scholarly journals The use of synchronous video-conference teaching to increase access to specialist nurse education in rural KwaZulu-Natal, South Africa

2010 ◽  
pp. 154-168
Keyword(s):  
Health Services ◽  
Rural Areas ◽  
Health Workers ◽  
Cost Savings ◽  
Nurse Education ◽  
Teaching Hospitals ◽  
Public Health Services ◽  
Potential Cost ◽  
Short Supply ◽  
Kwazulu Natal

In KwaZulu-Natal more than 50% of the population lives in the rural area but most of the health workers are based in urban centres where teaching hospitals and high incomes are common. Nursing provides the backbone of health care in the public sector. Specialist nurses such as advanced midwives or specialist HIV nurses are in short supply. Teaching via live synchronous videoconference (VC) provides an opportunity to extend specialist education to nurses at rural hospitals. Aim: The aim of the study was to review and evaluate the current use of videoconference education for nurses in KwaZulu-Natal. Methodology: A review the literature on VC education in nursing using bibliometric review strategies was conducted and two nurses’ education courses conducted via videoconferencing was evaluated against a set of criteria developed and validated by the Department of TeleHealth at the University. Results: 81 publications addressing videoconference nurse education were found, most being published after 2000. Over half were descriptive studies, but were still valuable for informing this study. Based on the evaluation of the two courses against the set of criteria, the two courses were aligned sufficiently well with the measurement criteria. Additionally, the delivery of the courses via videoconferencing allowed for the identification of potential cost savings. Discussion: This evaluation indicates that these two courses have been successfully implemented using VC. In the light of the potential savings of time and money, VC can be used to teach specialist nursing courses to rural nurses. Recommendations to improve the VC courses included orientation training for presenters and encouraging more research regarding the effectiveness of VC as a teaching modality for clinical nurses in rural areas. Conclusion: More attention should be given to developing the infrastructure and skills to make this technology available and commonly used in health services in under-resourced public health services and hospitals. Additional research is also suggested.

scholarly journals Who are CHWs? An ethnographic study of the multiple identities of community health workers in three rural Districts in Tanzania

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mohamed Yunus Rafiq ◽  
Hannah Wheatley ◽  
Hildegalda P. Mushi ◽  
Colin Baynes
Keyword(s):  
Health Care ◽  
Family Planning ◽  
Health Services ◽  
Health Care Providers ◽  
Rural Areas ◽  
Health Workers ◽  
Multiple Roles ◽  
Care Providers ◽  
Professional Identities ◽  
Community Members

Abstract Background Numerous studies have examined the role of community health workers (CHWs) in improving the delivery of health services and accelerating progress towards national and international development goals. A limited but growing body of studies have also explored the interactions between CHWs’ personal, communal and professional identities and the implications of these for their profession. CHWs possess multiple, overlapping roles and identities, which makes them effective primary health care providers when properly supported with adequate resources, but it also limits their ability to implement interventions that only target certain members of their community, follow standard business working days and hours. In some situations, it even prevents them from performing certain duties when it comes to sensitive topics such as family planning. Methods To understand the multiple identities of CHWs, a mixture of qualitative and ethnographic methods was utilized, such as participant observation, open-ended and semi-structured interviews, and focus group discussions with CHWs, their supervisors, and their clients. The observation period began in October 2013 and ended in June 2014. This study was based on implementation research conducted by the Connect Project in Rufiji, Ulanga and Kilombero Districts in Tanzania and aimed to understand the role of CHWs in the provision of maternal and child health services in rural areas. Results To our knowledge, this was the first study that employed an ethnographic approach to examine the relationship between personal, communal and professional identities, and its implications for CHWs’ work in Tanzania. Our findings suggest that it is difficult to distinguish between personal and professional identities among CHWs in rural areas. Important aspects of CHW services such as personalization, access, and equity of health services were influenced by CHWs’ position as local agents. However, the study also found that their personal identity sometimes inhibited CHWs in speaking about issues related to family planning and sexual health. Being local, CHWs were viewed according to the social norms of the area that consider the gender and age of each worker, which tended to constrain their work in family planning and other areas. Furthermore, the communities welcomed and valued CHWs when they had curative medicines; however, when medical stocks were delayed, the community viewed the CHWs with suspicion and disinterest. Community members who received curative services from CHWs also tended to become more receptive to their preventative health care work. Conclusion Although CHWs’ multiple roles constrained certain aspects of their work in line with prevalent social norms, overall, the multiple roles they fulfilled had a positive effect by keeping CHWs embedded in their community and earned them trust from community members, which enhanced their ability to provide personalized, equitable and relevant services. However, CHWs needed a support system that included functional supply chains, supervision, and community support to help them retain their role as health care providers and enabled them to provide curative, preventative, and referral services.

