1
|
Musoke D, Jonga M, Ndagire GK, Musasizi B, Gidebo A, Tolossa A, Thomas M, Waiswa P, Rumsey R. Involvement of community health workers in the COVID-19 pandemic response in Uganda: A qualitative study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003312. [PMID: 38905244 PMCID: PMC11192370 DOI: 10.1371/journal.pgph.0003312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 05/13/2024] [Indexed: 06/23/2024]
Abstract
Community Health Workers (CHWs) are a key human resource for health particularly in low- and middle-income countries. In many parts of the world, CHWs are known to have played an instrumental role in controlling the COVID-19 pandemic. This study explored the involvement of CHWs in the COVID-19 response in Uganda. A qualitative study that involved 10 focus group discussions (FGDs) among CHWs was conducted. The study was carried out in 5 districts of Amuria, Karenga, Kamwenge, Bugiri and Pader. The FGD guide used explored the role of CHWs in the COVID-19 response in their communities including lived experiences, challenges, and coping mechanisms. The data were analyzed thematically with the support of NVivo version 12 pro (QSR International). CHWs were at the frontline of COVID-19 prevention interventions at households and in the community. CHWs raised awareness on prevention measures including wearing face masks, hand hygiene, and social distancing. They identified suspected cases such as new members entering the community, as well as individuals returning from abroad with signs and symptoms of COVID-19. CHWs mobilized the community and increased awareness on COVID-19 vaccination which played an important role in reducing misinformation. They also supported home-based management of mild COVID-19 cases through isolation of patients; provided health and nutritional guidance among patients in their homes; and referred suspected cases to health facilities for testing and management. Both monetary and non-monetary incentives were provided to support CHWs in the COVID-19 response. However, the adequacy and timing of the incentives were inadequate. Routine services of CHWs such as health promotion and treatment of childhood illnesses were disrupted during the pandemic. CHWs played an instrumental role in response to the pandemic especially on surveillance, risk communication, and observance of preventing measures. Strategies to ensure that routine services of CHWs are not disrupted during pandemics are needed.
Collapse
Affiliation(s)
- David Musoke
- Makerere University School of Public Health, Kampala, Uganda
| | - Micheal Jonga
- Makerere University School of Public Health, Kampala, Uganda
| | | | | | | | | | | | - Peter Waiswa
- Makerere University School of Public Health, Kampala, Uganda
| | | |
Collapse
|
2
|
Adsul N, Tyagi J, Bhaumik S. Community health workers for health systems resilience during COVID-19: protocol for qualitative evidence synthesis. BMJ Open 2024; 14:e074920. [PMID: 38531568 DOI: 10.1136/bmjopen-2023-074920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/28/2024] Open
Abstract
INTRODUCTION COVID-19 exposed the fragility of health systems, where even the most basic health services in high-income and low-income and middle-income nations could not withstand the health systems shock due to the pandemic. Community health workers (CHWs) can contribute to improving the resilience of health systems, specifically to withstand shocks and emergencies and to avoid disruptions of routine service delivery. We aim to explore and understand the 'individual' and 'systems-level' resilience factors that shaped the involvement of CHWs in the COVID-19 response. METHODS AND ANALYSIS We will search five electronic databases (PubMed, Cochrane Library, EMBASE, CINAHL and SciELO (Spanish)) and conduct citation screening to identify studies on CHWs' response during the COVID-19 pandemic. Two review authors will independently screen the studies for inclusion and to extract data. The software Rayyan will be used to assist in screening the relevant literature. A thematic analysis approach will be followed to analyse and synthesise the qualitative evidence. The quality of the included studies will be critically assessed using the Critical Skills Appraisal Programme Tool. We will use the GRADE CERQual(Grading of Recommendations, Assessment, Development, and Evaluations - Confidence in the Evidence from Reviews of Qualitative Research) approach to assess certainty in the synthesised findings of the qualitative evidence. ETHICS AND DISSEMINATION This study will be conducted on published evidence, with no living participants; thus, no ethical approval is required. The final review will be submitted and published in a peer-reviewed journal. We will also develop a policy brief to communicate the review findings to the stakeholders.
Collapse
Affiliation(s)
- Neha Adsul
- Meta-research and Evidence Synthesis Unit, The George Institute for Global Health India, New Delhi, India
| | - Jyoti Tyagi
- Meta-research and Evidence Synthesis Unit, The George Institute for Global Health India, New Delhi, India
| | - Soumyadeep Bhaumik
- Meta-research and Evidence Synthesis Unit, The George Institute for Global Health India, New Delhi, India
- The George Institute for Global Health, Faculty of Medicine and Health, UNSW, Sydney, New South Wales, Australia
| |
Collapse
|
3
|
Gotsche CI, Meierkord A, Baruch J, Körner-Nahodilová L, Weishaar H, Hanefeld J. Approaches, challenges, and opportunities to strengthen the epidemic intelligence workforce: a scoping review. Public Health 2023; 225:353-359. [PMID: 37979312 DOI: 10.1016/j.puhe.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 08/30/2023] [Accepted: 09/16/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Weak surveillance systems have limited countries' ability to adequately respond to public health emergencies. Strengthening the human workforce in this field is considered an important opportunity to ensure the future response to infectious diseases outbreaks globally. A scoping review of the academic literature and relevant documents was conducted to identify approaches, challenges, and opportunities to strengthen the epidemic intelligence (EI) workforce. METHODS Five peer-reviewed databases were systematically searched, as well as Google as a grey literature source. English language articles and documents published between 2014 and 2022 were included. No geographical restrictions were set. RESULTS 37 articles and 20 documents were included in the review. Professional training, the acknowledgement of including a broad variety of disciplines into the workforce, the inclusion of communities, the pursuit of a One Health approach and the use of digital tools were identified as impeding and/or facilitating the EI workforce. The review shows that the field epidemiology training programme is a prominent approach for strengthening the EI workforce and that little evidence exists on how non-traditional disciplines (e.g., disciplines besides medicine, laboratory science, or epidemiology) contributing to surveillance may support the future EI workforce. CONCLUSION The identification of approaches, challenges, and opportunities of EI can inform future policy and practice on strengthening the EI workforce. The conduct of more high-quality studies is needed to guide this process. The potential benefits of integrating a wider range of disciplines than currently found in the surveillance workforce and of involving communities in disease surveillance needs to be further researched.
Collapse
Affiliation(s)
- C I Gotsche
- Robert Koch Institute, Centre for International Health Protection, Nordufer 20, Berlin, 13353, Germany; London School of Hygiene and Tropical Medicine, Faculty of Public Health and Policy, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom.
| | - A Meierkord
- Robert Koch Institute, Centre for International Health Protection, Nordufer 20, Berlin, 13353, Germany; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, 13353, Germany
| | - J Baruch
- Robert Koch Institute, Centre for International Health Protection, Nordufer 20, Berlin, 13353, Germany
| | - L Körner-Nahodilová
- Robert Koch Institute, Centre for International Health Protection, Nordufer 20, Berlin, 13353, Germany
| | - H Weishaar
- Robert Koch Institute, Centre for International Health Protection, Nordufer 20, Berlin, 13353, Germany
| | - J Hanefeld
- Robert Koch Institute, Centre for International Health Protection, Nordufer 20, Berlin, 13353, Germany; London School of Hygiene and Tropical Medicine, Faculty of Public Health and Policy, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom
| |
Collapse
|
4
|
Pitse SB, Risenga PR. A concept analysis: Support for lay healthcare workers in HIV services, Bojanala District, North West. Curationis 2023; 46:e1-e11. [PMID: 37916662 PMCID: PMC10546254 DOI: 10.4102/curationis.v46i1.2420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 04/12/2023] [Accepted: 04/19/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Different lay healthcare workers play an important role in the retention of clients to human immunodeficiency virus (HIV) care. Retention to HIV care is crucial to promote treatment continuation, viral suppression and reduced risk of transmission. However, lay healthcare workers view and perceive support differently. OBJECTIVES The aim of the study was to investigate perceptions of healthcare workers regarding support provided to lay healthcare workers in HIV services. This article is a report of a concept analysis of healthcare workers' support provided to lay healthcare workers in HIV services, that was collected during the study. A concept analysis was done to explore the support attributes, clarify meaning and to understand its use within the lay healthcare workers' context in Bojanala District, situated in the North West province of South Africa. METHOD The initial phase was data collection from lay healthcare workers, their supervisors and clients on antiretroviral therapy. Thereafter, the eight concept analysis steps of Walker and Avant were followed. Peer-reviewed articles on the support concept were searched and guided by data saturation. RESULTS Responsiveness, provision, reciprocity and integration are key characteristics of support. CONCLUSION Despite support being an interpersonal process, it is perceived subjectively. Support is necessary to continuously promote growth or endurance during adverse times.Contribution: The concept analysis will provide common understanding of support and information that is responsive to the needs of different lay healthcare workers.
Collapse
Affiliation(s)
- Sarah B Pitse
- Department of Health Studies, College of Human Sciences, University of South Africa, Pretoria.
| | | |
Collapse
|
5
|
Nyagah LM, Bangura S, Omar OA, Karanja M, Mirza MA, Shajib H, Njiru H, Mengistu K, Malik SMMR. The importance of community health workers as frontline responders during the COVID-19 pandemic, Somalia, 2020-2021. Front Public Health 2023; 11:1215620. [PMID: 37663863 PMCID: PMC10469613 DOI: 10.3389/fpubh.2023.1215620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction We examined the contribution of community health workers as frontline responders for the community-based surveillance in Somalia during the first year of the COVID-19 pandemic for detection of COVID-19 cases and identification of contacts. Methods We retrieved COVID-19 surveillance data from 16 March 2020 to 31 March 2021 from the health ministry's central database. These data were collected through community health workers, health facilities or at the points of entry. We compared the number of suspected COVID-19 cases detected by the three surveillance systems and the proportion that tested positive using the chi-squared test. We used logistic regression analysis to assess association between COVID-19 infection and selected variables. Results During the study period, 154,004 suspected cases of COVID-19 were detected and tested, of which 10,182 (6.6%) were positive. Of the notified cases, 32.7% were identified through the community-based surveillance system, 54.0% through the facility-based surveillance system, and 13.2% at points of entry. The positivity rate of cases detected by the community health workers was higher than that among those detected at health facilities (8.6% versus 6.4%; p < 0.001). The community health workers also identified more contacts than those identified through the facility-based surveillance (13,279 versus 1,937; p < 0.001). The odds of COVID-19 detection generally increased by age. Community-based surveillance and health facility-based surveillance had similar odds of detecting COVID-19 cases compared with the points-of-entry surveillance (aOR: 7.0 (95% CI: 6.4, 7.8) and aOR: 7.5 (95% CI: 6.8, 8.3), respectively). Conclusion The community health workers proved their value as first responders to COVID-19. They can be effective in countries with weak health systems for targeted community surveillance in rural and remote areas which are not covered by the facility-based surveillance system.
Collapse
|
6
|
França CDJ, Nunes CA, Vilasbôas ALQ, Aleluia ÍRS, Aquino R, Nunes FGDS, Prado NMDBL. Characteristics of the community health agent's work in the COVID-19 pandemic in municipalities of Northeastern Brazil. CIENCIA & SAUDE COLETIVA 2023; 28:1399-1412. [PMID: 37194874 DOI: 10.1590/1413-81232023285.18422022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/15/2023] [Indexed: 05/18/2023] Open
Abstract
The community health agents (CHAs) comprised the workforce at the forefront of health systems in the fight against COVID-19. The study identified the structural conditions for organizing and characterizing the work of CHAs in three municipalities of northeastern Brazil during the pandemic period. A qualitative study of multiple cases was carried out. Twenty-eight subjects were interviewed, including community agents and municipal managers. Data production assessed the interviews with document analysis. The operational categories that emerged from the data analysis were: structural conditions and characteristics of the activities. The results of this study disclosed the scarcity of the structural conditions in the health units, which during the pandemic made improvised adaptations of the internal spaces. As for the work characteristics, actions permeated by bureaucratic aspects of an administrative nature were evidenced in the health units, resulting in the elimination of their binding function of territorial articulation and community mobilization. Thus, changes in their work can be seen as signs of the fragility of the health system and, especially, of primary health care.
Collapse
Affiliation(s)
- Camila de Jesus França
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia. R. Hormindo Barros 58, Quadra 17, Lote 58, Candeias. 45.029-094 Vitória da Conquista BA Brasil.
| | | | | | | | - Rosana Aquino
- Instituto de Saúde Coletiva, Universidade Federal da Bahia. Salvador BA Brasil
| | | | - Nilia Maria de Brito Lima Prado
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia. R. Hormindo Barros 58, Quadra 17, Lote 58, Candeias. 45.029-094 Vitória da Conquista BA Brasil.
- Instituto de Saúde Coletiva, Universidade Federal da Bahia. Salvador BA Brasil
| |
Collapse
|
7
|
Skinner NA, Job N, Krause J, Frankel A, Ward V, Johnston JS. The Use of Open-Source Online Course Content for Training in Public Health Emergencies: Mixed Methods Case Study of a COVID-19 Course Series for Health Professionals. JMIR MEDICAL EDUCATION 2023; 9:e42412. [PMID: 36735834 PMCID: PMC9999253 DOI: 10.2196/42412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/15/2022] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The onset of the COVID-19 pandemic generated an urgent need for credible and actionable information to guide public health responses. The massive open-source online course (MOOC) format may be a valuable path for disseminating timely and widely accessible training for health professionals during public health crises; however, the reach and effectiveness of health worker-directed online courses during the pandemic remain largely unexplored. OBJECTIVE This study investigated the use of an open-source online course series designed to provide critical COVID-19 knowledge to frontline health workers and public health professionals globally. The study investigated how open-source online educational content can be optimized to support knowledge sharing among health professionals in public health emergencies, particularly in resource-limited contexts. METHODS The study examined global course enrollment patterns (N=2185) and performed in-depth interviews with a purposive subsample of health professionals enrolled in the course series (N=12) to investigate the sharing of online content in pandemic responses. Interviewed learners were from Ethiopia, India, Kenya, Liberia, Malawi, Rwanda, Thailand, Uganda, the United Arab Emirates, and the United States. Inductive analysis and constant comparative methods were used to systematically code data and identify key themes emerging from interview data. RESULTS The analysis revealed that the online course content helped fill a critical gap in trustworthy COVID-19 information for pandemic responses and was shared through health worker professional and personal networks. Enrollment patterns and qualitative data illustrate how health professionals shared information within their professional networks. While learners shared the knowledge they gained from the course, they expressed a need for contextualized information to more effectively educate others in their networks and in their communities. Due to technological and logistical barriers, participants did not attempt to adapt the content to share with others. CONCLUSIONS This study illustrates that health professional networks can facilitate the sharing of online open-source health education content; however, to fully leverage potential benefits, additional support is required to facilitate the adaptation of course content to more effectively reach communities globally.
