Frontline Health Workers Research Articles

Postpandemic fear of COVID-19, psychological distress, and resilient coping among frontline health workers in Ghana: An analytical cross-sectional study.

The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the psychological well-being of healthcare workers globally. However, little is known about the mental health state of frontline health workers in the postpandemic era. The purpose of this study was to examine postpandemic COVID-19-related psychological distress and fear among frontline health workers in Ghana. Data were collected from 245 frontline healthcare workers in the Western region of Ghana. COVID-19-related fear, psychological distress, and resilient coping were assessed with the fear of COVID-19 scale, Kessler Psychological Distress Scale, and the Brief Resilient Coping Scale, respectively. Multiple linear regression was used to assess the association between psychological distress and fear of COVID-19as well as the moderating effects of resilient coping. Participants were mostly female (57.1%), aged between 21 and 30 years (50.6%), and not married (58.0%). We found that 52.2% of frontline healthcare workers experienced mild-to-severe fear, while 40% experienced psychological distress. Fear of COVID-19, previous contact with COVID-19 patients, and earning a monthly income between 501 and 1000 Ghanaian cedis were significantly associated with higher psychological distress. The positive association between fear of COVID-19 and psychological distress was stronger among frontline health workers who had higher resilient coping. There is the need to provide frontline health workers with mental health support services to promote their psychological well-being and enhance their ability to provide quality care during the postpandemic era.

Nutrition education and counselling by frontline health and nutrition care workers is associated with improved iron adherence among pregnant women: evidence from the National Family Health Surveys, 2015-21

Background: Anaemia is a global public health problem affecting developing and developed countries with major consequences for human health and social and economic development. Methods: This paper attempted to understand the determinants of iron adherence among women of reproductive age during their last pregnancy in India and states/union territories, the iron deficiency being associated with anaemia, using multiple logistic regression analyses of data from the fourth (2015-16) and fifth (2019-21) rounds of the India National Family Health Survey. The individual unit-level data were analysed using Stata 17 software. Results: After adjusting for standard covariates, it was found that those who reported receiving counselling by a frontline health worker and/or antenatal care visits were much more likely to consume at least 90 days of iron-containing supplements. Results shows that for NFHS-4 women who had received counselling from a frontline health and nutrition care worker were 1.489 times (95% CI: 1.429-1.553) to adhere to at least 90 days of iron tablets or syrup after adjusting for potential confounders and for NFHS-5 women who had received counselling from a frontline worker were 1.162 times (95% CI :1.124-1.200) more likely to adhere to IFA supplements or syrup for at least 90 days. Conclusions: Based on insights from these analyses, it appears that counselling seems to be effective in making women aware of the benefits of IFA, thus increasing the likelihood of intake of iron-containing supplements. Counselling seems to be an important predictor of adherence to iron intake in India.

The why, what and how of preconception care: an exploratory descriptive qualitative study in Karnataka, India

BackgroundWomen’s health and nutrition are key to their reproductive health and are important for optimising pregnancy outcomes. Formation of most foetal organs starts soon after conception and much before the woman has her first antenatal visit. The provision of biomedical, behavioural and social interventions to couples to address health, nutrition, behaviour issues and individual environmental risk factors that could contribute to improved maternal and child health outcomes before conception is crucial. Most rural women in India, do not seek pregnancy care before the second trimester because of socio-cultural factors. Therefore, intervening in the preconception period is important. The objective of the study was to explore the challenges and opportunities of implementing preconception care interventions.MethodsIndividual, in-depth, semi-structured interviews (n = 25) were conducted with primary stakeholders (newly married women, newly married men, and family members) in Shorapur taluk of Yadgir district and Devadurga taluk of Raichur district. Thirty-one interviews were conducted with taluk, district, state officials and academicians. This descriptive qualitative study conducted four focus group discussions with front-line health workers. The in-depth interviews (IDIs) and Focus-group discussions (FGDs) used separate pre-tested semi-structured interview/discussion guides. Data analysis was carried out using NVivo software using a phenomenological approach with both inductive and deductive analysis.ResultsA strong influence of social and cultural norms shapes healthcare-seeking behaviour at the community level. Poor dietary diversity, lack of awareness, poor literacy levels, work pressure for women, lack of decision-making power and empowerment among women, pressure to conceive early, and gender norms are the roadblocks to successful preconception care programs in the rural Karnataka setting. The stakeholders expressed the need for interventions during the preconception period. The government functionaries recommended several interventions which could be potentially integrated into the existing Reproductive Maternal, Neonatal, Child and Adolescent Health (RMNCH + A) strategy to improve the health and nutrition of women before they conceive.ConclusionThe study highlights the need for structured interventions during the preconception period to improve maternal health and pregnancy outcomes. The recommendations provided by government functionaries are indicative of the feasibility of integrating interventions in the RMNCH + A strategy.