scholarly journals Design of Mobile Application for Community Health Workers: A Case Study in Rwanda

2020 ◽  
Vol 14 (11) ◽  
pp. 271
Author(s):  
Gahizi Emmanuel ◽  
Andi Wahju Rahardjo Emanuel ◽  
Djoko Budiyanto Setyohadi
Keyword(s):  
Public Health ◽  
Health Services ◽  
Community Health ◽  
Community Health Workers ◽  
Human Service ◽  
Mobile Application ◽  
Health Workers ◽  
User Centered Design ◽  
Public Health Services ◽  
Adequate Knowledge

Community health workers (CHWs) are the basis of public health services that aim to connect the gap between public health and the human service system. This gap can be completely bridged by navigating the health and human service systems and educating communities on disease prevention. Unfortunately, the way of sharing, accessing information, and delivering health services is still non-digitalized in Rwanda. Community Health workers use a manual system in their daily activities, which is prone to error and falsification. Moreover, these people selected to perform these activities often do not have adequate knowledge about diseases and health systems since they are not professional health workers. To address the above problem, we designed a prototype mobile application to enable these workers to automatically submit reports, transfer knowledge, share information, and receive training from professionals.  The design process followed a User-Centered Design approach to meet the users’ requirements. The evaluation of the design showed that 91.7% of the CHWs agreed with the designed application prototype.  This finding shows that CHWs has an interest in using the mobile application in their work. Using the mobile application will help CHWs to improve data collection, the reporting process, and ease of receiving training.

scholarly journals Model to assess workload of village doctors in the National Essential Public Health Services Program in six provinces of China

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Delu Yin ◽  
Tao Yin ◽  
Huiming Yang ◽  
Lihong Wang ◽  
Bowen Chen
Keyword(s):  
Public Health ◽  
Health Services ◽  
Health Workers ◽  
Public Health Services ◽  
Health Service Provision ◽  
Village Doctors ◽  
Essential Public Health Services ◽  
Town Hospital ◽  
Public Health Workers ◽  
Ev Model

Abstract Background No studies, particularly quantitative analyses, have been conducted regarding the workload of village doctors in the National Essential Public Health Services (NEPHS) program and differences in service delivery by village doctors, according to region and services. In this study, we developed a quantitative analysis approach to measure the workload of NEPHS provided by village doctors in six provinces of China in 2016. We aimed to identify areas and services of the NEPHS needing improvement, so as to implement targeted measures to ensure adequate delivery of NEPHSs in rural remote underserved areas. Methods Based on survey data from 300 town hospital centers (THCs) located in 60 counties in the six selected provinces, we calculated village doctors’ share of workload under the NEPHS using the equivalent value (EV) model. To define the workload and corresponding EV of each NEPHS, a series of five meetings was held with THC managers, public health workers, family physicians, nurses and village doctors. Field observations were conducted to verify the workload and EV of each service. Results Village doctors’ share of the workload under the NEPHS program was 43.71% across the 300 sampled THCs in six provinces. The village doctors’ workload shares for different NEPHS ranged from 17.14 to 57.00%. The percentage workload undertaken by village doctors under the NEPHS program varied across different provinces, with the highest proportion 63.4% and the lowest 28.5%. Conclusions The total NEPHS workload assigned to village doctors by THCs in the six sampled provinces exceeded the Chinese government’s requirement of 40%, but the workload proportion in some provinces was less than 40%. In addition, the percentage workload for some NEPHS undertaken by village doctors was lower than others. We suggest conducting district-level analysis of the workload among village doctors under the NEPHS program using the EV method, to identify areas and services needing improvement, to implement targeted measures to expand and promote health service provision in China’s rural underserved areas.