Collapse
Affiliation(s)
- Nadine Ann Skinner
- Stanford Center for Health Education, Stanford University, Stanford, CA, United States
| | - Nophiwe Job
- Stanford Center for Health Education, Stanford University, Cape Town, South Africa
| | | | | | - Victoria Ward
- Stanford Center for Health Education, Stanford University, Stanford, CA, United States
- Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Jamie Sewan Johnston
- Stanford Center for Health Education, Stanford University, Stanford, CA, United States
| |
Collapse
|
8
|
Health system response to COVID-19 among primary health care units in Ethiopia: A qualitative study. PLoS One 2023; 18:e0281628. [PMID: 36763695 PMCID: PMC9916627 DOI: 10.1371/journal.pone.0281628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 01/28/2023] [Indexed: 02/12/2023] Open
Abstract
INTRODUCTION There was limited data on the experiences and roles of sub-national health systems in the response against COVID-19 in Ethiopia. This study explored how sub-national primary health care units and coordinating bodies in Ethiopia responded to COVID-19 during the first 6 months of pandemic. METHODS We conducted a qualitative study with descriptive phenomenological design using 59 key informants that were purposively selected. The interviews included leaders across Ethiopia's 10 regions and 2 administrative cities. Data were collected using a semi-structured interview guide that was translated into a local language. The interviews were conducted in person or by phone. Coding and categorizing led to the development of themes and subthemes. Data were analyzed using thematic analysis. RESULTS Local administrators across different levels took the lead in responding to COVID-19 by organizing multisectoral planning and monitoring committees at regional, zonal and woreda (district) levels. Health leaders reacted to the demand for an expanded workforce by reassigning health professionals to COVID-19 surveillance and case management activities, adding COVID-19-related responsibilities to their workloads, temporarily blocking leave, and hiring new staff on contractual basis. Training was prioritized for: rapid response teams, laboratory technicians, healthcare providers assigned to treatment centers where care was provided for patients with COVID-19, and health extension workers. COVID-19 supplies and equipment, particularly personal protective equipment, were difficult to obtain at the beginning of the pandemic. Health officials used a variety of means to equip and protect staff, but the quantity fell short of their needs. Local health structures used broadcast media, print materials, and house-to-house education to raise community awareness about COVID-19. Rapid response teams took the lead in case investigation, contact tracing, and sample collection. The care for mild cases was shifted to home-based isolation as the number of infections increased and space became limited. However, essential health services were neglected at the beginning of the pandemic while the intensity of local multisectoral response (sectoral engagement) declined as the pandemic progressed. CONCLUSIONS Local government authorities and health systems across Ethiopia waged an early response to the pandemic, drawing on multisectoral support and directing human, material, and financial resources toward the effort. But, the intensity of the multisectoral response waned and essential services began suffering as the pandemic progressed. There is a need to learn from the pandemic and invest in the basics of the health system-health workers, supplies, equipment, and infrastructure-as well as coordination of interventions.
Collapse
|
9
|
Elimian K, King C, Dewa O, Pembi E, Gandi B, Yennan S, Myles P, Pritchard C, Forsberg BC, Alfvén T. Healthcare workers knowledge of cholera multi-stranded interventions and its determining factors in North-East Nigeria: planning and policy implications. HUMAN RESOURCES FOR HEALTH 2023; 21:6. [PMID: 36726147 PMCID: PMC9891191 DOI: 10.1186/s12960-023-00796-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Healthcare workers' (HCWs) knowledge of multi-stranded cholera interventions (including case management, water, sanitation, and hygiene (WASH), surveillance/laboratory methods, coordination, and vaccination) is crucial to the implementation of these interventions in healthcare facilities, especially in conflict-affected settings where cholera burden is particularly high. We aimed to assess Nigerian HCWs' knowledge of cholera interventions and identify the associated factors. METHODS We conducted a cross-sectional study using a structured interviewer-administered questionnaire with HCWs from 120 healthcare facilities in Adamawa and Bauchi States, North-East Nigeria. A knowledge score was created by assigning a point for each correct response. HCWs' knowledge of cholera interventions, calculated as a score, was recoded for ease of interpretation as follows: 0-50 (low); 51-70 (moderate); ≥ 71 (high). Additionally, we defined the inadequacy of HCWs' knowledge of cholera interventions based on a policy-relevant threshold of equal or lesser than 75 scores for an intervention. Multivariable logistic regression was used to identify the factors associated with the adequacy of knowledge score. RESULTS Overall, 490 HCWs participated in the study (254 in Adamawa and 236 in Bauchi), with a mean age of 35.5 years. HCWs' knowledge score was high for surveillance/laboratory methods, moderate for case management, WASH, and vaccination, and low for coordination. HCWs' knowledge of coordination improved with higher cadre, working in urban- or peri-urban-based healthcare facilities, and secondary education; cholera case management and vaccination knowledge improved with post-secondary education, working in Bauchi State and urban areas, previous training in cholera case management and response to a cholera outbreak-working in peri-urban areas had a negative effect. HCWs' knowledge of surveillance/laboratory methods improved with a higher cadre, 1-year duration in current position, secondary or post-secondary education, previous training in cholera case management and response to a cholera outbreak. However, HCWs' current position had both positive and negative impacts on their WASH knowledge. CONCLUSIONS HCWs in both study locations recorded a considerable knowledge of multi-stranded cholera interventions. While HCWs' demographic characteristics appeared irrelevant in determining their knowledge of cholera interventions, geographic location and experiences from the current position, training and involvement in cholera outbreak response played a significant role.
Collapse
Affiliation(s)
- Kelly Elimian
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
- Exhale Health Foundation, Abuja, Nigeria.
| | - Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ozius Dewa
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Emmanuel Pembi
- Adamawa State Ministry of Health, Yola, Adamawa State, Nigeria
| | - Benjamin Gandi
- Bauchi State Ministry of Health, Yola, Bauchi State, Nigeria
| | | | - Puja Myles
- Clinical Practice Research Datalink, Medicines and Healthcare Products Regulatory Agency, London, UK
| | | | | | - Tobias Alfvén
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Stockholm, Sweden
| |
Collapse
|
10
|
Khalil H, Liu C, Karimi L, Ferrier JA, Liang Z, Leggat S. General wellbeing and work impacts among community pharmacists during crisis management. Aust J Prim Health 2023; 29:56-63. [PMID: 36283681 DOI: 10.1071/py22007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 09/26/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Community pharmacists are highly accessible for advice, as most pharmacies are open long hours and no appointment is needed. Community pharmacists, as essential community health workers, play a critical role in the fight against coronavirus disease 2019 (COVID-19). This study aimed to determine the general wellbeing and work impacts of pharmacists and the factors important for adaptability and resilience during the COVID-19 pandemic. METHODS This study adopted a cross-sectional design. Community pharmacists from various professional networks in Australia were invited through emails and social media posts to complete an anonymous online survey during the second wave of the COVID-19 pandemic in Victoria, Australia. RESULTS Sixty-five community pharmacists completed the online survey. The respondents reported fair levels of general wellbeing during the COVID-19 pandemic, with a mean self-related health score of 33.57 (s.d.=13.19) out of a maximal of 96, despite relatively high levels of job stress and emotional labour. Lower levels of general wellbeing were correlated with higher levels of job stress (r =0.645, P <0.01) and emotional labour (r =0.513, P <0.01), and lower levels of occupational self-efficacy (r =-0.566, P <0.01). Leader member exchange was negatively correlated with job stress (r =-0.419, P <0.01) and positively correlated with psychological safety (r =0.693, P <0.01). The linear regression models showed that female pharmacists had lower occupational self-efficacy (β =-0.286, P =0.024), but higher psychological safety (β =0.234, P =0.042). Higher work ability was associated with lower job stress (β =-0.529, P <0.001), higher occupational self-efficacy (β =0.511, P =0.001), and poorer self-related health (β =-0.659, P <0.001). CONCLUSIONS The findings highlight the importance of a supportive work environment in helping community pharmacists to feel psychologically safe and reduce stress during a crisis.
Collapse
Affiliation(s)
- Hanan Khalil
- School of Psychology and Public Health, Department of Public Health, La Trobe University, Melbourne, Vic. 3086, Australia
| | - Chaojie Liu
- School of Psychology and Public Health, Department of Public Health, La Trobe University, Melbourne, Vic. 3086, Australia
| | - Leila Karimi
- School of Psychology and Public Health, Department of Public Health, La Trobe University, Melbourne, Vic. 3086, Australia; and School of Health and Biomedical Sciences, Department of Psychology, RMIT University, Melbourne, Vic., Australia
| | - J Adamm Ferrier
- School of Psychology and Public Health, Department of Public Health, La Trobe University, Melbourne, Vic. 3086, Australia
| | - Zhanming Liang
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld 4810, Australia
| | - Sandra Leggat
- School of Psychology and Public Health, Department of Public Health, La Trobe University, Melbourne, Vic. 3086, Australia
| |
Collapse
|
11
|
Byanyima W, Lauterbach K, Kavanagh MM. Community pandemic response: the importance of action led by communities and the public sector. Lancet 2023; 401:253-255. [PMID: 36528036 PMCID: PMC9750179 DOI: 10.1016/s0140-6736(22)02575-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Winnie Byanyima
- United Nations Joint Programme on HIV/AIDS (UNAIDS), CH-1211 Geneva 27, Switzerland
| | - Karl Lauterbach
- Federal Ministry of Health of Germany, Government of Germany, Berlin
| | - Matthew M Kavanagh
- United Nations Joint Programme on HIV/AIDS (UNAIDS), CH-1211 Geneva 27, Switzerland.
| |
Collapse
|
12
|
Akter F, Tamim M, Saha A, Chowdhury IA, Faruque O, Talukder A, Chowdhury MAK, Patwary MM, Rahman AU, Chowdhury M, Sarker M. Implementation barriers and facilitators to a COVID-19 intervention in Bangladesh: The benefits of engaging the community for the delivery of the programme. BMC Health Serv Res 2022; 22:1590. [PMID: 36578063 PMCID: PMC9795148 DOI: 10.1186/s12913-022-08939-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 12/06/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND BRAC (Bangladesh Rural Advancement Committee), the largest NGO globally, implemented a community-based comprehensive social behavior communication intervention to increase community resilience through prevention, protection, and care for COVID-19. We conducted implementation research to assess fidelity and explore the barriers and facilitators of this intervention implementation. METHODS We adopted a concurrent mixed-method triangulation design. We interviewed 666 members of 60 Community Corona Protection Committees (CCPCs) and 80 members of 60 Community Support Teams (CSTs) through multi-stage cluster sampling using a structured questionnaire. The qualitative components relied on 54 key informant interviews with BRAC implementers and government providers. RESULTS The knowledge about wearing mask, keeping social distance, washing hands and COVID-19 symptoms were high (on average more than 70%) among CCPC and CST members. While 422 (63.4%) CCPC members reported they 'always' wear a mask while going out, 69 (86.3%) CST members reported the same practice. Only 247 (37.1%) CCPC members distributed masks, and 229 (34.4%) donated soap to the underprivileged population during the last two weeks preceding the survey. The key facilitators included influential community members in the CCPC, greater acceptability of the front-line health workers, free-of-cost materials, and telemedicine services. The important barriers identified were insufficient training, irregular participation of the CCPC members, favouritism of CCPC members in distributing essential COVID-19 preventive materials, disruption in supply and shortage of the COVID-19 preventative materials, improper use of handwashing station, the non-compliant attitude of the community people, challenges to ensure home quarantine, challenges regarding telemedicine with network interruptions, lack of coordination among stakeholders, the short duration of the project. CONCLUSIONS Engaging the community in combination with health services through a Government-NGO partnership is a sustainable strategy for implementing the COVID-19 prevention program. Engaging the community should be promoted as an integral component of any public health intervention for sustainability. Engagement structures should incorporate a systems perspective to facilitate the relationships, ensure the quality of the delivery program, and be mindful of the heterogeneity of different community members concerning capacity building. Finally, reaching out to the underprivileged through community engagement is also an effective mechanism to progress through universal health coverage.