Enabling the Grass Root: Health Cadres Empowerment Program in Efforts to Prevent and Manage Hypertension in the Tanjung Sub-Village Community

Community health cadres are frontline health workers and essential allies in improving hypertension management and promoting health equity. However, the phenomenon in Indonesia shows that the support given to cadres in efforts to promote hypertension still needs to be higher. This article describes the community service program, especially health cadres empowerment in Tanjung Sub-villages, Sewon, Special Region of Yogyakarta, to optimize the capabilities of health cadres in promoting health and preventing disease. The methods to determine the lack in community used observation, interviews, and surveys. Then action planning was carried out by including cadres, primary health care services Sewon II, head of sub-village, village youth organization in Plan of Action (PoA). Implementation of the program was held in May 2023. The descriptive analysis was used for analyzing the preliminary surveys. The Wilcoxon test was carried out to measure cadres' knowledge before and after the program was held as an evaluation. There are two main programs for empowering health cadres in this community: health cadre training and hypertension exercise to increase cadres' innovation in doing exercise for the community. Both of these programs have been proven to increase the knowledge and understanding of cadres about hypertension, as well as improve the ability of cadres to carry out health screening and lead hypertension exercises. Based on the results of the Wilcoxon test, the pre-test, and post-test values yielded a Z value of -2.375 and a sig value of 0.018, indicating that there is an influence of the presentation of hypertension on the knowledge and understanding of the cadres. Community acceptance of this program runs well and the Tanjung Sub-Village’s Cadres independently is able to carry out health screening of non-communicable diseases, especially hypertension in their monthly Integrated Healthcare Center (Posyandu) program in the future.

Learning from implementation of a COVID case management desk guide and training: a pilot study in Sierra Leone

BackgroundWhen the COVID pandemic hit the world, there was need for applied guides and training materials to support frontline health care staff to manage patients effectively and safely and to educate themselves and communities. This article reports on the development and piloting of such a set of materials in Sierra Leone, which were based on international evidence but adapted to the local context. Reflecting on this experience, including community and health system barriers and enablers, is important to prepare for future regional shocks.MethodsThis study, in Bombali district in 2020, piloted user-friendly COVID guides for frontline health workers (the intervention), which was evaluated using facility checklists (pre and post training), routine data analysis and 32 key informant interviews.ResultsKey informants at district, hospital and community health centre levels identified gains from the training and desk guides, including improved diagnosis, triaging, infection prevention and management of patients. They also reported greater confidence to share messages on protection with colleagues and community members, which was needed to encourage continued use of essential services during the pandemic. However, important barriers were also revealed, including the lack of testing facilities, which reduced the sense of urgency, as few cases were identified. Actions based on the Ebola experience, such as setting up testing and isolation centres, which the community avoided, were not appropriate to COVID. Stigma and fear were important factors, although these were reduced with outreach activities. Supplies of essential medicines and personal protective equipment were also lacking.ConclusionThis pilot study demonstrated the relevance and importance of guides adapted to the context, which were able to improve the confidence of health staff to manage their own and the community’s fears in the face of a new pandemic and improve their skills. Previous epidemics, particularly Ebola, complicated this by both creating structures that could be revitalised but also assumptions and behaviours that were not adapted to the new disease. Our study documents positive adaptations and resilience by health staff but also chronic system weaknesses (particularly for medicines, supplies and equipment) which must be urgently addressed before the next shock arrives.

