Trained Health Workers Research Articles

IMPLEMENTATION OF MONITORING SIDE EFFECTS OF DRUGS IN DRUG-RESISTANT TUBERCULOSIS PATIENTS IN REFERRAL HOSPITALS: A QUALITATIVE STUDY

Drug-resistant tuberculosis (TB) is a public health problem that poses major challenges to patients, health workers, society, and the health care system. This research is a qualitative study to explore the implementation of drug side-effect monitoring and the role of health workers in handling side-effect monitoring medication for tuberculosis patients. We collected data through Focus Group Discussions (FGD) and conducted direct, in-depth interviews. The informants in this study were doctors, pharmacists, and nurses who were directly involved in treating drug-resistant tuberculosis patients. Two drug-resistant TB referral hospitals in the Cirebon area hosted the research. INVIVO 12 was used for qualitative analysis. Both hospitals still need to optimise the mechanism for tracking drug side effects in drug-resistant TB patients in accordance with the technical guidelines. Doctors at both hospitals play a significant role in implementation compared to other health workers. The similar role of doctors in both hospitals in implementation is in initial examination and history taking, determining causality, management, and education regarding drug side effects. Pharmacists have a similar role in managing drug side effects and documenting "unwanted events". The role of nurses in both hospitals is similar, namely providing patients with education on drug side effects. Efforts are needed to increase the implementation of monitoring of drug side effects by conducting assessments of the causality of drug side effects and documentation using specific instruments according to standards, ensuring the ensuring the completeness of manual monitoring forms, and providing continuous drug side effect monitoring training for health workers.

Enhancing geriatric care in Low- and Middle-Income Countries

Geriatric population is increasing worldwide, thus resulting in rise of healthcare issues. The advancing age has default rise in chronic illnesses, disabilities and mental health issues. Developed countries have improved their health care system by catering the needs of older population. However, low-middle- income countries (LMICs) have not yet addressed this major public health issue. Elderly population living in rural areas has multifaceted problems including lack of social support, financial dependence and insufficient healthcare facilities. Lack of specialized trained healthcare experts in geriatrics is also a major health issue in LMICs. The introducing geriatrics as a sub-specialty, specialized training of lady health workers and lady health visitors, community support groups can solve the issue of growing geriatric population in LMICs.

Unveiling autism spectrum disorder in South East Asia through a public health Lens

Autism spectrum disorder (ASD) is a multifaceted developmental condition characterized by persistent challenges in social communication, restricted interests, and repetitive behaviors. Though there is no cure, early and intensive interventions can significantly improve the quality of life for those affected. The aim of this paper is to examine the complexities of autism spectrum disorder (ASD) from a public health perspective in South East Asian region, highlighting the global rise in prevalence and the compounded challenges posed by the COVID-19 pandemic. The rise in ASD prevalence from 4 to 5 cases per 10,000 children in the 1980s to 11.3 per 1,000 children in 2012 highlights the need for effective interventions. The pandemic exacerbated behavioral issues, anxiety, and screen time-related health problems, underscoring the importance of adjusting strategies for early identification and support. Diagnostic tools like the Modified Checklist for Autism in Toddlers (M-CHAT) and the Social Communication Questionnaire (SCQ) play a critical role in community-based screening. Effective prevention strategies include primary measures such as public awareness campaigns and genetic counseling, secondary measures focusing on early identification and intervention, and tertiary measures involving ongoing support and therapy. Addressing implementation challenges, particularly in low-income countries, requires enhanced public awareness, training of community health workers, and integration of ASD services into primary healthcare systems. Future research should aim to develop and evaluate scalable, culturally relevant interventions and explore the impact of environmental factors on ASD. Comprehensive strategies at the community level, combined with robust public health policies, are crucial for improving outcomes for individuals with ASD and their families.

