Attitude Of Health Workers Research Articles

Awareness and attitudes of nurses of the Clinical center of the University of Sarajevo (ccus) towards the organization of palliative care

Introduction: The health system is one of the most complex systems in any country. According to the definition of the World Health Organization, the health caresystem includes health infrastructure that provides a spectrum of programs and services and provides health care to individuals, families and the community. A basichuman right is the right to health care, which includes health activities such as preventive, curative and palliative treatment. The organization of palliative medicineis necessary at all levels of health care.Aims: Situational analysis of the organization of palliative care in the Clinical Center of the University of Sarajevo. Examining the knowledge and approach of healthcareworkers in the process of providing palliative care at the Clinical Center of the University of Sarajevo. To examine the attitude of healthcare workers towards theAwareness and attitudes of nurses of the Clinical center of the University ofSarajevo (ccus) towards the organization of palliative care way palliative care is organized in the Clinical Center of the University of Sarajevo.Material and methods: 141 subjects employed at the Clinical Center of the University of Sarajevo (CCUS) participated in the research. The research is descriptiveand analytical. The results are presented in tables and graphs, chi-square and Fisher’s exact test were used for testing the significance of differences.Results: It was found that there are different knowledge, attitudes and approaches of the respondents regarding the way palliative care is organized, the provision ofservices and treatment in the hospital. The majority of respondents (64%) believe that palliative care should be organized in institutions for palliative care that meetthe conditions of the prescribed standards and criteria for palliative care.Conclusion: Significant differences were found in the knowledge, practice and attitudes of health workers about palliative care.

Exploring the Factors Influencing Home Delivery: A Cross Sectional Study among Rural Residents in Tamale Metropolis

Introduction: Maternal and child mortality continues as a disturbing public health problem facing Ghana and other low and middle-income countries. As such there are advocacy for skilled birth delivery. Despite the advocacy, in most rural communities, unskilled delivery still persists. It is against this background that this study aims to explore the factors influencing home delivery among women in rural areas of Tamale Metropolis.
 Methods: The study employed the descriptive cross-sectional design with the mixed method approach. The study recruited 200 women within reproductive age of 18-49 who had delivered at least once in the selected rural communities in the Tamale Metropolis. Questionnaire and interview guide were used to collect data for this study. The data was analyzed using SPSS version 26 and manual thematic content analysis for quantitative and qualitative data respectively.
 Results: The prevalence of home delivery was reported as (36.5%) among the respondents. More than quarter (35.5%) of the respondents rate their satisfaction of home delivery as good whereas more than half of the respondents rated TBAs’ attitude as good. Three (3) qualitative respondents indicated that most women chose to deliver at home in neglect of hospital because of better satisfaction gained from delivering at home. The qualitative data showed that the factors identified to influence home delivery were as followed: negative attitude of health workers, lack of trust in health workers competence, unnecessary expenses from hospitals, distance, and poor quality of services. Nearly 90.0% of the respondents were enrolled on the NHIS with a proof of active NHIS card. Majority of the respondents were aware of the free maternal health services and all respondents agreed that they had a CHPs compound in their communities, however, only 36.5% responded in the affirmative that these CHPs compound are resourced adequately.
 Conclusion: The study showed a substantive percentage of the respondents to be practicing home delivery with the support of unskilled birth attendants. Poor attitudes from health workers, better previous experience in delivering at home, unreliable means of transport to the hospital and additional informal delivery expenses were some of the factors found to be significant determinants of home delivery. It is recommended for the government and other stakeholders to provide rural ambulance services to aid in the transport of pregnant women in labor to the nearest health facility.

Are there differences in perceptions, preferences and attitudes towards disclosure of genetic testing for Stroke? A qualitative study among stroke-free SIREN-SIBS genomics study participants

ObjectiveThis study explored perceptions, preferences and attitudes towards disclosure of genetic testing results for stroke among stroke-free controls (and their family members) in the SIREN-SIBS Genomics Study, healthcare providers and policymakers. Materials and MethodsWe conducted a qualitative thematic analysis of key informant interviews with 61 participants recruited from community advisory boards (30) and health care providers (31) across seven sites in Nigeria and Ghana. ResultsMajor findings illustrate differences in the knowledge of genetic testing with superior knowledge among health care professionals. Relatives and religious leaders were opined as the best to receive the disclosure as they would be able to break the news to the patient in a culturally sensitive manner to reduce the likely resultant emotional outburst. Poor level of awareness of national guidelines for disclosing genetic results exist. Key facilitating factors for disclosure are education, enabling environment, involvement of religious and community leaders, campaigns, and possible treatment options. Disclosure inhibitors include inadequate information, fear of marital break-up or family displacement, fear of stigmatization, fear of isolation, religious beliefs, health worker attitude, and lack of preparedness to accept results. ConclusionsThese necessitate culturally sensitive interventions for continuing education, increased awareness and sustained engagement to equip all stakeholders in genetic testing disclosure process.

