Key Workers Research Articles (Page 1)

BackgroundAntimicrobial resistance (AMR) poses a major threat to public health, especially in LMICs. Accredited Social Health Activists (ASHAs) are key community health workers in India who can be empowered to promote rational antibiotic use.ObjectiveTo compare the effectiveness of gamified versus conventional teaching methods in improving AMR-related knowledge among ASHAs in Mysuru, south India.MethodsA prospective interventional study was conducted among 73 ASHAs during World Antimicrobial Awareness Week 2024. Group A (n = 31) received gamified training using interactive games, and Group B (n = 42) received conventional teaching through lectures and board-based instruction. Knowledge was assessed using a 25-item questionnaire before and after the intervention. Data were analysed via Wilcoxon signed-rank and Mann–Whitney U tests.ResultsKnowledge improved in both groups, but gains were markedly higher with gamification. The mean post-test score reached 86.08% in gamified training versus 54.48% for conventional teaching (p < 0.001; effect size r = 0.75). Gamified training consistently outperformed conventional methods across all infection domains, leading to predominantly good-to-excellent knowledge levels.ConclusionGamified interventions substantially enhanced ASHAs’ knowledge compared to conventional teaching, offering a scalable and low-cost strategy to strengthen antimicrobial stewardship in community settings. Long-term studies are needed to assess retention and behavior change.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12909-025-08092-9.

ABSTRACTThis article is about how labour in a sector can be upgraded through new labour market institutions by mobilizing political support across political camps, even if collective bargaining power through strong trade unions and employers' associations is insufficient. The article summarizes the results of several empirical research projects by the two authors on elderly care, in which the key players in the sector were interviewed. Institutional erosion in labour relations, with its particularly dynamic ‘force field’, is a key topic of recent institutional theories. In contrast, the analysis of the revitalization of successful institutional innovations for the upgrading of work plays a subordinate role. The field of elderly care in Germany is an example of the successful upgrading of key workers in this market‐oriented sector through a deliberate institutional change in the German industrial relations system.

Background: Pre-exposure prophylaxis (PrEP) is recommended as part of a comprehensive HIV prevention approach, but its uptake among women, particularly those in key populations, remains limited. Methods: A mixed-methods community-based study was conducted in Mali, Mauritius, and Morocco to assess barriers and facilitators to PrEP implementation among cis and transgender women at high risk of HIV infection. Quantitative data collected included demographic information, awareness, willingness to use PrEP, and perceived barriers. The qualitative component included in-depth interviews with key populations, policymakers, healthcare workers, and community stakeholders to better determine the barriers to PrEP implementation and scale-up for women. Data analysis and processing were performed using software adapted to the respondent-driven sampling technique. Results: Between 15 February and 15 March, 2020, a survey was conducted involving 1 003 female participants. The results indicated varying levels of awareness of PrEP across different populations, with transgender women in Mauritius exhibiting the highest awareness (54%). Moreover, there was generally a high willingness to use PrEP among participants, with rates of 77% and 84% among female sex workers in Morocco and Mali, respectively, and 71% among female partners of people who inject drugs, as well as 50% among transgender women in Mauritius. Additionally, qualitative insights revealed prevailing barriers such as issues related to accessibility, stigma, and the legal frameworks in the respective countries. Conclusion: This study provides critical insights into the challenges and opportunities for PrEP implementation among women in Mali, Mauritius, and Morocco. The findings underscore the importance of community-based research and the need for tailored interventions to improve PrEP awareness and uptake among women, particularly those in key populations. The results may inform advocacy efforts and the provision of adapted services within comprehensive HIV prevention programs to better address the needs of these populations.