scholarly journals Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health Programme for providing innovative mental health care in rural communities in India

2015 ◽  
Vol 2 ◽  
Author(s):  
P. K. Maulik ◽  
S. Devarapalli ◽  
S. Kallakuri ◽  
D. Praveen ◽  
V. Jha ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mixed Methods ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Rural Areas ◽  
Health Workers ◽  
Mental Health Programme ◽  
Health Programme

Background.India has few mental health professionals to treat the large number of people suffering from mental disorders. Rural areas are particularly disadvantaged due to lack of trained health workers. Ways to improve care could be by training village health workers in basic mental health care, and by using innovative methods of service delivery. The ongoing Systematic Medical Appraisal, Referral and Treatment Mental Health Programme will assess the acceptability, feasibility and preliminary effectiveness of a task-shifting mobile-based intervention using mixed methods, in rural Andhra Pradesh, India.Method.The key components of the study are an anti-stigma campaign followed by a mobile-based mental health services intervention. The study will be done across two sites in rural areas, with intervention periods of 1 year and 3 months, respectively. The programme uses a mobile-based clinical decision support tool to be used by non-physician health workers and primary care physicians to screen, diagnose and manage individuals suffering from depression, suicidal risk and emotional stress. The key aim of the study will be to assess any changes in mental health services use among those screened positive following the intervention. A number of other outcomes will also be assessed using mixed methods, specifically focussed on reduction of stigma, increase in mental health awareness and other process indicators.Conclusions.This project addresses a number of objectives as outlined in the Mental Health Action Plan of World Health Organization and India's National Mental Health Programme and Policy. If successful, the next phase will involve design and conduct of a cluster randomised controlled trial.

scholarly journals Community Empowerment in Health: An Exploratory Study in Rural Community of a District of West Bengal

2020 ◽  
pp. 11-19
Author(s):  
Dipta Kanti Mukhopadhyay ◽  
Sujishnu Mukhopadhyay ◽  
Nivedita Das ◽  
Tarun Kumar Sarkar ◽  
Fasihul Akbar ◽  
...  
Keyword(s):  
Health Services ◽  
Health System ◽  
National Health ◽  
Rural Areas ◽  
West Bengal ◽  
Health Workers ◽  
Community Empowerment ◽  
Current Status ◽  
Health Staff ◽  
Key Informants

Background: Community empowerment is the process and outcome where community itself is able to identify, prioritize health problems and address them. It has been considered as the key strategy for scalability and sustainability of health services. Objectives: To explore the status of community empowerment in health in rural areas in West Bengal, India and the interplay of different stakeholders. Methods: A cross-sectional, qualitative study was conducted in 2017 – 2018 among the people residing in rural areas of Birbhum district in West Bengal, India who utilized the public health system (lay informants), formal and informal leaders of the community, community level health workers and peripheral health staff (key informants). Three community blocks, two sub-centers from each block and one village from each sub-center were selected randomly. In-depth interviews were conducted among 36 lay and 36 key informants using Laverack’s nine dimension model of community empowerment. Framework analysis was done to summarize data. Results: Participation of people was restricted to awareness and utilization of existing health services. Unmet aspiration for greater participation was noted among a small section of the community. They were mostly fitted to the role of beneficiaries. Functioning of village level organization to promote communitization as envisaged in national health programmes was largely deficient. The community health workers acted as the most peripheral appendages of formal health system rather than the health activists to empower community regarding community’s health. Conclusion: Although, every national health programme advocated community empowerment, the current status and the process of empowerment in health is in nascent stage.

