Perceptions Of Health Workers Research Articles

A qualitative exploration of how a community engagement approach influences community and health worker perceptions related to family planning service delivery in Togo.

There is a growing body of evidence that asserts community engagement approaches can improve the quality of reproductive health services. Family planning (FP) programs in Togo are implementing such approaches, which aim to mobilize both health workers and communities to improve FP service quality and FP uptake. However, there is not enough known about the enabling factors and challenges associated with implementation, or the extent to which the programs improve outcomes leading to contraceptive uptake. We qualitatively explored how a community engagement approach influenced health worker and community perceptions related to FP service delivery in and around the city of Lomé, Togo, within the context of the broader integration of social and behavior change and service delivery. We conducted 18 in-depth interviews with health workers and 9 focus group discussions with community members. We found the approach, which included community dialogues, site walkthrough visits and the development of community action plans, worked synergistically together to support collaborative action between communities and health workers to increase mutual understanding of their collective needs related to FP services. Community members cited improved reception at the health facilities by health workers and indicated that the site walkthrough visits created a greater sense of empathy towards the providers and the challenges faced in their work environment. Health workers acknowledged a greater understanding of barriers at the community level following community dialogues, particularly among community members that are not routinely encountered at the health facility for reproductive health services such as men and youth. We found limited implementation of health facility improvements included in community action plans because they were dependent on commitment from community leadership and the need to mobilize additional support or financial resources. Community engagement approaches are a promising mechanism to support collaboration and enhance mutual understanding between health workers and communities to achieve improved FP service quality. Future programs should consider incorporating additional mechanisms to monitor community action plans and provide support to address structural challenges at the facility level particularly those that require financial resources.

COVID-19 and COVID-19 vaccination experiences and perceptions among health workers during the pandemic in Ebonyi state, Nigeria: An analytical cross-sectional study

Background COVID-19 continues to be a disease of global public health importance and requires long-term management and control. Health workers’ (previous) experiences and perceptions regarding the COVID-19 pandemic and COVID-19 vaccination/vaccination process will influence not only their subsequent use of control measures but also public experiences/perceptions. We explored the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions, and their predictors, among the health workers in Ebonyi state, Nigeria. Methods We conducted an online-offline analytical cross-sectional survey between March 12 and May 9, 2022 among all categories of health workers (clinical/non-clinical, public/private) working/living in Ebonyi state who consented to participate and were selected by convenience/snowballing techniques. A structured electronic questionnaire was used to collect data: self-administered via WhatsApp and interviewer-administered via KoBoCollect for participants who did not have WhatsApp. Data was analysed using descriptive statistics and bivariate/multivariate generalized linear models. Results Of the 1276 health workers surveyed: 55.8% had strong COVID-19 experience and perception, 80.7% had good COVID-19 vaccination expectation and perception, and 87.7% had positive COVID-19 vaccination process experience and perception. The most important predictors of the extent and level of COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions were level of place of work (primary-secondary/tertiary), level of attitude towards COVID-19 (vaccination), and level of knowledge about COVID-19. Another important predictor was place of work (public/private). Conclusions The evidence indicate the factors that should guide subsequent policy actions in the strategies to enhance the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions of health workers (and their use of control measures) in Ebonyi state, Nigeria, and other similar contexts. It also indicate factors to be considered by future policy actions regarding similar diseases.

The Vicious Worm education tool improves the knowledge of community health workers on Taenia solium cysticercosis in Rwanda.

