible", although the policy options were generally considered to be more acceptable than feasible. Conclusion The findings of this study provide insight into the revision and update of the 2010 WHO guideline on increasing access to health workers in remote and rural areas. Stakeholders’ views of the acceptability, feasibility of policy options and the importance of outcomes of interest are important for the development of relevant and effective policies to improve access to health workers in rural and remote areas.

Growth of Rural Indebtedness in Punjab

2020 ◽  
pp. 336-341
Keyword(s):  
Financial Institutions ◽  
Rural Areas ◽  
Agricultural Sector ◽  
Rural Households ◽  
Small Sample ◽  
Access To Health ◽  
Utilisation Pattern ◽  
Agricultural Labourers

The problem of indebtedness among the rural households of Punjab was become more serious in the last two decades. A large number of studies were carried out in India and abroad to look into the problem of rural indebtedness and its consequences but most of these studies are either based upon a very small sample of a few districts or cover the farmers only. The present study would be wider in scope as it was also included artisans, agricultural labourers (non- cultivators) along with the farmers (cultivators). This study analysed the situation of Punjab as a whole and district wise analysis was done. Therefore, in the present study, an attempt was made to analyse the growth of indebtedness among the rural households in Punjab and attempt was made to explain the utilisation pattern of loan used by rural households and tried to trace out how the situation of household indebtedness in the Punjab evolved and changed over the course of about ten years. The study will be helpful to planners, academicians, researchers as well as policymakers for solving the problem of indebtedness among rural households for the betterment of the society as a whole. It is suggested that encouragement should be given to subsidiary occupations, improvement in access to health at subsidised rate in rural areas to curb the indebtedness and to monitor the informal mechanism of credit by Government and financial institutions along with availability of the appropriate delivery of credit into the agricultural as well as non-agricultural sector of rural areas by eliminating costly sources of money lenders for the accurate functioning of the economy.

scholarly journals COPD awareness in the urban slums and rural areas around Pune city in India

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Deesha Deepak Ghorpade ◽  
Anchala Raghupathy ◽  
Jyoti Deepak Londhe ◽  
Sapna Jitendra Madas ◽  
Nisha Vijay Kale ◽  
...  
Keyword(s):  
Tobacco Smoking ◽  
Rural Areas ◽  
Total Population ◽  
Health Workers ◽  
Urban Slum ◽  
Urban Slums ◽  
Cross Sectional ◽  
Rural Villages ◽  
Disability Adjusted Life ◽  
Life Years

AbstractCOPD is the second leading cause of death and disability adjusted life years (DALYs) in India, yet, it remains poorly recognized. We aimed to study the level of awareness of COPD in urban slums of Pune city in India and its neighboring rural areas. All male and female subjects above the age of 30 years residing in 13 randomly selected slums of Pune city (total population of 3000) and 7 randomly selected neighboring rural villages (total population of 3000) were invited to participate in this cross-sectional community survey. After obtaining written informed consent, 13 trained community health workers (CHWs) administered a questionnaire that captured their level of awareness of COPD. Of the 6000 subjects approached, 5420 residents (mean age ± SD = 48.0 ± 13.5 years; 38% males) consented and answered all questions. The number of people who had ever heard the word COPD was 49/5420 [0.9% (0.6–1.1%); 0.7% (0.5–1.3%) of the urban slum dwellers and 1.15% (0.5–1.3%) of rural residents]. Among those who had never heard the word COPD (n = 5371), when asked what was the name of the disease caused by long-term tobacco smoking, 38% said cancer, 16.7% said asthma, and 4.4% said TB. Among those who had heard the word COPD (n = 49), 6.1% said it was a disease of the heart, and 61% attributed COPD to smoke and dust pollution and 20% to tobacco smoking. The level of awareness of COPD in the Indian community is extremely low, highlighting the need to have nationwide mass awareness programs in India.

scholarly journals The Challenges of Intersectionality in the Lives of Older Adults Living in Rural Areas with Limited Financial Resources

2021 ◽  
Vol 7 ◽  
pp. 233372142110093
Author(s):  
Adrienne Cohen
Keyword(s):  
Focus Groups ◽  
Rural Areas ◽  
Financial Resources ◽  
Policy Recommendations ◽  
Community Members ◽  
Individual Interviews ◽  
Study Population ◽  
Southern Georgia ◽  
Multiplicative Effects ◽  
Limit Access

