Primary Health Care Workers Research Articles

Effectiveness of autism training program introduction at primary health care (PHC) level

Background: Autism spectrum disorder (ASD) has become a public health issue in many countries especially in developing countries. Family members who have a toddler with ASD face significant physical, emotional, and financial challenges. Early detection is crucial to achieve improvement in children with ASD. Objectives: The aim of the current research is to study the implementation of a training program for Autism in 4 health care facilities and to evaluate its initial outcomes. Methodology: An interventional study conducted among 63 health care workers dealing with children 18-30 months in 4 health care facilities (2 urban health care facilities and 2 rural health care facilities) in Giza governorate. A tailored autism health education message as well as training on using the Arabic validated version of the Modified Checklist for Autism in Toddlers (M-CHAT) were provided to the HCWs. Results: 58.7% of participating primary health care workers (HCWs) had a satisfactory level of awareness about childhood autism prior to the intervention, and 71.4% had a satisfactory level of understanding following it. When comparing the study subjects' pre-intervention knowledge scores to their post-intervention knowledge scores, there was a statistically significant improvement in their knowledge about autism (p < 0.001). Conclusion: The study's findings validate the value of specialized training programs in raising healthcare workers' awareness of childhood autism. Recommendations: Incorporation of autism spectrum disorder (ASD) within the educational curriculum of medical and nursing schools and ongoing education and training in ASD for health care workers.

Factors Associated with the Knowledge, Attitudes, and Practices of Primary Healthcare Workers Regarding Neglected Tropical Diseases with Skin Manifestations in the Dakar Region, Senegal, 2022

Neglected tropical diseases (NTDs) with skin manifestations present a significant health and societal problems challenge worldwide. This study aimed to analyzed factors associated with the knowledge, attitudes and practices (KAPs) of primary healthcare workers (HCW) concerning NTDs with skin manifestations in the Dakar region of Senegal. We conducted a cross-sectional study utilizing a semi-structured questionnaire which was administered to eligible HCW (general practitioners, nurses and midwives) working at the 24 health centers located in the Dakar region. Data were collected using the ODK Collect application (version 2022.3.6). KAPs measures were constructed from questionnaire responses, and bivariate analysis was used to identify associated factors. Of the 187 HCW surveyed, 75.9% were female, with a mean age of 35.1 years (SD: 8.56). The majority of HCWs had a bachelor’s degree (40.6%), were nurses (49.2%) and had between 1- and 10-years of professional experience (52.4%). Regarding their knowledge of NTDs with skin manifestations, only 43.3% of HCW had received initial training on NTDs. The most commonly reported NTDs with skin manifestations were leprosy (53.5%), lymphatic filariasis (51.3%), scabies (49.7%), onchocerciasis (45.5%) and schistosomiasis (42.8%). Television was the main source of information about these NTDs (38.5%). In term of practices, only 47.6% of HCW reported being able to diagnose NTDs with skin. Factors associated with good knowledge regarding NTDs with skin manifestations included having received training on NTDs (p = 0.0015) and more years of professional experience (p = 0.004). In summary, there is a need to strengthen and raise awareness about NTDs with skin manifestations among HCWs and promote quality management of patients in Senegal.