The pork tapeworm Taenia solium causes human taeniasis and cysticercosis when ingested as viable cysts and eggs, respectively. Despite its high health burden in low-income countries, knowledge of the parasite in endemic areas such as Rwanda is often limited. Here, we assess whether The Vicious Worm education software can increase knowledge in endemic areas of Rwanda. A cross-sectional mixed-methods study was conducted to evaluate knowledge about T. solium among community health workers trained using the Vicious Worm education software. Knowledge was assessed before, immediately after, and four weeks after the training. The health workers perceptions of the software were analysed thematically. A total of 207 community health workers were recruited from Nyamagabe district in Southern Province, Rwanda. Participants were composed of males (33.5%) and females (66.5%), aged between 22 and 68 years, and most (71%) had only completed primary education. Knowledge of cysticercosis at baseline was low, particularly knowledge of human cysticercosis and neurocysticercosis. The overall knowledge score increased significantly after training and was maintained four weeks after the training. Overall, insufficient knowledge was associated with neurocysticercosis-related questions, which after the training, remained relatively lower compared to questions of other categories. Participants reported the software to be user-friendly and educational. Digital illiteracy and the lack of smartphones were among the critical challenges highlighted in responses. This study has shown gaps in knowledge regarding T. solium infections within rural Rwanda, particularly neurocysticercosis. Health education using the Vicious Worm education software should be considered in integrated control programs.

Perception of Health Workers on the Integration of Mental Health Care with HIV Services in Primary Health Care Centres in Ogun East Senatorial District, Nigeria: A qualitative studyealth Services into HIV Care in Ogun East Senatorial District, Nigeria: A qualitative study

Background: People Living with HIV/AIDS have an increased incidence of mental health disorders as compared to the general population, and there exists an enormous gap between the demand and supply of mental health services, particularly in low- and middle-income countries. Aim/Objective: This study aimed to assess the association between HIV and mental health and the knowledge and perception of health workers on their integration in Primary Health Care Services in Ogun East Senatorial District, Nigeria Methodology: Four Focused Group Discussions were conducted among 27 PHC workers in Highly Active Antiretroviral Therapy (HAART)-enabled centres of Ogun East senatorial district, Nigeria using a focused group guide designed according to study objectives. Data were analyzed using a thematic analysis approach. Result: Six important themes were extracted from the data in this study (Table 2); “Integration of PHC services”, “Multiple mental/psychological health challenges”, “Multiple factors as causes of mental illness”, “Diverse manifestations of mental illness”, “Necessity of incorporating HIV and Mental Healthcare into PHC services”, and “Challenges of incorporating HIV and Mental Healthcare into PHC services.” Conclusion and Recommendation: The primary health workers identified the need to integrate mental health care into HIV care in PHCs. However, there is a need to scale up the capacity of PHCs for optimal performance in this regard.

Perception and Acceptance of the Newly Introduced COVID-19 Precaution (THIRD) Vaccination Dose among Health Workers at an Indian Medical College.

India has run a nationwide vaccination campaign against COVID-19, which has recently introduced a precaution (third) dose for health workers. This study assessed the perception and attitude of health workers toward the Indian vaccination campaign against COVID-19, with an emphasis on this major change. A printed questionnaire was distributed among health-care workers at the Medical College of West Bengal. The completed forms were analyzed. Most of the participants were doctors (83.7%). Although all had received two doses of vaccine before, 44.4% were unwilling to be vaccinated with the third dose in the present scenario. The majority (63.8%) of the patients were concerned about side effects. The emergence of new COVID strains (65.6%) was viewed as a threat to the effectiveness of the vaccines. Participants with higher age, comorbidities, and those with the perception that the third dose was being introduced appropriately and would be effective against newer strains of the vaccine tended to be more willing to get vaccinated with the precaution dose compared to their counterparts. A dilemma regarding the acceptance of precaution doses was noted among health workers. This warrants the availability of more comprehensive information to increase acceptance of these vaccines.