To assess the duration of employment and examine the impact of emotional intelligence on the psychological well-being of men who have sex with men (MSM), trans women (TW), and female sex workers (FSW) working in HIV community-based organisations (CBOs) in Pakistan. Explanatory sequential mixed-methods study. Place and Duration of the Study: CBOs in 16 districts and 50 sites across Pakistan, from November 2023 to April 2024. Individuals over 18 years of age, self-identifying as MSM, TW, or FSW, and working at a CBO were enrolled. Psychological well-being was measured using the Ryff's psychological well-being scale, and emotional intelligence was measured using the Wong and Law Emotional Intelligence scale (WLEIS). The multiple linear regression was used to identify predictors of psychological well-being. Ten in-depth qualitative interviews were also conducted among CBO workers. A total of 188 CBO workers were included in the quantitative survey; of these, 128 (68.1%) were MSM, 18 (9.6%) were FSW, and 42 (22.3%) were TW. The multiple regression analysis showed that residence away from family (β = 2.85; p = 0.038), history of suicidal ideation (β = -3.74; p = 0.022), and emotional intelligence (β = 3.25; p <0.001) were significant predictors of psychological well-being. The qualitative analysis showed a positive effect of CBO employment, contributing to professional growth and empowerment and acceptance of gender and sexuality. Living away from family and having higher emotional intelligence were positive predictors of psychological well-being. A history of suicidal ideation was associated with poor psychological well-being. There is qualitative evidence that suggests that CBO employment improves psychological well-being. Men who have sex with men, Trans women, Female sex workers, Psychological well-being, HIV, Community-based organisations.

Challenges in data documentation and retrieval in the ASHA diary from a usability perspective.

BackgroundThe Indian tribal population is varied, with a wide range of customs, ways of life, and cultural practices. However, there is one thing that all Indian tribal communities have in common: they have worse health indicators, a higher rate of illness and mortality, and very restricted access to medical care. Their health issues require extra consideration in the right setting (Salil, Health and Population Perspectives and Issues 23:61-70, 2000). Growth in the utilization of reproductive and maternal health services will not only curtail down the reproductive morbidities, but it will also reduce the child mortality (Sharma et. al, Utilization of health services and RCH status in Madhya Pradesh: a District Level Analysis. In Proceedings of National Symposium on Tribal Health 2011). Men’s participation in prenatal care, delivery and postpartum period is rarely found, especially among tribal communities, due to their economic instabilities and priorities. Also our health system does not promote the involvement of men in the maternal and child health care. Hence, there was a need felt for development of gender and community sensitive interventions package that could address the individual and the community health care facility level barriers of male involvement in utilisation of the maternal care services. Our study was an effort to determine the feasibility of implementing a behaviour Change Communication Interaction developed for improvement in utilisation of maternity care services through male participation among the Saharia Tribes in Gwalior District, Madhya Pradesh.Methods The Study utilised a qualitative approach. Various activities were organised as a part of BCC, viz., Community mobilization, Campaign/Rallies, Interpersonal Communication-Drama & Mock Sessions, Face to Face counselling and Quiz etc. Action technique called Transect was used in order to know more about the environment and living of the people of Saharia Tribes in Gwalior District, Madhya Pradesh. Feasibility of the model was assessed by focusing on three main principles i.e., acceptability, integration and limited-efficacy testing.ResultAcceptability testing study reveal that BCC intervention was successfully accepted by intended individual- both targeted individuals and those involved in implementing programs. Integration approach reveal that no major change in infrastructure of Govt. Programmes and facilities is required. Instead, effective application relies on the engagement of key community members and local health service workers. Limited-efficacy testing reveals that there is a behavioural change in men’s perception of accompanying their spouse to the health centre; same was observed on the vaccination day in the village.ConclusionsThe BCC intervention proved to be feasible to implement. The Proposed BCC interaction is feasible and accepted by both Programme stake holders and beneficiaries.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12913-025-13099-5.

This study explores how social workers navigate and respond to the circulation of disinformation in disadvantaged neighbourhoods, with particular attention to the affective and socio-spatial dynamics that shape trust and knowledge-making. Grounded in feminist epistemology and anti-oppressive social work theory, the research positions social workers as epistemic agents embedded in contested knowledge environments. Using a qualitative research strategy, the study draws on interviews with five social workers who have both lived and professional experience in disadvantaged neighbourhoods in the Czech Republic. Thematic analysis, following Clarke and Braun's model, revealed three key roles social workers adopt in relation to disinformation: social workers as epistemic mediators; social worker as a knowledge steward and epistemic amplifier; and social workers as epistemic agents. The findings challenge dominant correctional paradigms that treat misinformation as individual ignorance, instead foregrounding relational, affective, and structurally constrained epistemic practices. This study contributes to feminist social work by reimagining practitioners as allies in epistemic justice—validating subjugated knowledges, responding to emotion as epistemic force, and resisting institutional distrust. Implications for social work education include the need for education that cultivate epistemic reflexivity, emotional literacy, and critical digital engagement. Social workers should be equipped to address not just disinformation, but the systemic conditions that make it persuasive.