Collapse
Affiliation(s)
- Fahmida Akter
- grid.52681.380000 0001 0746 8691BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Malika Tamim
- grid.52681.380000 0001 0746 8691BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Avijit Saha
- grid.52681.380000 0001 0746 8691BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Imran Ahmed Chowdhury
- grid.501438.b0000 0001 0745 3561Health, Nutrition, and Population Program, BRAC, Dhaka, Bangladesh
| | - Omor Faruque
- grid.52681.380000 0001 0746 8691BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Animesh Talukder
- grid.52681.380000 0001 0746 8691BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | | | - Monzur Morshed Patwary
- grid.501438.b0000 0001 0745 3561Health, Nutrition, and Population Program, BRAC, Dhaka, Bangladesh
| | - Albaab-Ur Rahman
- grid.501438.b0000 0001 0745 3561Health, Nutrition, and Population Program, BRAC, Dhaka, Bangladesh
| | - Morseda Chowdhury
- grid.501438.b0000 0001 0745 3561Health, Nutrition, and Population Program, BRAC, Dhaka, Bangladesh
| | - Malabika Sarker
- grid.52681.380000 0001 0746 8691BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh ,grid.7700.00000 0001 2190 4373Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
13
|
Fernandez M, Fernandes LDMM, Massuda A. atenção Primária à Saúde na pandemia da COVID-19. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2022. [DOI: 10.5712/rbmfc17(44)3336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introdução: A pandemia da COVID-19 afetou o mundo desigualmente. Países com ausência de coordenação nacional e/ou que resistiram a implementar as ações não farmacológicas de saúde pública tiveram suas populações impactadas pelo alto número de casos e pelas mortes por COVID-19, além de grandes impactos socioeconômicos, como o Brasil e os EUA. No caso brasileiro, especial atenção deve ser dada ao papel da Atenção Primária à Saúde (APS), considerando sua função de coordenadora e ordenadora do Sistema Único de Saúde. Objetivo: Este artigo tem como objetivo discutir as ações da APS no primeiro ano da emergência sanitária no Brasil. Métodos: Para realizar a análise proposta, consideramos os planos propostos por diversas organizações: Organização Mundial da Saúde, Conselho Nacional de Secretários de Saúde e Conselho Nacional de Secretarias Municipais de Saúde, Associação Brasileira de Saúde Coletiva e Sociedade Brasileira de Medicina de Família e Comunidade. Os documentos foram contrapostos ao conjunto de documentos publicados pelo Ministério da Saúde relacionados à APS. Resultados: A estratégia de combate à pandemia do Brasil falhou em subestimar o papel da APS. Mesmo diante do apelo e dos parâmetros estabelecidos por entidades nacionais e internacionais, a ação foi descoordenada e pouco do previsto em notas técnicas foi implementado. Conclusões: Entendendo que a pandemia ainda está em curso no Brasil, há a necessidade de retomar a centralidade da APS.
Collapse
|
14
|
Roy S, Kennedy S, Hossain S, Warren CE, Sripad P. Examining Roles, Support, and Experiences of Community Health Workers During the COVID-19 Pandemic in Bangladesh: A Mixed Methods Study. GLOBAL HEALTH, SCIENCE AND PRACTICE 2022; 10:GHSP-D-21-00761. [PMID: 36041841 PMCID: PMC9426994 DOI: 10.9745/ghsp-d-21-00761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 07/20/2022] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Understanding community health workers' (CHWs) experiences of sustaining routine health care promotion and provision activities as well as their challenges in adopting new responsibilities within a dynamic context is critical. This study explored the roles and perspectives of CHWs within the government-led coronavirus disease (COVID-19) community health response in Bangladesh. METHODS We conducted a mixed methods study to explore the government's response to COVID-19 and its association with community health programming through a telephone-based survey of 370 government-employed CHWs. We also conducted 28 in-depth interviews with policy makers, program managers, CHW supervisors, and CHWs. We conducted exploratory and regression analysis of survey data and qualitative analysis of interview data. RESULTS The majority of CHWs reported receiving training related to COVID-19, including community-based prevention strategies from government and nongovernment stakeholders. Access to infection prevention supplies differed significantly by CHW cadre, and perspectives on the provision of adequate supplies varied qualitatively. CHWs reported slight decreases in routine work across all health areas early in the pandemic, and a majority reported added COVID-19-related responsibilities as the pandemic continued, including advising on signs/symptoms in their communities and referring suspected cases of COVID-19 for advanced facility care. Regression analyses showed that government support and integration of CHWs into their response-particularly being trained on COVID-19-predicted CHW capacity to advise communities on symptoms and provide routine services. DISCUSSION Government-employed CHWs in Bangladesh continued to provide health education and routine services in their communities despite pandemic- and response-related challenges. Varied support and differential CHW cadre-specific effects on COVID-19 awareness building in the community, referral, and routine service provision merit attention in Bangladesh's pluralistic community health system. While COVID-19 infection and government-mandated lockdowns restricted CHW mobility, the workers' capacity to continue service provision and education can be leveraged in vaccination and surveillance efforts moving forward.
Collapse
Affiliation(s)
| | - Sarah Kennedy
- Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | | | | | | |
Collapse
|
15
|
Amani B, Cabral A, Sharif MZ, Huỳnh J, Skrine Jeffers K, Baptista SA, McAndrew B, Bradford NJ, de la Rocha P, Ford CL. Integrated Methods for Applying Critical Race Theory to Qualitative COVID-19 Equity Research. Ethn Dis 2022; 32:243-256. [PMID: 35909643 PMCID: PMC9311305 DOI: 10.18865/ed.32.3.243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background Racism persists, underscoring the need to rapidly document the perspectives and experiences of Black, Indigenous and People of Color (BIPOC) groups as well as marginalized populations (eg, formerly incarcerated people) during pandemics. Objective This methods paper offers a model for using Public Health Critical Race Praxis (PHCRP) and related critical methodologies (ie, feminist and decolonizing methods) to inform the conceptualization, methods, and dissemination of qualitative research undertaken in response to the evolving COVID-19 pandemic. Sample Using purposive snowball sampling, we identified organizations involved with health equity and social justice advocacy among BIPOC and socially marginalized populations. Focus group participants (N=63) included community members, organizers, activists, and health workers. Design We conducted topic-specific (eg, reproductive justice) and population-specific (eg, Asian and Pacific Islander) focus groups (N=16 focus groups) in rapid succession using Zoom software. Methods A self-reflexive, iterative praxis guided theorization, data collection and analysis. We obtained community input on study design, the semi-structured discussion guide, ethical considerations and dissemination. Applying PHCRP, we assessed our assumptions iteratively. We transcribed each interview verbatim, de-identified the data, then used two distinct qualitative techniques to code and analyze them: thematic analysis to identify unifying concepts that recur across focus groups and narrative analysis to keep each participant's story intact. Results The praxis facilitated relationship-building with partners and supported the iterative assessment of assumptions. Logistical constraints included difficulty ensuring the confidentiality of virtual discussions. Conclusions These novel approaches provide an effective model for community-engaged qualitative research during a pandemic.
Collapse
Affiliation(s)
- Bita Amani
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA,COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA, Address correspondence to Bita Amani, PhD, MHS; Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA;
| | - Alejandra Cabral
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA,Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA
| | - Mienah Z. Sharif
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA,Department of Epidemiology, University of Washington, School of Public Health, Seattle, WA
| | - James Huỳnh
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA,Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA
| | - Kia Skrine Jeffers
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA,School of Nursing, UCLA, Los Angeles, CA
| | - Shelby A. Baptista
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA
| | - Breann McAndrew
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA
| | - Natalie J. Bradford
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA,Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA
| | - Patanjali de la Rocha
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA,Department of Global Health, School of Public Health, University of Washington, Seattle, WA
| | - Chandra L. Ford
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA,Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA
| |
Collapse
|
16
|
Cuen AJ, Kante A, Tsemo S, Djoudalbaye B. Fighting COVID-19 and HIV through community mobilisation: lessons from an integrated approach to the Africa CDC Partnership to Accelerate COVID-19 Testing (PACT) initiative in seven countries. AFRICAN JOURNAL OF AIDS RESEARCH : AJAR 2022; 21:132-142. [PMID: 35901297 DOI: 10.2989/16085906.2022.2103005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
Recent literature has shown how the HIV architecture, including community systems, has been critical for fighting COVID-19 in many countries, while sustaining the HIV response. Innovative initiatives suggest that fostering the integration of health services would help address the colliding pandemics. However, there are few documented real-life examples of community mobilisation strategies responding to COVID-19 and HIV. The African Union and Africa Centres for Disease Control and Prevention (Africa CDC) launched the Partnership to Accelerate COVID-19 Testing (PACT) in June 2020 with the goal of training and deploying one million community health workers across the continent. UNAIDS partnered with Africa CDC to implement the PACT initiative in seven countries, i.e. Algeria, Côte d'Ivoire, Gabon, Ghana, Madagascar, Malawi and Namibia. The initiative engaged networks of people living with HIV and community-led organisations to support two of its pillars, test and trace, and the sensitisation to protective measures against COVID-19 for the most vulnerable populations. It later expanded to improve access to COVID-19 vaccines. Based on the assessment of country projects, this article explains how PACT activities implemented by communities contributed to mitigating COVID-19 and HIV among vulnerable and marginalised groups. This article contributes to a better understanding of the impact of a community-based approach in responding effectively to emerging health threats and provides lessons from integrated COVID-19 and HIV community-led responses.
Collapse
Affiliation(s)
| | - Agnes Kante
- UNAIDS Liaison Office to the African Union and United Nations Economic Commission for Africa, Addis Ababa, Ethiopia
| | - Sihaka Tsemo
- UNAIDS Liaison Office to the African Union and United Nations Economic Commission for Africa, Addis Ababa, Ethiopia
| | - Benjamin Djoudalbaye
- Health Diplomacy and Communication, Africa Centres for Disease Control, Addis Ababa, Ethiopia
| |
Collapse
|
17
|
Oliphant NP, Ray N, Curtis A, Musa E, Sesay M, Kandeh J, Kamara A, Hassen K, O'Connor S, Suehiro Y, Legesse H, Chimoun EFT, Jackson D, Doherty T. Optimising scale and deployment of community health workers in Sierra Leone: a geospatial analysis. BMJ Glob Health 2022; 7:bmjgh-2021-008141. [PMID: 35589152 PMCID: PMC9121426 DOI: 10.1136/bmjgh-2021-008141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 05/04/2022] [Indexed: 11/22/2022] Open
Abstract
Background Little is known about strategies for optimising the scale and deployment of community health workers (CHWs) to maximise geographic accessibility of primary healthcare services. Methods We used data from a national georeferenced census of CHWs and other spatial datasets in Sierra Leone to undertake a geospatial analysis exploring optimisation of the scale and deployment of CHWs, with the aim of informing implementation of current CHW policy and future plans of the Ministry of Health and Sanitation. Results The per cent of the population within 30 min walking to the nearest CHW with preservice training increased from 16.1% to 80.4% between 2000 and 2015. Contrary to current national policy, most of this increase occurred in areas within 3 km of a health facility where nearly two-thirds (64.5%) of CHWs were deployed. Ministry of Health and Sanitation-defined ‘easy-to-reach’ and ‘hard-to-reach’ areas, geographic areas that should be targeted for CHW deployment, were less well covered, with 19.2% and 34.6% of the population in 2015 beyond a 30 min walk to a CHW, respectively. Optimised CHW networks in these areas were more efficiently deployed than existing networks by 22.4%–71.9%, depending on targeting metric. Interpretations Our analysis supports the Ministry of Health and Sanitation plan to rightsize and retarget the CHW workforce. Other countries in sub-Saharan Africa interested in optimising the scale and deployment of their CHW workforce in the context of broader human resources for health and health sector planning may look to Sierra Leone as an exemplar model from which to learn.
Collapse
Affiliation(s)
- Nicholas Paul Oliphant
- University of the Western Cape, School of Public Health, Bellville, South Africa .,The Global Fund to Fight AIDS, Tuberculosis, and Malaria, Geneva, Switzerland
| | - Nicolas Ray
- Geohealth Group, University of Geneva, Institute of Global Health, Geneva, Switzerland.,University of Geneva, Institute of Environmental Sciences, Geneva, Switzerland
| | - Andrew Curtis
- Geohealth Group, University of Geneva, Institute of Global Health, Geneva, Switzerland.,University of Geneva, Institute of Environmental Sciences, Geneva, Switzerland
| | - Elizabeth Musa
- CHW Hub, Directorate of Primary Health Care, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Momodu Sesay
- Directorate of Primary Health Care, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Joseph Kandeh
- Directorate of Primary Health Care, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Anitta Kamara
- National Malaria Control Program, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Kebir Hassen
- UNICEF Sierra Leone, Freetown, Sierra Leone.,UNICEF Sudan, Khartoum, Sudan
| | | | | | | | | | - Debra Jackson
- University of the Western Cape, School of Public Health, Bellville, South Africa.,London School of Hygiene and Tropical Medicine, Centre for Maternal Adolescent Reproductive and Child Health, London, UK
| | - Tanya Doherty
- University of the Western Cape, School of Public Health, Bellville, South Africa.,Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa
| |
Collapse
|
18
|
Namdar P, Shafiekhani S, Teymori F, Abdollahzade S, Maleki A, Rafiei S. Predicting COVID-19 Cases Among Nurses Using Artificial Neural Network Approach. Comput Inform Nurs 2022; 40:341-349. [PMID: 35470304 PMCID: PMC9093222 DOI: 10.1097/cin.0000000000000907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We designed a forecasting model to determine which frontline health workers are most likely to be infected by COVID-19 among 220 nurses. We used multivariate regression analysis and different classification algorithms to assess the effect of several covariates, including exposure to COVID-19 patients, access to personal protective equipment, proper use of personal protective equipment, adherence to hand hygiene principles, stressfulness, and training on the risk of a nurse being infected. Access to personal protective equipment and training were associated with a 0.19- and 1.66-point lower score in being infected by COVID-19. Exposure to COVID-19 cases and being stressed of COVID-19 infection were associated with a 0.016- and 9.3-point higher probability of being infected by COVID-19. Furthermore, an artificial neural network with 75.8% (95% confidence interval, 72.1-78.9) validation accuracy and 76.6% (95% confidence interval, 73.1-78.6) overall accuracy could classify normal and infected nurses. The neural network can help managers and policymakers determine which frontline health workers are most likely to be infected by COVID-19.
