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The purpose of this paper is to train primary health care workers to be trainers and implementers of community‐based AIDS prevention activities in Oyo State, Nigeria, by describing an evaluation of the project.

A total of 148 primary health care workers recruited from the 33 local government areas (LGA) of the state were trained as trainers. They were provided seed grants to replicate similar training for health workers, implement and evaluate community‐based AIDS prevention activities. Questionnaires were used before and after the training and the community based projects to evaluate its impact on knowledge of cause of AIDS, routes of HIV transmission, signs and symptoms of AIDS, and precautions to prevent.

At pre‐test, only 30.8 per cent of trainers could list at least four signs and symptoms of AIDS compared with 70.9 per cent who could do so after the training. The trainers trained 973 health workers; the number trained ranged from 20‐80 with a mean of 32.4. The trainers also implemented community‐based AIDS prevention interventions which reached 2,082 persons including adolescents (48.2 per cent), long‐distance drivers (16.6 per cent), market men and women (15.8 per cent), female sex workers (14.2 per cent), traditional birth attendants (4.6 per cent) and herdsmen and women (5.6 per cent). The evaluation conducted after four months of implementation of the community‐based projects showed improvement in knowledge of HIV among all the target groups. It suggests reduction in reported unprotected sex among drivers (from 44 per cent at pre‐test to 18.9 per cent at post‐test) and increase in reported consistent use of condoms (from 53.4 per cent at pre‐test to 71.4 per cent at post‐test) among female sex workers.

Primary health care workers can successfully implement community‐based HIV/AIDS prevention activities.

Primary health care workers can make important contributions to HIV/AIDS prevention and control efforts.

Health education interventions delivered by primary health care workers multiplied the effects of HIV/AIDS prevention and control activities.

Accredited Social Health Activists (ASHAs) are community health workers under the National Rural Health Mission of Government of India (NRHM). They have played a pivotal role during the COVID-19 pandemic in providing information and healthcare services to and from the remotest part of a village in India, working round the clock tracing patients and providing other COVID-19 related services along with fulfilling their basic duties of anti-natal care, immunization, sanitization, etc. The chapter seeks to understand the causative factors of invisibility and marginalization of ASHA workers. As most of them come from low-income and low-literacy background, they face discrimination and marginalization with long working hours, very low wages, and being treated as social pariah by the community they work in and work for. The study is particularly relevant because ASHA workers have worked as a communicating link between doctors, hospitals, and communities, and also through door-to-door survey, they have collected massive data during the pandemic, which has helped the governments to frame policies and take decisions. Both qualitative and quantitative methods have been used. I have interviewed some 55 ASHA workers (some of being my former students). I have used news clippings and government reports, regulations, directives and guidelines, survey reports of Thomas Reuters foundation, Amnesty International, Aziz Premji Foundation, as source material for information. There are certain gaps in policy making, social behavior, and attitude toward the ASHA workers, which need to be addressed.

This paper reports findings from a qualitative study of the mental health needs of refugees, asylum seekers and migrant workers living in an East Anglian seaside town with high rates of socio‐economic deprivation. Nine key informants were recruited from people working with refugees, asylum seekers and migrant workers, and from people who were either members of, or had extensive knowledge of the issues affecting the relevant communities. Barriers were reported both at the stage of seeking services and in accessing services once sought. Barriers to seeking services included different understandings of mental health problems, lack of acknowledgement, discussion and prioritisation of mental health problems, stigma, lack of knowledge of services, fear of authority and lack of trust. Barriers to access included previous negative experiences of accessing NHS services, resource limitations, lack of interpreting and translation services, and practical barriers such as transport and hours of appointments. The findings are discussed in relation to mental health service delivery and mental health promotion.

This study aimed to analyze the role of community health workers (CHWs) called accredited social health activists (ASHAs) in improving maternal health outcomes in the rural community of Punjab, India. The study also examined the expectations of these workers from the community and identified the problems faced by them in carrying out their roles.

Using multistage sampling, a total of 28 villages were selected from seven districts of Punjab, and from these selected villages, a total of 57 ASHAs working as the interface between the rural community and the public health system and 420 women who had delivered a baby were interviewed.

Desire to earn money was the most prominent reason for joining the community work program, but ASHAs felt overburdened and underpaid compared to their work commitments. Not only was the incentive paid to these workers was insufficient and irregular but they also suffered at the hands of medical staff at public hospitals.

While exploring the problems experienced by the CHWs, this study recommends opting for a mix of monetary and nonmonetary incentives for acknowledging the work of CHWs. The study is the first of its kind for the state of Punjab battling with a worsening maternal mortality rate (MMR).

