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 Comparing the current status with desired situation of the quality ofeducation and improvement for rural health workers in Iran

2021 ◽  
Vol 10 (1) ◽  
pp. 1-1
Author(s):  
Beheshteh Shamsaee ◽  
Mehdi Bagheri ◽  
Nader Gholi Ghourchian ◽  
Parivash Jafari
Keyword(s):  
Health Care ◽  
Health System ◽  
Rural Health ◽  
Health Care Providers ◽  
Rural Areas ◽  
Health Workers ◽  
Current Status ◽  
Care Providers ◽  
Fuzzy Delphi ◽  
The Impact

Background: Rural health workers (Behvarz) are considered health- care pioneers standing at the forefront of providing services for rural areas. Those health providers need to be optimally educated throughout the country. What can serve this purpose is an integrated high quality "education". Methods: The current descriptive research compared two situations of education quality. To this end 300, rural health workers completed researcher-made questionnaires, including 2 dimensions,7 components and, 80 questions obtained from the analysis of the qualitative process through the fuzzy Delphi method. Results: The results indicated a gap between the current status and desirable situations of qualitative improvement components of rural health workers’ education. The findings also showed that the highest standardized coefficient in the area of education was related to the variable of learning and transfer of education with a coefficient of 0.971. In the area of optimization, the highest standard coefficient for the desirable situation belonged to the interpersonal and functional relationship variable, with the value of 0.978, while the lowest standardized coefficient was related to the variable of information and communication technology (ICT) development as 0.956. Conclusion: In brief, optimal education for the health- care providers is considered an integral part of the health system; therefore, the impact of education on the general health of the people should be taken into consideration. Therefore, there is a need for theoretical and practical exploration of qualitative education towards health system improvement and promotion.

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 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 Visceral Leishmaniasis in China: an Endemic Disease under Control

2015 ◽  
Vol 28 (4) ◽  
pp. 987-1004 ◽  
Author(s):  
Zhao-Rong Lun ◽  
Ming-Shui Wu ◽  
Yun-Fu Chen ◽  
Jun-Yun Wang ◽  
Xiao-Nong Zhou ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Rural Areas ◽  
Health Workers ◽  
Sand Fly ◽  
Current Status ◽  
Content Type ◽  
Control Programs ◽  
Treatment And Prevention ◽  
Special Value ◽  
The Government

SUMMARYVisceral leishmaniasis (VL) caused byLeishmaniaspp. is an important vector-borne and largely zoonotic disease. In China, three epidemiological types of VL have been described: anthroponotic VL (AVL), mountain-type zoonotic VL (MT-ZVL), and desert-type ZVL (DT-ZVL). These are transmitted by four different sand fly species:Phlebotomus chinensis,P. longiductus,P. wui, andP. alexandri.In 1951, a detailed survey of VL showed that it was rampant in the vast rural areas west, northwest, and north of the Yangtze River. Control programs were designed and implemented stringently by the government at all administrative levels, resulting in elimination of the disease from most areas of endemicity, except the western and northwestern regions. The control programs consisted of (i) diagnosis and chemotherapy of patients, (ii) identification, isolation, and disposal of infected dogs, and (iii) residual insecticide indoor spraying for vector control. The success of the control programs is attributable to massive and effective mobilization of the general public and health workers to the cause. Nationally, the annual incidence is now very low, i.e., only 0.03/100,000 according to the available 2011 official record. The overwhelming majority of cases are reported from sites of endemicity in the western and northwestern regions. Here, we describe in some depth and breadth the current status of epidemiology, diagnosis, treatment, and prevention of the disease, with particular reference to the control programs. Pertinent information has been assembled from scattered literature of the past decades in different languages that are not readily accessible to the scientific community. The information provided constitutes an integral part of our knowledge on leishmaniasis in the global context and will be of special value to those interested in control programs.

scholarly journals Penganggaran dan Penerimaan Dana Kapitasi Program JKN di Daerah Terpencil Kabupaten Kepulauan Mentawai

2018 ◽  
pp. 92-101
Author(s):  
Desi Fitria Neti ◽  
Lukman Waris ◽  
Anni Yulianti
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
National Health Insurance ◽  
National Health ◽  
Rural Areas ◽  
Health Workers ◽  
National Health Insurance Program ◽  
Insurance Program ◽  
Health Insurance Program ◽  
The Right