THE IMPACT OF PAEDIATRIC EMERGENCY MANAGEMENT SKILLS ON PATIENT OUTCOMES IN ZARIA

Paediatric emergencies represent a critical challenge in Nigeria, where approximately 2,300 children under the age of five die daily, predominantly from preventable and treatable conditions such as pneumonia, malaria, and diarrheal diseases. Mortality rates are disproportionately higher in rural areas, where primary health care (PHC) centers often serve as the only point of access to medical services. The effectiveness of these centers is largely dependent on the emergency management skills of their healthcare workers. Despite their importance, there has been limited research on how the skills of PHC workers in managing paediatric emergencies impact patient outcomes. This study aimed to assess the proficiency of healthcare workers in primary healthcare centers in Zaria in managing common paediatric emergencies. A cross-sectional descriptive study was conducted among 139 health workers selected through a multi-stage sampling technique in Sabon Gari and Zaria Local Government Areas. Data collection was carried out using a pre-tested semi-structured self-administered questionnaire. The data were analyzed using SPSS version 21, and associations were tested using the chi-square test, with results presented in tables and charts. The findings revealed a significant deficiency in the emergency management skills of healthcare workers. A majority of respondents demonstrated inadequate skills in handling paediatric emergencies, with 66 (48.5%) exhibiting very poor competency in the management of common paediatric emergencies, and 32 (23.5%) displaying poor competency. Only a small fraction, 4 (2.9%) of respondents, demonstrated excellent skills in emergency management. Similarly, 46.7% of the respondents had very poor skills in the treatment of common paediatric emergencies, while only 3.0% exhibited excellent treatment skills. A statistically significant relationship was observed between the level of academic qualification and emergency management skills (p < 0.05). The results underscore the critical need to enhance the skill levels of healthcare workers in PHCs through continuous professional development. This could be achieved through collaborative efforts between the Department of Paediatrics at Ahmadu Bello University Teaching Hospital and the Primary Health Care Departments of Zaria and Sabon Gari local governments, focusing on regular training and workshops. Improving the skills of healthcare workers in managing paediatric emergencies is essential for reducing child mortality and improving health outcomes in the region.

Turnover intention and influential factors among primary healthcare workers in Guangdong province, China: a cross-sectional study

ObjectivesPrimary health workers are crucial to the healthcare system, yet China experiences a notable shortage driven by high turnover rates. This study aimed to investigate the prevalence and determinants of turnover intention among primary health workers.DesignCross-sectional study.SettingPrimary healthcare facilities across 21 cities in Guangdong province, China.ParticipantsOnline questionnaires (SurveyStar, Changsha Ranxing Science and Technology) were administered to 16 573 primary health workers in September and October 2022.Primary and secondary outcome measuresVariables measured included demographics, work-related factors, job satisfaction, emotional exhaustion and turnover intention. Comparisons of turnover intention were made across different categorical groups, and hierarchical regression analysis was used to pinpoint influencing factors.ResultsThe average turnover intention score among participants was 10.49±2.93. Notable positive correlations included those with male gender, single marital status, leadership positions and roles as public health physicians. Emotional exhaustion correlated positively (β=0.108), while job satisfaction showed a significant negative correlation (β=−0.154). Other negative influential factors were observed with tenure lengths of 6–10 years, 11–15 years and ≥16 years, as well as with senior professional titles, lower salary levels and perceptions of fair compensation.ConclusionsTurnover intention is notably prevalent among primary healthcare workers, with emotional exhaustion and job satisfaction identified as primary determinants. Salary, payment justice in compensation and tenure also significantly influence turnover intention. Based on the above analysis, a series of intervention measures can be expectedly unveiled to reduce the turnover intention of primary health workers and maintained the steady development of basic medical resources.

