scholarly journals Heat Emergencies: Perceptions and Practices of Community Members and Emergency Department Healthcare Providers in Karachi, Pakistan: A Qualitative Study

2021 ◽  
Vol 18 (9) ◽  
pp. 4736
Author(s):  
Uzma Rahim Khan ◽  
Naveed Ahmed ◽  
Rubaba Naeem ◽  
Umerdad Khudadad ◽  
Sarwat Masud ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Healthcare Professionals ◽  
Health Workers ◽  
Heat Waves ◽  
Healthcare Providers ◽  
Community Members ◽  
Home Based ◽  
Facility Level ◽  
Training Community ◽  
Access And Quality

Heat waves are the second leading cause of weather-related morbidity and mortality affecting millions of individuals globally, every year. The aim of this study was to understand the perceptions and practices of community residents and healthcare professionals with respect to identification and treatment of heat emergencies. A qualitative study was conducted using focus group discussions and in-depth interviews, with the residents of an urban squatter settlement, community health workers, and physicians and nurses working in the emergency departments of three local hospitals in Karachi. Data was analyzed using content analysis. The themes that emerged were (1) perceptions of the community on heat emergencies; (2) recognition and early treatment at home; (3) access and quality of care in the hospital; (4) recognition and treatment at the health facility; (5) facility level plan; (6) training. Community members were able to recognize dehydration as a heat emergency. Males, elderly, and school-going children were considered at high risk for heat emergencies. The timely treatment of heat emergencies was widely linked with availability of financial resources. Limited availability of water, electricity, and open public spaces were identified as risk factors for heat emergencies. Home based remedies were reported as the preferred practice for treatment by community members. Both community members and healthcare professionals were cognizant of recognizing heat related emergencies.

scholarly journals Community health worker models in South Africa: a qualitative study on policy implementation of the 2018/19 revised framework

2020 ◽  
Author(s):  
Joshua P Murphy ◽  
Aneesa Moolla ◽  
Sharon Kgowedi ◽  
Constance Mongwenyana ◽  
Sithabile Mngadi ◽  
...  
Keyword(s):  
South Africa ◽  
Qualitative Study ◽  
Policy Implementation ◽  
Community Health ◽  
Resource Constraints ◽  
Health Workers ◽  
Healthcare Providers ◽  
Successful Implementation ◽  
Programme Implementation ◽  
Healthcare Facilities

Abstract South Africa has a long history of community health workers (CHWs). It has been a journey that has required balancing constrained resources and competing priorities. CHWs form a bridge between communities and healthcare service provision within health facilities and act as the cornerstone of South Africa’s Ward-Based Primary Healthcare Outreach Teams. This study aimed to document the CHW policy implementation landscape across six provinces in South Africa and explore the reasons for local adaptation of CHW models and to identify potential barriers and facilitators to implementation of the revised framework to help guide and inform future planning. We conducted a qualitative study among a sample of Department of Health Managers at the National, Provincial and District level, healthcare providers, implementing partners [including non-governmental organizations (NGOs) who worked with CHWs] and CHWs themselves. Data were collected between April 2018 and December 2018. We conducted 65 in-depth interviews (IDIs) with healthcare providers, managers and experts familiar with CHW work and nine focus group discussions (FGDs) with 101 CHWs. We present (i) current models of CHW policy implementation across South Africa, (ii) facilitators, (iii) barriers to CHW programme implementation and (iv) respondents’ recommendations on how the CHW programme can be improved. We chronicled the differences in NGO involvement, the common facilitators of purpose and passion in the CHWs’ work and the multitude of barriers and resource limitations CHWs must work under. We found that models of implementation vary greatly and that adaptability is an important aspect of successful implementation under resource constraints. Our findings largely aligned to existing research but included an evaluation of districts/provinces that had not previously been explored together. CHWs continue to promote health and link their communities to healthcare facilities, in spite of lack of permanent employment, limited resources, such as uniforms, and low wages.

Predicting Diabetes amongst Native American Elders

2011 ◽  
Vol 3 (4) ◽  
pp. 27-43
Author(s):  
S. Upadhyaya ◽  
K. Farahmand ◽  
T. Baker-Demaray
Keyword(s):  
Native American ◽  
Native Americans ◽  
Rural Areas ◽  
Operating Characteristic ◽  
Healthcare Professionals ◽  
Characteristic Curve ◽  
Healthcare Providers ◽  
Prevention Strategies ◽  
Community Members ◽  
Policy Makers

One in three Americans will be diabetic by 2050, and the rate of diabetes is disproportionately high among Native Americans, especially among Native elders age 55 and older. Early identification and prevention strategies have been regarded as the cornerstone of preventative medicine. The objective of the authors’ research was to identify factors related to diabetes and their interactions specifically among Native elders and develop a simple prediction model which can be used by healthcare professionals while interacting with Native elders in remote or rural areas. Data from a survey of 18,078 Native American elders was used in their study. After eliminating outliers using Pearson’s residuals and Cook’s distance, the area under the receiver operating characteristic curve was 0.7812 for men and 0.7230 for women. The results from the authors’ analysis provide additional perspective on how diabetes affects Native elders thus helping healthcare providers and policy makers when dealing with these community members.