HUBUNGAN ANTARA PENGETAHUAN DAN SIKAP TENAGA KESEHATAN TERHADAP PENGELOLAAN LIMBAH MEDIS DI PUSKESMAS SELAYO, SUMATERA BARAT

In this day and age that waste is a problem serious enough, so many efforts to reduce poverty by means of reducing, recycling and destroy it. The producing a great variety of waste in the form of of liquids, solid and gas. Is not a good medical management waste could cause problem with health care and the environment. The purpose of this study was to determine the relationship of knowledgeand attitudes of health workers with medical waste management at community health centerSelayo. The research is of research the quantitative cross sectional. The population in this research is all health workers of community health center Selayo totaled 60 people. The sample technique used is the total sampling. The sample in this research is all health workers medical waste of 60 people.The analysis used in this research use software IBM SPSS Statistics Version 26. The result showed a value of knowledge of health workers (X1) -value =0,000 < significance (Y)= 0,05 which means there is a relationship between knowledge of health workers with medical waste management at community health center Selayo an d a value of attitudes of health workers (X2) -value =0,003 <significance (Y)= 0,05 which means there is a relationship between attitude of health workers with medical waste management at community health center Selayo. A value of ( X1) and value (X2) value=0,000< significance (Y)=0,05 which means there is a relationship between knowledge and attitudes of health workers with medical waste management at community health center Selayo.The existence of a relationship between knowledge and attitudes of health workers with medical waste management, then to expect every health workershould have a good knowledge of and attitudes towards the medical waste management in community health center so that actions taken in the handle and manage medical waste can be run correctly

SOCIO-ECONOMIC IMPACT OF THE DEMAND FOR HERBAL MEDICINES IN SOUTH-WESTERN REGION OF NIGERIA

This study examined the socio economic impact of the demand for herbal medicines in SouthWestern region of Nigeria. Three states were randomly selected out of the six states in the SouthWest, Nigeria. These are Ekiti, Ondo, and Osun states. Two local governments were randomly selected from each state and three communities selected from each of the local governments. Convenience sampling method was used to arrive at our sample size of 1,224 with 204 respondents randomly selected from each local government area (LGA). Data gathered were analyzed using descriptive statistics while bivariate and multivariate logistic regressions were carried out to establish the relationship between the semi-structured questionnaires with E-views 12 package. Key findings revealed that 815 respondents representing 74% agreed that doctors’ industrial action was one of the reasons for the demand for herbal medicine. The adjusted odd ratio (AOR) of 1.51* (8.25-11.43) at 95% confidence intervals from the logit regression revealed that doctors’ strike has a significant effect on demand for herbal medicine. The impact of cost on demand for herbal medicine was affirmed by 693 respondents and was statistically significant with AOR 2.38* (1.02- 5.59). Effectiveness/potency of herbal medicines was alluded to by 71% of the respondents having AOR 2.22*(6.07-9.72). It was also evidenced in the study that poverty is a determinant of demand for herbal medicine as only 28% of respondents whose income are above N50,000 demands herbal medicines and 63% of respondents affirmed that they could not afford the cost of orthodox healthcare with AOR 2.38* (1.02-5.59). Availability of herbal medicine has effect on increasing demand for it as 64% of the respondents confirmed availability and accessibility of it having AOR 1.00* (2.22-2.91). The study concluded that Socio-economic factors such as doctors’ strike actions, low education, low income, distance to health facilities and the attitude of health workers contribute to high demand for Herbal Medicine in the South-West States of Nigeria.

Factors Influencing Uptake of Prostate Cancer Screening among Men Aged 40 Years and Above in Kazo Town Council, Kazo District, Uganda: A Cross-Sectional Study.