IMPLEMENTING AND EVALUATING A PAEDIATRIC EMERGENCY MANAGEMENT TRAINING PROGRAM FOR PRIMARY HEALTHCARE WORKERS IN ZARIA

Nigeria continues to grapple with alarmingly high under-five mortality rates, with approximately 2,300 children dying daily due to preventable and treatable diseases such as pneumonia, malaria, and diarrheal illnesses. This crisis is particularly pronounced in rural areas, where childhood mortality rates are significantly higher than in urban centres. For many rural communities, primary healthcare (PHC) centres serve as the sole access point to medical services, making these centres critical to addressing this public health challenge. Despite their importance, PHC centres often face significant challenges, including inadequate infrastructure, limited access to essential medications, and a shortage of adequately trained health personnel. This study aimed to implement and evaluate a Paediatric Emergency Management Training Program for healthcare workers at PHC centres in Zaria, Kaduna State. The primary objective was to assess the effectiveness of the training in improving the competency of health workers in managing common paediatric emergencies, thereby enhancing the overall quality of care provided at these centres. A cross-sectional descriptive study was conducted involving 139 healthcare workers from selected PHC centres in Sabon Gari and Zaria Local Government Areas, utilizing a multi-stage random sampling technique. Data collection was performed using a pre-tested, semi-structured, self-administered questionnaire designed to evaluate the participants' baseline knowledge, followed by an assessment after the training intervention. The data were analysed using SPSS version 21, with chi-square tests employed to examine the associations between variables. Results were presented using tables and charts for clarity. The findings revealed a generally low baseline competency in managing common paediatric emergencies among the healthcare workers. Specifically, 66 (48.5%) of the respondents demonstrated very poor knowledge regarding the causes of common paediatric emergencies, 32 (23.5%) had poor knowledge, 34 (25.0%) had good knowledge, and only 4 (2.9%) of the respondents exhibited excellent knowledge. Similarly, knowledge regarding the treatment of these emergencies was also lacking, with 46.7% of respondents showing very poor understanding, 34.1% having poor knowledge, 16.3% demonstrating good knowledge, and only 3.0% showing excellent knowledge. A statistically significant relationship was observed between academic qualifications and knowledge levels in both causes (p = 0.004) and treatment (p = 0.000) of paediatric emergencies. The low baseline knowledge underscores the critical need for targeted training interventions. The study highlights the importance of establishing a sustained partnership between the Department of Paediatrics at Ahmadu Bello University Teaching Hospital and the Departments of Primary Health Care in Zaria and Sabon Gari Local Governments. Regular training workshops, held quarterly, are recommended to continuously equip PHC workers with the necessary skills to effectively manage paediatric emergencies, ultimately contributing to a reduction in childhood mortality rates in the region.

Factors Influencing the Skill Level of Primary Healthcare Workers in Managing Paediatric Emergencies

Paediatric emergencies continue to be a significant public health concern in Nigeria, particularly in rural areas where primary healthcare centers (PHCs) often serve as the sole source of medical care. The ability of healthcare workers in these settings to effectively manage paediatric emergencies is crucial for improving child health outcomes. This study aimed to assess the factors influencing the skill level of primary healthcare workers in managing paediatric emergencies in Zaria, Nigeria. A cross-sectional descriptive study was conducted among 139 randomly selected healthcare workers in Sabon Gari and Zaria Local Government Areas. A pre-tested questionnaire was used to collect data on socio-demographic characteristics, work experience, and skills in managing paediatric emergencies. Data were analyzed using SPSS version 21. The results revealed that healthcare workers in PHCs in Zaria exhibited varying levels of skills in managing paediatric emergencies. Several factors were identified as influencing their skill levels. Healthcare workers with higher academic qualifications demonstrated significantly better skills in managing paediatric emergencies. This suggests that formal education plays a crucial role in developing the necessary competencies. While experience can be a valuable asset, the study did not find a strong association between years of experience and skill levels. This may indicate that experience alone is not sufficient for developing the necessary skills, and additional training and support may be required. Healthcare workers who had received recent training or participated in continuing medical education (CME) programs related to paediatric emergency management tended to have higher skill levels. This highlights the importance of ongoing professional development in maintaining and improving skills. The findings of this study suggest that a combination of factors influences the skill level of primary healthcare workers in managing paediatric emergencies. While academic qualifications are important, ongoing training and access to resources are also essential. It is crucial to address these factors through targeted interventions to improve the skills of healthcare workers and enhance the quality of care provided to children in need. This study highlights the critical need for targeted interventions to improve the skills of primary healthcare workers in managing paediatric emergencies in Zaria, Nigeria. By addressing factors such as academic qualifications, training, resource availability, and work environment, policymakers and healthcare providers can significantly enhance the quality of care provided to children in need.

Preventing deformities in paediatric cerebral palsy in poorly-resourced areas: A scoping review.