Analysis of factors affecting the utilization of BPJS health services at Royal Prima Hospital Medan in 2024

This study analyzes the utilization of BPJS Kesehatan services at RS Royal Prima Medan in 2024. Although BPJS Kesehatan offers affordable and equitable access to healthcare services, the suboptimal utilization rate indicates challenges in the effectiveness of healthcare services at the hospital. The research method used is a non-experimental quantitative approach with descriptive and associative analysis. The study population consists of patients who visited in the past 3 months, with a sample size of 200 respondents selected through purposive sampling techniques. The results of the analysis show a significant relationship between Age, Gender, Education, Occupation, Attitude Perception of Health Workers, and Facility Accessibility with the utilization of BPJS. Younger age groups, females, those with higher education, unemployed individuals, and those with positive perceptions of health workers and close accessibility are more likely to utilize BPJS. Multivariate analysis confirms that facility accessibility is the main factor influencing BPJS utilization, with an Odds Ratio of 13.558. This study provides a significant contribution to understanding the factors affecting BPJS service utilization at RS Royal Prima Medan. Strategic recommendations can be made to improve the effectiveness of healthcare services and the overall quality of the healthcare system, including improving accessibility to healthcare facilities for the public.

Health Workers Perception on Precautionary Knowledge and Practices in Secondary Hospitals and Isolation Centres for COVID-19 Preventive Measures in Lagos State, Nigeria

This paper assesses Health Workers' perception of precautionary measures, knowledge and practices in selected Secondary hospitals and Isolation centres for COVID-19 preventive measures in Lagos State, Nigeria. The study adopted a mixed-method research design. A sample of 302 respondents was obtained from Isolation Centres and Selected Secondary Health Facilities in Lagos State. The researcher used purposive and simple random sampling techniques to obtain data from the health workers. Through the administration of questionnaires and Key Informant Interviews, data for the study was obtained. The study found that about 201 (69.4%) of 290 respondents agreed that the information provided by the National Centre for Disease Control was adequate for the prevention of the COVID-19 Virus. guidelines: also revealed that all the Isolation centres studied had well-trained medical personnel and IPC guidelines on standard precautions, hand hygiene, and waste management guidelines; similarly, all facilities studied had guidelines for transmission–based precautions contained therein. The study therefore recommended amongst others that There should be adequate and efficient collaborations among all stakeholders in the fight against COVID-19 disease.

Use of a health worker-targeted smartphone app to support quality malaria RDT implementation in Busia County, Kenya: A feasibility and acceptability study.

Malaria rapid diagnostic tests (mRDTs) are an essential diagnostic tool in low-resource settings; however, administration and interpretation errors reduce their effectiveness. HealthPulse, a smartphone mRDT reader application, was developed by Audere to aid health workers in mRDT administration and interpretation, with an aim to improve the mRDT testing process and facilitate timely decision making through access to digitized results. Audere partnered with PSI and PS Kenya to conduct a pilot study in Busia County, Kenya between March and September 2021 to assess the feasibility and acceptability of HealthPulse to support malaria parasitological diagnosis by community health volunteers (CHVs) and private clinic health workers (private clinic HWs). Metadata was interpreted to assess adherence to correct use protocols and health worker perceptions of the app. Changes to mRDT implementation knowledge were measured through baseline and endline surveys. The baseline survey identified clear mRDT implementation gaps, such as few health workers correctly knowing the number of diluent drops and minimum and maximum wait times for mRDT interpretation, although health worker knowledge improved after using the app. Endline survey results showed that 99.6% of health workers found the app useful and 90.1% found the app easy to use. Process control data showed that most mRDTs (89.2%) were photographed within the recommended 30-minute time frame and that 91.4% of uploaded photos passed the app filter quality check on the first submission. During 154 encounters (3.5% of all encounters) a health worker dispensed an artemisinin-based combination therapy (ACT) to their patient even with a negative mRDT readout. Overall, study results indicated that HealthPulse holds potential as a mobile tool for use in low-resource settings, with future supportive supervision, diagnostic, and surveillance benefits. Follow-up studies will aim to more deeply understand the utility and acceptance of the HealthPulse app.

Perceptions of community health workers on teenage pregnancy in rural Limpopo: A qualitative study.