IntroductionIn Guinea, where 36% of people living with HIV (PLHIV) are unaware of their serostatus, innovative screening strategies are crucial to achieving the joint United Nations Program on HIV/AIDS’ 95–95-95 targets. Community-based HIV testing, as recommended by the World Health Organization, aims to reach at-risk populations by leveraging local resources and actors. Using the Consolidated Framework for Implementation Research (CFIR), this study assessed facilitators and barriers to implementing community-based HIV screening across 10 pilot sites in Guinea, with the goal to optimizing its effectiveness.MethodsThis qualitative descriptive study applied the CFIR framework to identify factors influencing the implementation of community-based HIV screening and capture the nuanced perspectives of stakeholders. Overall, 28 in-depth interviews were conducted with key participants, including PLHIV, health workers, community-based actors, and members of the national coordination teams.ResultsHome-based testing was identified as a key facilitator for improving access to healthcare by reducing financial and logistical barriers. However, several barriers hindered its effectiveness, including frequent stock shortages, concerns about confidentiality and stigma, insufficient training and incentives for community counselors, and the absence of clear protocols defining the roles and responsibilities of stakeholders.ConclusionThe findings emphasize the need to strengthen community-based HIV testing in Guinea by ensuring a consistent supply of essential resources, enhancing coordination among stakeholders, and providing adequate incentives for community counselors. Integrating this approach into national policies could enhance both its effectiveness and sustainability, offering actionable insights for adapting HIV testing strategies in similar resource-limited settings.

Seafarers are key workers who play a crucial role in international trade. Many studies have investigated various factors that influence the well-being, motivation and work performance of seafarers. According to the results of studies conducted among the general population, personal values could be important for the well-being of seafarers, but have not yet been investigated. The aim of this study was therefore to look into the differences in the personal values of future seafarers in a cross-cultural context. 423 students from maritime universities in Croatia, Spain and Iran took part in the online study. The participants completed the demographic questionnaire and the Portrait Values Questionnaire. The results show the differences in the perceived importance of values between students from different countries. For example, Croatian students considered value preservation less important than Spanish and Iranian students, while openness to change and self-improvement were more important for Iranian than for Croatian and Spanish students. In addition, differences were found in conformity, self-direction, stimulation, hedonism, power, security and achievement. The Iranian students considered the above values to be more important than Spanish and Croatian students. These results emphasize the importance of intercultural training for the different stakeholders in the maritime sector.

Identify desired training content for shift-working nurses to improve their sleep and fatigue. A descriptive qualitative design. We recruited night shift nurses (N = 23) to provide feedback during virtual focus groups/interviews. Data collection occurred in the U.S. between March and June 2024. Participants were presented with sleep and fatigue topics derived from the literature. Focus group/interview data were collected and transcribed. Data were analysed using a hybrid deductive-inductive manifest content analysis with an a priori coding schema based on topics shared during data collection. Data not fitting the schema, yet informing content, were analysed inductively. Three themes aligned with literature-derived topics. Theme 1, Why We Sleep and Why Should Nurses Care, explains the importance of sleep to health. Theme 2, Sleep Practices for Nurses to Support Health and Social Relationships, describes healthy strategies to promote sleep for enhanced quality of life. Theme 3, Fatigue and Work, illustrates the significance of nurse sleep and fatigue risk mitigation to safe working conditions and patient care. Study findings highlight night shift nurses' interest in gaining evidence-based information to promote their sleep. Sleep education and training could fill a knowledge and skills gap, not often offered in school or workplace. Identifying themes relevant to nurses may help increase the development and availability of sleep education and training currently tailored for nurses. Study findings describe content night shift nurses' desire for sleep and fatigue training, serving as an important first step in developing programmes most relevant to shift-working nurses. Our analysis found the findings largely align with key components workers should receive in sleep education and training and reinforced the need for employers to offer such training. This study could benefit the nursing workforce and employers who expect rested, high-functioning nurses to care for patients. Standards for Reporting Qualitative Research. No patient or public contribution. Clinicaltrials.gov, NCT06105307.