Abstrak Program Jaminan Kesehatan Nasional (JKN) dilaksanakan atas hak setiap warga negara memperoleh layanan kesehatan, baik yang bertempat tinggal di perkotaan maupun di perdesaan termasuk di daerah terpencil perbatasan kepulauan. Pelaksana program JKN dilaksanakan oleh unit pelayanan kesehatan mulai dari pelayanan kesehatan di puskesmas sampai dengan pelayanan kesehatan rujukan di rumah sakit dengan pembayaran yang dilakukan oleh Badan Pelaksana Jaminan Sosial Kesehatan (BPJS) kepada unit pelaksana pelayanan kesehatan dengan mekanisme transfer berdasarkan sistem dana kapitasi. Penelitian ini bertujuan untuk mendeskripsikan dan menganalisis pelaksanaan penganggaran dan penerimaan dana kapitasi tenaga kesehatan program jaminan kesehatan nasional di daerah terpencil Puskesmas Mapaddegat Kabupaten Kepulauan Mentawai dengan mengunakan metode kualitatif. Pengumpulan informasi melalui observasi wawancara mendalam terhadap informan dan informan kunci dan Dokumentasi. Penelitian dilaksanakan bulan januari s/d juni 2017. Hasil penelitian menggambarkan bahwa pelaksanaan penganggaran dan penerima dana kapitasi tenaga kesehatan pada tahun 2014-2015 belum berjalan sesuai ketentuan pembayaran, tahun 2016 masih ditemukan permasalahan pembayaran norma kapitasi oleh BPJS Kesehatan sudah normatif namun belum sesuai dengan jumlah peserta yang terdaftar. Tahun 2017 penerimaan dana kapitasi sudah berjalan lebih baik dibuktikan dengan telah teradministrasi dan terdokumentasi semua bentuk pemanfaatan dan realisasi belanja pencairan dana kapitasi untuk seluruh petugas di puskesmas dan jaringannya. Kata kunci: Tenaga kesehatan, penganggaran, penerimaan dana kapitasi dan program JKN. Abstract The National Health Insurance Program (JKN) is implemented on the right of every citizen to receive health services in both urban and rural areas, including in remote border areas of the island. Implementing the JKN program is implemented by health care unit starting from health service at puskesmas to referral health service in hospital with payment made by BPJS to health service implementation unit with transfer mechanism based on capitation fund system. This study aims to describe and analyze the implementation of budgeting and receiving capitation funds health workers national health insurance program in remote areas Mapaddegat Puskesmas Mentawai Islands by using qualitative methods. Information gathering through in-depth interview observation of key informants and informants and Documentation. The study was conducted from January to June 2017. The results of this study illustrate that the implementation of budgeting and recipients of capitation funds of health personnel in 2014-2015 has not run according to payment terms, in 2016 still found the problem of payment of capitation norms by BPJS Health has been normative but not in accordance with number of registered participants according to the provisions. In 2017, the capitation of the capitation funds has been better implemented as proven by the administration and documentation of all forms of utilization and realization of capitation fund disbursement expenditure for all officers at the puskesmas and its network. Keywords: Health Manpower, policy, budgeting, admission of capitation funds and Health Insurance Program.

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 Health Promotion and Medical Services on Health Services Through Performance at Tajuncu Health Center (Puskesmas)

2021 ◽  
Author(s):  
M Chairul Basrun Umanailo
Keyword(s):  
Health Promotion ◽  
Health Services ◽  
Health Center ◽  
Health Knowledge ◽  
Health Workers ◽  
Health Centre ◽  
Medical Services ◽  
Health Staff ◽  
Or Education ◽  
Successful Recovery

This analysis aims to define and evaluate the effects of health promotion and medical services on health services through success at the Tajuncu Health Centre, Soppeng Regency. This research used the causality design and quantitative method used at the Tajuncu Health Center, Soppeng Regency. This research sample was 100 health workers and nurses at the Tajunju Health Center, Soppeng Regency. The sampling procedure was carried out using an objective sampling technique. The analysis included all demographics as a sample. Data collection was carried out by observation, interviews, questionnaires, and documentation. Analysis of data using route analysis. The findings revealed that the degree of health promotion carried out by the Tajuncu Health Center in Soppeng Regency improved the awareness and ability of the population on the value of receiving health knowledge or education. Puskesmas related to sickness suffered by the group. Health promotion, which is well carried out, is due to the good results of health staff and health programs. Also, patient facilities are factors that decide the improvement of health services. The medical services are sufficient and proportionate to the specialty's level and specialization level. The social care given can be seen by advancing public health, early diagnosis and adequate consideration, prevention of injury, and successful recovery. Indirectly, success is a potent mediator between emergency care and health services.

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.

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