Despite measures put in place to combat teenage pregnancy, the rate remains high. Community health workers (CHWs) are a cadre of health workers that can help put measures in place to reduce teenage pregnancy in the communities in which they live and work. This article aims to gain a deeper understanding of CHWs' perceptions regarding teenage pregnancy in the rural districts of Limpopo province. An exploratory qualitative study approach was employed to collect data from CHWs in two rural districts of Limpopo. A non-probability purposive sampling approach was used to choose 81 CHWs. Eight focus group discussions (FGDs) were organised, and audio recorded to collect data from participants. The discussions were 2-3 h long and conducted in English, and data saturation was attained by the fifth FGDs. An eight-step tech's content analysis approach was employed to deductively code, analyse and summarise data into themes. Three themes emerged: the prevalence of teenage pregnancy in rural villages, factors contributing to teenage pregnancy and challenges faced by CHWs when dealing with teenage pregnancy. The study's findings revealed that CHWs face challenges in their communities when offering appropriate teen pregnancy services and CHWs believe that teen pregnancy numbers remain high. There is a significant barrier in combating teenage pregnancy; if contraceptives are not acceptable to the community, the only solution and option for combating teenage pregnancy is abstinence.Contribution:The CHWs presented their insights of teenage pregnancy in rural communities. The outcomes of this study could help clinical practise, schools, communities, youth-friendly services, policymakers and other non-governmental organisations reduce teenage pregnancy.

Analysis Of Factors Influencing Patient Safety Incidents at Royal Prima Medan General Hospital in 2021

Incident safety patients must be minimized to avoid undesirable danger during maintenance in the hospital. Perception of health workers reporting patient safety incidents at the Royal Prima Medan General Hospital still needs to be higher. Low perception of health workers in writing incident Patient safety is related to individual and organizational factors. The study aims to identify the influence factor on patients' personal and corporate incident safety in the inpatient room of royal prima hospital medan. The type of research used is a method survey with a cross-sectional approach. The population in the study of health workers at the Royal Prima General Hospital in Medan was 259 people, and the sample was 119. Collection data with primary, secondary, and tertiary data was analyzed with multiple logistic regression statistical tests with a level of trust of 95%. Results study show bring individual factors (knowledge with p-value = 0.021 and experience with p-value=0.021) effect-on-patient safety incident reporting and organizational factors (organizational environment with p-value = 0.038 and power with p-value=0.014) effect on reporting incident safety patient, individual characteristics (motivation with p-value = 0.557) have no impact on writing incident safety patient And factor organization (organizational culture with p-value =0.535) has no effect to reporting incident patient safety and most influence reporting incident patient safety in Royal Prima General Hospital Medan is a knowledge variable (OR=155.6). They are recommended for a hospital for-develop system information integration related to writing incident patient safety and officer health to increase the perception of officer health through improvement, knowledge, and experience of officer health.

Perception and Attitude of Health Care Workers in Tertiary Health Care Facilities in Plateau State, Nigeria towards Sexual and Reproductive Health Services for Unmarried Adolescents

Adolescents are faced with the challenges of having access to and the utilization of quality sexual and reproductive health services, and one of the barriers responsible for this situation is the negative personal attributes of service providers. This study aimed to assess the perception and attitude of health workers in the tertiary health facilities in Plateau State towards sexual and reproductive health services for unmarried adolescents. A cross-sectional study was conducted in December 2020 among 208 doctors and nurses/midwives who were selected using a stratified sampling technique. Data were collected using a semi-structured self-administered questionnaire and analyzed using the Statistical Product and Service Solutions version 23. The mean age of the respondents was 37.1 ± 9.1 years, 131 (63.0%) were doctors and females constituted 120 (57.7%). One hundred and twenty-nine (62.0%) had a good perception, while 105 (50.5%) had a positive attitude towards sexual and reproductive health services for unmarried adolescents. Younger age below 55 years and a good perception were found to be predictors of a positive attitude towards sexual and reproductive health services for unmarried adolescents. A considerable number of the health workers in the tertiary health facilities in Plateau state had a negative attitude towards sexual and reproductive health services for unmarried adolescents, an attribute that was significantly seen more in those who were older and had a poor perception. There is a need to improve healthcare workers’ attitudes towards the provision of sexual and reproductive health services for unmarried adolescents.