Managing children with cerebral palsy (CP) in poorly-resourced contexts, especially those with greater functional limitations, is challenging. Unmitigated orthopaedic complications can further restrict already compromised functional capacity. Where rehabilitation skills and knowledge are scarce, primary healthcare worker- and caregiver-implemented routines are warranted. The essential elements of a home-based routine to mitigate musculoskeletal (MSK) complications in children with severe CP in resource-limited settings (RLSs) have not been determined. To summarise the evidence for programmes and interventions that mitigate MSK complications in children with severe CP and make recommendations for a programme suited to RLSs. Scientific databases and professional websites were searched for studies and reports describing guidelines, interventions or programmes for children aged 0-18 years with severe, partially- or non-ambulant CP, that included aims for the prevention of MSK complications. Articles reporting on surgical, pharmacological and advanced or expensive technological interventions were excluded. A total of 57 studies or reports were included in the review. Low-grade evidence exists for 24-hour postural management (24-h PM), supported standing, sustained stretching and splinting to mitigate MSK complications in children with CP. Caregiver training and support, and integration of the programme into daily routines were identified as important components for successful implementation. Clinical guidelines and evidence that support caregiver-delivered interventions to reduce MSK complications in children with severe CP are limited, and only weak recommendations can be made. There is a need for context-specific, home-based intervention programmes to prevent MSK complications in children with CP in RLSs.

Ready to act? Factors associated with nurses’ desire to work in Primary Health Care in Italy

Abstract Background The rapid increase in demand for primary healthcare (PHC) services after the pandemic requires reconsidering nursing staff planning and availability. The objectives of the study were to i) identify knowledge, attitudes, practices and work expectations of future nurses in primary care; ii) estimate the prevalence of nursing students who desire to be employed in PHC and Family and Community Health Nursing (FCHN) services after graduation. Methods A cross-sectional study is being conducted on a sample of nursing students enrolled in universities in the Lazio Region. A structured instrument was built based on the literature and national regulations and validated (Cronbach’s alpha=0.81). Results In this first phase, 163 nursing students were enrolled. The majority of the sample was female (N = 125, 76.7%), with a mean age of 22 (SD ± 5) years and were enrolled in the last year of degree program (N = 85, 52.1%). A total of 49 students (30%) reported adequate knowledge of PHC service reorganization policies and nursing practice in this setting. While 74% (N = 122) of the sample intended to undertake a PHC curricular internship during their degree program, only seven students (4%) participated in one. 52 individuals (30%) expressed their intention to be employed in PHCs after graduation, and 29 (17.8%) indicated their desire to work as FCHN practitioners. The main factors contributing to the undesirability of employment in PHC reported by students were: i) preferring the hospital settings (N = 53, 48%); ii) not having adequate skills to be employed in the PHC (N = 21, 19%); and iii) believing that the PHC does not offer attractive services for nursing practice (N = 14, 13%). Conclusions A multivariable analysis will be conducted to identify predictors of nursing students’ desire to work in PHCs after graduation. Preliminary results of the study showed that only one-third of nursing students indicated a desire to work in PHCs. Key messages • Only one-third of nursing students express a desire to work in PHC and in Family and Community Health Nursing (FCHN) services post-graduation. • Collaboration between the PHC workforce, academics, stakeholders, and policymakers is needed to create tailored initiatives that increase the attractiveness of PHC.

Strategies for primary healthcare in Ukraine: An integrated response to gender-based violence

Abstract Issue/problem Survivors of gender-based violence (GBV) and conflict-related sexual violence (CRSV) in Ukraine face significant challenges in accessing appropriate healthcare services. Despite governmental commitment, acknowledgment and regulatory frameworks, including the ratification of the Istanbul Convention, gaps persist in integrating comprehensive GBV/CRSV services into primary healthcare (PHC) settings, exacerbated by the ongoing conflict with Russia. Description of the problem An analysis of healthcare providers’ knowledge has revealed deficiencies in effectively supporting GBV/CRSV survivors. Barriers include workload pressures, lack of inter-sectoral cooperation and case-management protocols, and insufficient training opportunities on survivor support. In collaboration with the World Health Organization, the global Clinical Management of Rape (CMR) guidelines was adapted for Ukrainian context. Among findings from CMR trainings attended by 443 PHC providers in 2022-2023 (213 participants in 2022 and 230 participants in 2023), the results underscore gaps in PHC workers’ basic knowledge and readiness to effectively support survivors during the war. Results Data from WHO training sessions underscored significant gaps in knowledge among healthcare professionals regarding legal protocols, available resources, and best practices in PHC service delivery. Identified barriers emphasized the urgent need for targeted interventions to enhance PHC workers’ capacity in GBV/CRSV response. Lessons Recommendations focus on systemic enhancements including revising regulatory frameworks, developing standardized protocols, and institutionalizing and providing comprehensive training programs. Innovative approaches like online courses, mentoring programs, and integrated service models are crucial for addressing multifaceted challenges. Key messages • A holistic GBV/CRSV response is an essential component in PHC. • This intersectoral survivor-centered approach provides safe spaces that can be adapted to other contexts in Europe.