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 Grief reaction and psychosocial impacts of child death and stillbirth on bereaved North Indian parents: A qualitative study

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0240270
Author(s):  
Manoja Kumar Das ◽  
Narendra Kumar Arora ◽  
Harsha Gaikwad ◽  
Harish Chellani ◽  
Pradeep Debata ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Economic Impacts ◽  
Child Death ◽  
Healthcare Providers ◽  
Financial Strain ◽  
Traumatic Experience ◽  
Community Members ◽  
Group Discussions ◽  
Psychological Disturbances ◽  
And Coping

Background Grief following stillbirth and child death are one of the most traumatic experience for parents with psychosomatic, social and economic impacts. The grief profile, severity and its impacts in Indian context are not well documented. This study documented the grief and coping experiences of the Indian parents following stillbirth and child death. Methods This exploratory qualitative study in Delhi (India) included in-depth interviews with parents (50 mothers and 49 fathers), who had stillbirth or child death, their family members (n = 41) and community representatives (n = 12). Eight focus group discussions were done with community members (n = 72). Inductive data analysis included thematic content analysis. Perinatal Grief Scale was used to document the mother’s grief severity after 6–9 months of loss. Results The four themes emerged were grief anticipation and expression, impact of the bereavement, coping mechanism, and sociocultural norms and practices. The parents suffered from disbelief, severe pain and helplessness. Mothers expressed severe grief openly and some fainted. Fathers also had severe grief, but didn’t express openly. Some parents shared self-guilt and blamed the hospital/healthcare providers, themselves or family. Majority had no/positive change in couple relationship, but few faced marital disharmony. Majority experienced sleep, eating and psychological disturbances for several weeks. Mothers coped through engaging in household work, caring other child(ren) and spiritual activities. Fathers coped through avoiding discussion and work and professional engagement. Fathers resumed work after 5–20 days and mothers took 2–6 weeks to resume household chores. Unanticipated loss, limited family support and financial strain affected the severity and duration of grief. 57.5% of all mothers and 80% mothers with stillbirth had severe grief after 6–9 months. Conclusions Stillbirth and child death have lasting psychosomatic, social and economic impacts on parents, which are usually ignored. Sociocultural and religion appropriate bereavement support for the parents are needed to reduce the impacts.

scholarly journals Feasibility testing of a community dialogue approach for promoting the uptake of family planning and contraceptive services in Zambia

2020 ◽  
Author(s):  
Margarate Nzala Munakampe ◽  
Theresa Nkole ◽  
Adam Silumbwe ◽  
Joseph Mumba Zulu ◽  
Joanna Paula Cordero ◽  
...  
Keyword(s):  
Family Planning ◽  
Health Care Providers ◽  
Health Workers ◽  
Quality Care ◽  
Healthcare Providers ◽  
Care Providers ◽  
Community Members ◽  
Community Dialogue ◽  
Awareness Programs ◽  
Feasibility Testing

Abstract Background: Community dialogues have been used in participatory approaches in various health prevention and awareness programs, including family planning interventions to increase understanding and alignment of particular issues from different peoples’ perspectives. The main aim of this paper is to document the feasibility testing of a community dialogue approach, which aimed to promote dialogue between healthcare providers and community members. The feasibility testing was part of formative-phase research needed to design an intervention, with the ultimate goal of increasing the uptake of family planning and contraception. The community dialogue intervention generated discussions on key approaches to improve family planning and contraception provision and uptake.Methods: Key stages of the community dialogue were undertaken, with representation from healthcare providers and community members. Participants included frontline and managerial health care providers, community health workers, family planning and contraception users, the youth, other stakeholders from the education sector, and civil society. How the dialogue was implemented (operational feasibility) as well as the cultural feasibility of the community dialogue content was evaluated through participant observations during the dialogue, using a standardised feasibility testing tick-list, and through focus group discussions with the stakeholders who participated in the community dialogue.Results: Overall, 21 of the 30 invited participants attended the meeting- 70 per cent attendance. The approach facilitated discussions on how quality care could be achieved in family planning and contraception provision, guided by the ground rules that were agreed upon by the different stakeholders. A need for more time for the discussion was noted. Also, more balanced representation from the adolescents, other stakeholders in family planning such as the community members was noted, especially in comparison to the healthcare providers. Some participants were not comfortable with the language used. And the young people felt older participants used complicated terminologies.Conclusion: Generally, the community dialogue was well received by the community members and the healthcare providers, as was observed from the sentiments expressed by both categories. Some key considerations for refining the approach included soliciting maximum participation from otherwise marginalized groups like the youth would provide stronger representation.

