Preparedness Of Health Care Facilities Research Articles

Utilisation of Maternal Health Services During COVID-19 Pandemic: Findings from Rural West Bengal, India

The existing state of health infrastructure and services, which is often poor in rural areas of the country is further faced with challenges due to the COVID-19 pandemic. The current study attempts to provide some key insights on the impact of COVID-19 on utilisation of maternal healthcare services during the pandemic. The study used the mixed-method data, gathered through a cross-sectional study conducted in 2020 in South 24 Parganas district of West Bengal. Currently, married women ( n = 318) who were pregnant or had delivered a child were selected for the interview through a multi-stage sampling technique. Frequency distribution, bi-variate cross tabulation and logistic regression were performed. Of the eligible women during the pandemic, 86% have received regular antenatal care, 73% have delivered in a health facility even though the quality of service was poor; and only 37.6% received postnatal care within 42 days of delivery. ‘Risk perception of women towards being infected with COVID-19’ were found to be the most significant determinants of maternal healthcare utilisation. COVID-19 pandemic has significantly affected the quality and utilisation of maternal health services in rural West Bengal. The results suggest the need for better preparedness of healthcare facilities in terms of human resources and physical infrastructure; as well as educating the community through awareness (counter rumours) and through risk and behaviour change communication regarding COVID-19 protocols and community engagement to effectively manage utilisation of Maternal healthcare services during pandemic.

Patients’ Satisfaction with Quality Healthcare Services in Omani Public Hospitals: The Moderating Role of the Perceived Risk of Covid 19

The quality of healthcare services becomes more important during crisis, In the event of a COVID-19 pandemic, the healthcare scenario is chaotic and confusing owing to the random and unexpected spread of the pandemic. The present study aims to use the SERVQUAL model in measuring the healthcare service quality and patient satisfaction and while the moderation of the perceived risk of COVID 19 between healthcare service quality, Resources availability, Healthcare facility preparedness and patient satisfaction in the public healthcare sector in Oman. The research is based on Expectancy-Disconfirmation Paradigm, Extended Valence Framework, and stakeholders’ theory. In this study, the use of mixed research design the sample size for the quantitative approach is 387 patients selected using probability random sampling and the sample size for the qualitative approach is 8 patients who visited public Omani hospitals during COVID 19 period. The result of the quantitative analysis using SEM and RMSEA results showed a good fit. Only the tangibility dimension of the SERVQUAL model and the resource availability had an insignificant effect on the healthcare quality in Omani public hospitals. The moderation effect of Perceived risk of COVID-19 pandemic between healthcare service quality, Resources availability, Healthcare facility preparedness and patient satisfaction among Omani patients in public hospitals was insignificant. The results of the qualitative analysis indicated that assurance, reliability, responsiveness and empathy were the most important aspects of quality healthcare service. This research adds value for practitioners by providing in depth view of the current status of the patient satisfaction of the public healthcare sector especially during COVID 19 pandemic Keywords: SERVQUAL, healthcare quality, Covid 19, Oman.

Feasibility of task-sharing with community health workers for the identification, emergency management and referral of women with pre-eclampsia, in Mozambique

BackgroundMaternal mortality is an important public health problem in low-income countries. Delays in reaching health facilities and insufficient health care professionals call for innovative community-level solutions. There is limited evidence on the role of community health workers in the management of pregnancy complications. This study aimed to describe the feasibility of task-sharing the initial screening and initiation of obstetric emergency care for pre-eclampsia/eclampsia from the primary healthcare providers to community health workers in Mozambique and document healthcare facility preparedness to respond to referrals.MethodThe study took place in Maputo and Gaza Provinces in southern Mozambique and aimed to inform the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomized controlled trial. This was a mixed-methods study. The quantitative data was collected through self-administered questionnaires completed by community health workers and a health facility survey; this data was analysed using Stata v13. The qualitative data was collected through focus group discussions and in-depth interviews with various community groups, health care providers, and policymakers. All discussions were audio-recorded and transcribed verbatim prior to thematic analysis using QSR NVivo 10. Data collection was complemented by reviewing existing documents regarding maternal health and community health worker policies, guidelines, reports and manuals.ResultsCommunity health workers in Mozambique were trained to identify the basic danger signs of pregnancy; however, they have not been trained to manage obstetric emergencies. Furthermore, barriers at health facilities were identified, including lack of equipment, shortage of supervisors, and irregular drug availability. All primary and the majority of secondary-level facilities (57%) do not provide blood transfusions or have surgical capacity, and thus such cases must be referred to the tertiary-level. Although most healthcare facilities (96%) had access to an ambulance for referrals, no transport was available from the community to the healthcare facility.ConclusionsThis study showed that task-sharing for screening and pre-referral management of pre-eclampsia and eclampsia were deemed feasible and acceptable at the community-level, but an effort should be in place to address challenges at the health system level.

Challenges Encountered by Healthcare Providers in COVID-19 Times: An Exploratory Study

Healthcare establishments are unique and complex. The Indian healthcare system comprises of public and private healthcare establishments. Different challenges are encountered by the healthcare professionals in their daily operations. The sudden emergence of COVID-19 posed a new threat to the already burdened healthcare system. The pandemic changed the healthcare paradox with newer workplace and societal challenges faced by the healthcare personnel. The purpose of this study is to identify the antecedents of workplace and societal challenges faced by the healthcare personnel. Our study conducted in Kolkata and other adjoining areas of West Bengal included respondents who volunteered for individual in-depth interviews. The sample size was kept at n = 20 after due technical considerations. Freelisting and pile sorting was done to generate clusters. The qualitative study identified five constructs with 18 items under workplace challenges and three constructs with five items under societal/community challenges. Workplace challenges included resource availability, adequacy and allocation, financial issues, perceived managerial ineffectiveness, inconsistent guidelines and perceived occupational stress, while societal/community challenges included dread disease, social adaptiveness and challenges related to essential services. A salience threshold was established and the multidimensional scaling provided four major clusters: financial support and sustainability, adaptive resilience, infection risk mitigation and healthcare facility preparedness. Suggestive actions for the identified challenges were summed as enhanced production of diagnostic kits through public–private partnership models and industrial production reforms. Enhanced testing facility for COVID-19 will help to identify new cases. Financial stresses need long-term sustainable alternative that will avoid pay cuts and unemployment. Treatment regimen, diagnostic protocols, waste disposal guidelines should be worked upon and leading national agencies be consulted for technical support, research and development.

Preparedness of healthcare facilities for an influenza pandemic – protecting the healthcare workers

Preparedness of healthcare facilities for an influenza pandemic – protecting the healthcare workers