Abstract for Scopus Indexing: COVID-19 pandemic public health restrictions degraded the labour and human rights of seafarers globally. Seafarers were denied medical care, repatriation, and leave. More than 400,000 seafarers were stranded at sea beyond the end of their contracts. Many studies evaluated the strengths and limitations of the Maritime Labour Convention, 2006 (MLC, 2006) and criticized the violation of seafarers’ rights during the pandemic worldwide. However, few academic studies have interpreted the new MLC, 2006 amendments unveiled in 2022. To fill this research gap, this article examines to what extent the 2022 amendments of MLC, 2006 address maritime labour governance deficits revealed during the COVID-19 pandemic. Through an examination of the efforts made by representatives of seafarers, shipowners and governments at the Fourth Meeting of the Special Tripartite Committee of the Maritime Labour Convention, 2006 (2021–2022), we find that the 2022 amendments can enhance seafarers’ health and safety rights to personal protective equipment, free potable water, urgent medical care, prompt repatriation, and social connectivity. However, significant gaps remain, such as the lack of recognition of seafarers as key workers, and inadequate support for port-based welfare services. Robust collaboration and communication channels between flag, port, and labour-supplying States are still missing.

Aims: Research shows that mental health problems are experienced by the majority of drug (70%) and alcohol (86%) users in community substance misuse treatment.Islington Better Lives is a busy inner London community substance misuse clinic and service users frequently present in mental health crisis. The substance misuse multidisciplinary team is primarily nonmedical, as a result substance misuse keyworkers reported feeling uncertain of how to manage and at times overwhelmed by service users in acute mental health crisis.Methods: To improve both the confidence of the keyworkers and more effectively and safely manage service users in acute mental health crisis we put on several talks across two sites in the borough. These talks covered how to manage, risk assess and appropriate referral to the various pathways within the North London Mental Health Partnership; the roles of Mental Health Crisis Assessment Service (MHCAS), the crisis team and crisis house and when psychiatric admission may be merited.Results: 30 keyworkers were surveyed before and after the talk on confidence in managing several domains of mental health crisis. Asked: How confident are you in managing a service user a. having a mental health crisis? b. with thoughts of self-harm? c. with suicidal thoughts? and finally d. Do you feel you know the appropriate next steps if you feel a patient is in mental health crisis?There was an average increase amongst key workers for a. 27%, b. 26%, c. 25% and d. 30% following the talk.Conclusion: Presentations from clinicians are an effective way of improving the confidence of nonmedical substance misuse keyworkers in managing service users in acute mental health crisis. This is likely to lead to more effective and safer management of community substance misuse service users in acute mental health crisis.

This article describes the Generative AI Education (GenAIE) programme: using generative AI (GenAI) to provide personalized education to disadvantaged people, notably probationers and prisoners. For the UK Probation and Prison Service, GenAI (Introducing ChatGPT, 2025, OpenAI; see https://openai.com/blog/chatgpt (accessed January 2025)) is providing education for felons to help stop them reoffending. The UK has over 80 000 prisoners and education is the best deterrent to reoffending, which costs £18bn ($23b) pa (Reoffending Costs, UK Parliament, 2022; see https://questions-statements.parliament.uk/written-questions/detail/2022-0309/137323 (accessed January 2025)). The AI ‘tsunami’ led by GenAI will be hugely disruptive for business and society. However, it also offers pioneering opportunities for social good, notably through personalized education/training for socially excluded and disadvantaged groups (e.g. people on probation, people in prison, refugees, long-term unemployed, long-term sick, low-aspiration young people); thereby transforming their future and addressing major social problems. As a starting point, University College London and MegaNexus are working with educational professionals to produce personalized training content specifically for the Justice sectors, including probation and prisons, described below, which evidences and demonstrates the positive power of GenAI for social benefit. This is part of our AI for Social Good programme. As of 31 November 2024, the GenAIE programme had gained over 53 400 users and accumulated over 596 600 hours of Education, Training and Employment learning. We are now working with local councils to support their social services key workers and their clients. To make our paper self-contained but concise, key technical terms are defined as bullet points.