Robust OCR Pipeline for Automated Digitization of Mother and Child Protection Cards in India

The Universal Immunization Programme in India has a mandate to fully vaccinate all of India’s 27 million children born annually. The vaccination doses are recorded by frontline health workers on standardized paper-based Mother and Child Protection (MCP) cards, which are manually digitized by data entry operators, resulting in poor data quality, delays, and significant time and resources. In our article, we focus on Optical Character Recognition– (OCR) based automated digitization of MCP card images captured through a smartphone application developed by us. By utilizing a standardized template for the MCP cards, which is available a priori , we register the card images and perform OCR on the extracted region of interest (ROIs). Since the cards with curvature or torn edges had poor ROIs, we built a global–local alignment technique that first approximates the ROI using global homography and then refines using a local homography resulting in improved accuracy. Our pipeline gives a character level accuracy of 98.73% on our dataset against 75.02% by Google Cloud Vision and 79.26% by Azure OCR. We also describe our field testing experience, where the digitized MCP card images were used to provide useful features on the smartphone application for health workers to conduct vaccination sessions.

Stewards of Society: Preparedness and Perceptions Among the Unsung Heroes of Public Health Service Delivery

Front-line public health workers are essential to protecting the health of the public, particularly during widespread public health emergencies. Local public health workers were instrumental in mitigating the spread of the coronavirus pandemic through their efforts to contract trace, disseminate tests and vaccines, and educate the public about the dynamic state of the crisis. Yet, reports indicate that the public health workforce has been shrinking for some time. Recent studies indicate more than one-quarter of those serving in public health roles hope to leave the profession within one year because of factors such as stress and burnout. Few studies examine the perceptions of local health workers or the impacts that multi-level governmental responses have on their ability to do their jobs. Having a strong public health workforce is essential for a thriving society, so addressing this gap and identifying solutions are important steps towards identifying solutions for slowing the exodus of public health workers from the field. Through analysis of original survey data of front-line workers mid-pandemic in two western states, this project examines perceptions regarding factors which contribute to added stress and burnout. Findings indicate that workers felt relatively prepared to address a public health crisis, but institutional factors, such as changing job responsibilities, competing governmental directives, and limited resources, may contribute to ongoing feelings of burnout. To address these concerns, decision makers need to provide more resources and have a clear strategy of communication to mitigate conflicting governmental directives.

Distribution of Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) Immunoglobulins G and M among Frontline Health Workers in Eleme Local Government of Rivers State, Nigeria

Background: The fight against Corona Virus Disease (COVID-19) globally among front line health workers has been a challenging task, it encompasses working lengthy hours at the isolation Centre’s, intensive care units, emergency departments and molecular laboratories, and also been exposed to pathogens, fatigue, and psychological distress. This has led to high morbidity and mortality rate among front line health workers all over the globe.
 Aim: This study aimed at determining the distribution of SARS CoV -2 IgG and IgM among frontline health workers in Eleme Local Government of Rivers State, Nigeria.
 Materials and Methods: A total of 100 frontline Covid-19 health workers were recruited for this study comprising 48 males and 52 females with ages between 23 and 49 years and included janitors, hygienist, nurses, data Officers, logistics and ambulance drivers, physicians, and medical laboratory scientists, working at the molecular laboratories, sample collection booths and isolation center. The bio-data of the subjects were obtained using a well-structured questionnaire. Only subjects who gave informed consent were recruited for this study. 60ul of capillary blood was collected from each participant using an aseptic technique and immediately followed by the analysis of SAR-CoV-2 IgM and IgG using a lateral flow immunochromatographic assay technique.
 Results: Results from this study showed a total of forty-two (42) 42% subjects were reactive to IgG antibodies while fifty-eight (58) 58% subjects were non-reactive to IgG antibodies also a total of Twenty-One (21) 21% subject were reactive to IgM antibodies while a total of seventy-nine (79) 79% subjects were none reactive to IgM antibodies. A total of nine (9) subjects who were exposed to SAR-CoV-2 for more than one year were reactive to SAR-Cov-2 IgM and IgG antibodies, while a total of two (2) subjects who were exposed to SAR-CoV-2 for less than one year were reactive to SAR-Cov-2 IgM and IgG antibodies and the difference (p ₌ 0.013) was statistically significant. Also, a higher number of subjects within the 20-29 age bracket were reactive to SAR-CoV-2 IgM antibodies while subjects with in the age bracket of 30-39 were more reactive to IgG antibodies.
 Conclusion: This study reveals that serological testing is an ideal approach in assessing the proportion of frontline health workers who might have been exposed to SARS-CoV-2 as part of effort in combating COVID-19 disease globally.