The objective of this study was to use intersectionality to better understand the challenges of having the combined statuses of being an older adult, living in a rural area and having limited financial resources. Eight focus groups and 38 individual interviews were conducted in southern Georgia. Participants included program participants and staff, community members, and community leaders. Thematic analysis was done using verbatim transcripts from focus groups and interviews. Results demonstrate that the multiplicative and intersecting statuses of the study population create challenges in the areas of transportation, health care, food, and housing. The challenges of these intersectional statuses limit access to services in ways that each individual status did not, thereby compounding challenges. While previous literature describes the challenges of one or two of these statuses, this work explores the multiplicative effects of the combination of the three statuses using intersectionality. Programmatic and policy recommendations and implications are discussed.

scholarly journals Umbilical cord care through community-based distribution of chlorhexidine in rural Sindh, Pakistan

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Shah ◽  
Q Jamali ◽  
F Aisha
Keyword(s):  
Rural Communities ◽  
Data Collection ◽  
Umbilical Cord ◽  
Rural Areas ◽  
Health Workers ◽  
High Rate ◽  
Cord Care ◽  
Community Based ◽  
Sindh Province ◽  
At Home

Abstract Background Unsafe practices such as cutting umbilical cord with unsterilized instruments and application of harmful substances, are in practice in many rural areas of Pakistan, and associated with high risk of neonatal sepsis and mortality. Methods We conducted an implementation research in 2015 in Tharparkar district, in Sindh province of Pakistan to understand the feasibility and acceptability of community-based distribution of chlorhexidine (CHX) in rural Pakistan. For this cohort group-only study, 225 lady health workers (LHWs) enrolled 495 pregnant women. Enrolled women received 4% CHX gel and user’s instructions for newborn cord care. The LHWs also counseled women on the benefits and correct use of CHX. Study enumerators collected data from CHX receiving women 3 times: at around 2 weeks before delivery, within 24 hours after delivery, and on the 8th day after delivery. We implemented this study jointly in collaboration with Ministry of Health in Sindh province, Pakistan. Results Among enrolled participants, 399 women (81%) received only the first visit, 295 women (60%) received first two visits and 261 women (53%) received all three visits by enumerators. Among 399 women, who received CHX gel, counseling on its use and were respondent to the first round data collection, 78% remembered that the CHX gel to be applied to cord stump and surrounding areas immediately after birth; but less than a third (29%) forgot the need to keep the cord clean and dry. Among 295 respondents in the first two rounds of data collection, who delivered at home, 97% applied CHX to cord stump on the first day. Conclusions Community-based CHX distribution by LHWs, along with counseling to recipient women, resulted in a high rate of cord care with CHX among newborn delivered at home. Results from this study may help program implementers to consider expanding this intervention for improving newborn cord care on the first day of life in Pakistan. Key messages Community-based distribution of chlorhexidine for newborn cord care appears as highly acceptable and feasible in rural communities in Pakistan. Relevant program policy supporting community-based CHX distribution along with counseling by LHW may help expanding coverage of newborn cord care in rural communities in Pakistan.

Issues in the Provision of Health Care in India: An Overview

2020 ◽  
pp. 097674792094518
Author(s):  
Vani Kant Borooah
Keyword(s):  
Health Outcomes ◽  
Rural Areas ◽  
Health Workers ◽  
Tertiary Care ◽  
Health Resources ◽  
Successful Implementation ◽  
Trade Offs ◽  
Vested Interests ◽  
Explicit Recognition ◽  
Optimal Mix

After reviewing health outcomes and policy in India, this paper concludes that there are at least six sets of issues to be addressed about improving the quantity and quality of health services, and ipso facto improving health outcomes, in India. First, the amount of resources earmarked for health needs to increase. Second, health resources need to be used in a fair and just manner and, in particular, complaints relating to egregious health outcomes need to be addressed. Predominant in this set of issues is oversight and regulation of private-sector health provision. The third set of issues relates to the allocation of health resources and, in particular, to the imbalance in the allocation of health resources between towns and villages. A fourth issue is the accessibility of rural areas since it is the most remote areas that have the lowest density of health workers. Another issue is the more efficient use of health workers in order to make them more productive. Finally, Indian health policy is stronger on rhetoric and aspiration than it is on action and implementation. The successful implementation of the policy requires the explicit recognition that objectives are often competing (primary versus tertiary care) and the acknowledgement that, with budgetary constraints, one cannot have more of one without having less of the other. The first role of policy is to then choose the optimal mix of objectives with respect to these trade-offs. Secondly, policies come up against vested interests which agitate (often with the support of opposition politicians) and litigate against proposed changes. Lastly, policies in India are made against a background of poor governance with the predatory presence of corruption looming over every policy initiative. In implementing, rather than simply articulating, a policy it is important to address these governance issues.

