African Physician Migration to High-Income Nations: Diverse Motives to Emigrate ("We Are not Florence Nightingale") or Stay in Africa ("There Is No Place Like Home") Comment on "Doctor Retention: A Cross-sectional Study of How Ireland Has Been Losing the Battle"

Research in assessing the global and asymmetric flows of health workers in general, and international medical graduates in particular, is fraught with controversy. The complex goal of improving health status of the citizens of home nations while ensuring the right of health workers to migrate generates policy discussions and decisions that often are not adequately informed by evidence. In times of global public health crises like the current coronavirus disease 2019 (COVID-19) global pandemic, the need for equitable distribution and adequate training of health workers globally becomes even more pressing. Brugha et al report suboptimal training and working conditions among Irish and foreign medical doctors practicing in Ireland, while predicting large-scale outward migration. We comment on health personnel migration and retention based on our own experience in this area of research. Drawing from our examination of medical migration dynamics from sub-Saharan Africa, we argue for greater consideration of health workforce retention in research and policy related to resource-limited settings. The right to health suggests the need to retain healthcare providers whose education was typically subsidized by the home nation. The right to migrate may conflict with the right to health. Hence, a deeper understanding is needed as to healthcare worker motives based on interactions of psychosocial processes, economic and material determinants, and quality of work environments.

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Determinants of knowledge, attitudes, and practices of front-line health workers during the first wave of COVID-19 in Africa: a multi-center online cross-sectional study

10.21203/rs.3.rs-1164116/v1 ◽

2021 ◽

Author(s):

Larrey Kasereka Kamabu ◽

Hervé Monka Lekuya ◽

Richard Newton Iranya ◽

Bienvenu Muhindo Kasusula ◽

Franck Katembo Sikakulya ◽

...

Keyword(s):

Health Workers ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Sectional Study ◽

Front Line ◽

African Countries ◽

Cross Sectional ◽

Poor Knowledge ◽

Attitude And Practice ◽

Good Attitude

Abstract Background: During its first wave of COVID-19 infection in sub-Saharan Africa, there was insufficient understanding of the pandemic among front-line health care professionals that has led to a misidentification, and mistreatment of affected patients, with a potential risk of contracting and spreading the disease. This study was carried out to determine the Knowledge, attitude, and practices (KAP) of front-line health workers (HWs) towards COVID-19 in Africa and their related factors.Methods: This was a multi-centers online cross-sectional study conducted over a 3-months study-period using a google survey link among front lines HWs involved in the COVID-19 response in 26 African countries. Chi-square test & logistic regression were used in the bivariate and multivariate analysis respectively to assess determinants of KAP. Statistical analysis was done using STATA version 16; all tests were two-sided with 95% confidence interval. Results: Five hundred and seventeen (517, 96.3%) consented to participate in this study from 26 African countries; 289 (55.9%) were male and 228 (44.1%) female. Overall, most of HWs, 379 (73.3%) showed poor knowledge about COVID-19 infection and preventive measures. In contrast, majority of them showed good attitude (89%) and practice (90.3%) towards prevention of COVID-19 infections. Knowledge varied among countries; Uganda had the greatest number of HWs with good knowledge. (OR = 28.09, p <0.0001) followed by Ghana (OR=10.92, p=0.001) and DRC (OR: 4.59, p=0.015). The cadre of HWs also influenced knowledge; doctors were the most knowledgeable as compared to other cadres (OR: 3.4, p= 0.005). Additionally, knowledge increased with increasing HWs’ education level (p=0.011).Attitude and practice were both influenced by HWs country of workplace (p=0.05 & p< 0.0001 respectively) and their cadre (p = 0.025 & p < 0.0001 respectively).Conclusions: Majority of the front-line HWs in the African region had an overall good attitude and practice towards COVID-19 infection and practice measures despite relatively poor Knowledge. The KAP is influenced by HWs country of workplace, their cadre and level of education.

