scholarly journals PERCEPTIONS OF MOTHERS AND CAREGIVERS REGARDING THE DETECTION AND TREATMENT OF SEVERELY MALNOURISHED CHILDREN IN KANCHELE, KALOMO DISTRICT, ZAMBIA

2015 ◽  
Vol 16 (2) ◽  
pp. 98-111 ◽  
Author(s):  
H Khunga ◽  
K J Okop ◽  
Thandi Puoane
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Health Care Facilities ◽  
Health Seeking ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Malnourished Children

Each year, malnutrition accounts for about 50% of the deaths of under-fives in developing countries. In Zambia, about 45% of children under the age of five exhibit stunted growth, mainly due to malnutrition. Early detection of cases by health workers and prompt health-seeking practices at household and community levels can improve the identification and management of malnutrition, and prevent unnecessary deaths. The study provides insights into the perceptions of mothers, caregivers, community members and community health workers regarding the detection, referral and health-seeking practices of malnourished children in Kalomo district of Zambia. This was a qualitative study which explored perceptions and challenges of detection and prompt treatment of malnutrition (kwashiorkor and marasmus) in children under five years of age in the community. Focus group discussions using pictographs were conducted with purposely selected mothers and caregivers of children attending immunization clinics in rural health centres in Zambia. In-depth interviews were also conducted with purposely selected grandparents, community health workers and nutrition advisors to validate the findings obtained from focus group discussions. Data were analysed using thematic analysis. Malnutrition, particularly marasmus, was linked to HIV infection. Barriers to seeking health care for severely malnourished children included beliefs about causes of malnutrition, failure to link malnutrition to poor feeding practices, distance to health care facilities and lack of free feeding schemes for malnourished children. Mothers’ decisions to seek care for malnourished children were influenced largely by grandparents. Increasing awareness about causes, signs and symptoms of malnutrition in this community is needed to improve detection and treatment of malnourished children.

scholarly journals Skills2Care: An innovative, cooperative learning programme for community health workers in South Africa

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Therese M. Boulle ◽  
Paul Cromhout ◽  
Khuzwayo August ◽  
Dave Woods
Keyword(s):  
South Africa ◽  
Focus Group ◽  
Cooperative Learning ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Large Numbers ◽  
Cognitive Knowledge

Background: Community health workers (CHWs) hold potential to support universal health coverage and better health for vulnerable communities. They are integral to the re-engineered Primary Health Care (PHC) strategy, introduced in South Africa in 2011. This study focussed on how to train CHWs in large numbers, especially in resource-limited, rural settings. Skills2Care, a method of cooperative learning for CHWS, has been pioneered in the Eastern Cape of South Africa.Aim: To determine whether Skills2Care could improve the cognitive knowledge of CHWs; to understand their response and attitude to the programme; to explore factors that enabled and inhibited learning and to consider its viability as a training method.Setting: Research was conducted in 2019 in the Ngqeleni subdistrict of the O.R. Tambo district, in rural Eastern Cape.Methods: A group-learning model using specifically tailored study modules in booklet format, addressing mother and baby care, was used. A facilitator promoted learning. Knowledge assessment was conducted by pre- and post-study testing using multiple choice questions. Focus group discussions and interviews explored the appropriateness and acceptability of this method, and factors enabling and inhibiting the learning.Results: This method of peer group cooperative learning can significantly increase the cognitive knowledge of CHWs. Test scores indicated a significant (13%) improvement. Focus group discussions indicated that participants valued this method as it increased knowledge and boosted their confidence.Conclusion: This innovative approach to district-based, continuing education suggests that CHWs could be trained in large numbers without the need for additional resources.

scholarly journals Barriers and facilitators to neonatal health and care-seeking behaviours in rural Cambodia: a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e035449 ◽  
Author(s):  
Gabriella Watson ◽  
Kaajal Patel ◽  
Daly Leng ◽  
Dary Vanna ◽  
Sophanou Khut ◽  
...  
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Barriers And Facilitators ◽  
Neonatal Health ◽  
Care Seeking ◽  
Focus Group Discussions ◽  
Group Discussions

ObjectivesNeonatal mortality remains persistently high in low-income and middle-income countries. In Cambodia, there is a paucity of data on the perception of neonatal health and care-seeking behaviours at the community level. This study aimed to identify influencers of neonatal health and healthcare-seeking behaviour in a rural Cambodian province.DesignA qualitative study using focus group discussions and thematic content analysis.SettingFour health centres in a rural province of Northern Cambodia.ParticipantsTwenty-four focus group discussions were conducted with 85 community health workers in 2019.ResultsCommunity health workers recognised an improvement in neonatal health over time. Key influencers to neonatal health were identified as knowledge, sociocultural behaviours, finances and transport, provision of care and healthcare engagement. Most influencers acted as both barriers and facilitators, with the exception of finances and transport that only acted as a barrier, and healthcare engagement that acted as a facilitator.ConclusionUnderstanding health influencers and care-seeking behaviours is recognised to facilitate appropriate community health programmes. Key influencers and care-seeking behaviours have been identified from rural Cambodia adding to the current literature. Where facilitators have already been established, they should be used as building blocks for continued change.