scholarly journals Integrated home-based screening for people living with disabilities: A case study from rural Malawi

2019 ◽  
Vol 8 ◽  
Author(s):  
Elizabeth M. Petersen ◽  
Emily B. Wroe ◽  
Kondwani Nyangulu ◽  
Chisomo Kanyenda ◽  
Sam Njolomole ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Screening Programme ◽  
Health Workers ◽  
Hiv Care ◽  
Access To Health Services ◽  
Home Based ◽  
Poor Access ◽  
Access To Health ◽  
Integrated Screening

People living with disabilities (PLWDs) have poor access to health services compared to people without disabilities. As a result, PLWDs do not benefit from some of the services provided at health facilities; therefore, new methods need to be developed to deliver these services where PLWDs reside. This case study reports a household-based screening programme targeting PLWDs in a rural district in Malawi. Between March and November 2016, a household-based and integrated screening programme was conducted by community health workers, HIV testing counsellors and a clinic clerk. The programme provided integrated home-based screening for HIV, tuberculosis, hypertension and malnutrition for PLWDs. The programme was designed and implemented for a population of 37 000 people. A total of 449 PLWDs, with a median age of 26 years and about half of them women, were screened. Among the 404 PLWDs eligible for HIV testing, 399 (99%) agreed for HIV testing. Sixty-nine per cent of PLWDs tested for HIV had never previously been tested for HIV. Additionally, 14 patients self-reported to be HIV-positive and all but one were verified to be active in HIV care. A total of 192 of all eligible PLWDs above 18 years old were screened for hypertension, with 9% (n = 17) referred for further follow-up at the nearest facility. In addition, 274 and 371 PLWDs were screened for malnutrition and tuberculosis, respectively, with 6% (n = 18) of PLWDs referred for malnutrition, and 2% (n = 10) of PLWDs referred for tuberculosis testing. We successfully implemented an integrated home-based screening programme in rural Malawi.

scholarly journals Determinants of antenatal care visits and their impact on the choice of birthplace among mothers in Uganda: a systematic review

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Shallon Atuhaire ◽  
John Francis Mugisha
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
Rural Areas ◽  
Health Workers ◽  
Cochrane Review ◽  
Maternal Health Services ◽  
Economic Factors ◽  
Sustainable Livelihood ◽  
Intrinsic Factors ◽  
Socio Economic Factors

Objective: The utilization of Antenatal Care (ANC) services to the recommended time by WHO is still low in developing countries. In Uganda, about 990,000 women become pregnant annually, 90 to 94% of whom attend at least the first ANC visit while 65% and 58% of them attend four or more times in urban and rural areas respectively with eventual health facility birth at about 62%, homebirth and TBA together at about 38%. The study determined antenatal care attendance and the mother’s choice of birthplace in Uganda. Materials and methods: Using electronic databases mainly Google Scholar, Science Direct, PubMed and African Journals Online, and journal articles of international Website, 70,195 articles were identified but only 19 met the Cochrane review inclusion criteria hence were reviewed. Results: Reviewed studies attribute a decline in antenatal care visits and subsequent choice of birthplace to institutional, demographic and socio-economic factors. The demographic factors are maternal age (mothers less than eighteen years are less likely to utilize maternal health services than those above), marital status, occupation, residency, distance from home to the health facility, and parity. The socio-economic factors are mothers’ and partners’ levels of education (less educated women and their partners are less likely to utilize ANC), household income which affects transportation and medical bills, cultural norms and taboos, patriarchy society, enrollment on ANC in the third trimester, and intrinsic factors of attending ANC such as obtaining ANC card to present in case of emergency. Institutional factors include quality of medical care, availability of logistics and supplies, and health workers’ influence in terms of attitude, referral, competences, and staffing. Conclusion: Pregnant women who attend ANC are more likely to deliver in the health facility than those who do not at all. To enable them to attend ANC to full term and have a health facility delivery, their empowerment for increased self-efficacy through education, sustainable livelihood training and provision of subsidized capital alongside partner involvement. The facilitation of health facilities would also attract them.

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