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A Cross-Sectional Study of Pain Among U.S. College Music Students and Faculty

Medical Problems of Performing Artists ◽

10.21091/mppa.2017.1005 ◽

2017 ◽

Vol 32 (1) ◽

pp. 20-26 ◽

Cited By ~ 12

Author(s):

Jeremy L Stanek ◽

Kevin D Komes ◽

Fred A Murdock

Keyword(s):

Performing Arts ◽

Large Scale ◽

Online Survey ◽

Treatment Options ◽

The United States ◽

Cross Sectional Study ◽

Medical Professional ◽

College Level ◽

Cross Sectional ◽

The Right

OBJECTIVES: Studies over recent decades have demonstrated significant performance-related pain among professional musicians. However, there have been no large-scale studies to evaluate pain among college musicians. The aim of this study was to determine the prevalence and anatomical locations of performance-related pain among students and faculty at the college level and learn what musicians do when they have pain. METHODS: Cross-sectional data were collected using an online survey distributed to colleges across the United States. Data were analyzed using REDCap electronic data capture tools and Microsoft Excel. RESULTS: We received 1,007 survey responses and found that 67% of musicians at colleges experienced performance-related pain. The highest prevalence of pain was in woodwind musicians, with 83% reporting performance-related pain. The most common locations of pain were upper back (27%), lower back (26%), and fingers of the right hand (25%). Many student musicians with pain seek help from their teacher, but almost as many do not seek help at all. Less than 25% see a medical professional. CONCLUSIONS: Most musicians at colleges experience performance-related pain in a variety of anatomical locations depending upon instrument/voice. Performing arts health organizations can increase awareness of treatment options for musicians suffering from performance-related pain, which may lead to improved quality of life and increased career longevity for college musicians.

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Knowledge and perceptions of preconception care among health workers and women of reproductive age in Mzuzu City, Malawi: a cross-sectional study

Reproductive Health ◽

10.1186/s12978-021-01282-w ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Mtondera Munthali ◽

Isabel Kazanga Chiumia ◽

Chrispin Mandiwa ◽

Saul Mwale

Keyword(s):

Preconception Care ◽

Health Workers ◽

Cross Sectional Study ◽

Reproductive Age ◽

Sub Saharan Africa ◽

Care Practice ◽

Sectional Study ◽

Positive Perception ◽

Women Of Reproductive Age ◽

Cross Sectional

Abstract Background Preconception care is one of the preventive strategies in maternal and new-born health as recommended by WHO. However, in sub-Saharan Africa there is poor preconception care practices. This study examined knowledge and perceptions of preconception care among health workers and women of reproductive age group in Mzuzu City, Malawi. Methods A descriptive cross-sectional study was conducted using a mixed methods approach. Selection of respondents was done through a multistage and purposive sampling techniques respectively. A total of 253 women of reproductive age from nine townships of Mzuzu City responded to the questionnaire and 20 health workers were interviewed. Results A total of 136 (54%) respondents had heard of preconception care. About 57.7% (n = 146) demonstrated a good level of knowledge of preconception care while 42.3% (n = 107) had poor knowledge. About 72% (n = 105) of those with good of knowledge of preconception care, lacked awareness on possibilities of talking to a health care provider on intentions of getting pregnant. About 74.7% (n = 189) of women had a positive perception towards preconception care. Knowledge of preconception care was a good predictor of positive perception (AOR = 2.5; 95% CI 1.2–5.0), however its predictability was influenced by the academic level attained. Those with secondary (AOR = 10.2; 95% CI 3.2–26.2) and tertiary (AOR = 2.3; 95% CI 1.1–4.9) were more likely to have good knowledge of preconception care than those with primary school education level. About 95% (n = 19) of health workers lacked details about preconception care but they admitted their role in preconception care. Conclusion Preconception care practice among health workers and women of reproductive age in Mzuzu City was low. However there was positive perception towards preconception care in both parties. There is an opportunity in existing platforms for implementation of interventions targeting identified predictors for increased knowledge and uptake of preconception care.

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Equity in the Distribution of Health Resources: A Case Study in Southeast Iran

Shiraz E-Medical Journal ◽

10.5812/semj.106392 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Mohammad Khammarnia ◽

Hesam Ghiasvand ◽

Fateme Javadi ◽

Fatemeh Safdari Adimi

Keyword(s):

Health Status ◽

Gini Index ◽

Health Workers ◽

Healthcare Providers ◽

Health Sector ◽

Health Resources ◽

Cross Sectional Study ◽

Medical Sciences ◽

Cross Sectional

Background: Equity in the distribution of equipment and resources in the health sector constitutes one of the main dimensions of justice, improving health status and increasing people's satisfaction. Objectives: The current study aimed at determining how health resources and equipment are distributed in the poorest region of Iran. Methods: The current retrospective, cross-sectional study was performed in Sistan and Baluchistan Province, as the poorest region of Iran, in 2020. Data were collected using a standard checklist from all five health centers affiliated to Zahedan University of Medical Sciences (ZAUMS). Excel and STATA software was used for data analysis; the Gini index was also calculated. Results: The Gini index for the distribution of midwives and rural health workers was equitable (0.216 and 0.287, respectively). The distribution of urban healthcare providers, nutrition and psychology counselors, and active beds in ZAUMS were 0.675, 0.545, 0.454, and 0.526, respectively. The distribution of general practitioners, based on the Gini index (0.492), was not fair. Also, the distribution of specialists and nurses was unfair (Gini index: 0.494 and 589, respectively). Conclusions: The distribution of most resources in the poorest region of Iran was not fair. Unfair distribution and disparities can affect population health status in the future. Then, it is suggested that health policymakers and managers pay more attention to deprived regions.

