Operations and Challenges of Performance-Based Financing Among the Health Workers at The Health Facilities in Nasarawa State, Nigeria

Background: Performance-based financing (PBF) is currently tested in many low- and middle-income countries as a health system strengthening strategy. One of the main mechanisms through which PBF is assumed to effect change is by motivating health workers to improve their service delivery performance. This article aims at a better understanding of such motivational effects of PBF. In particular, the study focused on organizational context factors and health workers’ perceptions thereof as moderators of the motivational effects of PBF, which to date has been little explored. Methods: We conducted a multiple case study in 2 district hospitals and 16 primary health facilities across three districts. Health facilities were purposely sampled according to pre-PBF performance levels. Within sampled facilities, 82 clinical skilled healthcare workers were in-depth interviewed one year after the start of the PBF intervention. Data were analyzed using a blended deductive and inductive process, using self-determination theory (SDT) as an analytical framework. Results: Results show that the extent to which PBF contributed to positive, sustainable forms of motivation depended on the "ground upon which PBF fell," beyond health workers’ individual personalities and disposition. In particular, health workers described three aspects of the organizational context in which PBF was implemented: the extent to which existing hierarchies fostered as opposed to hindered participation and transparency; managers’ handling of the increased performance feedback inherent in PBF; and facility’s pre-PBF levels in regards to infrastructure, equipment, and human resources. Conclusion: Our results underline the importance of leadership styles and pre-implementation performance levels in shaping health workers’ motivational reactions to PBF. Ancillary interventions aimed at fostering participatory as opposed to directional leadership or start-up support to low-performing health facilities will likely boost PBF effects in regards to the development of valuable motivational capacities.

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A health worker knowledge, attitudes and practices survey of SARS-CoV-2 infection prevention and control in South Africa

BMC Infectious Diseases ◽

10.1186/s12879-021-05812-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Saiendhra Vasudevan Moodley ◽

Muzimkhulu Zungu ◽

Molebogeng Malotle ◽

Kuku Voyi ◽

Nico Claassen ◽

...

Keyword(s):

South Africa ◽

Health Worker ◽

Prevention And Control ◽

Infection Prevention ◽

Health Workers ◽

Health Facilities ◽

World Health ◽

Infection Prevention And Control ◽

Successful Implementation ◽

And Control

Abstract Background Health workers are crucial to the successful implementation of infection prevention and control strategies to limit the transmission of SARS-CoV-2 at healthcare facilities. The aim of our study was to determine SARS-CoV-2 infection prevention and control knowledge and attitudes of frontline health workers in four provinces of South Africa as well as explore some elements of health worker and health facility infection prevention and control practices. Methods A cross-sectional study design was utilised. The study population comprised both clinical and non-clinical staff working in casualty departments, outpatient departments, and entrance points of health facilities. A structured self-administered questionnaire was developed using the World Health Organization guidance as the basis for the knowledge questions. COVID-19 protocols were observed during data collection. Results A total of 286 health workers from 47 health facilities at different levels of care participated in the survey. The mean score on the 10 knowledge items was 6.3 (SD = 1.6). Approximately two-thirds of participants (67.4%) answered six or more questions correctly while less than a quarter of all participants (24.1%) managed to score eight or more. A knowledge score of 8 or more was significantly associated with occupational category (being either a medical doctor or nurse), age (< 40 years) and level of hospital (tertiary level). Only half of participants (50.7%) felt adequately prepared to deal with patients with COVD-19 at the time of the survey. The health workers displaying attitudes that would put themselves or others at risk were in the minority. Only 55.6% of participants had received infection prevention and control training. Some participants indicated they did not have access to medical masks (11.8%) and gloves (9.9%) in their departments. Conclusions The attitudes of participants reflected a willingness to engage in appropriate SARS-CoV-2 infection prevention and control practices as well as a commitment to be involved in COVID-19 patient care. Ensuring adequate infection prevention and control training for all staff and universal access to appropriate PPE were identified as key areas that needed to be addressed. Interim and final reports which identified key shortcomings that needed to be addressed were provided to the relevant provincial departments of health.

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Health workers’ perceptions on where and how to integrate tobacco use cessation services into tuberculosis treatment; a qualitative exploratory study in Uganda

BMC Public Health ◽

10.1186/s12889-021-11502-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Elizeus Rutebemberwa ◽

Kellen Nyamurungi ◽

Surabhi Joshi ◽

Yvonne Olando ◽

Hadii M. Mamudu ◽

...