A GESTÃO DA CAPACITAÇÃO DO AGENTE COMUNITÁRIO DE SAÚDE NA ATENÇÃO BÁSICA COM AS ESPECIFICIDADES DA GESTÃO PÚBLICA

The article analyzes the management of training for Community Health Workers (CHWs) in Primary Care, focusing on strategies to promote the continuous improvement of these professionals' competencies. It highlights the relevance of CHWs, who act as a link between the community and health services, contributing to disease prevention and the promotion of educational and community mobilization actions. The research was conducted through a bibliographic and qualitative review, addressing the impact of investment in CHW training to strengthen Primary Care. Continuous training is presented as essential for ensuring comprehensive and humanized care, enabling CHWs to work more effectively and adapt to the specific needs of communities. It concludes that investment in qualification is indispensable for the consolidation of the Unified Health System (SUS), enhancing health actions and improving the indicators of the populations served.

Disease management program in patients with type 2 diabetes.

The aim of this paper was to study ethnic and socioeconomic (SEP) factors' association with provision and participation in a type 2 diabetes disease-management program. In 2016-21, 3464 persons were referred to type 2 diabetes management in Copenhagen municipality. Personalized plans included a mix of activities; program consultations, dietary education, telephone conversations, patient education, and physical training. We estimated the association between education, income, civic status, employment, and country of origin with the number of booked and participated activities using Poisson regression models. A total of 55394 program sessions were scheduled. Small differences in booked dietary education, program consultations, telephone conversations, and patient education were seen between SEP groupings. In situations where groups with lower SEP had booked more sessions (e.g. unemployed bookings of dietary education), these were predominantly translated into equal or more participated sessions among persons with high SEP. Regarding physical training, considerably more booked and participated sessions were delivered to women with lower SEP and ethnic minorities. This study is unique, in the sense that it is the first of its kind to analyze data on diabetes-management programs, systematically collected by primary healthcare workers. Our results suggest that specific elements of the program together with a higher number of booked sessions promoted vulnerable women to participate in more physical training sessions. In closing, these findings have the potential to provide motivation and ideas for policymakers and health professionals in how to design equitable type 2 diabetes management activities.

Assessing the Knowledge Gap in Paediatric Emergency Management among Primary Healthcare Workers in Zaria, Nigeria

Paediatric emergencies remain a significant cause of mortality in Nigeria, particularly in rural areas where primary healthcare centres (PHCs) often serve as the sole source of medical care. This study aimed to assess the knowledge gap among healthcare workers in PHCs in Zaria regarding the management of common paediatric emergencies. A cross-sectional descriptive study was conducted among 139 randomly selected healthcare workers in Sabon Gari and Zaria Local Government Areas. A pre-tested questionnaire was used to collect data, which was analysed using SPSS version 21. Results revealed a generally low level of knowledge among healthcare workers regarding both the causes and treatment of common paediatric emergencies. Only a small percentage of respondents demonstrated adequate knowledge in these areas. A statistically significant association was found between academic qualifications and knowledge levels. These findings underscore the urgent need for targeted interventions to improve the skills and knowledge of healthcare workers in PHCs. Collaborations between academic institutions and local health departments can play a crucial role in organising regular training programs to address these deficiencies and enhance the quality of care provided to children in need.