Collapse
Affiliation(s)
- Peyman Namdar
- Author Affiliations: School of Medicine (Drs Namdar and Abdollahzade), Qazvin University of Medical Sciences (Ms Teymori); Department of Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences (Dr Shafiekhani); and Student Research Center, School of Public Health (Mrs Maleki), and Social Determinants of Health Research Center (Dr Rafiei), Qazvin University of Medical Sciences, Iran
| | - Sajad Shafiekhani
- Author Affiliations: School of Medicine (Drs Namdar and Abdollahzade), Qazvin University of Medical Sciences (Ms Teymori); Department of Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences (Dr Shafiekhani); and Student Research Center, School of Public Health (Mrs Maleki), and Social Determinants of Health Research Center (Dr Rafiei), Qazvin University of Medical Sciences, Iran
| | - Fatemeh Teymori
- Author Affiliations: School of Medicine (Drs Namdar and Abdollahzade), Qazvin University of Medical Sciences (Ms Teymori); Department of Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences (Dr Shafiekhani); and Student Research Center, School of Public Health (Mrs Maleki), and Social Determinants of Health Research Center (Dr Rafiei), Qazvin University of Medical Sciences, Iran
| | - Sina Abdollahzade
- Author Affiliations: School of Medicine (Drs Namdar and Abdollahzade), Qazvin University of Medical Sciences (Ms Teymori); Department of Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences (Dr Shafiekhani); and Student Research Center, School of Public Health (Mrs Maleki), and Social Determinants of Health Research Center (Dr Rafiei), Qazvin University of Medical Sciences, Iran
| | - Aisa Maleki
- Author Affiliations: School of Medicine (Drs Namdar and Abdollahzade), Qazvin University of Medical Sciences (Ms Teymori); Department of Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences (Dr Shafiekhani); and Student Research Center, School of Public Health (Mrs Maleki), and Social Determinants of Health Research Center (Dr Rafiei), Qazvin University of Medical Sciences, Iran
| | - Sima Rafiei
- Author Affiliations: School of Medicine (Drs Namdar and Abdollahzade), Qazvin University of Medical Sciences (Ms Teymori); Department of Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences (Dr Shafiekhani); and Student Research Center, School of Public Health (Mrs Maleki), and Social Determinants of Health Research Center (Dr Rafiei), Qazvin University of Medical Sciences, Iran
| |
Collapse
|
19
|
Kyabaggu R, Marshall D, Ebuwei P, Ikenyei U. Health Literacy, Equity, and Communication in the COVID-19 Era of Misinformation: Emergence of Health Information Professionals in Infodemic Management. JMIR INFODEMIOLOGY 2022; 2:e35014. [PMID: 35529308 PMCID: PMC9066383 DOI: 10.2196/35014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/22/2022] [Accepted: 04/04/2022] [Indexed: 12/16/2022]
Abstract
The health information management (HIM) field’s contribution to health care delivery is invaluable in a pandemic context where the need for accurate diagnoses will hasten responsive, evidence-based decision-making. The COVID-19 pandemic offers a unique opportunity to transform the practice of HIM and bring more awareness to the role that frontline workers play behind the scenes in safeguarding reliable, comprehensive, accurate, and timely health information. This transformation will support future research, utilization management, public health surveillance, and forecasting and enable key stakeholders to plan and ensure equitable health care resource allocation, especially for the most vulnerable populations. In this paper, we juxtapose critical health literacy, public policy, and HIM perspectives to understand the COVID-19 infodemic and new opportunities for HIM in infodemic management.
Collapse
Affiliation(s)
- Ramona Kyabaggu
- Johnson-Shoyama Graduate School of Public Policy University of Regina Regina, SK Canada
- Department of Health Information Sciences Faculty of Information and Media Studies Western University London, ON Canada
| | - Deneice Marshall
- Division of Health Sciences Barbados Community College Saint Michael Barbados
| | - Patience Ebuwei
- College of Health Professions, Health Information Management Coppin State University Baltimore, MD United States
| | - Uche Ikenyei
- Department of Health Information Sciences Faculty of Information and Media Studies Western University London, ON Canada
| |
Collapse
|
20
|
Ballard M, Johnson A, Mwanza I, Ngwira H, Schechter J, Odera M, Mbewe DN, Moenga R, Muyingo P, Jalloh R, Wabwire J, Gichaga A, Choudhury N, Maru D, Keronyai P, Westgate C, Sapkota S, Olsen HE, Muther K, Rapp S, Raghavan M, Lipman-White K, French M, Napier H, Nepomnyashchiy L. Community Health Workers in Pandemics: Evidence and Investment Implications. GLOBAL HEALTH, SCIENCE AND PRACTICE 2022; 10:e2100648. [PMID: 35487542 PMCID: PMC9053152 DOI: 10.9745/ghsp-d-21-00648] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 03/08/2022] [Indexed: 11/18/2022]
Abstract
Community health workers have long played a critical role in preventing, detecting, and responding to pandemics across the globe. To expand, improve, and institutionalize these services, changes in the approach to bi/multilateral aid and private philanthropic investments in low- and middle-income countries are required.
Collapse
Affiliation(s)
- Madeleine Ballard
- Community Health Impact Coalition, London, United Kingdom.
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | | | | | | | | | | | | | | | | | - Nandini Choudhury
- Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Duncan Maru
- Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | | | | | | | | | | | | | - Harriet Napier
- Clinton Health Access Initiative, Salt Lake City, UT, USA
| | | |
Collapse
|
21
|
Olateju Z, Olufunlayo T, MacArthur C, Leung C, Taylor B. Community health workers experiences and perceptions of working during the COVID-19 pandemic in Lagos, Nigeria-A qualitative study. PLoS One 2022; 17:e0265092. [PMID: 35259204 PMCID: PMC8903241 DOI: 10.1371/journal.pone.0265092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 02/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Community Health Workers are globally recognised as crucial members of healthcare systems in low and middle-income countries, but their role and experience during COVID-19 is not well-understood. This study aimed to explore factors that influence CHWs' ability and willingness to work in the COVID-19 pandemic in Lagos. DESIGN A generic qualitative study exploring Community Health Workers experiences and perceptions of working during the COVID-19 pandemic in Lagos, Nigeria. METHODS 15 semi-structured, in-depth, video interviews were conducted with Community Health Workers purposively sampled across seven of Lagos' Local Government Areas with the highest COVID-19 burden. Interviews explored Community Health Workers' attitudes towards COVID-19, its management, and their experiences working in Lagos. Data was analysed thematically using the framework method. RESULTS Three main themes were identified. 1. Influences on ability to undertake COVID-19 Role: Trust and COVID-19 knowledge were found to aid Community Health Workers in their work. However, challenges included exhaustion due to an increased workload, public misconceptions about COVID-19, stigmatisation of COVID-19 patients, delayed access to care and lack of transportation. 2. Influences on willingness to work in COVID-19 Role: Community Health Workers' perceptions of COVID-19, attitudes towards responsibility for COVID-19 risk at work, commitment and faith appeared to increase willingness to work. 3. Suggested Improvements: Financial incentives, provision of adequate personal protective equipment, transportation, and increasing staff numbers were seen as potential strategies to address many of the challenges faced. CONCLUSION Despite Community Health Workers being committed to their role, they have faced many challenges during the COVID-19 pandemic in Nigeria. Changes to their working environment may make their role during disease outbreaks more fulfilling and sustainable. International input is required to enhance Nigeria's policies and infrastructure to better support Community Health Workers during both current and future outbreaks.
Collapse
Affiliation(s)
- Zahra Olateju
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, England, United Kingdom
| | - Tolulope Olufunlayo
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Yaba, Lagos State, Nigeria
| | - Christine MacArthur
- Department of Maternal Health, Institute of Applied Health Research, University of Birmingham, Birmingham, England, United Kingdom
| | - Charlotte Leung
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, England, United Kingdom
| | - Beck Taylor
- Department of Public Health, Institute of Applied Health Research, University of Birmingham, Birmingham, England, United Kingdom
| |
Collapse
|
22
|
Understanding Trustful Relationships between Community Health Workers and Vulnerable Citizens during the COVID-19 Pandemic: A Realist Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052496. [PMID: 35270193 PMCID: PMC8909775 DOI: 10.3390/ijerph19052496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/11/2022] [Accepted: 02/17/2022] [Indexed: 02/05/2023]
Abstract
(1) Background: Community health workers (CHWs) are an essential public health workforce defined by their trustful relationships with vulnerable citizens. However, how trustful relationships are built remains unclear. This study aimed to understand how and under which circumstances CHWs are likely to build trust with their vulnerable clients during the COVID-19 pandemic. (2) Methods: We developed a program theory using a realist research design. Data were collected through focus groups and in-depth interviews with CHWs and their clients. Using a grounded theory approach, we aimed to unravel mechanisms and contextual factors that determine the trust in a CHW program offering psychosocial support to vulnerable citizens during the COVID-19 pandemic. (3) Results: The trustful relationship between CHWs and their clients is rooted in three mental models: recognition, equality, and reciprocity. Five contextual factors (adopting a client-centered attitude, coordination, temporariness, and link with primary care practice (PCP)) enable the program mechanisms to work. (4) Conclusions: CHWs are a crucial public health outreach strategy for PCP and complement and enhance trust-building by primary care professionals. In the process of building trustful relationships between CHWs and clients, different mechanisms and contextual factors play a role in the trustful relationship between primary care professionals and patients. Future research should assess whether these findings also apply to a non-covid context, to the involvement of CHWs in other facets of primary healthcare (e.g., prevention campaigns, etc.), and to a low- and middle-income country (LMIC) setting. Furthermore, implementation research should elaborate on the integration of CHWs in PCP to support CHWs in developing the mental models leading to build trust with vulnerable citizens and to establish the required conditions.
Collapse
|
23
|
Perveen S, Lassi ZS, Mahmood MA, Perry HB, Laurence C. Application of primary healthcare principles in national community health worker programmes in low-income and middle-income countries: a scoping review. BMJ Open 2022; 12:e051940. [PMID: 35110314 PMCID: PMC8811559 DOI: 10.1136/bmjopen-2021-051940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To identify which primary healthcare (PHC) principles are reflected in the implementation of national community health worker (CHW) programmes and how they may contribute to the outcomes of these programmes in the context of low-income and middle-income countries (LMICs). DESIGN Scoping review. DATA SOURCES A systematic search was conducted through PubMed, CINAHL, EMBASE and Scopus databases. ELIGIBILITY CRITERIA The review considered published primary studies on national programmes, projects or initiatives using the services of CHWs in LMICs focused on maternal and child health. We included only English language studies. Excluded were programmes operated by non-government organisations, study protocols, reviews, commentaries, opinion papers, editorials and conference proceedings. DATA EXTRACTION AND SYNTHESIS We reviewed the application of four PHC principles (universal health coverage, community participation, intersectoral coordination and appropriateness) in the CHW programme's objectives, implementation and stated outcomes. Data extraction was undertaken systematically in an excel spreadsheet while the findings were synthesised in a narrative manner. The quality appraisal of the selected studies was not performed in this scoping review. RESULTS From 1280 papers published between 1983 and 2019, 26 met the inclusion criteria. These 26 papers included 14 CHW programmes from 13 LMICs. Universal health coverage and community participation were the two commonly reported PHC principles, while intersectoral coordination was generally missing. Similarly, the cultural acceptability aspect of the principle of appropriateness was present in all programmes as these programmes select CHWs from within the communities. Other aspects, particularly effectiveness, were not evident. CONCLUSION The implementation of PHC principles across national CHW programmes in LMICs is patchy. For comprehensiveness and improved health outcomes, programmes need to incorporate all attributes of PHC principles. Future research may focus on how to incorporate more attributes of PHC principles while implementing national CHW programmes in LMICs. Better documentation and publications of CHW programme implementation are also needed.
Collapse
Affiliation(s)
- Shagufta Perveen
- School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Zohra S Lassi
- Robinson Research Institute, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Mohammad Afzal Mahmood
- School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Henry B Perry
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Caroline Laurence
- School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
24
|
Méllo LMBDDE, Santos RCD, Albuquerque PCD. Agentes Comunitárias de Saúde na pandemia de Covid-19: scoping review. SAÚDE EM DEBATE 2022. [DOI: 10.1590/0103-11042022e125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Este artigo teve por objetivo sistematizar e analisar a literatura que aborda o trabalho das Agentes Comunitárias de Saúde (ACS) no enfrentamento da pandemia de Covid-19. Trata-se de uma revisão de escopo, realizada na Embase, Lilacs, SciELO, Medline e Cochrane Library. Envolve publicações no período de janeiro a dezembro de 2020, tendo os estudos selecionados sido submetidos à análise, considerando as seguintes categorias: práticas, formação, condições de trabalho e legitimidade. Foram incluídos 29 estudos na revisão cujo cenário de atuação das ACS foram países da África, América do Sul, América do Norte, Ásia e Europa. Os resultados revelaram enfoques diversificados de práticas nos países estudados que envolvem ações de cuidado, vigilância, comunicação e educação em saúde, práticas administrativas, articulação intersetorial e mobilização social. A formação recebida parece não corresponder ao rol de práticas e impacto esperado do trabalho das ACS. As condições de trabalho continuam precarizadas com alguns incentivos extras sendo ofertados em diferentes cenários. O reconhecimento e a legitimidade perante as autoridades sanitárias revelam a disputa em torno do próprio rumo dos modelos de atenção à saúde e abrangência dos sistemas de proteção social nos diversos países.
Collapse
|
25
|
Méllo LMBDDE, Santos RCD, Albuquerque PCD. Community Health Workers in the Covid-19 pandemic: scoping review. SAÚDE EM DEBATE 2022. [DOI: 10.1590/0103-11042022e125i] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT This paper aimed to systematize and analyze the literature that addresses the role of Community Health Workers (CHWs) in addressing the Covid-19 pandemic. This scoping review was conducted in the Embase, Lilacs, SciELO, Medline, and Cochrane Virtual Libraries databases. It includes publications from January to December 2020, and the selected studies were submitted to analysis, considering the following categories: practices, training, working conditions, and legitimacy. Twenty-nine studies were included in the review whose CHW performance backdrops were African, South American, North American, Asian, and European countries. The results revealed diversified approaches to practice in the countries studied that involve care, surveillance, health communication, education, administrative, intersectoral articula- tion, and social mobilization actions. The training received does not seem to correspond to the list of practices and expected impact of the CHWs. Working conditions remain substandard, with some extra incentives offered in different backdrops. The recognition and legitimacy before the health authorities reveal the dispute over the direction of health care models and the scope of social protection systems in different countries.