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Knowledge, perception and practices regarding novel coronavirus among sample of Ghanaian healthcare workers: a cross-sectional study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20210784 ◽

2021 ◽

Vol 8 (3) ◽

pp. 1072

Author(s):

Dorcas Serwaa ◽

Anthony Baffour Appiah ◽

Richard Wodag-Seme ◽

Charles Nkansah ◽

Selasie Ahiatrogah

Keyword(s):

Healthcare Workers ◽

Health Workers ◽

Healthcare Providers ◽

Cross Sectional Study ◽

Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Increased Risk ◽

Precautionary Measures ◽

Novel Coronavirus

Background: Healthcare workers’ have increased risk of contracting the deadly COVID-19 pandemic due to their exposures to infected persons and their specimens. Ghana, like many other countries, has felt the devastating effects of this virus; it was therefore prudent to assess the levels of knowledge, perception and practice of Ghanaian healthcare providers on the current pandemic.Methods: This descriptive cross-sectional study enlisted 979 healthcare workers’ in Ghana from 1st Apr to 20th Nov, 2020, via self-reported questionnaire. SPSS version 22.0 was used for the analysis. Responses were summarized using frequency and proportions. A chi-square test was utilized to test for association at significant level of p <0.05.Results: Out of the 979 healthcare workers recruited, 56.4% had good knowledge and 59.5% displayed good perception on the novel COVID-19 while 63.1% of them effectively practiced the expected precautionary measures. Age (p=0.001), gender (p=0.034) and profession (p<0.001) significantly affected the practice of precautionary measure among the health personnel. The respondents’ perceptions towards the pandemic were significantly linked to their age (p<0.001), gender (p=0.043), profession (p<0.001), type of occupation (p=0.001) and source of information (p=0.006). Also, knowledge significantly related to good practices but did not influence the perception of HCWs.Conclusions: The current study identifies that more than half of HCWs in Ghana have sufficient knowledge, perception, and practice of precautionary measures; however, it elucidates some significant concerns about the knowledge gap in this COVID-19 outbreak. There is an obvious need for progressive in-service training programs for the health workers to broaden their scopes on the risks and preventive measures.

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Adherence to Antiretroviral and Cancer Chemotherapy, and Associated Factors Among Patients with HIV–Cancer Co-Morbidity at the Uganda Cancer Institute: A Cross Sectional Study

10.21203/rs.3.rs-770283/v1 ◽

2021 ◽

Author(s):

Caroline Achieng ◽

Nelson Bunani ◽

Joseph Kagaayi ◽

Fred Nuwaha

Keyword(s):

Cancer Chemotherapy ◽

Associated Factors ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Public Health Issue ◽

Cancer Stage ◽

Global Public Health ◽

Sectional Study ◽

Cross Sectional ◽

Co Morbidity

Abstract Background: Human Immunodeficiency Virus is a major global public health issue affecting millions of people, and sub-Saharan Africa where Uganda lies is is disproportionately affected. There has been an increase in cancer among HIV patients which has resulted into use of co-medications that sometimes affect ART and cancer chemotherapy adherence. We aimed to determine adherence to antiretroviral and cancer chemotherapy and the associated factors among patients with HIV-cancer co-morbidity at the Uganda Cancer Institute.Methods: We conducted a cross-sectional study among 200 randomly selected adult cancer patients infected with HIV, attending Uganda cancer institute. Antiretroviral and anti-cancer chemotherapy adherences with associated factors were assessed quantitatively. We collected the data using interviewer administered semi-structured questionnaires. Modified Poisson regression with robust standard errors was used to estimate prevalence ratios at 95% confidence intervals for factors associated with adherence to ART and cancer chemotherapy.Results: Overall, 54% (107/200) of the study participants adhered to both ART and chemotherapy, and 55% (110/200) adhered to ART while 65% (129/200) adhered to cancer chemotherapy. A majority, 61% (122/200) of the respondents were males. The mean age of the respondents was 42(SD±11years), and at least 43% (86/200) belonged to protestant religion. More than half, 56.5% (113/200) were married and at least 45% (90/200) had attained a primary level of education. Patients with good adherence to antiretroviral therapy and chemotherapy were 107(54%, 95% CI=46.5-60.4). No knowledge of cancer stage (PR=0.4, 95% CI=0.25-0.56, P<0.0001), having an AIDS defining cancer (PR=0.7, 95% CI=0.50-0.88, P=0.005), ART clinic in district not near Uganda Cancer Institute (PR=0.7,95% CI=0.84-0.96, P=0.027) and affordability of cancer chemotherapy (PR=1.4, 95% CI=1.02-1.87, P=0.037) were associated with adherence to both ART and cancer chemotherapy.Conclusion: Adherence to both ART and cancer chemotherapy was low. Factors significantly associated with adherence were: knowledge of the cancer stage by the patient, the type of cancer diagnosis, source of ART and affordability/ availability of medications. There is need to provide information on stage of cancer and adherence counseling to patients. Furthermore, Integration of HIV- cancer care will be necessary for efficient and effective care for the patients.