Legal abortion performed by pre-teens: primary health care workers’ perception and knowledge

This study aims to put into evidence Distrito Federal’s (DF) primary health care workers’ perception and knowledge regarding legal abortion, performed by 10 to 14 year old pre-teens. This is a descriptive study of qualitative approach. Semi-structured interviews were done to 17 primary health care workers currently working in Basic Health Units (BHU) of DF, under contract with DF’s Secretariat of Health. This article showed the worker’s lack of knowledge regarding legal abortion and specific care towards the age group, copying their knowledge regarding adults without adaptation for pre-teens. Workers’ personal beliefs influenced their practice and their choice to correctly inform Health Care users.

Primary healthcare nurses' experiences in managing chronic diseases during COVID-19 in the North West province.

The World Health Organization, stated that the coronavirus disease 2019 (COVID-19) pandemic not only affected the socioeconomic well-being of millions but also had adverse effects on public health, particularly in the management of chronic diseases at the primary healthcare (PHC) level. What remained unknown was the experiences of professional nurses(PNs) working in PHC regarding this issue. The study aimed to explore and describe the lived experiences of PHC nurses in managing chronic diseases during the COVID-19 pandemic. The study was conducted in the North West province, South Africa. A qualitative descriptive phenomenological design was employed to collect and analyse data. Face-to-face interviews were conducted and audio recorded with 16 PNs from five high-volume PHC facilities selected purposively. The study's findings reveal four themes: suboptimal care for patients with chronic disease, a lack of resources, mental health challenges experienced by PHC nurses, and stigma and discrimination from both family and community members. The neglect of PHC and its frontline healthcare staff has impeded the mental health of PHC workers and the management of chronic diseases thus any progress made in reducing the burden of chronic diseases is likely to have regressed during the COVID-19 pandemic.Contribution:Policymakers should prioritise strengthening PHC by implementing integrated disease management policies, ensuring ethical clinical standards, providing supportive supervision, fair resource allocation and capacity building for PHC staff. In addition, addressing stigma and discrimination, and raising awareness among families and communities is crucial for future pandemics to effectively manage both chronic and infectious diseases.

Colonisation by multidrug-resistant organisms in health workers in primary care: narrow spectrum oral antimicrobials are a risk factor.

Limited information exists on carriage of multidrug-resistant organisms (MDRO) by health workers (HWs) in primary care settings. This study aims to determine the prevalence of MDRO carriage among HWs in primary care and to identify associated risk factors. A cross-sectional study was conducted across all 12 primary care units in São Caetano do Sul-SP, Brazil, from October to December 2023. Self-collected samples (nasal, oropharyngeal, and inguinal) were obtained. Environment cultures (potable water, sewage and stream water) were evaluated. Stenotrophomonas maltophilia isolates (human and environmental) were typed. The study included 265/288 (92%) of HWs in primary care teams, mostly women with a median age of 47years (IQR 38-57); 78% had no comorbidities. MDRO colonisation was found in 8.7% (23 HWs). The following bacteria were found: S. maltophilia (n = 9; 3.4%) in inguinal swabs; methicillin-resistant Staphylococcus aureus (n = 8; 3%) from all sites; extended-spectrum ß-lactamase-producing bacteria (n = 5; 2%) in inguinal swabs; and vancomycin-resistant enterococci in an inguinal swab (n = 1; 0.4%). Previous antibiotic use was significantly associated with MDRO colonisation (OR 2.91, 95% CI 1.19-7.09, p = 0.018), mainly narrow spectrum oral beta-lactams and macrolides. S. malthophilia was polyclonal and human and environmental isolates differed. Colonisation by MRSA, VRE, and ESBL-producing bacteria was low; however, 4% were surprisingly colonized by polyclonal S. maltophilia. This pathogen may also suggest using narrow-spectrum rather than the expected broad-spectrum antimicrobials. Antibiotic use was the only risk factor found, mainly with oral narrow-spectrum drugs.