Prostate cancer accounts for 20.3% of all cancers in men in sub-Saharan Africa. Early screening among at-risk groups is challenging in Uganda, with limited data on prostate cancer screening uptake in most districts, including newly established ones. The purpose of this study was to determine factors influencing the uptake of prostate cancer screening among men aged ≥ 40 in Kazo Town Council, Kazo District, a newly created district. We used a descriptive cross-sectional study design that employed both quantitative and qualitative data collection methods. Participants were recruited through simple random sampling between November 2020 and January 2021. Structured questionnaires were used for quantitative data (n = 300). Statistical analyses to determine associations were carried out using inferential and chi-square tests followed by logistic regression. In-depth interviews were conducted with 10 key informants and analyzed thematically to explore a range of perceptions related to prostate cancer screening. Only 10 (3.33%; 95% CI: 0.018-0.60) respondents had ever screened for prostate cancer. Lack of privacy (p < 0.033), access to prostate cancer information (p < 0.014), and distance to health facilities (p < 0.001) were significantly associated with the uptake of prostate cancer screening. Marital status (OR = 7.93; 95% CI: 1.85-33.99; p = 0.005), positive health worker attitudes (OR = 0.002; 95% CI: 0.000-0.023, p < 0.001), and perceived affordability (OR = 0.001; 95% CI: 0.000-0.011, p < 0.001) were independently associated with uptake of prostate cancer screening. Key barriers included lack of information, access to screening centres, and fear of screening. The level of uptake of prostate cancer screening was considerably low among men aged 40 and above in the Kazo District. Targeted community interventions to improve access to prostate cancer information, screening, sensitization, and addressing perceived and actual barriers are needed in newly created districts to bolster the uptake of prostate cancer screening. This has implications for prioritizing research evaluating district resource allocation to support optimized and integrated evidence-based service delivery in primary healthcare centres, especially for specialized services in newly created districts.

The Determinants of Places of Delivery by Women in the Savelugu/Nanton Municipality, Ghana

Despite improvement in health care services in Ghana, many women still choose to deliver at home. This practice has serious implications for maternal and child health. The phenomenon is not different in Savelugu/Nanton Municipal is even seriously educated women sometimes ignore the health facilities and deliver at home. This paper examines the factors associated with the choice of places of delivery by women in the Savelugu/Nanton Municipality. An analytical cross-sectional study design was used involving women, health workers, Traditional Birth Attendants, opinions, traditional and religious leaders and some key informants. Data was collected through questionnaires, in-depth interviews, focus group discussions and observations. The result indicates that distance to health centres, personal likes and dislikes of women and availability of TBAs in the community were among the factors influencing the choice of places of delivery. It was also revealed that bad attitudes of health workers and ineffective communication between health workers and patients are some of the factors that influence women's choice of places to deliver. The paper concludes that, despite improvement in health service delivery in Ghana, many women still deliver at home. The paper recommends effective health education by stakeholders to reverse the situation.

Analisis Faktor Yang Berhubungan Dengan Kepatuhan Penggunaan Alat Pelindung Diri Di Masa Pandemi COVID-19 Pada Tenaga Kesehatan

Compliance of health workers using Personal Protective Equipment (PPE) in the current pandemic conditions is more important to pay attention to because negligence in its use can endanger their safety. In fact, there are still many health workers who do not comply in using PPE according to predetermined standards. The study aims to determine the relationship between knowledge factors, attitudes towards the use of PPE and the availability of PPE with the compliance of health workers in the use of PPE in the Inpatient Installation of Kanjuruhan Hospital, Malang Regency. The study is correlational in design with a cross-sectional approach. The population of all health workers at the Wonosari Health Center, Kepanjen and Ngajum, Malang Regency, who focus on handling COVID-19. Determination of sample members using simple random sampling technique, a sample of 73 respondents. Data collection using questionnaire instruments, and data analysis using the Spearman test. Spearman's test results showed that there was a relationship between knowledge factors (p= 0.000,= 0.491), attitudes towards the use of PPE (p= 0.000, = 0.705), and the availability of PPE (p = 0.000, = 0.763) with the compliance of health workers in the use of PPE. Knowledge is related to compliance with the use of PPE because with good knowledge, health workers will increasingly realize the importance of using PPE for their safety. The attitude related to compliance with the use of PPE because of the positive attitude of health workers towards the importance of using PPE, is a situation where health workers view the use of PPE as an important thing to implement for their own safety, causing a tendency to behave towards compliance in the use of PPE. The availability of PPE is related to compliance with the use of PPE because to be able to comply with the use of PPE, of course, health workers need adequate facilities.