Keyword(s):

Tobacco Use ◽

Tobacco Cessation ◽

Health Workers ◽

High Volume ◽

Health Facilities ◽

Hospital Treatment ◽

Management Support ◽

Tobacco Use Cessation ◽

Tb Treatment

Abstract Background Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda. Methods Between March and April 2019, nine focus group discussions (FGDs) and eight key informant interviews were conducted among health workers attending to patients with tuberculosis on a routine basis in nine facilities from the central, eastern, northern and western parts of Uganda. These facilities were high volume health centres, general hospitals and referral hospitals. The FGD sessions and interviews were tape recorded, transcribed verbatim and analysed using content analysis and the Chronic Care Model as a framework. Results Respondents highlighted that just like TB prevention starts in the community and TB treatment goes beyond health facility stay, integration of tobacco cessation should be started when people are still healthy and extended to those who have been healed as they go back to communities. There was need to coordinate with different organizations like peers, the media and TB treatment supporters. TB patients needed regular follow up and self-management support for both TB and tobacco cessation. Patients needed to be empowered to know their condition and their caretakers needed to be involved. Effective referral between primary health facilities and specialist facilities was needed. Clinical information systems should identify relevant people for proactive care and follow up. In order to achieve effective integration, the health system needed to be strengthened especially health worker training and provision of more space in some of the facilities. Conclusions Tobacco cessation activities should be provided in a continuum starting in the community before the TB patients get to hospital, during the patients’ interface with hospital treatment and be given in the community after TB patients have been discharged. This requires collaboration between those who carry out health education in communities, the TB treatment supporters and the health workers who treat patients in health facilities.

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ASSOCIATION BETWEEN DURATION AS A FISHERMAN, DISTANCE OF HEALTH FACILITIES AND SMOKING WITH PTERYGIUM'S DISEASE IN FISHERMAN IN BENGKULU

Nurse and Health: Jurnal Keperawatan ◽

10.36720/nhjk.v10i1.223 ◽

2021 ◽

Vol 10 (1) ◽

pp. 65-71

Author(s):

Dwi Putri Sulistiya Ningsih ◽

Ida Rahmawati

Keyword(s):

Significant Relationship ◽

Health Workers ◽

Case Control ◽

High Risk Group ◽

Health Facilities ◽

Observational Research ◽

Validity And Reliability ◽

Chi Square ◽

Table Data ◽

Methods Analytical

Background: Fishermen are a high risk group for developing pterygium. The high frequency of exposure to UV, wind, dust and sand when working makes the prevalence of pterygium among fishermen quite high. The city of Bengkulu, which is geographically located on the west coast of Sumatra Island which is directly facing the Indonesian Ocean, makes the majority of its population work as fishermen. Objectives: This study aims to determine the relationship between duration of being a fisherman, distance to health facilities and smoking with pterygium disease in a group of fishermen in, Bengkulu. Methods: Analytical observational research with case control design. The sample of 120 fishermen consisted of 40 cases and 80 controls, because researchers used a case-control ratio of 1:2. Sampling using purposive sampling method. The dependent variable was pterygium disease. Independent variables of duration as a fisherman, distance of health facilities and smoking. The research instrument uses a structured questionnaire that has been tested for validity and reliability with Alpha Cronbach value (0.996) > r table. Data were analyzed by Chi Square. Results: Based on the research results, it was found that there was a significant relationship with duration as a fisherman (≥ 21 years) (OR = 3.980; 95%CI = 1.404-11.284; p = 0.006) with pterygium disease. There is no relationship between smoking (OR = 1.246; 95%CI = 0.559-2.778; p = 0.590) with pterygium disease. There is a significant relationship between the distance of health facilities (OR = 5.133; 95%CI = 2.249-11.715; p = 0.000) with pterygium disease. Conclusion: The length of time working as a fisherman increases the risk of developing pterygium disease as the frequency of exposure to UV, dust, wind and sand increases. It is necessary to use personal protective equipment to reduce the risk of exposure and education from health workers so that the public can take good preventive measures. Keywords: Duration as a fisherman, distance health facilities, smoking, pterygium.