Challenges and Benefits of Sports for the Elderly: A Case Study in Panimbang District, Banten, from the Perspective of the Elderly and Health Professionals

Aging is a natural process that causes significant changes in many aspects of life, including physical and psychological aspects. As older people age, they often experience a decline in physical function, which can lead to reduced mobility and an increased risk of various chronic diseases such as diabetes, hypertension, and osteoporosis. One way to improve the quality of life of the elderly is through exercise. Regular exercise can help maintain or improve the physical and mental health of the elderly, improve sleep quality, and reduce symptoms of stress, anxiety, and depression. However, the elderly often face various barriers to exercise, such as physical limitations, fear of injury, and lack of elderly-friendly sports facilities. Therefore, it is important to explore the challenges faced by the elderly when exercising and how to overcome these barriers. This study used a qualitative approach with a case study in Panimbang District, Banten, involving 15 elderly and 8 health workers. Data were collected through in-depth interviews, focus group discussions (FGDs), and observations of elderly sports activities. The results showed that despite various challenges, elderly who exercise regularly reported significant physical and mental benefits, such as reduced joint pain, increased mobility, and reduced stress and improved sleep quality. It was also found that health workers face challenges in providing specific training on exercise for the elderly and managing the risk of injury. However, they acknowledge the benefits of exercise in improving public health, reducing chronic diseases, and increasing patient satisfaction. It is recommended that the government and related institutions pay attention to providing elderly-friendly sports facilities and provide training for health workers so that exercise programs can be implemented safely and effectively.

Cost of delivering childhood RSV prevention interventions to the health system in Kenya: a prospective analysis

ObjectivesTo evaluate the cost of delivering childhood respiratory syncytial virus (RSV) prevention interventions to the health system in Kenya.DesignA prospective (cost projection) activity-based costing study.SettingKenya, national introduction of interventions.ParticipantsNot applicable.InterventionsA...

The association between exposure to a radio campaign on nutrition and mothers' nutrition- and health-related attitudes and minimal acceptable diet of children 6-36 months old: a quasi-experimental trial.

To evaluate the effectiveness of a radio campaign involving serial 10-minute drama episodes, 10-minute on air discussion of each episode by trained community health workers and 30-minute phone-ins from listeners in improving mothers' nutrition- and health-related attitudes (HNRAs) and children's minimum acceptable diet (MAD). A two-arm quasi-experimental trial with a pre-post design was used to quantify the effect of a radio campaign on nutrition before and immediately after the 6-month intervention. Difference-in-difference (DID) analysis was performed to assess the intervention's effect. Saboba district (intervention) and Central Gonja (comparison district) of northern region of Ghana. At baseline, a total of 598 mothers with children aged 6-22 months were randomly selected from the intervention (n 298) and control (n 300) districts. At endline (6 months post-intervention), 252 mother-child dyads in the intervention district and 275 mother-child dyads in the control district were followed up. The radio campaign was significantly and positively associated with a change in health- and nutrition-related attitudes (HNRA) over time, with DID in mean attitudes significantly improving more over time in the intervention district than the control (DID = 1·398, P < 0·001). Also, the prevalence of MAD over time in the intervention district was significantly higher than the control district (DID = 16·1 percentage points, P = 0·02) in the presence of food insecurity. The study indicates that a radio campaign on nutrition is associated with improved mothers' HNRA and children's MAD. Communication interventions on child nutrition targeting low-resource settings should consider this innovative approach.

Barriers, attitudes and perceptions to physical activity among pregnant women in Ibadan, Nigeria and the associated factors: a mixed method study.