Factors associated with initial AstraZeneca vaccine knowledge, attitudes, and uptake among hospital nurses: A cross-sectional study in Ghana's Upper East region.

The COVID-19 pandemic has caused over 171,657 confirmed cases and 1,462 deaths in Ghana, particularly among frontline health-workers involved in pandemic response. Prevention measures in Ghana include AstraZeneca 'Covishield' vaccination of health-workers, but research on factors affecting uptake of COVID-19 vaccines in Ghana were initially limited. Therefore, this study aimed to analyse knowledge, attitudes, and initial uptake of Covishield among nurses in the War Memorial Hospital in Navrongo, Upper East Region. We conducted a cross-sectional survey of 128 district hospital nurses using simple random sampling. We first calculated descriptive statistics and two composite variables summing either participant knowledge or attitude variables, with a threshold over 50% considered 'sufficient' or 'positive' respectively. We then analysed associations between demographic variables and Covishield knowledge, attitudes, or uptake using binomial logistic regression with a 95% confidence interval and p-value of <0.05 considered significant. All participants had heard of Covishield vaccine, with attitudes toward it generally positive (53%), and uptake high (72%). Reasons cited by the 28% unvaccinated included absence during vaccination, having already been infected with COVID-19, lack of trust in vaccine safety/efficacy, or pregnancy/breastfeeding. Education, residence, and family type were the only demographic factors significantly associated with nurses' knowledge about, attitudes towards, or uptake of COVID-19 vaccination. While 'positive' attitude was significantly associated with higher odds of being vaccinated (AOR 4.75; 95%CI 1.59-14.1), 'sufficient' knowledge was not (AOR 1.33; 95%CI 0.53-3.32). This is the first study in Ghana's resource-constrained Upper East region to examine health-worker perceptions of a novel vaccine and showed nurses' knowledge, attitudes, and uptake of COVID-19 vaccination were good overall. Further research is needed to determine how best to address hesitancy and understand findings that attitudes appeared more relevant than knowledge for uptake. Findings are relevant for local health authorities in improving vaccine availability and strengthening emergency risk communication and management of adverse events following immunisation.

Construção e validação do questionário de percepção dos Agentes Comunitários de Saúde sobre condições sensíveis à fisioterapia na Atenção Primária

Abstract Introduction Community health workers, like the physiotherapist, perform essential functions in primary health care, being an important element in the transformation of public policies. There are no reported studies investigating the knowledge of community health workers about health conditions amenable to physiotherapy intervention in primary health care. Objective To construct a questionnaire to investigate the perception of community health workers about health conditions that could be remedied by physiotherapy intervention in primary health care. Methods This was a methodological study in which it was initially an analysis matrix with the aim of encompassing the ideas contemplated in the questionnaire. To construct the instrument, a literature review was carried out, and health conditions treatable with physiotherapy in primary health care were chosen. To validate the content and appearance of the items, twelve physiotherapists specialized in primary health care judged the suitability of the items contained. The content validity index was used to determine the degree of agreement during the response analysis process. Subsequently, a semantic analysis was carried out through the understanding of the items by 15 community health workers. In the validation stage, two rounds of evaluation were carried out. Adjustments were made to 17 questions. Results The study investigated a questionnaire with 20 questions containing hypothetical situations of home visits, in which the resident's situation could or could not constitute a health risk amenable to physiotherapeutic intervention. Conclusion The community health workers perception instrument on health conditions amenable to physiotherapy intervention in primary health care proved to be valid for use in this context. The use of the instrument may contribute to the development of community health worker training programs, with the aim of facilitating team communication.