Collapse
|
26
|
Garcini LM, Rosenfeld J, Kneese G, Bondurant RG, Kanzler KE. Dealing with distress from the COVID-19 pandemic: Mental health stressors and coping strategies in vulnerable latinx communities. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:284-294. [PMID: 33894080 PMCID: PMC8251305 DOI: 10.1111/hsc.13402] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/25/2021] [Accepted: 03/26/2021] [Indexed: 05/30/2023]
Abstract
Distress secondary to the COVID-19 pandemic has been substantial, especially in vulnerable Latinx communities who are carrying an undue share of the pandemic-related social, health and economic burden in the United States. In collaboration with 43 community health workers (CHWs) and Promotor/as serving the needs of underserved Latinx communities in South Texas and guided by principles of community-based participatory research (CBPR), the purpose of this study was to identify relevant mental health stressors and related consequences, and to identify strategies for coping with distress among underserved Latinx communities during the COVID-19 pandemic. Data were collected on July 2020 using mixed methods to obtain more in-depth information. Surveys were administered, and three focus groups were conducted. Quantitative data were analysed using descriptive statistics, whereas qualitative data were analysed systematically by starting with a priori questions and themes followed by data categorisation, reduction, display and conclusion drawing. Results showed six themes related to mental health stressors including economics (e.g., job insecurity), immigration (e.g., undocumented status), misinformation, family stress (e.g., changes in family dynamics and the home environment), health (e.g., limited healthcare access) and social isolation. Coping skills of the community were categorised into four themes with multiple codes including behavioural strategies (e.g., identifying reliable information), cognitive strategies (e.g., collectivistic thinking), social support and spirituality. Findings indicate that underserved Latinx communities are dealing with substantial distress and mental health concerns secondary to the COVID-19 pandemic; yet these are resilient communities. Implications of these findings can inform development of resources, interventions, best practices and training avenues to address the mental health needs of underserved Latinx communities, while considering relevant cultural and contextual factors that may influence their effectiveness.
Collapse
Affiliation(s)
- Luz M. Garcini
- Center for Research to Advance Community Health (ReACH)University of Texas Health Science Center at San AntonioSan AntonioTXUSA
- Department of MedicineJoe R. and Teresa Lozano Long School of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
- Department of Psychiatry and Behavioral SciencesJoe R. and Teresa Lozano Long School of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
| | - Jason Rosenfeld
- Department of MedicineJoe R. and Teresa Lozano Long School of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
- Joe R. and Teresa Lozano Long School of MedicineCenter for Medical Humanities and EthicsUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
| | - Garrett Kneese
- Department of MedicineJoe R. and Teresa Lozano Long School of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
| | - Ruth G. Bondurant
- Department of MedicineJoe R. and Teresa Lozano Long School of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
| | - Kathryn E. Kanzler
- Center for Research to Advance Community Health (ReACH)University of Texas Health Science Center at San AntonioSan AntonioTXUSA
- Department of Psychiatry and Behavioral SciencesJoe R. and Teresa Lozano Long School of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
- Department of Family and Community MedicineJoe R. and Teresa Lozano Long School of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
| |
Collapse
|
27
|
Oliphant NP, Sy Z, Koné B, Berthé M, Beebe M, Samake M, Diabaté M, Tounkara S, Diarra B, Diarra AB, Diawara CH, Yakimova T, Florisse S, Jackson D, Ray N, Doherty T. Improving the efficiency of scale-up and deployment of community health workers in Mali: A geospatial analysis. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000626. [PMID: 36962591 PMCID: PMC10021816 DOI: 10.1371/journal.pgph.0000626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/04/2022] [Indexed: 11/06/2022]
Abstract
Optimising the scale and deployment of community health workers (CHWs) is important for maximizing geographical accessibility of integrated primary health care (PHC) services. Yet little is known about approaches for doing so. We used geospatial analysis to model optimised scale-up and deployment of CHWs in Mali, to inform strategic and operational planning by the Ministry of Health and Social Development. Accessibility catchments were modelled based on travel time, accounting for barriers to movement. We compared geographic coverage of the estimated population, under-five deaths, and plasmodium falciparum (Pf) malaria cases across different hypothetical optimised CHW networks and identified surpluses and deficits of CHWs compared to the existing CHW network. A network of 15 843 CHW, if optimally deployed, would ensure that 77.3% of the population beyond 5 km of the CSCom (community health centre) and CSRef (referral health facility) network would be within a 30-minute walk of a CHW. The same network would cover an estimated 59.5% of U5 deaths and 58.5% of Pf malaria cases. As an intermediary step, an optimised network of 4 500 CHW, primarily filling deficits of CHW in the regions of Kayes, Koulikoro, Sikasso, and Ségou would ensure geographic coverage for 31.3% of the estimated population. There were no important differences in geographic coverage percentage when prioritizing CHW scale-up and deployment based on the estimated population, U5 deaths, or Pf malaria cases. Our geospatial analysis provides useful information to policymakers and planners in Mali for optimising the scale-up and deployment of CHW and, in turn, for maximizing the value-for-money of resources of investment in CHWs in the context of the country's health sector reform. Countries with similar interests in optimising the scale and deployment of their CHW workforce may look to Mali as an exemplar model from which to learn.
Collapse
Affiliation(s)
- Nicholas P Oliphant
- University of the Western Cape, School of Public Health, Bellville, Republic of South Africa
- The Global Fund to Fight AIDS, Tuberculosis, and Malaria, Geneva, Switzerland
| | - Zeynabou Sy
- Faculty of Medicine, GeoHealth group, Institute of Global Health, University of Geneva, Geneva, Switzerland
- Institute for Environmental Sciences, University of Geneva, Geneva, Switzerland
| | - Brehima Koné
- Ministère de la Santé et du Développement Social du Mali, Direction Générale de la Santé et de l'Hygiène Publique, Bamako, Mali
| | - Mohamed Berthé
- Ministère de la Santé et du Développement Social du Mali, L'Unité de Mise en Œuvre de Renforcement du Système de Santé, Bamako, Mali
| | - Madeleine Beebe
- Ministère de la Santé et du Développement Social du Mali, L'Unité de Mise en Œuvre de Renforcement du Système de Santé, Bamako, Mali
| | - Moussa Samake
- Ministère de la Santé et du Développement Social du Mali, Cellule de Planification et de Statistique Secteur Santé, Développment Social et Promotion de la Famille, Bamako, Mali
| | - Mamoutou Diabaté
- Ministère de la Santé et du Développement Social du Mali, Direction National de la Santé, Bamako, Mali
| | - Salimata Tounkara
- Ministère de la Santé et du Développement Social du Mali, Direction Générale de la Santé et de l'Hygiène Publique, Bamako, Mali
| | - Borodjan Diarra
- Ministère de la Santé et du Développement Social du Mali, Direction Générale de la Santé et de l'Hygiène Publique, Bamako, Mali
| | - Amadou B Diarra
- Ministère de la Santé et du Développement Social du Mali, L'Unité de Mise en Œuvre de Renforcement du Système de Santé, Bamako, Mali
- MUSO, Bamako, Mali
| | - Cheickna H Diawara
- Ministère de la Santé et du Développement Social du Mali, L'Unité de Mise en Œuvre de Renforcement du Système de Santé, Bamako, Mali
- MUSO, Bamako, Mali
| | - Tsvetana Yakimova
- The Global Fund to Fight AIDS, Tuberculosis, and Malaria, Geneva, Switzerland
| | - Sonia Florisse
- The Global Fund to Fight AIDS, Tuberculosis, and Malaria, Geneva, Switzerland
| | - Debra Jackson
- University of the Western Cape, School of Public Health, Bellville, Republic of South Africa
- London School of Hygiene and Tropical Medicine (LSHTM), Centre for Maternal Adolescent Reproductive and Child Health (MARCH), London, United Kingdom
| | - Nicolas Ray
- Faculty of Medicine, GeoHealth group, Institute of Global Health, University of Geneva, Geneva, Switzerland
- Institute for Environmental Sciences, University of Geneva, Geneva, Switzerland
| | - Tanya Doherty
- University of the Western Cape, School of Public Health, Bellville, Republic of South Africa
- South African Medical Research Council, Health Systems Research Unit, Tygerberg, Republic of South Africa
| |
Collapse
|
28
|
Yayehrad AT, Siraj EA, Yimenu DK, Ambaye AS, Derseh MT, Tamene AA, Yayeh TG. Multidisciplinary Effort and Integrative Preparedness: A Lesson for the Foreseen Multivariate COVID-19 Pandemic Flare-Up. J Multidiscip Healthc 2021; 14:2905-2921. [PMID: 34703243 PMCID: PMC8524181 DOI: 10.2147/jmdh.s332049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022] Open
Abstract
It has been a year and a half since the world suffered the horrific COVID-19 pandemic which has still continued becoming a prominent headache for the whole world. Recently, we are facing the second and third wave of multivariate outbreaks with great intensity of transmission which renders huge disaster. Presently, new strains of the virus are emerging that are predicted to be resistant for the current vaccines and other management approaches. It needs collaborative and coordinated role at professional, facility, regional, and global levels to ameliorate the pandemic by monitoring the existing and emerging variants. This review addressed the multidisciplinary roles in patient screening and detection, emergency management, moderate and critical care, vaccination, complication prevention, comorbidity management, psychological therapy, and digital health care. The inevitable roles of academicians, researchers, private health sectors, policy makers, regulatory bodies, and partners are also discussed.
Collapse
Affiliation(s)
- Ashagrachew Tewabe Yayehrad
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ebrahim Abdela Siraj
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Dawit Kumilachew Yimenu
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abyou Seyfu Ambaye
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Manaye Tamrie Derseh
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Andargachew Almaw Tamene
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | |
Collapse
|
29
|
Birhanu A, Balis B, Assebe Yadeta T, Bayu M. Personal protective equipment utilization practice and psychological preparedness of health care workers against COVID-19 pandemic in Eastern Ethiopia. SAGE Open Med 2021; 9:20503121211051925. [PMID: 34659769 PMCID: PMC8511914 DOI: 10.1177/20503121211051925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/21/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Effective implementation of prevention and control actions by health professionals is substantial to contain the deadly COVID-19 pandemic. Thus, this study aimed to assess health care worker's practice of using personal protective equipment and psychological preparedness against the COVID-19 pandemic in Eastern Ethiopia. METHODS A facility-based cross-sectional study design was used. The health care workers (HCW) who were working in the selected health facilities were randomly selected. Variables that had p-value of < 0.15 were transformed to multivariable logistic regression model. Finally, the significance level was declared at the p-value < 0.05 with a 95% confidence interval (CI). RESULTS A total of 418 HCWs were randomly selected and included in this study. The study participants mean age was 27.96 years with a ±5.6SD. HCWs who were male (adjusted odds ratio(AOR) = 2.21, 95% CI: 1.29-3.79), regularly using sanitizer, accessing COVID-19 management guideline (AOR = 2.83, 95% CI: 1.46-5.47), trained on COVID-19 prevention methods (AOR = 2.6, 95% CI: 1.4-4.7), hopeless of eventually getting COVID-19 at workplace (AOR = 1.9, 95% CI: 1.13-3.28), and feeling unsafe at work when using standard precautions (AOR = 0.46, 95% CI: 0.27-0.79) were associated with good PPE using compared to their counterparts. Moreover, nursing/midwifery professionals practiced good personal protective equipment compared to physicians (AOR = 3.7, 95% CI: 1.8-7.7). CONCLUSION The study demonstrated that being a male, being a nurse/midwifery, regularly sanitizing hands/medical equipment, having COVID-19 management guidelines, trained on COVID-19, and feeling of eventually getting COVID-19 at workplace had a positive association with PPE utilization. Besides, the study revealed that not feeling safe at work when using standard precautions was negatively associated with PPE utilization of HCWs. Therefore, the prevention priorities should be given to frontline HCWs by providing all possible support and strictly implementing the prevention and control guidelines of COVID-19 to prevent the health system from collapse.
Collapse
Affiliation(s)
- Abdi Birhanu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bikila Balis
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Miesso Bayu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| |
Collapse
|
30
|
Moir S, Yamauchi J, Hartz C, Kuhaulua R, Kelen M, Allison A, Kishaba G, Vocalan C. The Critical Role Hawai'i's Community Health Workers Are Playing in COVID-19 Response Efforts. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2021; 80:46-49. [PMID: 34704068 PMCID: PMC8538113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Community health workers play an instrumental role in the health care system and are critical partners in pandemic response. In Hawai'i, community health workers are working to reduce the burden of chronic disease among Pacific Islander, Filipino, and Native Hawaiian populations in partnership with government agencies and health care organizations. This commentary reviews the role community health workers in Hawai'i are playing in assisting with the COVID-19 response. Utilizing their skills and the community's trust, they are optimally positioned to reach marginalized and vulnerable populations hit hardest by COVID-19; community health workers educate, screen, and provide social service referrals to community members.
Collapse
Affiliation(s)
| | | | - Claudia Hartz
- West Hawai‘i Community Health Center, Kailua-Kona, HI
| | | | | | | | | | | |
Collapse
|
31
|
Siya A, Mafigiri R, Migisha R, Kading RC. Uganda Mountain Community Health System-Perspectives and Capacities towards Emerging Infectious Disease Surveillance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8562. [PMID: 34444315 PMCID: PMC8394296 DOI: 10.3390/ijerph18168562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/05/2021] [Accepted: 08/11/2021] [Indexed: 11/22/2022]
Abstract
In mountain communities like Sebei, Uganda, which are highly vulnerable to emerging and re-emerging infectious diseases, community-based surveillance plays an important role in the monitoring of public health hazards. In this survey, we explored capacities of village health teams (VHTs) in Sebei communities of Mount Elgon in undertaking surveillance tasks for emerging and re-emerging infectious diseases in the context of a changing climate. We used participatory epidemiology techniques to elucidate VHTs' perceptions on climate change and public health and assessed their capacities to conduct surveillance for emerging and re-emerging infectious diseases. Overall, VHTs perceived climate change to be occurring with wider impacts on public health. However, they had inadequate capacities in collecting surveillance data. The VHTs lacked transport to navigate through their communities and had insufficient capacities in using mobile phones for sending alerts. They did not engage in reporting other hazards related to the environment, wildlife, and domestic livestock that would accelerate infectious disease outbreaks. Records were not maintained for disease surveillance activities and the abilities of VHTs to analyze data were also limited. However, VHTs had access to platforms that could enable them to disseminate public health information. The VHTs thus need to be retooled to conduct their work effectively and efficiently through equipping them with adequate logistics and knowledge on collecting, storing, analyzing, and relaying data, which will improve infectious disease response and mitigation efforts.