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Antimicrobial Stewardship from Health Professionals’ Perspective: Awareness, Barriers, and Level of Implementation of the Program

Antibiotics ◽

10.3390/antibiotics11010099 ◽

2022 ◽

Vol 11 (1) ◽

pp. 99

Author(s):

Haya Nassar ◽

Rana Abu-Farha ◽

Muna Barakat ◽

Eman Alefishat

Keyword(s):

Health Professionals ◽

Treatment Guidelines ◽

Healthcare Providers ◽

Cross Sectional Study ◽

Public Hospitals ◽

Cross Sectional ◽

Lack Of Information ◽

Tertiary Hospitals ◽

The Right ◽

Main Barrier

This study aimed to evaluate health professionals’ perceptions regarding the level of implementation of the Antimicrobials Stewardship (AMS) programs in Jordanian tertiary hospitals and to assess the perceived barriers to its implementation. During this cross-sectional study, a total of 157 healthcare providers agreed to participate (response rate 96.3%). Participants were asked to complete an electronic survey after meeting them at their working sites. Only 43.9% of the healthcare providers (n = 69) reported having an AMS committee in their hospital settings. The results suggested that private hospitals have significantly better AMS implementation compared to public hospitals among four areas (p ≤ 0.05). Moreover, the results showed that the most widely available strategies to implement AMS were infectious disease/microbiology advice (n = 112, 71.3%), and treatment guidelines (n = 111, 70.7%). Additionally, the study revealed that the main barrier to AMS implementation was the lack of information technology support (n = 125, 79.6%). These findings could draw managers’ attention to the importance of AMS and support the health care provider’s practice of AMS in Jordanian tertiary hospitals by making the right decisions and the required modifications regarding the strategies needed for the implementation of AMS programs.

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Pattern of otitis media in young children and adolescents with traditional uvulectomy in Kano, Nigeria

Annals of African Medical Research ◽

10.4081/aamr.2019.83 ◽

2020 ◽

Vol 2 (2) ◽

Author(s):

Abdulrazak Ajiya

Keyword(s):

Young Children ◽

Children And Adolescents ◽

Otitis Media ◽

Failure To Thrive ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Common Finding ◽

Cross Sectional ◽

Sub Saharan ◽

The Right

Traditional uvulectomy is not an uncommon practice in Nigeria and most part of sub-Saharan Africa. Its practice is well documented in these countries. Traditional uvulectomy and otitis media are both prevalent in Nigeria. However, there is a dearth of studies on a causal relationship between the two in the Nigerian subpopulation. This study aims to assess the pattern of otitis media among young children and adolescents who had traditional uvulectomy. This study was a prospective, descriptive, cross-sectional study conducted on all consecutive eligible consenting patients aged 5- to 18-years seen in the ear, nose and throat clinic of Aminu Kano Teaching Hospital with amputated uvula detected during routine examination were recruited. A standard tool was developed to obtain data from the patients. Thereafter otoscopy was done for all the patients. A total of 400 patients were recruited into the study, 246 (61.5%) were male and 154 (38.5%) female. The mean (standard deviation) of age was 12.4 (3.8) years. The commonest indication for traditional uvulectomy among the patients was as ritual [356 (89%)] with the least been speech disorder and failure to thrive [3 (76%)] each. Most (60%) had no symptoms suggestive of otitis media over the years. However, most (263 and 259 in the right and left ear respectively) participants had dull tympanic membrane on otoscopy. Majority (280) had their uvulectomy in the neonatal period, and post uvulectomy complications were low (17%). Symptoms of otitis media are not a common finding in patients with traditionally amputated uvulae.