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Evaluation of Infection, Prevention and Control Program in Goromonzi District, Zimbabwe, 2018: A process outcome evaluation

10.21203/rs.2.18251/v1 ◽

2019 ◽

Author(s):

Govha Emmanuel ◽

Zizhou Simukai Tirivanhu ◽

Shambira Gerald ◽

Gombe Tafara Notion ◽

Tsitsi Juru ◽

...

Keyword(s):

Health Facility ◽

Prevention And Control ◽

Infection Prevention ◽

Health Workers ◽

Outcome Evaluation ◽

Hazard Identification ◽

Health Facilities ◽

Infection Prevention And Control ◽

Hiv Test ◽

And Control

Abstract Background A healthcare-associated infection (HAI) is defined as an infection originating in the environment of a health facility that was not present or incubating at the time of patient admission. HAIs can be prevented through infection, prevention and control (IPC) measures. No hazard identification and risk assessment IPC rounds and monthly meetings were conducted in Goromonzi district since 1st of January to 30th of June 2018. No trainings nor orientation for the new employees was conducted. We therefore evaluated Goromonzi District IPC program. Methods A process-outcome evaluation using the logic model was conducted in Goromonzi district’s 15 health facilities. Checklists, interviewer administered questionnaires and key informant guides were used to collect data on availability of inputs, knowledge of health workers, processes performed, outputs and outcomes achieved. Data were entered into Epi Info 7TM, which was used to generate frequencies and proportions. Qualitative data from checklists and key informants interviews was sorted manually into themes and analysed. Results All 15 health facilities had adequate stocks of HIV test kits and PEP kits. Adequate bins and detergents were found in only 3/15 (20%) of health facilities. All facilities failed to hold a single IPC meeting and none had specific budget for IPC in 2018. No IPC mentorship activities were carried out in the district. Only 7/13 (54%) health workers who had needle pricks received PEP with 2/7 (29%) of them finishing the course. No health facility had a functional HAI surveillance system. The overall knowledge rating was fair. Conclusion The IPC program inputs in Goromonzi district were inadequate hence its failure to achieve the intended outputs and outcomes. Inadequate knowledge, unavailability of health worker training plans, specific budgets and absence of IPC committees reflected non prioritisation of the program.

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Health Workers’ Perceptions on Where and How to Integrate Tobacco use Cessation Services into Tuberculosis Treatment; A Qualitative Exploratory Study in Uganda

10.21203/rs.3.rs-71580/v1 ◽

2020 ◽

Author(s):

Elizeus Rutebemberwa ◽

Kellen Nyamurungi ◽

Surabhi Joshi ◽

Yvonne Olando ◽

Hadii M. Mamudu ◽

...

Keyword(s):

Tobacco Use ◽

Health Workers ◽

High Volume ◽

Health Facilities ◽

Treatment Programs ◽

Tobacco Use Cessation ◽

Tb Treatment ◽

Routine Basis ◽

Referral Hospitals ◽

The Media

Abstract Background: Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda.Methods: Between March and April 2019, nine focus group discussions (FGDs) and eight key informant interviews were conducted among health workers attending to patients with tuberculosis on a routine basis in nine facilities from the central, eastern, northern and western parts of Uganda. These facilities were high volume health centres, general hospitals and referral hospitals. The FGD sessions and interviews were tape recorded, transcribed verbatim and analysed using content analysis to identify themes.Results: Participants indicated that tobacco use cessation activities should be integrated in TB treatment starting from communities when people are still healthy. Cessation should also be implemented in health facilities including referral facilities, and be extended to those who have been healed as they go back to communities. This calls for collaborations beyond health workers to TB treatment supporters, peers and the media. Conclusions: Tobacco use cessation should take place in communities as well as health facilities. Partnerships with media and families are needed. Health system challenges need to be addressed to support effective implementation.