This paper presents results from a participatory action research study with 46 LGBTQIA+ community leaders and 60 library workers who participated in four community forums at public libraries across the US. The forums identified barriers to LGBTQIA+ communities addressing their health questions and concerns and explored strategies for public libraries to tackle them.

Forums followed the World Café format to facilitate collaborative knowledge development and promote participant-led change. Data sources included collaborative notes taken by participants and observational researcher notes. Data analysis consisted of emic/etic qualitative coding.

Results revealed that barriers experienced by LGBTQIA+ communities are structurally and socially entrenched and require systematic changes. Public libraries must expand their strategies beyond collection development and one-off programming to meet these requirements. Suggested strategies include outreach and community engagement and mutual aid initiatives characterized by explicit advocacy for LGBTQIA+ communities and community organizing approaches.

Limitations include the sample's lack of racial diversity and the gap in the data collection period between forums due to COVID-19. Public libraries can readily adopt strategies overviewed in this paper for LGBTQIA+ health promotion.

This research used a unique methodology within the Library and Information Science (LIS) field to engage LGBTQIA+ community leaders and library workers in conversations about how public libraries can contribute to LGBTQIA+ health promotion. Prior research has often captured these perspectives separately. Uniting the groups facilitated understanding of each other's strengths and challenges, identifying strategies more relevant than asking either group alone.

The purpose of this paper is to assess perceptions of organizational readiness to integrate clinic-based community health workers (cCHWs) between traditional CHWs and potential cCHW employers and their staff in order to inform training and implementation models.

A cross-sectional mixed-methods approach evaluated readiness to change perceptions of traditional CHWs and potential employers and their staff. Quantitative methods included a printed survey for CHWs and online surveys in Qualtrics for employers/staff. Data were analyzed using SPSS software. Qualitative data were collected via focus groups and key informant interviews. Data were analyzed with NVIVO 11 Plus software.

CHWs and employers and staff were statistically different in their perceptions on appropriateness, management support and change efficacy (p<0.0001, 0.0134 and 0.0020, respectively). Yet, their differences lay within the general range of agreement for cCHW integration (4=somewhat agree to 6=strongly agree). Three themes emerged from the interviews which provided greater insight into their differences and commonalities: perspectives on patient-centered care, organizational systems and scope of practice, and training, experiences and expectations.

Community health workers serve to fill the gaps in the social and health care systems. They are an innovation as an emerging workforce in health care settings. Health care organizations need to learn how to integrate paraprofessionals such as cCHWs. Understanding readiness to adopt the integration of cCHWs into clinical settings will help prepare systems through trainings and adapting organizational processes that help build capacity for successful and sustainable integration.

This chapter explores the significance and implementation of family planning practices, emphasizing their vital role in enhancing reproductive health outcomes. This chapter conducts an in-depth examination of family planning practices within marginalized communities in Bangladesh, shedding light on the unique challenges and opportunities faced by these populations. By uncovering the nuances of family planning practices in marginalized contexts, this chapter underscores the need for tailored and culturally sensitive family planning programs. It advocates for program designs that facilitate the effective adoption of family planning practices among marginalized communities, ultimately promoting better reproductive health outcomes. Furthermore, this chapter highlights the importance of empowerment strategies in reaching and engaging marginalized communities. Through practice enhancement initiatives, it seeks to empower marginalized populations with the knowledge and resources necessary to make informed decisions about family planning, thereby contributing to improved reproductive health and overall well-being.

This article compares the processes of community verification (CV) and user satisfaction surveys during the implementation of performance-based financing (PBF) in Mali and Burkina Faso.

The authors adopted a qualitative approach based on a multiple-case study design. Data were collected from August 10 to 25, 2017, in Mali, and from January to May 2016 in Burkina Faso. In Mali, 191 semi-structured interviews were conducted with investigators (people who collect information from health centre users in the communities, using survey tools), users, users' relatives, and health workers in three of the 10 health districts in the Koulikoro region. In Burkina Faso, 241 non-participatory observation sessions were recorded in a research diary, and 92 semi-structured interviews and informal discussions were conducted with investigators, community verifiers, users, PBF support staff at the national level, and administrative staff in one of the 15 health districts involved in PBF. The data were analysed inductively.

In both Mali and Burkina Faso, the delayed availability of survey forms led to a delay in starting the surveys. In Mali, to get off to a quick start, some investigators went to health centres to conduct the sampling with their supervisors. In both countries, investigators reported difficulties in finding certain users in the community due to incorrect spelling of names, lack of telephone details, incomplete information on the forms, common or similar sounding names within the community, and user mobility. There was little interference from health workers during user selection and surveys in both countries. In both countries, many surveys were conducted in the presence of the user's family (husband, father-in-law, brother, uncle, etc.) and the person accompanying the investigator. Also in both countries, some investigators filled in forms without investigating. They justified this data fabrication by the inadequate time available for the survey and the difficulty or impossibility of finding certain users. In both countries, the results were not communicated to health centre staff or users in either country.