Attributes development for a discrete choice experiment on preferences in sexual and reproductive health services for adolescents and young people in Nigeria

BackgroundA major component of the validity of the discrete choice experiment (DCE) research design lies in the correct specification of attributes and levels relevant to the research focus. In this paper, we set out the validation steps we took in designing the tool for a DCE on preferences in sexual and reproductive health (SRH) services for adolescents and young people.MethodologyThis study was carried out among adolescents and young people (AYP) in Ogun State, Southwest Nigeria. We used a three-step mixed-methods process in developing the attributes and attribute-levels for our DCE tool. The first was to conduct a series of 16 focus group discussions (FGD) with AYP ensuring maximal variation (by age group, sex, marital status, and location). The FGD included a priority listing process in which participants were asked to list and rank the most important characteristics of optimal SRH services for AYP. The lists were harmonized and items were scored. The main (highest scoring) themes emerging from the harmonized priority list were converted into an initial set of attributes and the subthemes as level. These initial attributes and levels were presented to a panel of methods and content experts in a virtual modified Delphi process. This was for deciding on the importance of the attributes in providing optimum sexual and reproductive health services for young people, and the appropriateness of the levels. The same set of attributes was presented to another set of AYP in a series of four FGD to clarify meanings, and test whether the wordings were well understood. We applied some decision rules for including and excluding attributes and levels in the different phases of the development process.ResultsWe extracted an initial set of nine attributes with 2-4 levels each from the first FGD sessions. These were revised to a final set of seven attributes with 2-4 levels each based on findings from the expert review and final validation FGDs with AYP. The final attributes were: the type of staff, physical environment, health worker attitude, cost, waiting time, contraceptive availability, and opening hours.ConclusionThe final set of attributes covered those relating to the services provided, the health workers providing the services, and the AYP. Our three-step process which included both quantitative and qualitative approaches ensured a rigorous process that produced a reliable combination of attributes and levels. Although we had to trade off some competing attributes to come to a final list, our decision rules helped us to conduct a transparent and reproducible process.

“They will judge you more like a parent instead of like a health practitioner”: Perceptions and preferences of young people regarding sexual and reproductive health services in Southwest Nigeria

Adolescents and young people (AYP) experience many barriers in the utilization of sexual and reproductive health (SRH) services. These barriers can be cultural, structural, personal or health worker-related. In this study, we explored the perceptions and preferences of AYP in receiving SRH services at public health facilities in a Nigerian setting. We conducted 16 focus group discussion (FGD) sessions with adolescents and young people allowing for maximum variation by sex (male, female), age (15-19 years and 20-24 years), and marital status (married and unmarried). We applied a thematic framework analysis to explore the data collected. Our findings included both positive and negative attitudes of health workers at public health facilities, non-involvement of AYP in activities relating to the planning, implementation, or evaluation of SRH programs for AYP, and non-awareness among AYP of some of the rights that AYP have with respect to SRH services in public health facilities. Many participants preferred younger health workers or those living within their neighborhood. Some older health workers were said to often act as (strict) parents, not health workers. We conclude that the role ascribed to ‘neighborhood’ nurses in this study is instructive and deserves more attention. Also, there is a need to increase the awareness of the young people about the type of SRH services they can obtain in the public health facilities, as well as, a need for health workers to be trained and retrained in providing SRH services to AYP.

Comparing attitudes towards people with substance use disorders between healthcare professionals and general public

Objective: This study was conducted to compare attitudes and to examine the variables related to the attitudes and attitudes of health professionals in a psychiatric hospital and the general public towards individuals who use substances. Methods: The study was carried out as a descriptive cross-sectional study. The sample study included 212 healthcare professionals employed in a psychiatric hospital and 427 individuals representing the general public. The study data were obtained by using the Introductory Information Form, the Attitudes Toward Treatment of Substance Use Disorders Scale, and the Attitudes and Behaviors of the Society Towards Individuals Using the Addictive Substances Scale. Results: In this study, it was determined that marital status, number of children, educational status, and alcohol consumption related to the attitude. The attitudes of healthcare professionals towards addiction treatment were determined to be positive. When the attitudes scores of an average of healthcare professionals (80.23±19.10) and the general public (91.40±17.76) were compared, a statistically significant difference was found according to the T-test results. Conclusion: The results of this study can increase awareness about the level of attitudes of health workers and the general public toward individuals who use substances. By considering the results of this study, educational activities can be planned to reduce negative attitudes. Individuals who do not or rarely use alcohol, individuals with a low level of knowledge, and those with relatives with substance use disorder can be encouraged to participate more in these training activities. It is recommended to review motivations, the working conditions, and the training curriculum of nurses, and in-depth investigation of the variables that cause the public’s negative attitude.

