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Shin H, Shon S, Kim H, Lee SJ. Understanding community health workers' activities in a community-based child health promotion project in Kyrgyzstan. EVALUATION AND PROGRAM PLANNING 2023; 99:102307. [PMID: 37182341 DOI: 10.1016/j.evalprogplan.2023.102307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/27/2022] [Accepted: 05/06/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Community health workers (CHWs) have strong potential for conducting health initiatives in vulnerable countries. Their continuing activities are essential for positive outcomes. The purpose of this study is to understand CHW activities in Kyrgyzstan migrant villages and their impact on individuals and communities. METHODS This study used a mixed-method design. All active CHWs were invited to participate in the survey and the first reflection note regarding their experience and satisfaction with CHW activities. Respondents who agreed to participate in the second reflection notes wrote additional reflection notes. Participatory observational CHW activity report meeting data was collected for additional qualitative analysis. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed thematically. RESULTS CHWs started their activities with altruistic and personal motives, such as social recognition and knowledge acquisition. Job-related satisfaction after the activity tended to be high. After performing home visits and resident participatory events, they experienced intrinsic motivation, resource mobilization efforts, increased autonomy, and social recognition. Although the material rewards were small as volunteers, they recognized their positive impact on individuals and communities and gained pride and happiness. CONCLUSIONS CHWs participating in health promotion projects had training and CHW-nurse network activities and were gradually empowered in the process. When considering the sustainability of CHW activities, it is important to increase self-confidence and strengthen social recognition through empowerment.
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Affiliation(s)
- Hyunsook Shin
- College of Nursing Science, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Soonyoung Shon
- College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Republic of Korea
| | - Hyerang Kim
- Nursing Department, Vision College of Jeonju. 235 Cheonjam-ro, Wansan-gu, Jeonju-si, Jellabul-do 55069, Republic of Korea
| | - Suk Jeong Lee
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseik-ro, Dongjak-gu, Seoul 06974, Republic of Korea.
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Taaffe J, Sharma R, Parthiban ABR, Singh J, Kaur P, Singh BB, Gill JPS, Gopal DR, Dhand NK, Parekh FK. One Health activities to reinforce intersectoral coordination at local levels in India. Front Public Health 2023; 11:1041447. [PMID: 36960366 PMCID: PMC10029730 DOI: 10.3389/fpubh.2023.1041447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 01/30/2023] [Indexed: 03/09/2023] Open
Abstract
India's dense human and animal populations, agricultural economy, changing environment, and social dynamics support conditions for emergence/re-emergence of zoonotic diseases that necessitate a One Health (OH) approach for control. In addition to OH national level frameworks, effective OH driven strategies that promote local intersectoral coordination and collaboration are needed to truly address zoonotic diseases in India. We conducted a literature review to assess the landscape of OH activities at local levels in India that featured intersectoral coordination and collaboration and supplemented it with our own experience conducting OH related activities with local partners. We identified key themes and examples in local OH activities. Our landscape assessment demonstrated that intersectoral collaboration primarily occurs through specific research activities and during outbreaks, however, there is limited formal coordination among veterinary, medical, and environmental professionals on the day-to-day prevention and detection of zoonotic diseases at district/sub-district levels in India. Examples of local OH driven intersectoral coordination include the essential role of veterinarians in COVID-19 diagnostics, testing of human samples in veterinary labs for Brucella and leptospirosis in Punjab and Tamil Nadu, respectively, and implementation of OH education targeted to school children and farmers in rural communities. There is an opportunity to strengthen local intersectoral coordination between animal, human and environmental health sectors by building on these activities and formalizing the existing collaborative networks. As India moves forward with broad OH initiatives, OH networks and experience at the local level from previous or ongoing activities can support implementation from the ground up.
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Affiliation(s)
| | - Rajnish Sharma
- Centre for One Health, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - Aravindh Babu R. Parthiban
- Translational Research Platform for Veterinary Biologicals, Centre for Animal Health Studies, Tamil Nadu Veterinary and Animal Sciences University, Chennai, Tamil Nadu, India
| | - Jaswinder Singh
- Department of Veterinary and Animal Husbandry Extension Education, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - Paviter Kaur
- Department of Veterinary Microbiology, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - Balbir B. Singh
- Centre for One Health, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - Jatinder P. S. Gill
- Centre for One Health, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - Dhinakar Raj Gopal
- Translational Research Platform for Veterinary Biologicals, Centre for Animal Health Studies, Tamil Nadu Veterinary and Animal Sciences University, Chennai, Tamil Nadu, India
| | - Navneet K. Dhand
- EpiPointe, Cary, NC, United States
- Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW, Australia
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Saks M. The regulation of healthcare professions and support workers in international context. HUMAN RESOURCES FOR HEALTH 2021; 19:74. [PMID: 34103060 PMCID: PMC8185486 DOI: 10.1186/s12960-021-00618-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 06/03/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND The objective of this paper is to outline and compare the regulation of paid healthcare professions and associated support workers in international context, bringing out the lessons to be learned as appropriate. Modern neo-liberal societies have sought to enhance healthcare through greater professional regulation, albeit in different ways and at variable pace. This general trend is illustrated with reference to medicine in the UK. However, although such reforms have helpfully cascaded to other health professions, government policy in high-income countries has not yet adequately regulated the interrelated group of non-professionalised health support workers who form the largest and least recognised part of the workforce. Nonetheless, in low- and middle-income (LMIC) countries-aside from the greater need for regulation of health professions-there is even more of an imperative to regulate the disparate, largely invisible support workforce. METHODS With reference to existing studies of the medical and wider health professions in the UK and selected other higher income societies, the importance of health professional regulation to the public is underlined in the Global North. The larger gap in the regulation of support workers in modern neo-liberal countries is also emphasised on a similar basis, with an increasingly ageing population and advances in healthcare. It is argued from the very limited patchwork of secondary literature, though, that policy-makers may want to focus even more on enhancing regulation of both the professional and non-professional workforce in LMIC societies centred mainly in the Global South, drawing on lessons from the Global North. RESULTS/CONCLUSIONS Efforts to reform health professional regulatory approaches in more economically developed countries, while needing refinement, are likely to have had a positive effect. However, even in these societies there are still substantial shortfalls in the regulation of health support workers. There are even larger gaps in LMICs where there are fewer health professional staff and a greater dependence on support workers. With higher rates of morbidity and mortality, there is much more scope here for reforming health regulation in the public interest to extend standards and mitigate risk, following the pattern for healthcare professions in the Global North.
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Affiliation(s)
- Mike Saks
- University of Suffolk, Ipswich, UK.
- University of Lincoln, Lincoln, UK.
- Royal Veterinary College, University of London, London, UK.
- University of Westminster, London, UK.
- University of Toronto, Toronto, Canada.
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