Effects of COVID-19 on sexual and reproductive health services access in the Asia-Pacific region: a qualitative study of expert and policymaker perspectives

The COVID-19 pandemic has strained health systems globally, with governments imposing strict distancing and movement restrictions. Little is known about the effects of the COVID-19 pandemic on sexual and reproductive health (SRH). This study examined perceived effects of COVID-19 on SRH service provision and use in the Asia-Pacific region. We conducted a qualitative study using semi-structured interviews with 28 purposively sampled SRH experts in 12 Asia-Pacific countries (e.g. United Nations, international and national non-governmental organisations, ministries of health, academia) between November 2020 and January 2021. We analysed data using the six-stage thematic analysis approach proposed by Braun and Clarke (2019). Interviewees reported that COVID-19 mitigation measures, such as transport restrictions and those that decreased the availability of personal protective equipment (PPE), reduced SRH service provision and use in most countries. SRH needs related to service barriers and gender-based violence increased. Systemic challenges included fragmented COVID-19 response plans and insufficient communication and collaboration, particularly between public and private sectors. SRH service-delivery challenges included COVID-19 response prioritisation, e.g. SRH staff task-shifting to COVID-19 screening and contact tracing, and lack of necessary supplies and equipment. Innovative SRH delivery responses included door-to-door antenatal care and family planning provision in the Philippines, online platforms for SRH education and outreach in Viet Nam, and increasing SRH service engagement through social media in Myanmar and Indonesia. To ensure continuation of SRH services during health emergencies, governments should earmark human and financial resources and prioritise frontline health-worker safety; work with communities and the private sector; and develop effective risk communications.

How much do we follow birth preparedness? A community-based snapshot study from rural Delhi, India.

Maternal healthcare remains a challenging public health problem in low and middle-income countries like India. The comprehension and services regarding practices related to birth preparedness and its complications in rural areas of India remain poor and underused. In view of this, we conducted this study to explore the preparedness of the pregnant women in the community residing in rural settlements of Delhi. This cross-sectional community-based study was carried out in 165 currently pregnant women selected through proportionate sampling from rural Delhi. A semi-structured questionnaire adapted from Birth Preparedness and Complication Readiness (BPCR) tool kit was used. Binary and multivariate regression analysis was applied to identify the predictors of BPCR. In our study, BPCR index was found to be 25.78%. Only 17.6% pregnant women were well prepared. Multigravida, literacy, and higher socioeconomic status were found significant predictors for well preparedness for child birth and complication readiness in bivariate analysis. In multivariate logistic regression, multigravida and literacy were found to be predictors for well preparedness. The skill and knowledge level of the mother-in-laws and other women along with husband in the family needs to be improved in context of pregnancy and child birth. Frontline health workers can assist the to-be mothers and their family members in informed decision-making for better feto-maternal outcomes.

Neural network models selection scheme for health mobile app development

Mobile healthcare application (mHealth app) assists the frontline health worker in providing necessary health services to the patient. Unfortunately, existing mHealth apps continue to have accuracy issues and limited number of disease detection systems. Thus, an intelligent disease diagnostics system may help medical staff as well as people in poor communities in rural areas. This study proposes a scheme for simultaneously selecting the best neural network models for intelligent disease detection systems on mobile devices. To find the best models for a given dataset, the proposed scheme employs neural network models capable of evolving altered neural network architectures. Eight neural network models are developed simultaneously and then implemented on the Android Studio platform. Mobile health applications use pre-trained neural network models to provide users with disease prediction results. The performance of the mobile application is measured against the existing available datasets. The trained neural network engines perform admirably, detecting 7 out of 8 diseases with high accuracy ranging from 86.00% to 100% and a low detection accuracy of 63%. The detection times vary from 0.01 to 0.057 seconds. The developed mHealth app may be used by health workers and patients to improve resource-poor community health services and patients' healthcare quality.