scholarly journals Perceptions and experiences of men and women towards acceptability and use of contraceptives in underserved areas of Karachi, Pakistan: A Midline Qualitative Assessment of Sukh Initiative, Karachi Pakistan

2020 ◽  
Author(s):  
Sarah Saleem ◽  
Narjis Rizvi ◽  
Anam Feroz ◽  
Sayyeda Reza ◽  
Saleem Jessani ◽  
...  
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
Contraceptive Use ◽  
Health Workers ◽  
Healthcare Providers ◽  
Reproductive Age ◽  
Qualitative Assessment ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Men And Women

Abstract Background: Family planning (FP) is an essential component of Sustainable Development Goals (SDG) and contributes directly to SDG targets 3.7 and 5.6. In Pakistan, contraceptive use has remained stagnant over the past 5 years. This change has been very slow when compared to the FP2020 pledge. The Sukh initiative project was conceived and implemented to alleviate these challenges by providing access to quality contraceptive methods in some underserved areas of Karachi, Pakistan. A qualitative study was been conducted to understand the perceptions and experiences of men and women towards acceptability and contraceptive use.Methods: A qualitative study was conducted at ten Sukh stations located in four towns of Karachi. Focus group discussions (FGDs) were conducted with Married Women of Reproductive Age (MWRA) and married men who received FP services through the Sukh initiative. Study participants were purposively sampled for focus group discussions (FGDs). Interview data was manually transcribed and analyzed using thematic analysis.Results: A total of 20 FDGs(Men=10 FGDs; MWRA=10 FGDs) were conducted. Three overarching themes were identified: (I) Appropriateness and means to promote contraceptive use; (II) Equity and Accessibility to contraceptives; and (III) Perspective on available FP services. Generally, both men and women were informed about FP methods but women were more cognizant of FP information. The Door to Door services by community health workers in Sukh initiative areas was largely appreciated both by women and men as it has made the accessibility and availability of the information and services easy. Women suggested that the Sukh initiative should bring some strategies that can help men broaden their perspective towards FP. The study informed that the men feel left out from the FP programs. Therefore, male participants expressed keen interest in initiatives for men in their communities that would cater to their FP needs.Conclusions: This qualitative study provided a unique opportunity to understand the perceptions of men and women towards the phenomena of contraceptive use. The study identified the need for trained and qualified female and male healthcare providers and well-established health facilities alongside door-to-door services.

scholarly journals Community Contribution to Tuberculosis Care in the Krachi West District of Ghana: A Qualitative Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Samuel Agbenyegah Addy ◽  
Eric Osei ◽  
Joyce Komesuor ◽  
Evelyn Acquah ◽  
Prince Justin Anku ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Community Involvement ◽  
Health Workers ◽  
World Health ◽  
Community Members ◽  
Community Health Volunteers ◽  
Directly Observed Treatment ◽  
Community Contribution ◽  
Tuberculosis Care ◽  
Selection Of

Background. Eradicating tuberculosis (TB) is one of the targets of the recently constituted Sustainable Development Goal (SDG) Three. In the light of limitations inherent in prevailing tuberculosis care and the global urgency to improve TB care, decentralising TB care beyond health facilities by harnessing the contribution of communities is essential in ensuring effective tuberculosis care. In this paper, we explored community contribution to TB care in the Krachi West District of Ghana. Methods. In this qualitative study, 24 TB stakeholders made up of 7 health workers, 9 tuberculosis patients, 4 community health volunteers, 2 treatment supporters, and 2 opinion leaders were interviewed. Data collected were analysed manually, but thematically. Statements of the participants were presented as quotes to substantiate issues discussed. Results. Community contribution to TB care was low. Most of the community members were not aware of any community level activity towards tuberculosis care. Though patients were mainly the ones responsible for the selection of their treatment supporters, there were instances where health workers selected supporters for them without their consent. Some treatment supporters were also not given any education concerning their roles in supporting their patients, resulting in some patients defaulting treatment and others taking their medications wrongfully. Conclusion. Our study revealed low community involvement in tuberculosis care in the Krachi West District of Ghana. Community sensitisation on the World Health Organisation’s Directly Observed Treatment Strategy (which Ghana adopted in 1994) to increase community involvement in tuberculosis activities is, therefore, recommended.

scholarly journals “Our culture prohibits some things”: Qualitative inquiry into how sociocultural context influences the scale up of community-based injectable contraceptives in Nigeria