Physical activity has several health benefits during pregnancy. However, it remains low among pregnant women because of various barriers. This study assessed the attitude, perception, barriers to physical activity during pregnancy and the associated factors. We conducted a cross-sectional study using a sequential explanatory mixed method among 465 pregnant women attending antenatal care from four healthcare facilities in Ibadan, Nigeria. Data was collected using a pretested interviewer-administered questionnaire, and we conducted four focus group discussions. Using the Barriers to Physical Activity during Pregnancy Scale questionnaire, we assessed the barriers based on the socioecological theory. The explanatory variables included sociodemographic characteristics, obstetric factors, past obstetric history and physical activity-related issues. Data were analysed using univariate and bivariatemethods (independent T-tests and ANOVA), and multiple linear regression was at 5% significance. We applied thematic content analysis to qualitative data. The mean age of the participants was 29.22 + 5.01years. The mean ± SD of the total physical activity barrier score (PABS) was 85.35 ± 22.82. The PABS for the subscales were intrapersonal barriers (34.46 ± 8.79), non-pregnancy intrapersonal barriers (14.47 ± 5.67), and interpersonal barriers (11.67 ± 4.25), environmental, political and organisational barriers (24.766 ± 8.82). The significant relationships between the total score of physical activity barriers and religion (p < 0.030), education (p < 0.000), complaints in pregnancy (p < 0.043), antenatal admission in the hospital (p < 0.004), physical activity advice (p < 0.018), pre-pregnancy physical activity (p < 0.000). Factors associated with physical activity barrier score were maternal education: adjusted β: -15.26, 95% CI: -27.83; -2.69; p = 0.017, antenatal admission adjusted β: 12.20, 95% CI 3.74; 20.67, p = 0.005 pre-pregnancy physical activity: adjusted β: -12.27, 95% CI -1.6.5; -7.99, p = 0.001. Significant themes that emerged in the perception of pregnant women towards physical activity are understanding physical activity, personal experience of physical activity, barriers experienced by pregnant women, the role of support, perceived benefits, and information from health care workers. Our study showed that pregnant women attending antenatal clinics in Ibadan, Nigeria, face various barriers to physical activity during pregnancy. Using the socioecological framework, the most commonly reported barriers by our respondents were intrapersonal andenvironmental barriers. Sociodemographic characteristics, pre-pregnancy physical activity, and antenatal admission were significant factors associated with the total barrier scores of respondents. Healthcare professionals should be trained in promoting physical activity during pregnancy. Tailored interventions are necessary to promote physical activity among pregnant women in Nigeria, including the training of health workers.

State of the health workforce in the WHO African Region: decade review of progress and opportunities for policy reforms and investments

IntroductionAn adequate health workforce is one of the cornerstones of a healthy nation. Over the last two decades, Africa has gained momentum in mitigating critical health workforce gaps, but urgent...

Evaluation of the Implementation of the Elderly Posyandu in the Petumbukan Health Center Work Area Deli Serdang District in 2024

Posyandu was formed to facilitate the elderly in obtaining health services, coaching and developing potential abilities in order to realize an independent person. Monitoring and evaluation of the implementation of Posyandu Petumbukan is important to do by providing education and socialization of the interests of the elderly, facilitating transportation of Posyandu for the elderly that are difficult to reach, taking a personal and empathetic approach by inviting participation, including home visits, providing additional services such as specialist health checks, social activities, and welfare programs. This qualitative study aims to evaluate the implementation of Posyandu in the Petumbukan Health Center Work Area. The informants were 15 people by conducting in-depth interviews equipped with a voice recorder. The research variables were communication, human resources, attitudes, and SOPs. The results of the study were that there was a need for communication training for cadres and health workers to improve the delivery of clearer and more detailed health information, cadres and health workers need to manage queues well, a friendly attitude needs to be maintained and improved with better training, increasing the number of cadres and health workers with special training for elderly health, the health center also needs to ensure the availability of drug and vitamin stocks periodically through better inventory management,

Analysis of Challenges and Opportunities for Improving the Health System in Afghanistan: Innovative Approaches and Sustainable Solutions

This research explores the challenges and opportunities for improving the health system in Afghanistan. The main objective is to identify the major issues within the healthcare system and propose sustainable solutions to enhance the quality of health services. Using a mixed-method approach (qualitative and quantitative), data were collected through semi-structured interviews with experts and a review of credible scientific sources. The findings indicate that a lack of healthcare infrastructure, a shortage of specialized human resources, and management issues are among the primary challenges facing Afghanistan's healthcare system. Additionally, opportunities such as international support and utilizing modern technologies in healthcare have been identified. The study concludes that investment in infrastructure, human resource training, and strengthening international collaborations are essential to improve the healthcare situation in Afghanistan. The study's recommendations emphasize the importance of investments in infrastructure, comprehensive training for health workers, and international partnerships to strengthen service delivery. This analysis provides practical insights for policymakers and international organizations, which could ultimately help build a more resilient health framework in Afghanistan.

Content and design of respectful maternity care training packages for health workers in sub-Saharan Africa: Scoping review.