A formative research to explore the programmatic approach of vaccinating the Rohingya refugees and host communities against COVID-19 infection in Bangladesh

BackgroundThe vaccination of the Rohingya refugees and host communities against COVID-19 in Cox’s Bazar started in August 2021. Government authorities and Non-Government Organisation partners implemented a project around the initial period of vaccination to improve awareness and access to target beneficiaries. We conducted formative research to understand the programmatic approach of this project and identify potential challenges and community perceptions regarding immunisation against COVID-19.MethodologyThis was formative research in which we used a qualitative method of data collection. Purposively chosen 12 key-informant interviews and conveniently chosen 20 in-depth interviews were conducted using semi-structured interview guidelines from August to September 2022 in the Rohingya camp and host communities of Cox’s Bazar District, Bangladesh. Ethical approval was obtained from the North South University Institutional Review Board, and written informed consent was obtained from all the participants. We used a thematic analysis approach to analyse the data.ResultsThe project neither provided any promotional or tailored messages regarding the COVID-19 vaccine nor conducted any vaccine hesitancy surveys before implementing the project. The project did not provide any storage facilities for the vaccines’ cold chain management but provided transport support to carry the vaccines from the district to the sub-district level. Community leaders were included in the decision-making process during local-level planning of the vaccination programme. The project supported the reporting of any adverse effects following immunisation from community members to the government health authorities. Vaccine hesitancy among participants was high in the early stages, but mass campaigns and vaccination of frontline health workers increased their acceptance. The major challenges reported by the informants were low budget and lower salaries of field staff, stacking of the registration process at the beginning, reluctance of participants, inadequate transportation and manpower, and inadequate baby feeding corners at vaccination centers.ConclusionThe findings from our study will help policymakers from the Government, the UN, and other humanitarian agencies to adapt and better address the issue of vaccine acceptance and strengthen the vaccination programme.

Survey on the psychosocial impact of COVID-19 on the Sri Lankan mental healthcare system and the needs of frontline healthcare workers in the post-covid era.

The COVID-19 pandemic severely strained the health care in Sri Lanka. The subsequent economic crisis compounded this issue. Priority was given to treating those afflicted with COVID-19 and preventing its spread, and healthcare staff faced immense difficulties dealing with the situation. The psychosocial impact of COVID on health care staff has not been properly assessed or addressed. A study was conducted to identify the psychosocial impact of COVID-19 among four different categories of health care workers, and perform a needs assessment among these groups. A convenient sample of frontline health workers, mental health teams, 1926 mental health helpline workers and 1990 Suwa Sariya emergency ambulance service staff were assessed via a self-administered questionnaire for mental health impact, work capacities and needs. Among frontline workers (n=188), 42.5% experienced anxiety symptoms, 12.8% depressive symptoms and 4.1% suicidal thoughts. Most (58.9%) lacked a psychological support system at the workplace. Only 20% have accessed specific programs or services at their workplace to obtain support for mental health issues, and all have benefitted from them. All categories of health workers lacked training and resources. The findings demonstrate that a significant amount of health care workers undergo psychological problems in the course of their work especially in the aftermath of the COVID-19 pandemic. The analysis reveals that Sri Lanka lacks structured psychological support systems for health workers and needs more resources and training. Psychological support for health workers through strengthening resources and training should be prioritised when planning service development.

Using Machine Learning Prediction to Create a 15-question IPV Measurement Tool.

Domestic violence, especially intimate partner violence (IPV), is an important issue worldwide, especially in India. Those that experience it may not always be able to come forward or have access to the required social support to act against it. We use National Family Health Survey data (n = 66,013 women) to create machine learning models which can predict IPV instances with a recall of 78%. We use the top 15 best predicting questions that avoid sensitive issues to create a field tool that frontline health workers can use to identify women with a high risk of IPV and provide the support they need.