CV and user satisfaction surveys are important components of PBF implementation. However, their implementation and evaluation remain complex. The instruments for CV and user satisfaction surveys for PBF need to be adapted and simplified to the local context. Emphasis should be placed on data analysis and the use of CV results.

There are similarities and differences in the CV process and user satisfaction surveys in Mali and Burkina Faso. In Mali, the data from the user satisfaction survey was not analyzed, while in Burkina Faso, the analysis did not allow for feedback. The local non-governmental organisations (NGOs) that carried out the CV were pre-financed for 50% of the amount in Mali. In Burkina Faso, community-based organisations (CBOs) were not pre-financed. The lack of financing negatively impacted the conduction of the surveys. In Mali, fraudulent completion of survey forms by interviewers was more common in urban than in rural areas. In Burkina Faso, the frauds concerned consultations for children under five years of age. In Burkina Faso, the survey form was not adapted to collect data on the level of satisfaction of the indigent.

1. There were similarities and differences in the community verification (CV) processes in Mali and Burkina Faso.

2. In both Mali and Burkina Faso, tracing users within their community was difficult for several reasons, including incorrect or incomplete information on forms, common or similar names, and user mobility.

3. In both countries, there was no feedback on the results of the CV process to health centre staff or users.

4. Survey forms were falsified by investigators in both countries. In Mali, falsification was more common in urban than in rural areas. In Burkina Faso, falsification was more often observed for consultations for children under five years of age.

There were similarities and differences in the community verification (CV) processes in Mali and Burkina Faso.

In both Mali and Burkina Faso, tracing users within their community was difficult for several reasons, including incorrect or incomplete information on forms, common or similar names, and user mobility.

In both countries, there was no feedback on the results of the CV process to health centre staff or users.

Survey forms were falsified by investigators in both countries. In Mali, falsification was more common in urban than in rural areas. In Burkina Faso, falsification was more often observed for consultations for children under five years of age.

The purpose of this paper is to provide a comprehensive narrative review of the literature on migrant farm worker child and adolescent health. It highlights current health issues and suggests methods to improve research and clinical practices with this underserved and vulnerable population.

The methodology for this narrative review included a search of articles published between 2000 and 2012. From the primary search, 76 articles met the search criteria. A secondary search revealed three additional articles.

The various methodologies used in the current literature have limited rigorous analysis of the health of pediatric migrant populations. The findings highlight the complex factors that influence migrant pediatric health. Despite the many challenges migrant farm worker children and their families face, they exhibit enormous resilience and strengths that may help counterbalance these challenges. Study categories that emerged from the analysis include health perspectives and behaviors, occupational health, access to care, utilization and satisfaction with health services, health outcomes and health disparities, and oral health. This review provides a strong foundation from which to work toward improving migrant pediatric health.

This paper provides an original review of the unique health needs and the complex factors influencing the health of migrant farm worker children and adolescents. This will be of value to clinicians and researchers since migrant farm worker families are part of communities across the country. It offers public health professionals insight into services and programs that can improve the health and well-being of children, families, and communities.

The purpose of this paper is to explore the efficacy of a community‐based outreach initiative, piloted in Worcester, Massachusetts, to reduce children's exposure to toxic chemicals in common household products by changing parental behavior regarding product purchase and use.

The program model was based on the premise that community health workers have the potential to deliver health education messages with particular effectiveness. Community health workers in Worcester received customized training to learn about the impact of toxic chemicals on children's health and strategies to reduce children's exposure to toxics in household products. The health workers then delivered this information to low‐income parents in English or Spanish. Through follow‐up interviews, the health workers used short surveys to collect data regarding the effect, if any, of the outreach on parental behavior regarding household product purchase and use.

Parents were receptive to receiving technical information about toxics and household products from outreach workers who could convey the message at an appropriate comprehension level. Parents' responses to the survey questions suggest that the outreach efforts increased their awareness and understanding of how toxics affect their children's health.

Design and implementation aspects of the initiative – notably the size of the cohort recruited to the project – make it difficult to draw robust conclusions from the survey data. Nevertheless, the data do reflect at least a modest degree of parental behavior change regarding household product purchase and use.

Outreach efforts that reach parents individually in their homes are effective at communicating targeted information but do not necessarily result in parental behavior change. As consumers, many parents need to hear the message more than once before they will change their behavior regarding product use and purchase.

This paper describes a health education model that addresses an important but often overlooked area of risk to children's health: their exposure to toxics in common household products.