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THE CHILDBIRTH UTILIZATION IN HEALTH FACILITIES IN THE WORKING AREA OF SUNGAI LOKAN PHC TANJUNG JABUNG TIMUR REGENCY: A CROSS SECTIONAL STUDY

NSC Nursing ◽

10.32549/opi-nsc-54 ◽

2021 ◽

pp. 20-33

Author(s):

Lia Artika Sari ◽

Yuli Suryanti ◽

Enny Susilawati

Keyword(s):

Health Center ◽

Family Support ◽

Health Workers ◽

Community Health Center ◽

Cross Sectional Study ◽

Health Facilities ◽

Service Access ◽

Cross Sectional ◽

Family Culture ◽

Work Area

Introduction: The low number of deliveries assisted by midwives or health workers is an indicator of the low utilization of health facilities by mothers in labor. This study analyzes the factors related to the utilization of childbirth in health facilities in the Sungai Lokan Community Health Center Work Area, Tanjung Jabung Timur Regency. Materials and Methods: This research is an analytic observational using a cross-sectional approach involving 74 participants. The research was conducted from January to July 2019 in the Sungai Lokan Health Center Work Area, Tanjung Jabung Timur Regency. Results: The results showed that the factor of the utilization of childbirth in health facilities was related to family culture (p = 0.0001) and family support (p = 0.003), while the service access factor was not related (p = 0.364). Conclusion: The role of health workers in socializing the importance of utilizing health facilities as a place of delivery is significant in reducing maternal mortality Keywords: Health Facilities; Family Culture; Family Support; Access To Services

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An assessment of mental health programs at community health centers in north Minahasa, Indonesia

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20214556 ◽

2021 ◽

Vol 8 (12) ◽

pp. 5707

Author(s):

Jessica Gloria Mogi ◽

Gustaaf A. E. Ratag

Keyword(s):

Mental Health ◽

Community Health ◽

Community Health Centers ◽

Supported Employment ◽

Health Workers ◽

Health Facilities ◽

Health Centers ◽

Healthcare Facilities ◽

Family Approach ◽

Mental Health Programs

Background: The Indonesian government recognizes the importance of mental health issues as indicated by the inclusion of such issues as indicators in the national program, the Healthy Indonesian Program with Family Approach (PIS-PK). This program is enforced in community health centers (puskesmas) in every regency in the country. However, the continually increasing number of mental disorder cases and the intense stigmatization of people with these disorders indicate the need to re-evaluate the capacity and delivery of designated centers’ mental health programs.Methods: This community survey involved interviewing the program directors of four community health centers in north Minahasa using the WHO-AIMS 2.2 questionnaire.Results: Very little effort has been made to improve mental health facilities and programs. Examples of aspects of health facilities that are lacking include training for health workers, the provision of psychotropic drugs, and supported employment or occupational rehabilitation.Conclusions: Community health centers are primary healthcare facilities for society. Therefore, mental health services should be implemented as one of their main programs.

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Evaluation of advanced infection and prevention technical training

Monas: Jurnal Inovasi Aparatur ◽

10.54849/monas.v3i2.87 ◽

2021 ◽

Vol 3 (2) ◽

pp. 321-330

Author(s):

Ai Siti Sutilah

Keyword(s):

Health Workers ◽

Evaluation Model ◽

Quantitative Description ◽

Health Facilities ◽

Technical Training ◽

Primary Data ◽

Average Value ◽

Training Materials ◽

Four Levels ◽

Evaluation Of Learning

Evaluation of a technical education and training organization can provide positive outputs. This study aims to evaluate the implementation and understanding of the training participants regarding the knowledge of the training materials provided at the Advanced Infection and Prevention Technical Training for Health Workers at the Health Facilities during the COVID-19 Pandemic online, which was held at the Puslatkesda Provinsi DKI Jakarta. This study uses a quantitative description method using the Kirkpatrick Four Levels Evaluation Model, namely through four levels consisting of reaction, learning, behavior, and result. As for what was carried out in the study, it was evaluated at levels 1 and 2. This training was held in October 2020 Batch 1 with 40 participants. Instruments The instrument used is a questionnaire, and the results of the participants' assessment are in the form of pretest and posttestt. The source of data in this study is Puslatkesda data in 2020, namely primary data on the implementation of Advanced PPI Technical Training during the COVID-19 Pandemic. Following are the results of the research data analysis that of the seven evaluation categories at the reaction level to the implementation of the training. The results showed that as many as 18 respondents with a percentage of (45 percent) answered Very Satisfactory, then for reactions to resource persons an average, of 52.5-82.5 percent participants answered satisfactorily and very satisfactory. As for the evaluation of learning or learning, it appears that the average value of participants is 84.3, and there are 100 percent (40) training participants who have complete scores in the posttest stage. With all these descriptions, the Advanced Infection and Prevention Technical Training for Health Workers at Health Facilities during the COVID-19 Pandemic went well and satisfactorily.

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