scholarly journals Operability, Usefulness, and Task-Technology Fit of an mHealth App for Delivering Primary Health Care Services by Community Health Workers in Underserved Areas of Pakistan and Afghanistan: Qualitative Study

10.2196/18414 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e18414 ◽  
Author(s):  
Shehla Zaidi ◽  
Abdul Momin Kazi ◽  
Atif Riaz ◽  
Ammarah Ali ◽  
Rabia Najmi ◽  
...  
Keyword(s):  
Focus Group ◽  
Community Health ◽  
Community Health Workers ◽  
Health Systems ◽  
Health Workers ◽  
Daily Routine ◽  
End User ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Task Technology Fit

Background The recent proliferation of digital health technology in low- and middle-income countries has made it possible for community health workers (CHWs) to use mobile health (mHealth) to perform tasks such as data collection and training. Although most studies focus on the prospect of digital apps to motivate and connect CHW, only a few have captured end-user experiences with mobile-based apps. We examined the experience of frontline health workers with a move towards digitalized real-time data to record maternal and childcare services in remote areas of Afghanistan and Pakistan. Objective Our study aimed to explore CHW perceptions on the operability of the mHealth app in a community setting, usefulness of the app in the delivery of assigned maternal and childcare functions, and the task-technology fit with monitoring information systems. Methods The Hayat app, designed to digitalize and facilitate electronic record keeping, was evaluated to be embedded into mainstream health systems. The app had 2 components: smartphone app for data entry and web dashboard for visualization of the maternal, newborn, and child health reports. Using a qualitative exploratory study design, we conducted a total of 8 focus group discussions with purposively selected lady health workers (LHWs) and CHWs in 3 districts of Pakistan and 3 hamlets of Afghanistan, respectively. Focus group discussions were conducted in the local language, audio recorded, and converted into expanded notes for thematic analysis. Results Although a majority of LHWs used the app with ease, some initially faced difficulties in operating it and requested a longer duration of training. Contrary to LHWs, the CHWs were able to use the app without difficulty, as they were using it only to register clients. Overall, use of the mHealth app in both countries resulted in a positive impact on health education sessions, easier communication with parents or clients, tracking of routine immunization defaulters and follow-ups, improved data validity, easily accessible vaccination schedules, and faster registration. In addition to building up their image in the community and personal development, the improved reporting and monitoring mechanisms also set the stage for the LHWs to get recognized for their hard work. CHWs in Afghanistan also reported the app provided immediate access to information when requested by their supervisor. Although the Hayat app eliminates the need to carry multiple registers and helps in recalling client information at the touch of a button, technical issues around connectivity and data inputting tabs were highlighted by the participants. Conclusions The digitization of records not only provided CHWs support in their daily routine but also strengthened monitoring mechanisms and improved motivation. We recommend conducting end user experience studies before embedding apps into mainstream health systems as high acceptability does not always result in high uptake of digital technology.

scholarly journals Operability, Usefulness, and Task-Technology Fit of an mHealth App for Delivering Primary Health Care Services by Community Health Workers in Underserved Areas of Pakistan and Afghanistan: Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Shehla Zaidi ◽  
Abdul Momin Kazi ◽  
Atif Riaz ◽  
Ammarah Ali ◽  
Rabia Najmi ◽  
...  
Keyword(s):  
Focus Group ◽  
Community Health ◽  
Community Health Workers ◽  
Health Systems ◽  
Health Workers ◽  
Daily Routine ◽  
End User ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Task Technology Fit