Construction and validation of the community health workers perception questionnaire on conditions amenable to physiotherapy in primary health care

Resumo Introdução O Agente Comunitário de Saúde (ACS), assim como o fisioterapeuta, desencadeia funções fundamentais na Atenção Primária à Saúde (APS), sendo ele-mento importante na transformação de políticas públicas. Inexistem estudos que investiguem o conhecimento dos ACS sobre as condições de saúde sensíveis à inter-venção da fisioterapia na APS. Objetivo Construir um questionário de investigação da percepção dos ACS sobre as condições de saúde sensíveis à intervenção da fisioterapia na APS. Métodos Trata-se de um estudo metodológico no qual, inicialmente, construiu-se uma matriz de análise com o intuito de englobar as ideias contempladas no questionário. Para a construção do instrumento, realizou-se uma revisão da literatura, sendo eleitas condições de saúde sensíveis à intervenção da fisioterapia na APS. Para a validação de conteúdo e aparente dos itens, 12 fisioterapeutas especialistas em APS julgaram a adequação dos itens contidos. Utilizou-se o índice de validade de conteúdo para verificar o grau de concordância durante o processo de análise das respos-tas. Posteriormente, realizou-se análise semântica por meio da compreensão dos itens por 15 ACS. Na etapa de validação, foram realizadas duas rodadas de avaliação. Foram feitos ajustes em 17 questões. Resultados O estudo resultou em um questionário com 20 questões contendo situações hipotéticas de visitas domiciliares, cuja situação do morador poderia ou não configurar um risco à saúde sensível à intervenção fisioterapêutica. Conclusão O instrumento de percepção dos ACS sobre as condições de saúde sensíveis à intervenção da fisioterapia na APS mostrou-se válido para ser utilizado no contexto da APS. A utilização do instrumento poderá contribuir na elaboração de programas de capacitação dos ACS, com o intuito de facilitar a comunicação da equipe.

The Effect of Psychological Empowerment on Job Satisfaction: Regulatory role of generations X and Y

The objective of this study is to determine the moderator role of generation gap in the effect of psychological empowerment perception on job satisfaction. The population (N: 200) and sample (n=136) of the study consists of health professionals working in the Karaman Provincial Health Directorate, Türkiye. In the research data were collected with a questionnaire technique and the hypotheses were tested through the SPSS Macro Process program. The significance of the regulatory role (statistically) was calculated by the bootstrap test. As a result of the analyzes made, it was found that the moderator effect of psychological empowerment perception on job satisfaction differed between the X and Y generations. While the effect of the psychological empowerment perceptions of the X Generation employees on job satisfaction did not show a statistically significant difference, this effect was found to be statistically significant in the Y Generation employees. It has been found that generations have a moderator effect on the effect of psychological empowerment perceptions of health workers on job satisfaction (X and Y).

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.

Determinants of Artificial Intelligence Adoption in Disease Diagnosis for Improving Health Sector Services in Tanzania: A Case of Muhimbili National Hospitals

The study was conducted at Muhimbili national Hospitals to assess the use of Artificial Intelligence in Disease Diagnosis for Improving Health Sector Services in Tanzania. Specifically, the study was interested to assess factors affecting AI adoption in public hospital, examine health workers perception on AI adoption in public hospital and find out effectiveness of AI adoption in proper diagnostic of diseases for improving patient health in public hospitals. The study guided by Technology Acceptance Model. It employed quantitative research approach and survey research design. A sample size of 47 respondents was used where questionnaire were used in data collection. The study revealed that artificial intelligence was useful in diseases diagnosis as it provides accurate information pertaining to patient health; it is quicker in diseases diagnosis and quicker in predicting and diagnosis of patient health. The findings also posited that artificial intelligence is effective in monitoring heart attack and asthma in real time, AI is effective in managing health services, AI is also effective in improving diagnostic and patient. The study recommends the government to provide health workers with training regularly on how to use AI in diseases diagnosis.

Understanding variations in diarrhea management across healthcare facilities in Bangladesh: a formative qualitative study.