Health System Structural Factors Associated with Use of Scorecard to Improve RMNCAH Performance Indicators in Public Primary Health Facilities in Kenya

Purpose: Researchers looked into how the structure of the health system affects the use of scorecards to boost reproductive, maternal, newborn, child, and adolescent health (RMNCAH) in Kenya's Kwale and Kilifi Counties' public primary health facilities. Specifically, this includes use of the RMNCAH indicators, trainings received on RMNCAH indicators, and factors associated with the utilization of the RMNCAH indicators. Materials and Methods: We conducted a cross-sectional study to gather quantitative data from 119 primary healthcare workers in chosen public primary facilities via one-on-one interviews. We collected data using tablets and the Kobo Collect app. Findings: The findings revealed that 89% of the selected facilities analyzed RMNCAH variables, whereas only 13% used scorecards at the time of the study. The study found that 75% of the facilities that used scorecards did not indicate the specific type of scorecard they received training on. Further research revealed a relationship between scorecard type and utilization (p<0.001, χ2= 2.365), with 84% of facilities analyzing RMNCAH indicators on a monthly basis, focusing on immunization and family planning. However, 63% of healthcare workers rated the health system's structures as either low or poor. Only 11% of facilities had monitoring and evaluation budgets, yet 78% had RMNCAH indicator targets. While most public primary facilities analyze RMNCAH indicators, only a small percentage of these facilities use scorecards due to barriers such as limited training on different types of scorecards, a lack of monitoring and evaluation budget commitments, and poor structural components of the health system Implications to Theory, Practice and Policy: While facilities appreciate the availability of RMNCAH indicators, still the main focus is on immunization and family planning, hence the need for a more comprehensive monitoring of all RMNCAH indicators.

Prevalence and factors associated with burnout among primary health-care workers in China during COVID-19: a national survey

BackgroundPrimary health-care workers (PHWs) managed increased workloads and pressure during the COVID-19 pandemic. This study conducted a national survey examining burnout among PHWs at the end of the COVID-19 pandemic, and identifies related factors. By doing so, it addresses the gap in understanding the burnout situation among PHWs at a national level, taking into account urban-rural disparities.MethodsWe conducted a nationwide cross-sectional survey of PHWs in China from May to October 2022, covering 31 provinces. The MBI-HSS was used to measure overall burnout and emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA). We used multivariable logistic regression to identify risk factors, and subgroup analyses to identify differences between rural and urban areas.Results3769 PHWs from 44 primary health-care institutions completed the survey. Overall, 16.6% reported overall burnout, and the prevalence of EE, DP, and reduced PA was 29.7%, 28.0%, and 62.9%, respectively. The prevalence of overall burnout (17.6% vs. 13.7%, P = 0.004) and EE (31.5% vs. 24.8%, P < 0.001) was higher in urban than rural areas (AOR = 1.285; 95%CI, 1.021–1.617). Job satisfaction was a protective factor against burnout in both settings. The protective factors of overall burnout, EE and DP vary between urban and rural areas.ConclusionsThe Mental Health Status Questionnaire-Short Form (MSQ-SF) score functioned as a protective factor against burnout across both rural and urban locales, highlighting the intrinsic link between job satisfaction and burnout. Other influencing factors differed between urban and rural areas, so interventions should be tailored to local conditions. Rural married PHWs experienced the lower prevalence of burnout indicates the support structure may play a significant role. In urban settings, it is recommended to strategically pre-emptively stock essential supplies like PPE.

Prevalence and factors influencing long COVID among primary healthcare workers after epidemic control policy adjustment in Jiangsu, China