BACKGROUND The recent proliferation of digital health technology in low- and middle-income countries has made it possible for community health workers (CHWs) to use mobile health (mHealth) to perform tasks such as data collection and training. Although most studies focus on the prospect of digital apps to motivate and connect CHW, only a few have captured end-user experiences with mobile-based apps. We examined the experience of frontline health workers with a move towards digitalized real-time data to record maternal and childcare services in remote areas of Afghanistan and Pakistan. OBJECTIVE Our study aimed to explore CHW perceptions on the operability of the mHealth app in a community setting, usefulness of the app in the delivery of assigned maternal and childcare functions, and the task-technology fit with monitoring information systems. METHODS The Hayat app, designed to digitalize and facilitate electronic record keeping, was evaluated to be embedded into mainstream health systems. The app had 2 components: smartphone app for data entry and web dashboard for visualization of the maternal, newborn, and child health reports. Using a qualitative exploratory study design, we conducted a total of 8 focus group discussions with purposively selected lady health workers (LHWs) and CHWs in 3 districts of Pakistan and 3 hamlets of Afghanistan, respectively. Focus group discussions were conducted in the local language, audio recorded, and converted into expanded notes for thematic analysis. RESULTS Although a majority of LHWs used the app with ease, some initially faced difficulties in operating it and requested a longer duration of training. Contrary to LHWs, the CHWs were able to use the app without difficulty, as they were using it only to register clients. Overall, use of the mHealth app in both countries resulted in a positive impact on health education sessions, easier communication with parents or clients, tracking of routine immunization defaulters and follow-ups, improved data validity, easily accessible vaccination schedules, and faster registration. In addition to building up their image in the community and personal development, the improved reporting and monitoring mechanisms also set the stage for the LHWs to get recognized for their hard work. CHWs in Afghanistan also reported the app provided immediate access to information when requested by their supervisor. Although the Hayat app eliminates the need to carry multiple registers and helps in recalling client information at the touch of a button, technical issues around connectivity and data inputting tabs were highlighted by the participants. CONCLUSIONS The digitization of records not only provided CHWs support in their daily routine but also strengthened monitoring mechanisms and improved motivation. We recommend conducting end user experience studies before embedding apps into mainstream health systems as high acceptability does not always result in high uptake of digital technology.

scholarly journals Knowledge, beliefs and attitudes of community health workers about hypertension in the Cape Peninsula, South Africa

Curationis ◽  
2004 ◽  
Vol 27 (1) ◽  
Author(s):  
M.J. Sengwana ◽  
T. Puoane
Keyword(s):  
Risk Factors ◽  
South Africa ◽  
Health Promotion ◽  
Focus Group ◽  
Community Health ◽  
Health Workers ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Cape Peninsula ◽  
Beliefs And Attitudes

This article explores the perceptions and attitudes of community health workers (CHWs) about hypertension. The level of knowledge of hypertension, as well as their personal attitude towards this is crucial in the style and quality of their interventions. CHWs, whose role in health promotion is being increasingly recognised, can help contain or reduce the prevalence of hypertension by influencing the community to adopt healthy lifestyles. Forty-three CHWs employed by Zanempilo in two study areas, Sites B and C in Khayelitsha in the Cape Peninsula, South Africa, were included in the study. Firstly, focus group discussions were conducted with 17 purposively selected CHWs to explore attitudes, beliefs and perceptions of hypertension. Secondly, interviews were conducted to assess their basic knowledge about causes, prevention and control of hypertension. The focus group discussions revealed that CHWs were uncertain about the causes of hypertension. They also found it difficult to grasp the fact that people without risk factors, such as overweight or a family history of hypertension, could be hypertensive. Many CHWs believe in traditional medicines and home-brewed beer as the best treatment for hypertension. They believe that people who take medical treatment become sicker and that their health deteriorates rapidly. Risk factors of hypertension mentioned during the structured interviews include inheritance, lack of physical activity, consuming lots of salty and fatty food. Conclusions drawn from the findings of the CHWs’ responses highlighted their insufficient knowledge about hypertension as a chronic disease of lifestyle. Meanwhile they are expected to play a role in stimulating community residents’ interest in the broad principle of preventive health maintenance and follow-up. Data obtained from this research can be used for the planning of health-promotion programmes. These should include preventing hypertension and improving primary management of individual sufferers. Because of their working relations and close link with CHWs, community nurses in primary health-care facilities need to recognise these beliefs and attitudes since these may differ from their own.

scholarly journals Contribution of community health workers to primary health care performance in Brazil

2020 ◽  
Vol 54 ◽  
pp. 143
Author(s):  
Alaneir de Fátima dos Santos ◽  
Hugo André da Rocha ◽  
Ângela Maria de Lourdes Dayrell de Lima ◽  
Daisy Maria Xavier de Abreu ◽  
Érica Araújo Silva ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Scale Up ◽  
Health Care Facilities ◽  
Children's Health ◽  
Children’S Health ◽  
Primary Health

OBJECTIVE: To associate the strength of community health workers interventions with primary health care strategies for women’s and children’s health, diabetes, and hypertension. METHODS: This is a cross-sectional study assessing 29,778 family health teams working in primary health care in Brazil in 2014. The association between community health workers activity levels and primary health care facilities was analyzed using multiple logistic regression. RESULTS: We found higher levels of community health workers activities strongly associated with primary health care practices (OR = 6.88) for those activities targeting hypertension management, followed by children’s health (OR = 6.56), and women’s health (OR = 6.21). CONCLUSIONS: At a time when Brazil discusses whether community health workers should or should not remain in the same scale-up and skill level as they currently are, our results reinforce the importance of these workers for the care model advocated by the Brazilian Unified Health System.