Acute diarrhea remains a leading cause of morbidity and mortality with over 6.3 billion cases and 1.3 million deaths annually. Despite the existence of standardized guidelines for diarrhea management, wide variability in clinical practice exists, particularly in resource-limited settings. The goal of this study was to qualitatively explore how diarrhea management in Bangladesh varies according to resource availability, clinical setting, and provider roles. This was a secondary analysis of a cross-sectional qualitative study conducted in three diverse hospital settings (district hospital, subdistrict hospital, and specialty diarrhea research hospital) in Bangladesh. A total of eight focus group discussions with nurses and physicians were conducted. Applied thematic analysis was used to identify themes regarding variations in diarrhea management. Of the 27 focus group participants, 14 were nurses and 13 doctors; 15 worked in a private diarrhea specialty hospital and 12 worked in government district or subdistrict hospitals. Several key themes emerged from the qualitative data analysis: 1) priorities in the clinical assessment of diarrhea 2) use of guidelines versus clinical judgment; 3) variability in clinician roles and between clinical settings influences care delivery; 4) impact of resource availability on diarrhea management; and 5) perceptions of community health workers' role in diarrhea management. Findings from this study may aid in informing interventions to improve and standardize diarrhea management in resource-constrained settings. Resource availability, practices regarding diarrhea assessment and treatment, provider experience, and variability in provider roles are essential considerations when developing clinical tools in low- and middle- income countries.

FACTORS AFFECTING INDONESIAN PUBLIC HEALTH CENTERS' HEALTH WORKERS' INCOME ADEQUACY

Background: Dissatisfaction, additional work, and desired compensation are related to the needs and perceptions of civil servant health workers to increase their income. However, the probability and influencing factors regarding the income adequacy of civil servant health workers in Indonesia are still unknown. Aims: to find out the factors related to the income adequacy of health workers. Methods: This observational study with a cross-sectional design uses data from the Employment Research in the Health Sector (RISNAKES) 2017 in Public Health Centers in Indonesia. Probit analysis was conducted to assess the probability of income adequacy. Results: A total of 963 respondents were analyzed. The study found that changes in each variable, including income, official residence facilities, training facilities/ seminars/ training, motivation, and job satisfaction of a unit, would increase the probability of income adequacy ranging from 2% - 81%, except for the age variable. By referring to high job satisfaction of &gt; 75% and taking into account the probability of 80%, the presumed adequate income is no less than IDR 28,800,000. Conclusion: The probability of the monthly income adequacy of civil servants in the health sector is influenced by job satisfaction, ability to save, official residence facilities, facilities to attend seminars, age, and income. Increasing and reformulating the amount of income must be done to optimize the performance and productivity of health workers. Keywords: health workers, income adequacy, public health center, saving

FACTORS AFFECTING INDONESIAN PUBLIC HEALTH CENTERS' HEALTH WORKERS' INCOME ADEQUACY

Background: Dissatisfaction, additional work, and desired compensation are related to the needs and perceptions of civil servant health workers to increase their income. However, the probability and influencing factors regarding the income adequacy of civil servant health workers in Indonesia are still unknown. Aims: to find out the factors related to the income adequacy of health workers. Methods: This observational study with a cross-sectional design uses data from the Employment Research in the Health Sector (RISNAKES) 2017 in Public Health Centers in Indonesia. Probit analysis was conducted to assess the probability of income adequacy. Results: A total of 963 respondents were analyzed. The study found that changes in each variable, including income, official residence facilities, training facilities/ seminars/ training, motivation, and job satisfaction of a unit, would increase the probability of income adequacy ranging from 2% - 81%, except for the age variable. By referring to high job satisfaction of &gt; 75% and taking into account the probability of 80%, the presumed adequate income is no less than IDR 28,800,000. Conclusion: The probability of the monthly income adequacy of civil servants in the health sector is influenced by job satisfaction, ability to save, official residence facilities, facilities to attend seminars, age, and income. Increasing and reformulating the amount of income must be done to optimize the performance and productivity of health workers. Keywords: health workers, income adequacy, public health center, saving