Training health workers might facilitate respectful maternity care (RMC); however, the content and design of RMC training remain unclear. To explore the content and design of RMC training packages for health workers in sub-Saharan Africa. MEDLINE, EMBASE, CINAHL Complete, Web of Science Core Collections, SCOPUS, and grey literature sources (including websites of RMC-focused key organizations and Ministries of Health) were searched for journal papers, reports, and training guides from January 2006 up to August 2022. There were no restrictions on study designs, language, or health-worker cadre. Two reviewers independently screened results. Key data, including training content and methods used, were extracted and summarized. Thirty-two citations from 26 studies/programs were identified (24 journal papers, 5 manuals/guides, 2 reports and 1 PhD thesis), with 27 citations from 22 studies informing the review findings. About half of all conducted studies were from East Africa. The most common topics in RMC trainings were communication, privacy and confidentiality, and human resources. Most trainings were multicomponent and appear to be largely in-service training. Health workers providing direct care to women, compared with non-clinical staff such as receptionists and cleaners, were the only recipients of training in most studies (81.8%). Two broad categories of training methods/tools were identified: workshop-based and action-based. Over 90% of the studies assessed impact of the training, with a majority focused on impacts on maternal health and care; however, half of the latter studies did not appear to have feedback mechanisms in place for implementing change. The content and design of RMC training in sub-Saharan Africa are multifaceted, suggesting the complexity of implementing/promoting RMC. Some progress has been made; however, missed opportunities in training remain with respect to study populations, training topics, cadres, and feedback mechanisms.

Challenges And Strategies For Implementing Performance-Based Capitation In Indonesian Community Health Center : A Scoping Review

This study examines the implementation and challenges of performance-based capitation (KBK) at Community Health Centers (Puskesmas) in Indonesia, as a part of the National Health Insurance Program, aiming to improve the efficiency and quality of primary health services. Despite its potential, the implementation of KBK faces various challenges including inadequate human resources, limited infrastructure, and insufficient monitoring systems. The study uses a scoping review framework based on the Public Health Care Monitoring Conceptual Framework by WHO, analyzing 11 selected studies from 2021 to 2024. Findings indicate that internal factors such as management capacity, health worker competence, and organizational culture significantly impact the effectiveness of KBK. External factors like local government support, funding policies, and infrastructure availability also play crucial roles. Technological barriers, particularly in remote areas, hinder optimal policy implementation. The study emphasizes the need for clear regulations, consistent policy dissemination, and effective monitoring to ensure successful KBK implementation. Recommendations include strengthening leadership, training health workers, improving infrastructure, and enhancing digital health technology utilization. These strategies aim to optimize resource allocation, enhance service access, and improve patient satisfaction in Indonesia’s primary health care system.

COMMUNITY INTERVENTIONS TO REDUCE MATERNAL MORTALITY IN LOW-RESOURCE AREAS

Maternal mortality, defined as the death of women during pregnancy, childbirth or in the postpartum period, continues to be a serious public health problem, especially in low-resource areas. Factors such as limited access to quality healthcare, lack of infrastructure, shortage of qualified professionals and socio-economic inequalities contribute to high mortality rates. In many of these regions, community interventions have been key to reducing maternal mortality by providing direct assistance to pregnant women, promoting health care education and strengthening the link between communities and medical services. This study seeks to analyze community interventions implemented in low-resource areas to reduce maternal mortality, evaluating their strategies, challenges and the results obtained in improving maternal survival rates. This study is a systematic review that investigates the effectiveness of maternal health interventions in low- and middle-income countries, focusing on skilled birth attendant programs, community transport, and technological innovations. The analyses were carried out in databases such as PubMed, BMC Pregnancy and Childbirth and African Journal of Reproductive Health, using data from articles published between 2015 and 2021. Community interventions to reduce maternal mortality range from health education programs, training traditional birth attendants and strengthening maternal and child support networks. One of the main approaches involves training community health agents, who work directly in communities, providing basic prenatal care, referral to medical services in cases of risk and promoting knowledge about signs of pregnancy complications. These actions are especially important in remote areas, where access to health facilities is limited. Another key aspect of these interventions is the promotion of safe practices during childbirth and the strengthening of emergency transport systems, ensuring that pregnant women at risk can be transferred to health centers equipped to deal with complications. The introduction of simple technologies, such as clean delivery kits and essential medicines, has shown promising results in reducing infections and hemorrhages, which are primary causes of maternal mortality. Awareness campaigns also play a crucial role, educating the population about the importance of prenatal care, proper nutrition and birth assistance in controlled environments. These initiatives aim not only to improve knowledge about maternal health, but also to combat cultural and social barriers that can prevent pregnant women from seeking medical care in a timely manner. It is concluded that community interventions have proven to be an effective approach to reducing maternal mortality in low-resource areas. Training health workers, implementing safe delivery practices and raising awareness about antenatal care are strategies that have contributed significantly to improving maternal health outcomes. However, for these interventions to be sustainable and scaled up, continued public policy support, adequate funding and the integration of these actions with formal health systems are essential.