scholarly journals “Now You Have Become Doctors”: Lady Health Workers' Experiences Implementing an mHealth Application in Rural Pakistan

2021 ◽  
Vol 2 ◽  
Author(s):  
Mai-Lei Woo Kinshella ◽  
Sana Sheikh ◽  
Sohail Bawani ◽  
Michelle La ◽  
Sumedha Sharma ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Focus Group ◽  
Qualitative Analysis ◽  
Health System ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Community Level ◽  
Rural Pakistan

Background: PIERS on the Move (POM) is a mobile health application developed to support community health workers identification and management of women at risk of adverse outcomes from pre-eclampsia. The objective of this study was to evaluate the impact of using POM in Pakistan on Lady Health Workers' (LHWs) knowledge and self-efficacy related to caring for women with pre-eclampsia, and their perception of usefulness of the tool.Methodology: An evaluation was designed for health care workers involved in the Community-Level Intervention for Pre-eclampsia (CLIP) cluster randomized trial from 2014 to 2016 in Sindh Province, Pakistan (NCT01911494). A semi-structured focus group guide was developed based on the Technology Acceptance Model (TAM), which theorizes that an individual's behavioral intention to use a system is determined by perceived usefulness and ease of use. Preliminary qualitative analysis was undertaken by the Pakistan and Canadian teams to create a coding framework for full qualitative analysis, which was completed using NVivo12.Results: Three key informant interviews were conducted with two Lady Health Supervisors and one Senior Medical Officer. Sixty-two LHWs were included in three focus group discussions. LHWs found the POM app easy to use and useful for their work as a helpful repository for maternal health information and guiding counseling and management of pre-eclampsia. LHWs reported increased knowledge and confidence in their work. Availability of clinical homecare, including postpartum, was felt to positively impact healthcare provided to pregnant and postpartum women. Potential community level impacts included strengthening relationships between health care providers and communities and between LHWs and the health system. LHWs shared reports of earlier care-seeking and increased awareness of maternal health issues by community members.Conclusions: LHWs carry a large burden of responsibility for community health in rural Pakistan and appreciated the investment in their skills and capacity during the CLIP trial with the POM app. Investing in communications technology for community health workers through improved referrals and follow up may strengthen cohesiveness of the health system overall.

scholarly journals Perceptions of Community Health Workers (CHW) On Barriers And Enablers To Care For People With Psychosis In Rural Mozambique: Findings of a Focus Group Discussion Study Using The Capability, Opportunity, Motivation and Behavior Framework (COM-B Framework).

2021 ◽  
Author(s):  
Dirceu Mabunda ◽  
Déborah Oliveira ◽  
Mohsin Sidat ◽  
Francine Cournos ◽  
Milton Wainberg ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Community Health ◽  
Community Health Workers ◽  
Rural Areas ◽  
Psychotic Disorders ◽  
Health Workers ◽  
Traditional Healers ◽  
Rural Settings ◽  
And Behavior

Abstract Background: Psychotic disorders contribute significantly to the global disease burden by causing disability, impaired quality of life, and higher mortality in affected people compared with the general population. In rural settings, where there is limited or no access to healthcare, individuals living with psychotic disorders often seek support from Community Health Workers (CHWs). However, little is known about what CHWs know about psychosis and how they manage such cases. This study aimed to explore the CHWs perception of psychosis and their experiences and beliefs about the factors that might enable or hinder care taking for patients with psychosis in rural settings in Mozambique. Methods: A qualitative study was conducted in rural districts of Maputo Province, a southern region of Mozambique, using six focus group discussions with participation of 79 CHWs. Thematic analysis was used informed by the Capabilities, Opportunities, Motivation and Behavior framework (COM-B).Results: Nine primary themes were identified. Overall, CHWs perceived psychosis as treatable medical conditions and held a positive attitude about being part of the care taking process of patients with psychosis in rural settings. Partnerships with key-stakeholders such as traditional healers, health care workers and families, were perceived by CHWs as enablers to improve access to care in rural areas. However, stigma, myths, and lack of competencies to treat people with psychosis were perceived by CHWs as barriers for appropriate care. Conclusion: CHWs, with adequate support, can play an important role in the care of patients with psychosis in rural settings, including identification of patients requiring care and referring them to appropriate healthcare professionals, and follow-up of medicated patients with psychosis within the rural remote setting. Training of CHWs should consider inclusion of basic mental health care competencies.

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.

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