Predictors of malaria vaccine uptake among children 6–24 months in the Kassena Nankana Municipality in the Upper East Region of Ghana

BackgroundThe Malaria Vaccine Implementation Programme (MVIP) coordinates the routine implementation of the RTS,S vaccine pilot in strategically selected locations in Malawi, Kenya, and Ghana. The pilot programme thoroughly assesses the programmatic feasibility of administering the four doses of the RTS,S vaccine. It will also assess the impact on malaria morbidity and mortality, as well as monitor and detect the vaccine's safety for routine usage. The malaria vaccine was introduced into Ghana's routine vaccination programme in May 2019 in seven regions, comprising 42 districts, including Kassena Nankana Municipal in the Upper East region of Ghana. Therefore, this study seeks to assess the predictors of the malaria vaccine uptake in children 6 to 24 months in the Kassena Nankana Municipal in Ghana.MethodsThe survey used a cross-sectional study design and included 422 mothers/caregivers with children aged 6 to 24 months from the Kassena Nankana Municipality. WHO cluster survey questionnaire was altered for use in data gathering with caregivers as respondents. The Statistical Package for the Social Sciences (SPSS) version 25.0 (for descriptive statistics) and Stata version 13 (for calculating odds ratios) were used to analyse the data.ResultsThe findings depict that, the mean age of respondents for the study was 27 ± 5 years and average age of children was 15 ± 8 months. The study found that coverage uptake was high (94%). Chi-square and odds ratios testing revealed statistically significant associations between health service factors and vaccine uptake: education on malaria vaccine cOR(Cl); 9.69(3.496–25.425), (P < 0.001), giving caregivers the option to accept malaria vaccine cOR(Cl); 7.04 (2.759–17.476), (P < 0.001). Confidence in the efficiency of the vaccination was found to have a statistically significant association with malaria vaccine uptake (P < 0.005) and (p < 0.001) for ‘somewhat confidence’ and ‘not confidence at all’, respectively. Attitude of health workers was found to be significant predictor of malaria vaccine uptake (P < 0.003).ConclusionMalaria vaccine uptake was high among the study population in the municipality; however, dose four uptake coverage by age two was low. This indicates that mothers/caregivers did not understand the notion of immunization throughout the second year of life. As a result, it is recommended that the municipality raise awareness about immunization services among mothers/caregivers beyond year one in order to improve performance and reduce the risk of disease outbreaks in the municipality.

Barriers and Facilitators to Community Acceptability of Integrating Point-of-Care Testing to Screen for Sickle Cell Disease in Children in Primary Healthcare Settings in Rural Northern Ghana

Introduction: Sickle cell disease (SCD) remains a public health problem especially in sub-Saharan Africa including Ghana. While pilot initiatives in Africa have demonstrated that neonatal screening coupled with early intervention reduces SCD-related morbidity and mortality, only 50-70% of screen-positive babies have been successfully retrieved to benefit from these interventions. Further, systematic newborn screening for SCD as public health programs is lacking. To address this problem, innovation is needed to bridge the diagnostic gap and develop sustainable care programs through universal health coverage. Point-of-care testing (POCT) with high specificity and sensitivity for SCD screening can be more easily integrated into existing immunization programs in Africa and are more likely to improve retrieval rates. This study explored community perceptions and acceptability of integrating POCT to screen for SCD in newborns and children under 5 years of age in primary healthcare facilities in rural Kassena-Nankana Districts of Northern Ghana. Method: This was an exploratory study using qualitative research approach where 10 focus group discussions and 20 in-depth interviews were conducted with community members and health workers between April and June 2022 covering major thematic areas such as community awareness and perceptions of SCD, their views on integrating POCT to screen for SCD, and barriers and facilitators of community acceptability and uptake of SCD screening in children under 5 years of age in primary care settings. The theoretical framework on acceptability of healthcare interventions validated by Sekhon et al. was adopted and used in this study. The interviews were recorded with participants’ consent and transcribed verbatim after repeatedly listening to the recordings. Data was coded into themes using Nvivo 12 software before thematic analysis. The study was approved by the Institutional Review Board of the Navrongo Health Research Centre. Results: Most participants (70.9 %) described SCD as serious and potentially life-threatening condition affecting children. Of 148 community members and health workers, 141 (95.2%) expressed positive views about the screening exercise, which could facilitate diagnosis of SCD in children for early management. However, discrimination, fear of being tested positive, stigmatization, negative health worker attitude linked with issues of maintaining confidentiality were reported by majority of participants as key factors that could negatively impact uptake of the screening exercise. Most participants suggested that health education (74.3 %), short duration of screening processes (74.3%), positive attitude of health workers (69.5%), and screening health workers not being biased (58.8%) as factors that could promote community acceptability. Conclusion: A large majority (over 95%) of participants viewed screening of SCD in children as very important. However, views expressed by most participants suggest that health education, short duration of the screening process, and professionalism of health workers in keeping patients’ information confidential could improve community acceptability. These findings have informed the implementation design for using POCT to screen for SCD in children under 5 years of age in primary care settings in rural Northern Ghana.