scholarly journals The Effectiveness of Health Services Delivered by Community Health Workers on Outcomes Related to Non-Communicable Diseases among Elderly People in Rural Areas: A Systematic Review

2021 ◽  
Author(s):  
Vita Widyasari ◽  
Ferry Fadzlul Rahman ◽  
Kuan-Han Lin ◽  
Jiun-Yi Wang
Keyword(s):  
Systematic Review ◽  
Health Services ◽  
Community Health ◽  
Elderly People ◽  
Rural Areas ◽  
Health Workers ◽  
Intervention Group ◽  
Communicable Diseases ◽  
The Other ◽  
Non Communicable Diseases

Background: The number of elderly and the burden of non-communicable diseases increase with time. Community involvement is expected to be an important prevention agent for their neighbors. This study aimed to determine the effectiveness of health services delivered by community health workers (CHWs) which focus on physiological indices related to non-communicable diseases among elderly people and to explain the health services or interventions carried out by CHWs.   Methods: This systematic review was conducted based on the PRISMA guidelines. PubMed, ProQuest Science Database, Scopus, EBSCOhost CINAHL, and Web of Science were taken as the source of databases. Manual search was also conducted for articles published before March 2019 without time restriction. The quality of each study was assessed using Critical Checklist by Joanna Briggs Institute. Results: Of the 3,275 initial studies retrieved, 4 studies were included in qualitative synthesis analysis. Three studies arranged a face-to-face interview, while the other study was conducted over the phone. All the 4 studies were intervention studies. Three of them showed a significant improvement in mean systolic blood pressure for the intervention group compared to the control group. The other study showed a significant improvement in weight loss for the intervention group. Conclusion: Health services delivered by CHWs was beneficial to elderly people in rural areas on some physiological indices. It suggested that health services delivered CHWs could contribute toward secondary prevention programs.

scholarly journals Gambaran Pemanfaatan Pelayanan Kesehatan Tradisional pada Penduduk Lanjut Usia di Indonesia

2021 ◽  
Vol 24 (1) ◽  
pp. 68-78
Author(s):  
Rukmini Rukmini ◽  
Lusi Kristiani
Keyword(s):  
Health Services ◽  
Traditional Medicine ◽  
Rural Areas ◽  
Urban Areas ◽  
Health Workers ◽  
The Elderly ◽  
Traditional Healers ◽  
Self Medication ◽  
Traditional Health ◽  
Manual Skills