ObjectiveThe persistent symptoms arising from COVID-19 infection pose a substantial threat to patients’ health, carrying significant implications. Amidst the evolving COVID-19 control strategies in China, healthcare workers (HCWs) endure considerable stress. This study aims to evaluate the prevalence of long COVID infections and their influencing factors among primary HCWs after epidemic control policy adjustment in Jiangsu.MethodsA self-designed questionnaire was administered through on-site surveys among primary HCWs in five counties and districts within Jiangsu Province from July 4 to July 20, 2023. Logistic regression analysis was employed to identify factors associated with long COVID.ResultsThe prevalence of long COVID among primary HCWs stood at 12.61%, with a 95% confidence interval (CI) of 11.67-13.55%. Among those affected, the most common long COVID symptoms were hypomnesia (4.90%, 95%CI: 4.29-5.51%), sleep difficulties (2.73%, 95%CI: 2.27-3.19%), fatigue (2.35%, 95%CI: 1.92-2.78%), disturbances in the reproductive system (1.93%, 95%CI: 1.54-2.32%), hair loss (1.85%, 95%CI: 1.47-2.23%), and myalgia/arthralgia (1.51%, 95%CI: 1.16-1.86%). Multivariate logistic regression revealed that older age groups (30–45 years (adjusted odds ratio (aOR) = 1.93, 95%CI: 1.44–2.58), 45–60 years (aOR = 2.82, 95%CI: 2.07–3.84)), females (aOR = 1.26, 95%CI: 1.03–1.55), and higher work stress (high stress (aOR = 1.52, 95%CI: 1.24–1.86), extremely high stress (aOR = 1.37, 95%CI: 1.03–1.82)) were more prone to long COVID. Conversely, individuals with educational attainment below the bachelor’s degree (aOR = 0.67, 95%CI: 0.55–0.82) and those who received four or more doses of the COVID-19 vaccine (aOR = 0.55, 95%CI: 0.33–0.92) were at a reduced risk.ConclusionThis study investigates the prevalence of long COVID among primary HCWs and identifies key influencing factors. These findings are crucial for assisting in the early identification of COVID-19 patients at risk for long-term complications, developing targeted interventions aimed at optimizing healthcare resource allocation and enhancing the work conditions and quality of life of HCWs. To mitigate the prevalence of long COVID, healthcare providers and local authorities should implement effective measures, such as optimizing work-rest schedules and actively advocating for vaccination.

Factors predicting the level of vaccine protection against hepatitis B virus infection among physicians and nurses in Šabac, Serbia.

As healthcare workers run a high and constant occupational risk of hepatitis B virus (HBV) infection through exposure to biological material, vaccination is mandatory as well as the monitoring of antibody levels one to two months after complete immunisation. The aim of this descriptive cross-sectional study was to determine HBV vaccine coverage of 200 primary and secondary healthcare workers (100 each) from Šabac, Serbia and their blood anti-HBs titre. We also wanted to identify factors that could predict the titre. Anti-HBV vaccination covered all participants, of whom 89.5 % were fully vaccinated, and 85 % had a protective antibody titre. We found a statistically significant association between antibody titre and the number of received vaccine doses, chronic jaundice, autoimmune disease, and cancer in our participants. The fact that 15 % did not achieve the protective antibody titre confirms the necessity of its control after immunisation, which is not routinely carried out in most countries, Serbia included. It is, therefore, necessary to develop a detailed strategy for monitoring vaccination and serological status of healthcare workers in order to improve their safety at work. An important role should also be given to continuous education of healthcare workers from the beginning of schooling to the end of their professional career.

Transforming HIV Care: Adapting the Health4All Module to Combat the Stigma Among Malaysian Primary Healthcare Workers.

Globally, stigma and discrimination in healthcare settings have been identified as significant barriers to implementing HIV prevention and treatment strategies. However, research on interventions to reduce the stigma in healthcare facilities, particularly in Malaysia, is lacking. Hence, this study aims to bridge these gaps by implementing a globally accepted training module to reduce HIV stigma among healthcare workers (HCWs). This study aims to implement the Health4All module to reduce HIV stigma among HCWs in Malaysia. A randomized controlled trial (RCT) study with repeated measures over a period of six months was conducted to implement the Health4All module and evaluate the study outcomes. The implementation process involved a total of 300 randomly selected HCWs from 10 primary health clinics in the study area. A total of 263 respondents participated at the beginning, giving a response rate of 88%, but only 177 completed records were used for the final analysis. The mean score for perceived risk and fear was reduced by 1.07between baseline and one month (p < 0.001) and reduced further by 0.81 between one month and three months (p < 0.05). The mean score for value-driven stigma was reduced by 2.31 between baseline and one month (p < 0.001) and reduced further by 0.86 between one month and three months (p = 0.25). The mean score for discriminatory attitude was reduced by 1.65 between baseline and one month (p = 0.002) and reduced further by 1.65 between one month and three months (p = 0.002). The Health4All module was effective in reducing the HIV stigma among HCWs over three months. This study suggests that the training program can be replicated across different healthcare settings worldwide for wider implementation.