An Analysis Study on the Effect of the Use of Electronic Medical Records on the Effectiveness and Efficiency of Services at Public Health Centers (Puskesmas) in Indonesia: A Systematic Review

Background: EMR utilize electronic systems to store, manage, and share patient health information more efficiently and accurately. Given the importance of using EMR in improving the quality and efficiency of health services in Indonesia, this study aims to systematically review the existing evidence related to the effectiveness of EMR implementation on the effectiveness and efficiency of services at Puskesmas in Indonesia. This study follows the PRISMA 2020 standard, examining English literature from 2014 to 2024. The study excluded editorials, reviews from the same journal, and submissions without DOI. PubMed, SagePub, SpringerLink, and Google Scholar are used as literary sources. Results: Initially getting 360 articles from online databases (PubMed, SagePub, SpringerLink, and Google Scholar), eight relevant papers were selected after three rounds of screening for full-text analysis. Conclusion: Overall, the use of Electronic Medical Records at primary healthcare in Indonesia provides many advantages in terms of the effectiveness and efficiency of health services, especially in accelerating queue waiting time, registration, service in the police, and drug taking. However, to achieve optimal implementation, efforts to improve technology infrastructure, training for health workers, and good network management are needed to overcome technical obstacles and ensure smooth service flow at the primary healthcare.

Tantangan dan Solusi Administrasi Kesehatan di Era Digital ( Tinjauan Literature Review atas Implementasi Teknologi )

The aim of this research is Challenges and Solutions of Health Administration in the Digital Era (Literature Review Review of Technology Implementation). This type of research is a literature study. Data collection with documentation. Data analysis with SLR. The results of the research Based on the literature review on challenges and solutions in health administration in the digital era, it was found that the implementation of health technology offers great opportunities to improve efficiency and quality of services, but is also faced with various obstacles. The main challenges include limited digital infrastructure, lack of skills of health workers in using technology, and patient data security risks. Proposed solutions include increasing investment in technology infrastructure, ongoing training for health workers, and implementing stricter data security policies. By addressing these challenges, technology can significantly improve the effectiveness of health administration and patient care

Insights From Community Organizations Collaborating With Government and Academia to Foster Health Literacy.

The COVID-19 pandemic disproportionately impacted ethnic minority and other underserved communities, prompting the federal government to fund community-led health literacy initiatives. This evaluation shares challenges and lessons learned, and identifies best practices from community-based organizations (CBOs) partnering with academia and local government to support health literacy programming. In 2023, 20 representatives from 12 CBOs in Southern California responded to an interviewer-administered survey, including open-ended questions about lessons learned. We analyze text data to identify key themes. CBOs expressed a need for additional financial resources and technical assistance, including grantsmanship training, access to in-language resources, support to build and use in-house evaluation systems, and greater university oversight for student collaborators. Respondents highlighted the importance of community engagement efforts to build trust and enhance the uptake of programming. They also stressed the need for specialized training of community health workers engaged in health programs and the utilization of population sub-group data to inform policy and funding development to better serve communities' needs. CBOs are eager to partner with government and academia and acknowledge the need for targeted support and resources that can be facilitated through multisectoral partnerships. We offer recommendations and actionable strategies for funders and academia to create and improve equitable partnerships with CBOs. Partnerships that address the needs and systemic barriers experienced by ethnic minority communities will support local public health goals while fostering resilience and health equity.