Collapse
Affiliation(s)
- Aggrey Siya
- Department of Environmental Management, Makerere University, Kampala P.O. Box 7062, Uganda
- EcoHealth180, Kween District, Kapchorwa P.O. Box 250, Uganda
| | - Richardson Mafigiri
- Global Health Department, Infectious Diseases Institute, Makerere University, Kampala P.O. Box 22418, Uganda;
| | - Richard Migisha
- Department of Physiology, Mbarara University of Science and Technology, Mbarara P.O. Box 1410, Uganda;
| | - Rebekah C. Kading
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO 80523, USA;
| |
Collapse
|
32
|
A review and agenda for integrated disease models including social and behavioural factors. Nat Hum Behav 2021; 5:834-846. [PMID: 34183799 DOI: 10.1038/s41562-021-01136-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 05/14/2021] [Indexed: 02/05/2023]
Abstract
Social and behavioural factors are critical to the emergence, spread and containment of human disease, and are key determinants of the course, duration and outcomes of disease outbreaks. Recent epidemics of Ebola in West Africa and coronavirus disease 2019 (COVID-19) globally have reinforced the importance of developing infectious disease models that better integrate social and behavioural dynamics and theories. Meanwhile, the growth in capacity, coordination and prioritization of social science research and of risk communication and community engagement (RCCE) practice within the current pandemic response provides an opportunity for collaboration among epidemiological modellers, social scientists and RCCE practitioners towards a mutually beneficial research and practice agenda. Here, we provide a review of the current modelling methodologies and describe the challenges and opportunities for integrating them with social science research and RCCE practice. Finally, we set out an agenda for advancing transdisciplinary collaboration for integrated disease modelling and for more robust policy and practice for reducing disease transmission.
Collapse
|
33
|
Byrd-Williams C, Ewing M, Rosenthal EL, St. John JA, Menking P, Redondo F, Sieswerda S. Training Needs of Community Health Workers Facing the COVID-19 Pandemic in Texas: A Cross-Sectional Study. Front Public Health 2021; 9:689946. [PMID: 34195172 PMCID: PMC8236534 DOI: 10.3389/fpubh.2021.689946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/14/2021] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic has required the professional healthcare workforce not only to adjust methods of delivering care safely but also act as a trusted sources of information during a time of uncertainty and rapid research and discovery. The Community Health Worker COVID-19 Impact Survey is a cross-sectional study developed to better understand the impact of COVID-19 on this sector of the healthcare workforce, including training needs of those working through the pandemic. The survey was distributed in Texas, New Mexico, and Arizona. This study focuses on Texas, and the data presented (n = 693) is a sub-set of qualitative data from the larger survey. Results of the content analysis described in this paper are intended to inform current COVID-19-related CHW training curriculum, in addition to future infectious disease prevention and preparedness response trainings.
Collapse
Affiliation(s)
- Courtney Byrd-Williams
- Health Promotion and Behavioral Sciences, Michael & Susan Dell Center for Healthy Living at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX, United States
| | - Mollie Ewing
- Michael & Susan Dell Center for Healthy Living at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX, United States
| | - E. Lee Rosenthal
- Department of Medical Education, Paul L. Foster School of Medicine, Texas Tech University Health Science Center, El Paso, TX, United States
| | - Julie Ann St. John
- Julia Jones Matthews Department of Public Health, Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Abilene, TX, United States
| | - Paige Menking
- University of New Mexico School of Medicine, Albuquerque, NM, United States
| | | | - Stephanie Sieswerda
- Michael & Susan Dell Center for Healthy Living at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX, United States
| |
Collapse
|
34
|
Vanden Bossche D, Lagaert S, Willems S, Decat P. Community Health Workers as a Strategy to Tackle Psychosocial Suffering Due to Physical Distancing: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063097. [PMID: 33802870 PMCID: PMC8002631 DOI: 10.3390/ijerph18063097] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/05/2021] [Accepted: 03/16/2021] [Indexed: 11/29/2022]
Abstract
Background: During the COVID-19 pandemic, many primary care professionals were overburdened and experienced difficulties reaching vulnerable patients and meeting the increased need for psychosocial support. This randomized controlled trial (RCT) tested whether a primary healthcare (PHC) based community health worker (CHW) intervention could tackle psychosocial suffering due to physical distancing measures in patients with limited social networks. Methods: CHWs provided 8 weeks of tailored psychosocial support to the intervention group. Control group patients received ‘care as usual’. The impact on feelings of emotional support, social isolation, social participation, anxiety and fear of COVID-19 were measured longitudinally using a face-to-face survey to determine their mean change from baseline. Self-rated change in psychosocial health at 8 weeks was determined. Results: We failed to find a significant effect of the intervention on the prespecified psychosocial health measures. However, the intervention did lead to significant improvement in self-rated change in psychosocial health. Conclusions: This study confirms partially the existing evidence on the effectiveness of CHW interventions as a strategy to address mental health in PHC in a COVID context. Further research is needed to elaborate the implementation of CHWs in PHC to reach vulnerable populations during and after health crises.
Collapse
|
35
|
Gichaga A, Masis L, Chandra A, Palazuelos D, Wakaba N. Mind the Global Community Health Funding Gap. GLOBAL HEALTH: SCIENCE AND PRACTICE 2021; 9:S9-S17. [PMID: 33727316 PMCID: PMC7971370 DOI: 10.9745/ghsp-d-20-00517] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 01/26/2021] [Indexed: 12/02/2022]
Abstract
Community health workers play a critical role in providing both essential health services and pandemic response. Community health demonstrates a strong return on investment, but funding for this sector is limited and fragmented. Understanding the underlying costs of a community health system is crucial for both planning and policy; the data demonstrate a strong investment case.
Collapse
Affiliation(s)
| | | | | | - Dan Palazuelos
- Financing Alliance for Health.,Harvard Medical School, Boston, MA, USA.,Partners In Health, Boston, MA, USA
| | | |
Collapse
|
36
|
Rahman R, Ross A, Pinto R. The critical importance of community health workers as first responders to COVID-19 in USA. Health Promot Int 2021; 36:1498-1507. [PMID: 33569593 PMCID: PMC7928891 DOI: 10.1093/heapro/daab008] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
COVID-19 has served to exacerbate existing health disparities and inequities, most—if not all—of which can be traced to the social determinants of health (SDOH) that affect specific populations and communities. Essential to health and health systems long before, community health workers are experts in addressing SDOH in community-based settings; however, they have yet to be mobilized as part of the COVID-19 response both in the US and internationally. We use data from our mixed-methods study with supervisors (n=6), Executive Directors (EDs) (n=7), and CHWs (n=90) to describe the critical role that CHWs can play to assist in response to COVID-19 using New York State's (NYS) as a case example. Building on these findings, we raise specific CHW workforce issues and propose recommendations for how to mobilize this workforce in national pandemic response efforts.
Collapse
Affiliation(s)
- Rahbel Rahman
- Graduate School of Social Service, Fordham University, New York, NY 10023, USA
| | - Abigail Ross
- Graduate School of Social Service, Fordham University, New York, NY 10023, USA
| | - Rogério Pinto
- University of Michigan School of Social Work, Ann Arbor, Michigan 48109, USA
| |
Collapse
|
37
|
Kanzler KE, Kilpela LS, Pugh J, Garcini LM, Gaspard CS, Aikens J, Reynero E, Tsevat J, Lopez ES, Johnson-Esparza Y, Ramirez AG, Finley EP. Methodology for task-shifting evidence-based psychological treatments to non-licenced/lay health workers: protocol for a systematic review. BMJ Open 2021; 11:e044012. [PMID: 33526503 PMCID: PMC7852942 DOI: 10.1136/bmjopen-2020-044012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION 'Task-shifting' or 'task-sharing' is an effective strategy for delivering behavioural healthcare in lower resource communities. However, little is known regarding the actual steps (methods) in carrying out a task-shifting project. This paper presents a protocol for a systematic review that will identify steps in adapting an evidence-based psychological treatment for delivery by lay/non-licenced personnel. METHODS AND ANALYSIS A systematic review of peer-reviewed, published studies involving a non-licenced, non-specialist (eg, community health worker, promotor/a, peer and lay person) delivering an evidence-based psychological treatment for adults will be conducted. Study design of selected articles must include a statistical comparison (eg, randomised controlled trials, quasiexperimental trials, pre-post designs and pragmatic trials). Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Databases including PubMed, the Cochrane Library, Cochrane Central Register of Controlled Trials, SCOPUS, Cumulative Index to Nursing and Allied Health Literature, APA PsycInfo and Google Scholar will be searched from 2000 to 2020. Risk of bias will be assessed using the Cochrane Collaboration's Risk of Bias (RoB 2) tool, and publication bias will be evaluated with the Cochrane GRADE approach. A narrative synthesis will be conducted for all included studies, and a summary table following Proctor's framework for operationalising implementation strategies will be included. This protocol was developed following the 2015 guidelines of Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. ETHICS AND DISSEMINATION This review will analyse data from published studies only; thus, it will not require institutional board review. Findings will be presented at conferences, to the broader community via the Community Health Worker Translational Advisory Board and social media, and the final systematic review will be published in a peer-reviewed journal.
Collapse
Affiliation(s)
- Kathryn E Kanzler
- Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
- Department of Psychiatry & Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
- Department of Family & Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Lisa Smith Kilpela
- Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
- Department of Psychiatry & Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
- Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Jaqueline Pugh
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Luz M Garcini
- Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Christine S Gaspard
- Briscoe Library, Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - James Aikens
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Erick Reynero
- Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Joel Tsevat
- Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
- Departments of Population Health and Internal Medicine, Dell Medical School, University of Texas, Austin, Texas, USA
| | - Eliot Santana Lopez
- Department of Psychiatry & Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
- Department of Family & Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Yajaira Johnson-Esparza
- Department of Family & Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Amelie G Ramirez
- Department of Population Health Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Erin P Finley
- Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
- Department of Psychiatry & Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
- Center for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| |
Collapse
|
38
|
Kaseje N, Kaseje D, Oruenjo K, Milambo J, Kaseje M. Engaging community health workers, technology, and youth in the COVID-19 response with concurrent critical care capacity building: A protocol for an integrated community and health system intervention to reduce mortality related to COVID-19 infection in Western Kenya. Wellcome Open Res 2021. [DOI: 10.12688/wellcomeopenres.16493.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Globally, the number of COVID-19 infections is approaching 63 million; more than 1 million individuals have lost their lives. In Kenya, the number of infections has surpassed 80,000 and 1469 people have lost their lives. In Kenya, the community health strategy has been used to deliver essential health services since 2007. Furthermore, the population in Kenya is young (the median age is 21 years old) and Kenya is recognized as a technology hub in the East African region. Community-based health care, youth, and technology, are assets within the Kenyan context that can be leveraged to respond to the COVID-19 pandemic with concurrent strengthening of the critical care capacity at the health system level. This is a quasi-experimental study with quantitative and qualitative methods of data collection to complete a baseline assessment of community health unit and health facility service readiness in the study site of Siaya County in western Kenya. Following the baseline assessment, service ready community health units and health facilities with oxygen capacity will form intervention groups. At the community level, the intervention will consist of training youth, community health assistants and community health workers in screening, case detection, prevention, management and referral of COVID-19 cases with maintenance of essential health services. The community intervention will be enhanced by youth and use of digital tools. At the health facility level, the intervention will consist of training health care workers in basic critical care and caring for severe COVID-19 patients with maintenance of essential health services. The primary outcome measure will be mortality related to COVID-19 infection both at community and health facility levels. This study would be the first study to evaluate the effectiveness of an integrated approach in preparing for and implementing a robust pandemic response. Registration: ClinicalTrials.gov ID NCT04501458; registered on 6 August 2020.
Collapse
|
39
|
Yasobant S, Bruchhausen W, Saxena D, Memon FZ, Falkenberg T. Who could be One Health Activist at the community level?: A case for India. HUMAN RESOURCES FOR HEALTH 2021; 19:13. [PMID: 33482845 PMCID: PMC7821660 DOI: 10.1186/s12960-021-00558-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 01/11/2021] [Indexed: 05/24/2023]
Abstract
BACKGROUND Community health workers (CHWs) are the mainstay of the public health system, serving for decades in low-resource countries. Their multi-dimensional work in various health care services, including the prevention of communicable diseases and health promotion of non-communicable diseases, makes CHWs, the frontline workers in their respective communities in India. As India is heading towards the development of One Health (OH), this study attempted to provide an insight into potential OH activists (OHA) at the community level. Thus, this case study in one of India's western cities, Ahmedabad, targeted identifying OHA by exploring the feasibility and the motivation of CHWs in a local setting. METHODS This case study explores two major CHWs, i.e., female (Accredited Social Health Activists/ASHA) health workers (FHWs) and male (multipurpose) health workers (MHWs), on their experience and motivation for becoming an OHA. The data were collected between September 2018 and August 2019 through a mixed design, i.e., quantitative data (cross-sectional structured questionnaire) followed by qualitative data (focus group discussion with a semi-structured interview guide). RESULTS The motivation of the CHWs for liaisoning as OHA was found to be low; however, the FHWs have a higher mean motivation score [40 (36-43)] as compared to MHWs [37 (35-40)] out of a maximum score of 92. Although most CHWs have received zoonoses training or contributed to zoonoses prevention campaigns, their awareness level was found to be different among male and female health workers. Comparing the female and male health workers to act as OHA, higher motivational score, multidisciplinary collaborative work experience, and way for incentive generation documented among the female health workers. CONCLUSION ASHAs were willing to accept the additional new liaison role of OHAs if measures like financial incentives and improved recognition are provided. Although this study documented various systemic factors at the individual, community, and health system level, which might, directly and indirectly, impact the acceptance level to act as OHA, they need to be accounted for in the policy regime.