Implementasi Kebijakan Tatalaksana HIV di Puskesmas Kabupaten Sleman

Background: HIV AIDS is still a global and national challenge. The government is trying to control it by expanding access to HIV treatment at the Puskesmas, including 4 Puskesmas in Sleman Regency. However, efforts to expand access to treatment have not yet reached the target of 95% of people living with HIV who are receiving ART and 95% of people living with HIV who are viral loadsuppressed. WHO in 2017 recommended the immediate initiation of diagnosed HIV-positive people regardless of CD4 cell count and followed by changes in the national HIV management policy through a fast-track strategy in 2018 to provideimmediate initiation of ARVs, provision of Tuberculosis Preventive Therapy, and viral load monitoring. The rapid change in HIV management strategies raises the question of whether the Puskesmas in Sleman Regency can carry out HIVmanagement according to the latest policy recommendations in achieving the target of 90% of people living with HIV who are suppressed by viral load. Objectives: Measuring the suitability of the implementation of HIV management at the Puskesmas based on regulations and finding the supporting factors and obstacles in the implementation of HIV management at the Puskesmas.Methods: This is mixed-method research with a sequential explanatory approach. The location of research was carried out in four health centres in Sleman Regency, which had organized the HIV Treatment Support Care Service Program. Data was collected in May-June 2022. Quantitative data was secondary data on cases of people with HIV who accessed PDP services registered at the Puskesmas from 2019 until July 2021. Qualitative data were taken from 9 informants, selected by the purposive sampling method, through in-depth interviews. The quantitative sampling method uses a non-probability sampling method. Results: There is a discrepancy in the suitability of treatment at the Puskesmas with management standards according to regulations, as well as the low number of people living with HIV who are monitored for viral load suppression. The inhibiting factor for implementing HIV management in Puskesmas is the attitude of health workers to delay treatment related to perceptions of HIV prevention policies that have not been well socialized. Not all service providers are trained,lack of viral load testing facilities in hospitals, inefficient HIV management records systems, and stigma are obstacles to implementing HIV management. The supporting factors for the implementation of PDP HIV are the attitude of the willingness of health workers to provide treatment related to the perception of peer support and the presence of trained officers in counseling and logisticalsupport for adequate drugs. Conclusion: Not all people living with HIV treated at the Puskesmas have received treatment according to regulations until viral load suppression is monitored. For this reason, it is necessary to increase the capacity of HIV counselingand management for all health workers involved in providing PDP services, adding viral load testing facilities at regional hospitals, and providing HIV stigma prevention programs for people living with HIV, families, communities and health services.

Removing barriers to utilisation of support services for abused female adolescents in Nigeria slums