An exploration of health workers’ experiences in providing bereavement care to mothers following a stillbirth: results from a subnational level health system in Uganda

BackgroundStillbirth is a profound emotion-laden event to the mothers and health workers who provide care due to its sudden and unexpected occurrence. Health workers offering support in regions shouldering the highest-burden experience providing support to a stillbirth mother in their professional lifetime. However, their experiences seldom get documented as much of the focus is on mothers causing a dissonance between parental and clinical priorities. This study aimed to explore the health worker’s experiences in the provision of bereavement care to mothers following a stillbirth.MethodsAn exploratory cross-sectional qualitative study was undertaken on a purposively selected sample of key informants drawn from frontline health workers and health systems managers providing maternal health services at a subnational level health system in Uganda. An interview guide was used to collect data with the audio-recorded interviews transcribed using Microsoft office word. Atlas. ti a qualitative data management software aided in coding with analysis following a thematic content analysis technique.ResultsThere was no specialised bereavement care provided due to inadequate skills, knowledge of content, resources and support supervision for the same. However, health workers improvised within the available resources to comfort mothers upon news of a stillbirth. Disclosure to mothers about the stillbirth loss often took the form of forewarnings, direct and sometimes delayed disclosure. A feeling of unpreparedness to initiate the disclosure process to the mother was common while the whole experience had an emotional effect on the health workers when establishing the cause, particularly for cases without clear risk factors. The emotional breakdown was often a reflexive response from the mothers which equally affected the care providers. Health workers engaged in comforting and rebuilding the mothers to transition through the loss and validate the loss. Efforts to identify the skills and health systems gaps for address were a common response targeted at improving the quality of maternal healthcare services to avert similar occurrences in the future.ConclusionProviding care to mothers after stillbirth was an emotional and challenging experience for health workers requiring different approaches to disclosure and provision of emotional support. The aspect of specialised bereavement care was lacking within the current response. Reflection of unpreparedness to handle the tasks demonstrates a deficit in the required skills. It is a critical gap missing hence calling for dedicated efforts to address it. Targeting efforts to improve health workers’ competencies and preparedness to manage grieving mothers is one way to approach it.

Access to health care among internal migrants in Chhattisgarh, India: critical perspectives on the question of health equity and urban development

PurposeMigrants face some unique health-care challenges, which often remain unaddressed by the health system. The purpose of this study is to determine health-care access among migrants in Chhattisgarh, from a lens of health equity.Design/methodology/approachThis study was conducted in a government-built tenement under the Integrated Housing and Slum Development program in Bilaspur district of Chhattisgarh state of India. It is a mixed-methods study which used a survey method, focus group discussion, in depth-interviews, semi-structured interviews and non-participant observations of health facilities in the area. Respondents included residents (migrants) and other local stakeholders like the Chief Medical Officer of the district, elected representatives of the local government and frontline health workers. This paper focuses on the findings from the qualitative component of the study.FindingsThe move to resettle the people living in the slums to the periphery of the city had a negative impact on their health-care access. They find it difficult to access public health services, given the services are concentrated in the city. Women, elderly people and disabled people grapple with additional challenges in being able to access basic reproductive health services and care for chronic illnesses. Equity in health-care access is linked to various social determinants of health including access to housing and social security. However, the authors found that the migrant community is being deprived of appropriate housing facilities and social security.Originality/valueThis paper explores the health-care access of internal migrants in Chhattisgarh state of India in the larger context of urban development with a focus on health equity.

Effect of Structured Yoga Program on Stress and Well-being Among Frontline Healthcare Workers During COVID-19 Pandemic.

Frontline healthcare workers are at risk of developing psychological distress during a pandemic. Yoga, a form of mind-body medicine can reduce body stress and increases well-being. To assess the effect of yoga on the stress and well-being of healthcare workers during the COVID-19 pandemic. This single-arm pre-post study was conducted among frontline health workers (support staff, paramedics, and medics) posted at a secondary care hospital in a North Indian district. Basic demographic details, blood pressure, anthropometric variables like height, weight, and biochemical variables like glycosylated hemoglobin (Hb1Ac), fasting and post-prandial blood sugar, lipid profile, serum cortisol, and C-reactive protein were measured. Stress levels were assessed using the depression anxiety and stress scale (DASS)-21 while well-being was assessed using the World Health Organization (WHO)-5 well-being scale.Twelve weeks of supervised yoga session was provided for 1 hour per session, 3 times per week. The mean value was compared from baseline to post-intervention with paired t-test/Wilcoxon signed rank test. A total of 89 participants were enrolled, 53 (59.5%) being male. Two-thirds of the participants were aged 20-39 years. During follow-up, 80 participants completed 12 weeks of yoga sessions. Post-intervention DASS-21 score decreased and WHO-5 increased significantly. The glycosylated hemoglobin (HbA1c) level and cholesterol-HDL ratio decreased significantly. Other variables didn't change significantly. No adverse effects were reported by the participants. Supervised structured yoga sessions helped decrease stress, depression, and anxiety and improved well-being. Therefore, it can be a feasible strategy to manage workplace-related stress and phycological morbidities.