Collapse
Affiliation(s)
- Sandul Yasobant
- Center for Development Research (ZEF), University of Bonn, Genscherallee 3, 53113, Bonn, Germany.
- Global Health, Institute for Hygiene and Public Health (IHPH), University Hospital Bonn, 53127, Bonn, Germany.
| | - Walter Bruchhausen
- Center for Development Research (ZEF), University of Bonn, Genscherallee 3, 53113, Bonn, Germany
- Global Health, Institute for Hygiene and Public Health (IHPH), University Hospital Bonn, 53127, Bonn, Germany
| | - Deepak Saxena
- Indian Institute of Public Health Gandhinagar (IIPHG), Gandhinagar, 382042, India
- Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (DMIMS), Wardha, 442004, India
| | - Farjana Zakir Memon
- Indian Institute of Public Health Gandhinagar (IIPHG), Gandhinagar, 382042, India
| | - Timo Falkenberg
- Center for Development Research (ZEF), University of Bonn, Genscherallee 3, 53113, Bonn, Germany
- GeoHealth Centre, Institute for Hygiene and Public Health (IHPH), University Hospital Bonn, 53127, Bonn, Germany
| |
Collapse
|
40
|
Shammi M, Bodrud-Doza M, Islam ARMT, Rahman MM. Strategic assessment of COVID-19 pandemic in Bangladesh: comparative lockdown scenario analysis, public perception, and management for sustainability. ENVIRONMENT, DEVELOPMENT AND SUSTAINABILITY 2021; 23:6148-6191. [PMID: 32837281 PMCID: PMC7368637 DOI: 10.1007/s10668-020-00867-y] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/07/2020] [Indexed: 05/20/2023]
Abstract
ABSTRACT Community transmission of COVID-19 is happening in Bangladesh-the country which did not have a noteworthy health policy and legislative structures to combat a pandemic like COVID-19. Early strategic planning and groundwork for evolving and established challenges are crucial to assemble resources and react in an appropriate timely manner. This article, therefore, focuses on the public perception of comparative lockdown scenario analysis and how they may affect the sustainable development goals (SDGs) and the strategic management regime of COVID-19 pandemic in Bangladesh socio-economically as well as the implications of the withdrawal of partial lockdown plan. Scenario-based public perceptions were collected via a purposive sampling survey method through a questionnaire. Datasets were analysed through a set of statistical techniques including classical test theory, principal component analysis, hierarchical cluster analysis, Pearson's correlation matrix and linear regression analysis. There were good associations among the lockdown scenarios and response strategies to be formulated. Scenario 1 describes how the death and infection rate will increase if the Bangladesh Government withdraws the existing partial lockdown. Scenario 2 outlines that limited people's movement will enable low-level community transmission of COVID-19 with the infection and death rate will increase slowly (r = 0.540, p < 0.01). Moreover, there will be less supply of necessities of daily use with a price hike (r = 0.680, p < 0.01). In scenario 3, full lockdown will reduce community transmission and death from COVID-19 (r = 0.545, p < 0.01). However, along with the other problems gender discrimination and gender-based violence will increase rapidly (r = 0.661, p < 0.01). Due to full lockdown, the formal and informal business, economy, and education sector will be hampered severely (R = 0.695). Subsequently, there was a strong association between the loss of livelihood and the unemployment rate which will increase due to business shutdown (p < 0.01). This will lead to the severe sufferings of poor and vulnerable communities in both urban and rural areas (p < 0.01). All these will further aggravate the humanitarian needs of the most vulnerable groups in the country in the coming months to be followed which will undoubtedly affect the Bangladesh targets to achieve the SDGs of 2030 and other development plans that need to be adjusted. From our analysis, it was apparent that maintaining partial lockdown with business and economic activities with social distancing and public health guidelines is the best strategy to maintain. However, as the government withdrew the partial lockdown, inclusive and transparent risk communication towards the public should be followed. Recovery and strengthening of the health sector, economy, industry, agriculture, and food security should be focused on under the "new normal standard of life" following health guidelines and social distancing. Proper response plans and strategic management are necessary for the sustainability of the nation.
Collapse
Affiliation(s)
- Mashura Shammi
- Department of Environmental Sciences, Jahangirnagar University, Dhaka, 1342 Bangladesh
| | | | | | - Md. Mostafizur Rahman
- Department of Environmental Sciences, Jahangirnagar University, Dhaka, 1342 Bangladesh
| |
Collapse
|
41
|
Tse DMS, Li Z, Lu Y, Li Y, Liu Y, Wong WCW. Fighting against COVID-19: preparedness and implications on clinical practice in primary care in Shenzhen, China. BMC FAMILY PRACTICE 2020; 21:271. [PMID: 33339508 PMCID: PMC7747774 DOI: 10.1186/s12875-020-01343-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 12/01/2020] [Indexed: 11/26/2022]
Abstract
Background The new coronavirus pneumonia (NCP) caused by COVID-19 has affected more than 46 million people worldwide. In China, primary care has played a vital role during the COVID-19 outbreak, and it is important to examine the challenges faced by general practitioners (GPs). This study investigated the roles, preparedness and training needs of GPs in China in managing the NCP outbreak. Based on the outcomes of the study, we hope to take lessons and identify how GPs could be supported in delivering their gatekeeping roles and clinical duties in times of infectious disease outbreak. Methods An online survey on the official website of Shenzhen Continuing Education Center. It included questions on GPs’ demographics, their awareness of COVID-19 and their preparedness in managing suspected cases of NCP, as well as referrals and their training needs. Conditional multi-variate logistic models were used to investigate the relationships between GPs’ preparedness, situational confidence and anxiety. Results GPs’ clinical practice was significantly affected. GPs endeavoured to answer a flood of COVID-19-related enquiries, while undertaking community preventive tasks. In addition to in-person consultations, GP promoted COVID-19 awareness and education through telephone consultations, physical posters and social media. Overall GPs in Shenzhen felt well supported with adequate Personal Protective Equipment (PPE) and resources from secondary care services. Higher levels of self-perceived preparedness (OR = 2.19; 95%CI, 1.04–4.61), lower level of anxiety (OR = 0.56; 95%CI, 0.29–1.09) and fewer perceived family worries (OR = 0.37; 95%CI, 0.12–1.12) were associated with better confidence in coping at work. Conclusions Training and supporting GPs while reducing their (and their families’) anxiety increase their confidence in delivering the important roles of gatekeeping in face of major disease outbreaks.
Collapse
Affiliation(s)
- Desiree Man-Sik Tse
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong
| | - Zhuo Li
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, 1 Haiyuan 1st Rd, Futian District, Shenzhen, 518009, Guangdong Province, China
| | - Ye Lu
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, 1 Haiyuan 1st Rd, Futian District, Shenzhen, 518009, Guangdong Province, China
| | - Yang Li
- Shenzhen Health Capacity Building and Continuing Education Center, National Health Commission, 21 Tian Bei Yi, LuLuohu Qu, Shenzhen Shi, 518041, Guangdong Sheng, China
| | - Ying Liu
- Shenzhen Health Capacity Building and Continuing Education Center, National Health Commission, 21 Tian Bei Yi, LuLuohu Qu, Shenzhen Shi, 518041, Guangdong Sheng, China
| | - William Chi Wai Wong
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong. .,Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, 1 Haiyuan 1st Rd, Futian District, Shenzhen, 518009, Guangdong Province, China.
| |
Collapse
|
42
|
Al-Ashwal FY, Kubas M, Zawiah M, Bitar AN, Mukred Saeed R, Sulaiman SAS, Khan AH, Ghadzi SMS. Healthcare workers' knowledge, preparedness, counselling practices, and perceived barriers to confront COVID-19: A cross-sectional study from a war-torn country, Yemen. PLoS One 2020; 15:e0243962. [PMID: 33306750 PMCID: PMC7732096 DOI: 10.1371/journal.pone.0243962] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 12/02/2020] [Indexed: 12/23/2022] Open
Abstract
Background The coronavirus disease of 2019 (COVID-19) represents a difficult challenge and could have devastating consequences for the healthcare system and healthcare workers in war-torn countries with poor healthcare facilities such as Yemen. Our study aimed to evaluate the knowledge, preparedness, counselling practices of healthcare workers regarding COVID-19, and the perceived barriers to adequately prevent and control COVID-19 in Yemen. Methods Healthcare workers (HCWs) from major healthcare facilities participated in this cross-sectional study. A self-administered questionnaire comprising of five main domains (demographics, knowledge, self-preparedness, counselling practice, perceived barriers) was distributed among HCWs after obtaining informed consent. A convenient sampling technique was used. Descriptive and inferential analyses were applied using SPSS software. Results A total of 1000 participants were initially targeted to participate in the study with 514 (51.4%) responding, of which 55.3% were female. Physicians and nurses constituted the largest proportion of participants, with 39.5% and 33.3%, respectively. The median scores for knowledge, self-preparedness, and counselling practice were 8 (out of 9), 9 (out of 15), and 25 (out of 30), respectively. The physician group showed a statistically significant association with better knowledge compared to the nurse group only, P<0.001. Males had higher preparedness scores than females, p<0.001. Also, the intensive care unit (ICU) and emergency departments presented a statistically significant difference by which the participants from these departments were more prepared compared to the others (e.g. outpatients, paediatrics and surgery) with P < 0.0001. The lack of awareness among the general population about COVID-19 preventive measures was perceived as the most common barrier for the adequate prevention and control of COVID-19 in Yemen (89.1%). Conclusion The major highlight of this study is that HCWs have, overall, good knowledge, suboptimal preparedness, and adequate counselling practices prior to the outbreak of COVID-19 in Yemen, despite the high number of perceived barriers. However, urgent action and interventions are needed to improve the preparedness of HCWs to manage COVID-19. The perceived barriers also need to be fully addressed by the local healthcare authorities and international organisations working in Yemen for adequate prevention and control measures to be in place in managing COVID-19.
Collapse
Affiliation(s)
- Fahmi Y. Al-Ashwal
- Clinical Pharmacy Department, University of Science and Technology Hospital (USTH), Sana'a, Yemen
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Mohammed Kubas
- Clinical Pharmacy Department, University of Science and Technology Hospital (USTH), Sana'a, Yemen
- Pharmacy Practice Department, Kulliyyah of Pharmacy, International Islamic University Malaysia (IIUM), Kuantan, Pahang, Malaysia
| | - Mohammed Zawiah
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- Department of Pharmacy Practice, College of Clinical Pharmacy, University of Al Hodeida, Al Hodeida, Yemen
- * E-mail:
| | - Ahmad Naoras Bitar
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Ramzi Mukred Saeed
- Department of Clinical Pharmacy and Pharmacy Practice, University of Science and Technology (UST), Sana'a, Yemen
- Department of Pharmaceutical sciences, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Syed Azhar Syed Sulaiman
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia
| | - Amer Hayat Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | | |
Collapse
|
43
|
Sindato C, Mboera LEG, Beda E, Mwabukusi M, Karimuribo ED. Community Health Workers and Disease Surveillance in Tanzania: Promoting the Use of Mobile Technologies in Detecting and Reporting Health Events. Health Secur 2020; 19:116-129. [PMID: 33217238 DOI: 10.1089/hs.2019.0096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This cross-sectional study was conducted in the Kilosa, Morogoro Urban, Ngorongoro, and Ulanga districts of Tanzania to investigate the practices of community health workers (CHWs) related to disease surveillance functions and to establish their needs and technology capacities. We also established the strength of mobile phone networks and internet connections in the study areas to inform the feasibility of using mobile-based applications in community-based disease surveillance. A total of 135 CHWs from 85 villages participated in the study. Health events captured at the community level were entirely paper-based. CHWs submitted reports to higher-level health authorities mainly on foot (100%), but they also used public transport (65%) and telephone calls (56%). The median number of days between the onset of a suspected disease outbreak at the community level and reporting to a primary healthcare facility was 10 days (interquartile range [IQR] 2-30). The median number of days between submitting a report and receiving a response was 7 days (IQR 2-30). Of the 53 CHWs who reported the most recent health events to a higher-level health authority, 39 (74%) never received feedback. All 85 villages had a reliable mobile phone network and 74 (87%) had a mobile phone internet connection that was strong enough to support data transmission using digital technology. Almost all (n = 132, 98%) of the CHWs owned mobile phones. The practices related to detection and reporting of health events could be improved to enhance early warning disease surveillance. Reliable mobile networks and internet connections and the ownership of mobile phones among CHWs in the study areas present opportunities to strengthen community event-based surveillance using mobile-based solutions.