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Perceived Stress and Its Associated Factors during COVID-19 among Healthcare Providers in Ethiopia: A Cross-Sectional Study

Advances in Public Health ◽

10.1155/2020/5036861 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Yigrem Ali Chekole ◽

Solomon Yimer Minaye ◽

Semagn Mekonnen Abate ◽

Birhanie Mekuriaw

Keyword(s):

Mental Health ◽

Perceived Stress ◽

Large Scale ◽

Healthcare Providers ◽

Cross Sectional Study ◽

World Health ◽

Southern Ethiopia ◽

Sectional Study ◽

Early Screening ◽

Cross Sectional

Background. Coronavirus causes serious health problems worldwide including increased mental health burden to the society at large scale and particularly the healthcare providers. Understanding the immediate mental health and psychological response of the healthcare providers after a public health emergency is important for implementing better prevention and response mechanisms to a disaster. Objective. This study aimed to assess the prevalence of perceived stress and risk factors of coronavirus disease 2019 among healthcare providers in Dilla, Southern Ethiopia. Methods. An institution-based cross-sectional study was conducted among 244 samples selected with the systematic random sampling technique from March to April 2020. Data collection was carried out with a validated perceived stress scale adapted from the World Health Organization. Data were coded and entered into Epi Info Version 7 and were exported and analyzed with SPSS version 20. Crude and adjusted OR were analyzed using logistic regression, and the level of significance of association was determined at P value <0.05. Result. The prevalence of perceived stress among participants was 126 (51.6%). Being at the age range of 25–31 years (AOR = 2.5, 95% CI, 1.12, 5.81), master’s and above in their qualification (AOR = 6.0, 95% CI 1.59, 22.31), nurse professionals (AOR = 8.2, 95% CI 2.69, 24.74), and pharmacist professionals (AOR = 4.8, 95% CI, 1.25, 18.64) were variables found to have a strong statistically significant association with the perceived stress of coronavirus disease. Conclusion. More than half of the study participants were found to have perceived stress for coronavirus disease. Early screening and intervention of stress among frontline healthcare providers based on the findings are suggested.

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Knowledge Sharing Practice and Its Associated Factors Among Healthcare Providers at University of Gondar Comprehensive Specialized Hospital, North West Ethiopian: Cross-sectional Study

10.21203/rs.3.rs-407759/v1 ◽

2021 ◽

Author(s):

Addisalem Workie Demsash ◽

Biniyam Chakilu ◽

Atsede Mazengia

Keyword(s):

Logistic Regression ◽

Knowledge Sharing ◽

Associated Factors ◽

Logistic Regression Model ◽

Healthcare Providers ◽

Cross Sectional Study ◽

Sectional Study ◽

Multivariable Logistic Regression Model ◽

Cross Sectional ◽

The Right

Abstract Background In healthcare, information and knowledge needs of health care providers arise in the patient care process. However, the right information and knowledge at the right time and place to the right person is not reached so far yet. Thus, leads limited knowledge sharing practice among health providers in Ethiopia. Objectives The objectives of the study were to assess knowledge sharing practice and associated factors among healthcare providers at University of Gondar hospital. Methods Institutional based cross-sectional study design was conducted through stratified simple random sampling technique among 423 samples from February 24 up to March 27, 2020. Pretested and self-administered questionnaire was used. Epi info version 7 and stata version 15 software were used for data entry, processing and analysis respectively. Descriptive statistics and multivariable logistic regression model were applied to describe the study objects and to assess knowledge sharing practice and its associated factors by considering P value ≤ 0.05. Results 423 respondents were participated with 100% response rate. From the total respondents, 222 of 423 (52.48%) of respondents were male. More than two third (66.90%) of respondents were degree and diploma holders. Nearly three fourth of 423 (74.70%) healthcare providers were under the age group of 21–30 years. The level of knowledge sharing practice among the respondents was 65.01% (95% CI: 60.46–69.56). In multivariable logistic regression model awareness AOR = 2.44, 95% CI= [1.32–4.50], willingness AOR = 1.96, 95% CI= [1.10–3.53], loss of knowledge power AOR = 0.192, 95% CI= [.12-.32], availability of health information resource AOR = 2.00, 95% CI= [1.56–5.38] and opportunity AOR = 2.91, 95% CI= [1.71–4.95] were significantly associated with knowledge sharing practice. Conclusions Knowledge sharing practice of healthcare providers is higher as compared with most studies conducted in Ethiopia. However, it needs further opportunity, resource allocation and supportive leadership.

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