Abstract This paper contributes to the literature on the unequal effects of Covid-19 on workers and labor markets by focusing on the experience of migrant key workers in EU countries. Using survey data on over 2.7 million workers, our analysis explores three main dimensions. First, we document the over-representation of migrant workers in key occupations, particularly in low-qualified roles. Second, we examine the selection into key occupations. According to our estimates, women are more likely to be key workers, the relationship with education is V-shaped, and EU and Extra EU migrants are, respectively, 12 and 15 percent more likely than comparable natives to be key workers. Migrant women almost entirely drive these latter gaps. Finally, we estimate the labor market impact of Covid-19, showing that migrant key workers endured reductions in working hours similar to those of natives during the pandemic, but faced a 3 times higher increase in job loss probability. Our findings imply that although migrant workers played a crucial role in the response to the pandemic, they endured a harsher fate than native workers.

This study focuses on strategies to prevent stunting prevalence, which to date have shown inconsistent results. Several previous studies have stated that stunting prevalence cannot be prevented optimally because it is influenced by other factors, such as early marriage and low family literacy. This study uses a qualitative approach with in-depth interview techniques with a number of key informants, including families, community leaders, and health workers. The purpose of the interviews was to gain a deeper understanding of the effectiveness of stunting prevention efforts. The research findings show that the mechanism for preventing stunting prevalence is starting to show improvement. However, these efforts will be more optimal if there is synergy between families, community institutions, and the government in providing education, especially regarding the negative impacts of early marriage. Multi-party collaboration is an important key in building collective awareness and strengthening efforts to prevent stunting sustainably.

Background: Staff nurses are key frontline workers in the prevention, early identification, and treatment of hepatitis C in the hospital context. This study examined the knowledge, behaviors, and attitude regarding hepatitis C infection. Methods: A quantitative descriptive cross-sectional survey was conducted among 284 nurses using a self-administered questionnaire. Results: The nurses were knowledgeable in the mode of transmission as 92% on the spread through contact with blood of infected person, 89% that is a viral infection. In attitude, the Hepatitis C is a serious disease got mean 3.36. In practices, 97% of nurses dispose syringe and needle to sharps container. Conclusion: Despite the study participants' high level of awareness, educational programs should address significant gaps in their knowledge, practices, and attitudes on HCV prevention, screening, and management. Nurses' practices should be addressed generally since they may have an impact on the spread of infection.

Background: Working from home (WFH) has become more popular and has spread rapidly around the world. This became especially noticeable during the COVID-19 pandemic because most individuals had to work from home if they were not key workers (e.g., healthcare and public safety workers). However, further research is needed on the possible consequences of WFH, particularly in terms of benefits and challenges. Objective: The present study aimed to examine the advantages and disadvantages of WFH from an employee perspective. Methods: Two simple questions were asked to white-collar Turkish employees (N = 613) who experienced WFH during the COVID-19 pandemic: "What do you think are the advantages of working from home?" and "What do you think are the disadvantages of working from home?". The answers to the questions were then content analyzed. Results: The key advantages identified were protection from COVID-19, saving time, better focus on work, more time for self-improvement, reduced personal expenses, and reduced social pressure. The key disadvantages included increased work-family conflict, alienation from work, non-ergonomic working conditions, technostress, miscommunication, social isolation, increased workload, inefficiency, and depression. Conclusions: The results indicate that although WFH has many advantages for employees, it also has many disadvantages that need to be carefully considered by both organizations and employees.