Training and mentoring of Health Workers and Cadres of Bengkulu City Health Center in Monitoring The Growth and Development of Toddlers with The SDIDTK Application

Monitoring children's growth and development is one of the basic programs implemented by Community health center (Puskesmas) to ensure a healthy life and improve children's welfare. The Bengkulu City Health Office identified limited human resources and a lack of supporting tools as inhibiting factors in achieving SDIDTK service targets. The service was carried out through training on Growth and Development Monitoring with the Android-based SDIDTK Application and field assistance. The training was held on July 24-25, 2024 with 36 participants consisting of 17 health workers, 17 cadres from 17 health centers, and 2 staff from the Family Welfare Division of the Bengkulu City Health Office at the Campus 4 Hall of Bengkulu University. The results of the pre and post-test of the training showed that 94% of participants increased their knowledge. The results of the assessment of skills in using the application showed that 100% of participants were able to do as directed. SDIDTK Kit assistance was delivered to 17 Puskesmas with the signing of the Minutes by the Head of Service implementer and staff of the Health Division of the Bengkulu City Health Office. Field assistance was carried out for 2 weeks after the training in 17 Puskesmas working areas.

Efficacy of a burn prevention educational program to diminish the incidence of burn injuries in the pediatric population

BackgroundPediatric burn injuries are a significant public health issue in low- and middle-income countries, leading to substantial morbidity and mortality. This study aimed to evaluate the efficacy of the No+Quema2 educational program, implemented in Aguascalientes, Mexico, in preventing burn injuries among children under nine years old. MethodsThe No+Quema2 program, initiated in 2014, included educational courses for children, training for health workers, and specialized care for children with burn sequelae. Epidemiological data on burn injuries from 2014 to 2022 were retrieved from the National System of Epidemiological Surveillance of the Health Ministry of Mexico. Monthly incidence rates per 100,000 inhabitants were analyzed using the Mann-Kendall trend test and segmentation analysis to detect trends and changes. ResultsThe program trained over 25,000 scholars from 1750 elementary schools and distributed medical kits for immediate burn care. Additionally, 200 children with burn sequelae received scheduled treatment. The analysis showed a significant decrease in the state incidence rate of burn injuries compared to the national mean post-implementation. The estimated number of burn injuries prevented during the study period was approximately 3839, or 604 per year. ConclusionThe No+Quema2 program has made a significant impact on burn prevention among children in Aguascalientes, Mexico. Despite the limitations of relying on government-reported data, the correlation between the program's activities and the observed decrease in burn injuries is promising. These findings underscore the critical importance of the No+Quema2 program's activities in achieving sustained, targeted educational interventions and long-term reductions in burn injury incidence. They also highlight the need for more robust study designs to validate these outcomes, emphasizing the importance of evidence-based strategies in future burn prevention efforts.

Posyandu Cadres' Contributions to Elderly Health Improvement

Background: This study investigates the role of community health workers in promoting elderly health through integrated health posts. Specific Background: A qualitative descriptive approach is used to examine the significance of these workers in ensuring regular attendance of the elderly at health services. Knowledge Gap: While previous studies have focused on health post activities, they often overlook the specific strategies employed by community health workers. Aims: The study aims to clarify the contributions of community health workers in facilitating elderly health programs. Results: Findings indicate that these workers adapt activities, such as health consultations and educational sessions, to enhance elderly participation and health outcomes. Novelty: The research provides new insights into innovative service delivery by community health workers amid logistical challenges. Implications: The results highlight the need for ongoing support and training for community health workers, advocating for structured programs to enhance elderly engagement and well-being, with potential applications in similar contexts to improve elderly healthcare. Highlights : Community health workers play a crucial role in facilitating elderly health services. Adaptation of activities enhances elderly engagement and health outcomes. Continuous support and training for health workers are essential for effective program implementation. Keywords: community health workers, elderly health, qualitative study, health post, participation

Projected health workforce requirements and shortage for addressing the disease burden in the WHO Africa Region, 2022–2030: a needs-based modelling study

IntroductionAn adequate health workforce (HWF) is essential to achieving the targets of the Sustainable Development Goals (SDG), including universal health coverage. However, weak HWF planning and constrained fiscal space for...