Knowledge, attitude, and practice of pediatric residents towards oral health of children in Addis Ababa: A cross-sectional study

Background: The state of good oral health in children is mainly contributed by the knowledge, practice and attitude of front-line health workers like general practitioners, family physicians, postgraduate pediatric residents, and pediatricians. Assessing the knowledge, practice, and attitude of residents would give directions for further quality improvement projects. This study aimed to assess the knowledge, attitude and practice of pediatric residents on oral health in children in 3 public post-graduate teaching institutions in Addis Ababa, Ethiopia.
 Methods: Hospital-based cross-sectional study was conducted among 169 pediatric residents from 3 public postgraduate teaching institutions of Addis Ababa from June 1-August 30. 2022. The knowledge, Attitude and practice of residents were assessed by a structured questionnaire adapted from an extensive literature survey. Then the data was analyzed using SPSS version 25 software package. Descriptive summary statistics such as frequency and proportion were applied and finally, the results were presented using tables and figures.
 Results: In this study, 169 residents were involved. Males were 106 (62.7%) and the remaining were females. Only 18 (10.7%) of participating residents had good knowledge but 43 (25.4 %) and 108 (70.2%) had moderate and poor knowledge of oral health in children respectively. Most 164 (97%) had a good attitude towards oral health, but 19 (11.2%), 86 (50.,9%), and 64 (37.9%) had good, moderate, and poor practice respectively.
 Conclusion: The majority of pediatric residents in Addis Ababa had good attitude toward oral health but moderate practice and poor knowledge about oral health in children. Residents should be trained to improve their knowledge and practice toward oral health.

The growing needs of genetic counselling-Feasibility in utilization of tele-genetic counselling in Asia and Hong Kong.

The need for the expansion of genomic services has been at a record time high in the past decade. As technological advancement continues to strengthen the entire genetic and genomic pipeline and clinical operational workflow, the major challenge remains to be the speed of workforce development to meet service growth. In particular, the international expansion of genetic counselling (GC) services has been a topic of interest for the past few years. GC is an emerging profession in most of Asia, and in many countries the profession of GC often refers to physicians or front-line health workers with expertise in genetics to provide GC services rather than being a specific independent profession. As genetic and genomic services, especially pre-test and post-test GC, expand globally, the need to tackle the longstanding obstacles of GC personnel shortage and funding issues must not be overlooked. There is an urgent need internationally, and especially in Asia, where GC profession is comparatively less well-established, to seek alternative approaches to meet service demand. The present review examines the global development and feasibility of tele-genetics and tele-genetic counselling (TGC), and serves as the foundation to explore a possible roadmap in Hong Kong via the Hong Kong Genome Project.

Improving the Recruitment and Retention of Healthcare Professionals in Rural Areas: Evidence from the medical doctors of six districts of India

Background: The Human Resource in Health (HRH) crisis is one of the most critical constraints to achieving health and development goals. In this study, the WHO's recommendations were used to highlight the health workforce issues in remote and rural areas with a prime focus on four major policy domains: education, regulatory, financial incentives, and professional and personal support. Objectives: Medical doctors are one of the essential frontline health workers for primary health care in rural India. This study adopted World Health Organization's (WHO's) human resource policy framework to evaluate doctors' responses in understanding the recruitment and retention of medical doctors in rural areas. Materials and Methods: A cross-sectional, descriptive study was conducted in the rural and remote areas of Odisha state, India. A multistage sampling procedure was used to select the participants, who were all government medical doctors working in rural and remote locations. The primary outcome measure is percentage responses using WHO’s Human Resource policy framework Results: Medical doctors working in rural and remote areas perceived the practice as challenging. They were mainly least satisfied with the items asked in the professional and personal support domain. However, more than half of the doctors (56.7%) are eager to work in remote and rural areas for the next three years. Conclusion: Public health administrators and policymakers should create an enabling environment and design interventions encouraging doctors to stay in remote areas. Most importantly, this includes a political and financial commitment to achieve targeted interventions.