Abstract Background Female adolescents in urban slums experience a plethora of violence. The inherent health inequalities in the urban slums also present barriers to adolescents’ access to support services that can alleviate the impact of violence and bring perpetrators to justice. Health facilities can play key proactive roles in facilitating effective responses to address the problems of violence. This research sought to answer the questions: what support services are available to female adolescents in the event of violence; what are the barriers to accessing these services; and what roles can health workers play in removing these barriers? Methods The study used an ethnographic approach involving 40 in-depth interviews and 9 focus group discussions with female adolescents, 17 in-depth interviews were conducted with health providers and community leaders. The study setting comprised intentionally sampled slum communities in Lagos and Oyo states, southwest Nigeria. Thematic data analysis was conducted to address the study questions. Results Potential support services available to female adolescents in the study setting included the Community Development Association, police, family members, and health facilities. Identified barriers to utilizing available support services included stigmatization, non-formalization of police reports of violence, ambiguous attitudes of health workers to abused adolescents, and unfamiliarity on the part of adolescents. Although resources are available to adolescents in the event of violence, the lack of coordination of services has led to gross inefficiency for intervening. Conclusions To address the inefficiency of services, the health sector is best positioned to ensure synergy among the key stakeholders to reduce stigma and stop abuse experience among adolescent girls. Beyond a reactionary, curative approach, health providers need to play a preventive role through education, advocacy, and coordination of interventions at the community level. Key messages • Health workers at primary health facilities need to support adolescents who experience violence, especially those who using their services. • In addition, health workers are best positioned to create synergy among available support services to alleviate and mitigate the impact of violence on female adolescents in the community.

Drivers and Barriers to Improved Data Quality and Data-Use Practices: An Interpretative Qualitative Study in Addis Ababa, Ethiopia.

An objective of the Information Revolution Roadmap of Ethiopia's Health Sector Transformation Plan was to improve health management information system (HMIS) data quality and data use at the point of health service delivery. We aimed to assess drivers of and barriers to improving HMIS data quality and use, focusing on key Information Revolution strategies including Connected Woreda, capacity building, performance monitoring teams, and motivational incentives. We conducted an interpretative qualitative study across all 11 health centers in 3 subcities of Addis Ababa, Ethiopia: Yeka, Akaki-Kaliti, and Ledeta. A total of 40 key informant interviews and 6 focus group discussions with a total of 43 discussants were conducted. We coded information gathered line-by-line and grouped responses under thematic codes as they emerged. Findings were triangulated and validated. Our findings indicate that the main drivers of data quality and use at the point of service delivery were the use of the Connected Woreda strategy and its tools, capacity-building activities including mentorship, performance monitoring-team activities that led to active leadership engagement, and motivational incentives for data producers and users. Barriers to optimal data-use practices were the use of duplicative data collection tools at health facilities, under-developed health information system infrastructure, inadequate health information technician staffing and capacity limitations at the health facility level, insufficient leadership commitment, and unfavorable health worker attitudes toward data. Improvements in quality and use of HMIS data at health facilities are expected to result in delivering better-quality health services to the community as data enable health workers to identify gaps in health care, fix them, and monitor improvements. Future investments should focus on strengthening the promising data-use practices, resolving bottlenecks caused by duplicative data collection tools, enhancing individual and institutional capacity, addressing suboptimal health worker attitudes toward data, and overcoming infrastructure and connectivity challenges.

Perception and attitude of COVID-19 health workers and their family members

Background: Work and family environment play important role in coping with stressful conditions due to COVID-19. This study was conducted to identify the perception and attitude of health workers engaged in management of COVID-19 along with the family members.Methods: A cross-sectional study was conducted at tertiary care center through a self-administered online survey among health worker engaged in management of COVID-19 and with their family members. Data through Google forms were collected from 150 participants who consented to participate in the study. The study guaranteed anonymity and consent was sought from participant prior to participation.Results: A total 150 participants surveyed, out of them 75 [42 (56.2%) females and 33 (43.8%) males] were healthcare workers and 75 [38 (50.7%) females and 37 (49.3%) males] were family members. Around 50% of healthcare workers agreed that they were facing interference in daily routine as a result of involvement in COVID-19 related duties and 31% were afraid that they might get COVID-19 infection as result of current posting or duties. Around 35% of family members agreed that their other family members will also get COVID-19 infection because COVID-19 posting. Comparative mean perception towards healthcare workers and their family members showed non-significant difference (t=0.0739; p=0.4714).Conclusions: This study illustrated the concerns of health workers engaged in COVID-19 management and their family members. Strategies for providing health education and necessary support for plummeting perception of the fear of infection can be planned for improving phycological and social wellbeing of HCW and their family members.