2019 ◽  
Author(s):  
Oluwaseun Akinyemi ◽  
Bronwyn Harris ◽  
Mary Kawonga
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
Health Workers ◽  
Scale Up ◽  
Community Members ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Community Based ◽  
Injectable Contraceptives ◽  
Depth Interviews

AbstractObjectivesTo explore how sociocultural factors may support or impede the adoption of community-based distribution of injectable contraceptives in Nigeria.DesignA qualitative study based on a grounded theory approach was conducted through in-depth interviews and focus group discussions.SettingMost participants lived in Gombe State, North East Nigeria. Other participants were from Ibadan (South West) and Abuja (Federal capital territory).ParticipantsThrough seven key informant interviews, 15 in-depth interviews and 10 focus group discussions, 102 participants were involved in the study.MethodsThis study, conducted in 2016 was part of a larger study on scale up of community-based distribution of injectable contraceptives. Qualitative data were collected from traditional and religious leaders, health workers and community members. The data were audio recorded, transcribed and analysed using a thematic framework method.ResultsSociocultural challenges to scale up included patriarchy and men’s fear of losing control over their spouses, traditional and religious beliefs about fertility, and myths about contraceptives and family planning. As a result of deep-rooted beliefs that children are ‘divine blessings’ and that procreation should not be regulated, participants described a subtle resistance to uptake of injectable contraceptives. Since Gombe is largely a patriarchal society, male involvement emerged as important to the success of meaningful innovation uptake. Community leaders largely described their participation in the scale up process as active, although they also identified scope for further involvement and recognition.ConclusionScale up is more than setting up health sector implementing structures, training health workers and getting innovation supplies, but also requires preparedness which includes paying attention to complex contextual issues. This requires the health system and those who work in it, to move beyond a narrow health ‘comfort zone’ by actively engaging with, and learning from, those who are leading, caring for and living in, the community.Strengths and limitations of this studyThe study participants represented a range of stakeholders - users of injectable contraceptives, community members, providers and health system managers.Our results highlighted that scale up is influenced by several socio-cultural factors; thus, showing the importance of paying attention to complex contextual issues during innovation uptake.The findings of our study emphasized how health systems and communities should interact in order to ensure successful scale up of health innovations.As with any qualitative study, the findings of this study are not statistically generalizable.FundingThis research was supported by the Consortium for Advanced Research Training in Africa (CARTA). CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand and funded by the Carnegie Corporation of New York (Grant No--B 8606.R02), Sida (Grant No:54100113), the DELTAS Africa Initiative (Grant No: 107768/Z/15/Z) and Deutscher Akademischer Austauschdienst (DAAD). The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)’s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust (UK) and the UK government. The statements made and views expressed are solely the responsibility of the authors.Declarations of interestNone.

scholarly journals The Experiences of Healthcare Providers Regarding Professional Ethics of Front Line Health Workers (A Qualitative Study)

2020 ◽  
Author(s):  
Ghasem Abedi ◽  
Ghader Momeni Rahkola ◽  
Samad Rouhani
Keyword(s):  
Qualitative Study ◽  
Health Services ◽  
Professional Ethics ◽  
Health Workers ◽  
Healthcare Providers ◽  
Health Centers ◽  
Front Line ◽  
Services Delivery ◽  
Comprehensive Health ◽  
And Behavior

Background and purpose: There is a return to rationality and ethics in the approach of current world. After several eras, humanity comes to consider rationality and ethics in addressing its physical and moral needs. From this point of view, ethics could be considered as a center of evolution in the future. This approach mainly influences those practices that are in the lead in serving people. Therefore, in this study, the aim was to investigate stakeholders’ points of view about Phenomenological ethics and professional behavior of auxiliary health workers at first level of health services delivery.  Materials and methods: This qualitative study was conducted through semi-structural interview in 2017. The study population included 9 principals of staff technical unit, 5 physicians in charge of rural comprehensive health centers, and 12 auxiliary health workers of affiliated health houses who were selected purposefully. After conducting the interviews, the data was transferred to paper and analyzed using content analysis with emphasis on core and non-core factors that influence behavior and professional ethics of auxiliary health workers from inter-organization stakeholders’ viewpoints. Findings: The results of this study included two general domains of the main elements (ethical and behavioral), and a total of 12 sub-areas of each of the two main elements, including 3 sub-domains that comprised the moral criterion: (secrecy, censorship, good behavior), as well as three behavioral criteria (accountability, expressive power, motivation), and ultimately 107 basic categories from 3 perspectives, which were all selected by institutional stakeholders: technical units, physicians of comprehensive health centers, as well as healthcare providers.Conclusion: The expressed experiences have shown that the issues surrounding the ethics and behavior of auxiliary health workers who are providing health services at the front line of health system, is inevitable in order to intervene in improving and promoting the quality of morality and behavior of this group of health professionals. 

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