Collapse
Affiliation(s)
- Calvin Sindato
- Calvin Sindato, PhD, is a Principal Research Scientist, National Institute for Medical Research, Tabora, Tanzania. At the time this work was conducted, he was a Postdoctoral Research Associate and One Health Epidemiologist with the SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania. Leonard E. G. Mboera, PhD, is Leader, Emerging and Vector-Borne Diseases Community of Practice; Eric Beda, MSc, is Regional ICT Specialist; and Mpoki Mwabukusi is an ICT Specialist/Computer System Analyst; all with SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania. Esron D. Karimuribo, PhD, is a One Health Epidemiologist, Professor, and Director of the Directorate of Postgraduate Studies, Research, Technology Transfer and Consultancy, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Leonard E G Mboera
- Calvin Sindato, PhD, is a Principal Research Scientist, National Institute for Medical Research, Tabora, Tanzania. At the time this work was conducted, he was a Postdoctoral Research Associate and One Health Epidemiologist with the SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania. Leonard E. G. Mboera, PhD, is Leader, Emerging and Vector-Borne Diseases Community of Practice; Eric Beda, MSc, is Regional ICT Specialist; and Mpoki Mwabukusi is an ICT Specialist/Computer System Analyst; all with SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania. Esron D. Karimuribo, PhD, is a One Health Epidemiologist, Professor, and Director of the Directorate of Postgraduate Studies, Research, Technology Transfer and Consultancy, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Eric Beda
- Calvin Sindato, PhD, is a Principal Research Scientist, National Institute for Medical Research, Tabora, Tanzania. At the time this work was conducted, he was a Postdoctoral Research Associate and One Health Epidemiologist with the SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania. Leonard E. G. Mboera, PhD, is Leader, Emerging and Vector-Borne Diseases Community of Practice; Eric Beda, MSc, is Regional ICT Specialist; and Mpoki Mwabukusi is an ICT Specialist/Computer System Analyst; all with SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania. Esron D. Karimuribo, PhD, is a One Health Epidemiologist, Professor, and Director of the Directorate of Postgraduate Studies, Research, Technology Transfer and Consultancy, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Mpoki Mwabukusi
- Calvin Sindato, PhD, is a Principal Research Scientist, National Institute for Medical Research, Tabora, Tanzania. At the time this work was conducted, he was a Postdoctoral Research Associate and One Health Epidemiologist with the SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania. Leonard E. G. Mboera, PhD, is Leader, Emerging and Vector-Borne Diseases Community of Practice; Eric Beda, MSc, is Regional ICT Specialist; and Mpoki Mwabukusi is an ICT Specialist/Computer System Analyst; all with SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania. Esron D. Karimuribo, PhD, is a One Health Epidemiologist, Professor, and Director of the Directorate of Postgraduate Studies, Research, Technology Transfer and Consultancy, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Esron D Karimuribo
- Calvin Sindato, PhD, is a Principal Research Scientist, National Institute for Medical Research, Tabora, Tanzania. At the time this work was conducted, he was a Postdoctoral Research Associate and One Health Epidemiologist with the SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania. Leonard E. G. Mboera, PhD, is Leader, Emerging and Vector-Borne Diseases Community of Practice; Eric Beda, MSc, is Regional ICT Specialist; and Mpoki Mwabukusi is an ICT Specialist/Computer System Analyst; all with SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania. Esron D. Karimuribo, PhD, is a One Health Epidemiologist, Professor, and Director of the Directorate of Postgraduate Studies, Research, Technology Transfer and Consultancy, Sokoine University of Agriculture, Morogoro, Tanzania
| |
Collapse
|
44
|
Ajuebor O, Boniol M, McIsaac M, Onyedike C, Akl EA. Increasing access to health workers in rural and remote areas: what do stakeholders' value and find feasible and acceptable? HUMAN RESOURCES FOR HEALTH 2020; 18:77. [PMID: 33066792 PMCID: PMC7565226 DOI: 10.1186/s12960-020-00519-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/02/2020] [Indexed: 05/30/2023]
Abstract
BACKGROUND The primary aim of this study is to assess stakeholders' views of the acceptability and feasibility of policy options and outcome indicators presented in the 2010 World Health Organization (WHO) global policy recommendations on increasing access to health workers in remote and rural areas through improved retention. METHODS A survey on the acceptability, feasibility of recruitment and retention policy options, and the importance of their outcome indicators was developed. It followed a cross-sectional approach targeting health workers in rural and remote settings as well as policy- and decision-makers involved in the development of recruitment and retention policies for such areas. Respondents were asked their perception of the importance of the policy outcomes of interest, as well as the acceptability and feasibility of the 2010 WHO guidelines' policy options using a 9-point Likert scale. RESULTS In total, 336 participants completed the survey. Almost a third worked in government; most participants worked in community settings and were involved in the administration and management of rural health workers. Almost all 19 outcomes of interests assessed were valued as important or critical. For the 16 guideline policy options, most were perceived to be "definitely acceptable" and "definitely feasible", although the policy options were generally considered to be more acceptable than feasible. CONCLUSION The findings of this study provide insight into the revision and update of the 2010 WHO guideline on increasing access to health workers in remote and rural areas. Stakeholders' views of the acceptability, feasibility of policy options and the importance of outcomes of interest are important for the development of relevant and effective policies to improve access to health workers in rural and remote areas.
Collapse
Affiliation(s)
- Onyema Ajuebor
- Health Workforce Department, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland.
| | - Mathieu Boniol
- Health Workforce Department, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland
| | - Michelle McIsaac
- Health Workforce Department, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland
| | - Chukwuemeka Onyedike
- Health Workforce Department, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland
| | - Elie A Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| |
Collapse
|
45
|
Abstract
PURPOSE OF REVIEW The purpose of this review is to describe the role, responsibilities, hiring, training, and retention of community health workers (CHWs) on clinical care teams in the United States. RECENT FINDINGS CHWs are unique members of clinical care teams because of their ability to foster a deep trust and understanding with patients by sharing similar life experiences, participating in home visits, and providing constant support and advocacy. By partnering with CHWs, other clinical care members also gain a better understanding of their patients allowing them to deliver more culturally competent, patient/family-centered care. CHWs when incorporated into interdisciplinary teams have shown to lower healthcare costs, reduce hospital stays and admissions, and improve health outcomes and quality of life for children and families. However, the lack of standardization among CHW programs makes it difficult to quantify the overall effect and impact of integrating CHWs into clinical care teams. SUMMARY CHWs are able to improve health outcomes and address social determinants of health when properly integrated into clinical care teams. However, without adequate support, integration, funding, and training, CHWs are not able to reach their full potential. The standardization of CHWs' responsibilities and training, like other clinical care team members, is lacking within the United States, making it a challenge to evaluate programs and maintain sustainable funding for these vital members of the clinical care team.
Collapse
|
46
|
Mayfield-Johnson S, Smith DO, Crosby SA, Haywood CG, Castillo J, Bryant-Williams D, Jay K, Seguinot M, Smith T, Moore N, Wennerstrom A. Insights on COVID-19 From Community Health Worker State Leaders. J Ambul Care Manage 2020; 43:268-277. [PMID: 32858726 PMCID: PMC7461725 DOI: 10.1097/jac.0000000000000351] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Community health workers (CHWs) leverage their trusting relationships with underresourced populations to promote health equity and social justice in their communities. Little is known about CHWs roles in addressing COVID-19 or how the pandemic may have affected CHWs' ability to interact with and support communities experiencing disparities. A focus group with CHW leaders from 7 states revealed 8 major themes: CHW identity, CHW resiliency, self-care, unintended positives outcomes of COVID-19, technology, resources, stressors, and consequences of COVID-19. Understanding the pandemic's impact on CHWs has implications for workforce development, training, and health policies.
Collapse
Affiliation(s)
- Susan Mayfield-Johnson
- Associate Professor, School of Health Professions, The University of Southern Mississippi, Hattiesburg, MS
| | - Denise O. Smith
- Executive Director, National Association of Community Health Workers (NACHW), Boston, MA
| | - Sara A. Crosby
- Graduate Student, Department of Public Health, The University of Southern Mississippi, Hattiesburg, MS
| | | | - Joelisa Castillo
- Strategy Coordinator, Milwaukee Coalition for Children’s Mental Health, Milwaukee, WI
| | | | - Kim Jay
- Senior CHW Consultant & Trainer, Sinai Urban Health Institute, Chicago, IL
| | | | - Treva Smith
- Prenatal Care Coordinator, KC Care Health Center, Kansas City, MO
| | - Nicole Moore
- Hui Mālama Ola Nā ʻŌiwi Native Hawaiian Health Care Center, Hilo, HI
| | - Ashley Wennerstrom
- Associate Professor, Behavioral and Community Health Sciences, Center for Healthcare Value and Equity, LSU Health Sciences Center- New Orleans, New Orleans, LA
| |
Collapse
|
47
|
Nepomnyashchiy L, Dahn B, Saykpah R, Raghavan M. COVID-19: Africa needs unprecedented attention to strengthen community health systems. Lancet 2020; 396:150-152. [PMID: 32682465 PMCID: PMC7365630 DOI: 10.1016/s0140-6736(20)31532-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/18/2020] [Accepted: 06/22/2020] [Indexed: 01/08/2023]
|
48
|
Bhaumik S, Moola S, Tyagi J, Nambiar D, Kakoti M. Community health workers for pandemic response: a rapid evidence synthesis. BMJ Glob Health 2020; 5:bmjgh-2020-002769. [PMID: 32522738 PMCID: PMC7292038 DOI: 10.1136/bmjgh-2020-002769] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 12/16/2022] Open
Abstract
Introduction Coronavirus disease (COVID-19), affects 213 countries or territories globally. We received a request from National Health Systems Resource Centre, a public agency in India, to conduct rapid evidence synthesis (RES) on community health workers (CHWs) for COVID-19 prevention and control in 3 days. Methods We searched PubMed, websites of ministries (n=3), public agencies (n=6), multilateral institutions (n=3), COVID-19 resource aggregators (n=5) and preprints (n=1) (without language restrictions) for articles on CHWs in pandemics. Two reviewers screened the records independently with a third reviewer resolving disagreements. One reviewer extracted data with another reviewer cross-checking it. A framework on CHW performance in primary healthcare not specific to pandemic was used to guide data extraction and narrative analysis. Results We retrieved 211 records and finally included 36 articles. Most of the evidence was from low-and middle-income countries with well-established CHW programmes. Evidence from CHW programmes initiated during pandemics and for CHW involvement in pandemic response in high-income countries was scant. CHW roles and tasks change substantially during pandemics. Clear guidance, training for changed roles and definition of what constitutes essential activities (ie, those that must to be sustained) is required. Most common additional activities during pandemics were community awareness, engagement and sensitisation (including for countering stigma) and contact tracing. CHWs were reported to be involved in all aspects of contact tracing - this was reported to affect routine service delivery. CHWs have often been stigmatised or been socially ostracised during pandemics. Providing PPE, housing allowance, equal training opportunities, transportation allowance, improving salaries (paid on time and for a broad range of services) and awards in high-profile public events contributed to better recruitment and retention. We also created inventories of resources with guiding notes on guidelines for health workers (n=24), self-isolation in the community (n=10) and information, education and counselling materials on COVID-19 (n=16). Conclusions CHWs play a critical role in pandemics. It is important to ensure role clarity, training, supportive supervision, as well as their work satisfaction, health and well-being. More implementation research on CHWs in pandemics is required.
Collapse
Affiliation(s)
- Soumyadeep Bhaumik
- The George Institute for Global Health, Vishakhapatnam, India .,The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Sandeep Moola
- The George Institute for Global Health, Vishakhapatnam, India
| | - Jyoti Tyagi
- The George Institute for Global Health, Vishakhapatnam, India
| | - Devaki Nambiar
- The George Institute for Global Health, Vishakhapatnam, India.,The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Misimi Kakoti
- The George Institute for Global Health, Vishakhapatnam, India
| |
Collapse
|
49
|
Awoonor-Williams JK, Phillips JF, Kachur SP, Jackson EF, Moresky RT, Chirawurah D. Response to “How prepared is Africa to face COVID-19?” by Wadoum and Clarke. Pan Afr Med J 2020; 35:59. [PMID: 33623584 PMCID: PMC7875759 DOI: 10.11604/pamj.supp.2020.35.2.23829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 05/29/2020] [Indexed: 11/11/2022] Open
Abstract
A recent commentary published in this journal correctly notes the important challenges that must be addressed to mitigate the effects of the COVID-19 pandemic in Africa. While we agree with the basic assumptions and arguments of their essay, we argue that common social institutional norms in most rural settings could be marshalled for organizing preventive measures.
Collapse
|
50
|
Ballard M, Bancroft E, Nesbit J, Johnson A, Holeman I, Foth J, Rogers D, Yang J, Nardella J, Olsen H, Raghavan M, Panjabi R, Alban R, Malaba S, Christiansen M, Rapp S, Schechter J, Aylward P, Rogers A, Sebisaho J, Ako C, Choudhury N, Westgate C, Mbeya J, Schwarz R, Bonds MH, Adamjee R, Bishop J, Yembrick A, Flood D, McLaughlin M, Palazuelos D. Prioritising the role of community health workers in the COVID-19 response. BMJ Glob Health 2020; 5:e002550. [PMID: 32503889 PMCID: PMC7298684 DOI: 10.1136/bmjgh-2020-002550] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 11/03/2022] Open
Abstract
COVID-19 disproportionately affects the poor and vulnerable. Community health workers are poised to play a pivotal role in fighting the pandemic, especially in countries with less resilient health systems. Drawing from practitioner expertise across four WHO regions, this article outlines the targeted actions needed at different stages of the pandemic to achieve the following goals: (1) PROTECT healthcare workers, (2) INTERRUPT the virus, (3) MAINTAIN existing healthcare services while surging their capacity, and (4) SHIELD the most vulnerable from socioeconomic shocks. While decisive action must be taken now to blunt the impact of the pandemic in countries likely to be hit the hardest, many of the investments in the supply chain, compensation, dedicated supervision, continuous training and performance management necessary for rapid community response in a pandemic are the same as those required to achieve universal healthcare and prevent the next epidemic.
Collapse
Affiliation(s)
- Madeleine Ballard
- Community Health Impact Coalition, New York, New York, USA
- Department of Health System Design and Global Health, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | | | - Josh Nesbit
- Medic Mobile, San Francisco, California, USA
| | - Ari Johnson
- Muso, Bamako, Mali
- Global Health Sciences, University of California San Francisco, San Francisco, California, USA
| | - Isaac Holeman
- Medic Mobile, San Francisco, California, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | | | | | | | | | - Helen Olsen
- Medic Mobile, San Francisco, California, USA
| | | | - Raj Panjabi
- Last Mile Health, Monrovia, Liberia
- Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | | | | | | | | | | | | | - Nandini Choudhury
- Department of Health System Design and Global Health, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- POSSIBLE, New York, New York, USA
| | - Carey Westgate
- Community Health Impact Coalition, New York, New York, USA
| | | | - Ryan Schwarz
- Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- POSSIBLE, New York, New York, USA
| | - Matthew H Bonds
- Harvard Medical School Department of Global Health and Social Medicine, Blavatnik Institute, Boston, Massachusetts, USA
- PIVOT, Ranomafana, Madagascar
| | | | | | | | - David Flood
- Wuqu' Kawoq, Santiago Sacatepéquez, Sacatepéquez, Guatemala
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Daniel Palazuelos
- Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Partners In Health, Boston, Massachusetts, USA
| |
Collapse
|