Prevalence and determinants of home delivery among reproductive age women, Margibi County, Liberia

BackgroundThe use of institutional delivery services is essential for improving maternal and child health. However, studies in Liberia reveal over 20% of women still deliver at home. We assessed the prevalence and associated factors of home delivery among women of reproductive age in Margibi County, Liberia.MethodsWe conducted a cross-sectional study among 438 women of reproductive age in Margibi County. Data were obtained using a semi-structured questionnaire. A simple random sampling approach was used to select the participants for the study. We performed binary logistic regression to identify factors influencing home delivery. Findings were summarized into tables displaying the frequencies, percentages, crude, and adjusted odds ratios (ORs) and 95% confidence intervals (CIs).ResultsPrevalence of home delivery in the County was 90.6% (95% CI = 87.5 – 93.0). Women who were ≥ 31 years (aOR = 6.74, 95%CI = 2.86—15.90), women who had two or more children (aOR = 9.68, 95%CI = 4.07—22.99) and those who had rapid onset of labor (aOR = 6.35, 95%CI = 1.59 – 25.27) were associated with increased odds of home delivery. Good attitude of health workers (aOR = 0.01, 95%CI = 0.001 – 0.08) and the availability of transport to the nearest health facility (aOR = 0.01, 95%CI = 0.003 – 0.03) were factors associated with a decreased odds of home delivery among the study participants.ConclusionThe high prevalence of home delivery in the county is a call for urgent interventions by the government of Liberia and various non-governmental organizations. The government may need to supply the county with ambulances and ensure in-service training of health workers on good attitudes.

English

Since January, 2012, the Pacific region has faced a heavy burden of concurrent epidemics of dengue, chikungunya, and zika virus infections. In 2016, WHO developed a global response strategic framework to ensure that zika virus is a priority and accelerated area of public health research. This study conducted in Bouak&eacute; (C&ocirc;te d&#39;Ivoire) is part of this framework. The main objective was to assess the knowledge and attitudes of health workers working there on the zika virus disease in order to consider a better preparation and response to a possible epidemic in C&ocirc;te d&#39;Ivoire. Cross-sectional study covering the period from October 2016 to March 2017 was used here. The sampling was comprehensive and included interviews with 258 persons. Subjects were interviewed using a questionnaire edited and adapted from the CAP questionnaire developed by WHO in 2016. People with prior knowledge of the zika virus disease represented 66.3% of the health workers surveyed. Their level of knowledge was insufficient in 83.5% of cases. Their attitudes were good in 51.5% of cases. In the authors&rsquo; final model, the exercise structure which was adjusted to the level of education and the corporation significantly influenced health workers&#39; attitudes toward illness. Health workers in public settings appeared to have a better attitude compared to their private colleagues (adjusted OR = 4.88; CI: 2.37-10.03; p-value: 0.000). The zika virus disease has attracted the attention of the medical community during the 2014-2016 period. This attention, while mitigated by the West African Ebola virus epidemic, deserves to be highlighted. Key words: Health workers-C&ocirc;te d&rsquo;Ivoire-knowledge-attitudes-Zika.

Factors that influence diagnostic delay among pulmonary tuberculosis patients in Osogbo, Nigeria

Objectives: Delay in the diagnosis of pulmonary tuberculosis (TB) is reportedly common in Nigeria. This results in delayed initiation of treatment and increased spread of the disease. This study assessed diagnostic delay and its influencing factors among pulmonary TB patients who were attending directly observed treatment clinics in Osogbo, Nigeria. Materials and Methods: This descriptive cross-sectional study was carried out from August to October 2019 in 10 directly observed treatment clinics in Olorunda Local Government Area, Osogbo, Osun State, Nigeria. Multistage random sampling was used to select 280 registered TB patients. Data were collected using an interviewer-administered semi-structured questionnaire and analyzed with Statistical Package for the Social Sciences version 23. Results: Most respondents, that is, 220 (80.3%) were Yoruba, 69 (25.2%) had tertiary education, and 53 (19.3%) had no education at all. Only 135 (49.3%) respondents had good knowledge of pulmonary TB. We found that 157 (57.3%) respondents had patient-related diagnostic delays, while 135 (49.3%) had health system-related delays. Median patient-related delay was 1 month, while median health system-related delay was 3 weeks. There was no significant association between patient-related delay and any sociodemographic characteristic, knowledge about TB, or perceived attitude of health care workers. A significant difference in health-system-related delay was found concerning the attitude of health care workers toward patients (P = 0.043) and patients’ religion (P = 0.030), and level of education (P = 0.001). Conclusion: While pulmonary TB is common in the lower socioeconomic class, health workers should be open-minded while evaluating all patients to ensure correct and prompt diagnosis. A good attitude of health workers towards patients is important for preventing diagnostic delays.