One of the health efforts that have the opportunity to improve the health status of the elderly is traditional health services (Yankestrad). This paper aims to describe the use of Yankestrad among the elderly in Indonesia. The data source in this analysis is Riskesdas 2018, a research conducted by the Ministry of Health with the elderly (≥60 years) as the analysis unit. Data were analyzed descriptively. The results showed that the use of Yankestrad in the elderly was 37.0% and self-medication with traditional medicine was 17.3%. Young elderly people mostly use Yankestrad (37.9%), while self-medication with traditional medicine are dominated by elderly women (18.3%) in rural areas (19.5%). The use of Toga in the elderly in Indonesia (31.9%), mostly women (33.3%) in rural areas (36.3%). The most common types of Yankestrad used by the elderly were manual skills, potions, and homemade potions. Male elderly (55.5%) in urban areas (56.5%) used more prepared ingredients, while female elderly (43.6%) in rural areas (46.5%) preferred homemade ingredients. Older people with low expenditure levels tend to take advantage of prepared ingredients or homemade ingredients, while high expenditures tend to take advantage of manual skills. Traditional healers (98.2%) are the type of yakestrad used mostly by the elderly. In conclusion, Yankestrad in Indonesia is mostly used by the elderly, therefore it has the potential to be developed as an alternative model of health services for the elderly. Given the high interest of the elderly with Yankestrad and the use of traditional healers, it is necessary to provide Yankestrad facilities, especially in Puskesmas with traditional health workers who are able to provide safe and quality health services to the elderly. Abstrak Salah satu upaya kesehatan yang berpeluang meningkatkan status kesehatan lansia adalah pelayanan kesehatan tradisional (Yankestrad). Tulisan ini bertujuan untuk mengetahui gambaran pemanfaatan Yankestrad pada penduduk lansia di Indonesia. Sumber data dalam analisis ini adalah Riskesdas 2018. Riset yang dilakukan oleh Kementerian Kesehatan dengan unit analisis lansia (≥60 tahun). Analisis data secara deskriptif. Hasil menunjukkan, pemanfaatan Yankestrad pada lansia 37,0% dan upaya sendiri dengan obat tradisional 17,3%. Lansia muda terbanyak memanfaatkan Yankestrad (37,9%), sedangkan upaya sendiri dengan obat tradisonal didominasi lansia perempuan (18,3%) di perdesaan (19,5%). Pemanfaatan Toga pada lansia di Indonesia (31,9%), terbanyak perempuan (33,3%) di perdesaan (36,3%). Jenis Yankestrad terbanyak dimanfaatkan lansia adalah keterampilan manual, ramuan jadi dan ramuan buatan sendiri. Lansia laki-laki (55,5%) di perkotaan (56,5%) lebih banyak memanfaatkan ramuan jadi, sedangkan lansia perempuan (43,6%) di perdesaan (46,5%) lebih menyukai ramuan buatan sendiri. Lansia dengan tingkat pengeluaran rendah cenderung memanfaatkan ramuan jadi atau ramuan buatan sendiri, sedangkan pengeluaran tinggi cenderung memanfaatkan ketrampilan manual. Penyehat tradisional (98,2%) adalah jenis tenaga terbanyak dimanfaatkan lansia. Kesimpulan, Yankestrad di Indonesia lebih banyak dimanfaatkan oleh lansia, oleh karena itu berpotensi untuk dikembangkan sebagai alternatif model pelayanan kesehatan bagi lansia. Rekomendasi, mengingat tingginya minat para lansia dengan Yankestrad dan pemanfaatan penyehat tradisional, maka diperlukan penyediaan fasilitas Yankestrad khususnya di Puskesmas dengan tenaga kesehatan tradisional yang mampu memberikan pelayanan kesehatan yang aman dan berkualitas bagi para lansia.

scholarly journals Factors influencing uptake of schistosomiasis research findings in ingwavuma area, uMkhanyakude District, Kwazulu-Natal, South Africa

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Tafadzwa Mindu ◽  
Moses J. Chimbari
Keyword(s):  
South Africa ◽  
Rural Areas ◽  
Health Workers ◽  
Sub Saharan Africa ◽  
Primary School Children ◽  
Factors Influencing ◽  
Kwazulu Natal ◽  
Research Uptake ◽  
Research Findings ◽  
Sub Saharan

Background: Research uptake is concerned with spreading ideas across multiple levels of the community. Barriers such as poverty, lack of infrastructure, illiteracy and culture prevent information sharing in arid rural areas of sub-Saharan Africa. Objective: This study explores the factors influencing schistosomiasis research uptake and the available channels for the uptake of research findings from a transdisciplinary and eco-health research project on schistosomiasis in Ingwavuma area, uMkhanyakude district, KwaZulu-Natal province in South Africa. Methods: This case study conducted in 2017 involved 78 primary school children and 73 heads of household recruited through convenience and purposive sampling. Data were collected through focus group discussions, then transcribed and analysed by the researcher using thematic analysis. Results: Factors such as poor knowledge, water and sanitation problems, and lack of sufficient health workers hindered the uptake of schistosomiasis research findings. Participants recommended several platforms to share schistosomiasis research findings with the community, including: door to door visits; social gatherings such as sports events, talent shows, and religious gatherings; mass media platforms such as radio and television; social media platforms such as WhatsApp, Facebook and Twitter; and printed media such as posters, booklets and pamphlets. Conclusions: There is a need to train health workers and peer educators in this area of South Africa to educate people about schistosomiasis infection, screening and treatment through home visits or social events. Schistosomiasis research findings must be synthesised and packaged in different forms for dissemination via multimedia media-based communication channels.

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