BackgroundUniversal health coverage (UHC) is a key component of Afghanistan’s health plan, but the country faces challenges due to decades of conflict and instability. Concurrently, healthcare successes have been achieved despite significant shortages in the health workforce. A fit-for-purpose health workforce is crucial for achieving UHC, and requires decision-making by policy-makers driven by sufficient evidence. This study presents a comprehensive situational analysis of Afghanistan’s health workforce in 2023, focusing on distribution by geography, gender, facility type, as well as trends in health worker production.MethodsA multi-stage assessment of the active health workforce was conducted through a national census-style count using active registries and facility-level verification through sampled facilities visits. Health worker production was estimated through an analysis of enrollment and graduation figures from public and private institutions from 2019 to 2023.FindingsWe estimated 63,632 health workers in Afghanistan in 2023, with 73% in the public sector and 27% in the private sector. Key health workers (physicians, nurses and midwives) total 10.3 per 10,000 population, falling significantly short of the aspirational UHC threshold (44.5 key health workers per 10,000). Substantial geographic disparity exists between provinces, with remote provinces reporting far fewer key health workers compared to the national average and Kabul representing approximately 50% of the country’s specialized physicians. Significant gender imbalances exist as only 18% of specialized physicians and 29% of nurses are female. Health workforce production is largely dependent on the private sector, and has declined for certain cadres due to restrictions on female education, which are increasing in severity. Majority female cadres, such as Obstetrics/Gynecology, are anticipating significant declines in active staff, jeopardizing aspirations of UHC.InterpretationAfghanistan faces critical health workforce challenges, including shortages, gender imbalances and unequal geographic distribution. These findings provide essential insights for policymakers to guide human resources policies aimed at achieving UHC.

Young key populations-sex workers and men who have sex with men (MSM)-face significant barriers to accessing HIV care in Chad due to stigma, discrimination, and socio-economic challenges. Although legal protections exist, gaps in enforcement continue to undermine care efforts. This study explored care pathways for young key populations in Chad to identify their specific challenges and propose targeted strategies to strengthen the HIV care continuum. Conducted in April 2025 in N'Djamena Chad, the qualitative study involved ten in-depth interviews with sex workers and MSM, aged 15-24 years, recruited through snowball sampling. Framework analysis revealed key themes across the HIV care continuum, specifically in testing, linkage to care, and retention in antiretroviral therapy (ART). Three major themes and 13 sub-themes emerged: (1) HIV testing and diagnosis, (2) linkage to care and ART initiation, and (3) retention in care and adherence to ART. Stigma-both externalized and internalized-was a significant barrier at every stage. Fear of disclosure, discrimination in healthcare settings, and financial constraints further hindered care engagement. Conversely, community-based awareness programs in faith-based institutions, and peer support networks were crucial in facilitating access to services. Addressing these challenges requires a comprehensive, multi-level approach that includes stigma-reduction training for healthcare workers, enforcement of anti-discrimination laws, targeted financial aid mechanisms, and integrated psychosocial counseling. Strengthening community-based interventions and peer-led outreach can further enhance engagement and retention, thereby improving health outcomes and reducing new infections among young key populations in Chad while aligning with global HIV targets.

ABSTRACTBackgroundIn the UK, families in temporary accommodation reached record numbers in 2023. Pregnant mothers experiencing homelessness are at risk of poor health outcomes, yet little is known about their experiences. Most biomedical research emphasizes obstetric outcomes rather than maternal experiences. Our study aimed to explore maternal experiences of pregnancy while living in temporary accommodation in the UK.MethodsUsing an interpretivist paradigm and critical feminist theory, we collected and analyzed semi‐structured interview narratives from pregnant and postnatal mothers experiencing homelessness. Interviews with key workers from relevant Third Sector Organisations provided complementary insights. Study planning included Patient and Public Involvement. Data were analyzed using reflexive thematic analysis.ResultsFourteen mothers and six keyworkers were interviewed. Reflexive thematic analysis generated three themes. Theme one, Pregnant/postnatal bodies in unsafe spaces, described participants' experiences with unsafe accommodations, exposure to environmental hazards, and frequent moves which affected physical and mental health. In Undermining mothers, participants explained how the constant struggle to meet basic needs eroded opportunities to engage with caring roles and destabilized their sense of being “good” mothers. Together these contributed to pregnancy disengagement and feeling unprepared for birth. The third key theme, Feeling unseen in midwifery blind spots, describes barriers to accessing maternity services, as well as interactions with midwives that often reinforced feelings of being invisible.DiscussionLiving in temporary accommodations whilst pregnant negatively impacts physical, mental, and emotional well‐being. Improving care for pregnant mothers experiencing homelessness requires systemic change within housing and maternity services to acknowledge housing security as an essential need for pregnant and parenting mothers.