Measuring nurses' satisfaction in primary health care centers at Khartoum, Sudan

Background: The primary healthcare sector has experienced significant growth globally, and the nursing workforce has also expanded in recent decades in response to health system reforms. This study aims to assess job satisfaction among primary healthcare nurses in Khartoum, Sudan. Methods: This descriptive cross-sectional study was conducted in 10 primary healthcare centers on 50 nurses who were selected using simple random sampling. Data were collected using an online questionnaire and it was analyzed using SPSS. Results: The findings of this study indicate that the job satisfaction level among nurses working at primary healthcare centers in Khartoum was high (4.4/5). Most nurses reported high satisfaction with all items including protocols, salary, environment, and relationships. The study also found a significant correlation between nurses' sex and experience with their level of job satisfaction. Female nurses reported significantly higher job satisfaction (4.4/5) compared to male nurses (3.6/5), (p-value = 0.04). Additionally, nurses with fewer years of experience reported significantly higher job satisfaction compared to those with more years of experience (p-value = 0.03). Conclusion: The study concludes that nurses working at primary healthcare centers in Khartoum have high job satisfaction, particularly regarding the working environment, salary, relationships, and availability of guidelines. Female nurses and those with less experience have significantly higher job satisfaction.

The Effect of Community Health Information System on Health Care Services Utilization in Rural Ethiopia

BACKGROUND: The Health Extension Program (HEP) was introduced in 2003 to extend primary health care services by institutionalizing the former volunteer-based village health services. However, this program is not comprehensively evaluated. MATERIALS AND METHODS: The 2019 comprehensive national assessment of HEP involved (1) assessment through quantitative and qualitative primary data, (2) a thorough systematic review of the HEP literature, and (3) a synthesis of evidence from the two sources. The assessment included household survey(n=7122), a survey of health extension workers (HEWs) (n=584) _, and an assessment of health posts (HPs)(n=343) and their supervising health centers (HCs)(n=179) from 62 randomly selected woredas. As part of the comprehensive assessment. OUTPUT AND RESULTS: The outputs were (a) full and abridged reports, (b) 40 posters, (c) seven published, three under review scientific papers and (d) seven papers in this special issue. During the one-year period preceding the study, 54.8% of women, 32.1% of men, and 21.9% of female youths had at least a one-time interaction with HEWs. HPs and HEWs were universally available. There were critical gaps in the skills and motivation of HEWs and fulfillment of HP standards: 57.3% of HEWs were certified, average satisfaction score of HEWs was 48.6%, and 5.4% of HPs fulfilled equipment standards. CONCLUSIONS: The findings informed policy and program decisions of the Ministry of Health, including the design of the HEP Optimization Roadmap 2020­2035 and the development Health Sector Transformation Plan II. It is also shared with global community through published papers.

The Quality of Logistics Management Information System and the Availability of Tracer Drugs at Health Posts in Rural Ethiopia: A Mixed-Method Study

BACKGROUND: Proper implementation of the logistics management information system (LMIS) would facilitate access to essential pharmaceutical products. It also prevents wastage at health posts. The aim of this study was to assess the implementation of the LMIS and the availability of tracer drugs at health posts in rural Ethiopia. METHODS: We employed a cross-sectional descriptive design with a mixed-method approach. The data used for this paper was collected from March to May 2019 as part of the National HEP assessment. The study involved 343 health posts randomly selected from nine regions of Ethiopia. Women's Development Army members and household heads participated in the qualitative study (i.e. in FGD and KII). The quantitative data were exported from Open Data Kit (ODK) to Stata 15.1 for statistical analysis, and the qualitative data were entered into NVivo 12 and analyzed using thematic content analysis. RESULTS: Of the health posts, 59.4% had a space for storing drugs; less than half (41.9%; 95% confidence interval (CI) [36%, 48%]) had a functioning refrigerator. The mean percentage of the availability of selected tracer drugs at health posts was 59.6%, with a 95% CI (58.9%, 60.3%). Bin cards were available at 43% (95% CI [40%, 46%]) of health posts, and among these, only 27.5% of the health posts adequately used the bin cards. CONCLUSION: The absence and poor use of LMIS tools was observed at health posts. Proper implementation of the LMIS has the potential to improve the availability of essential drugs that, in turn, improve health post level delivery of health services.

Does Combining Antenatal Care Visits at Health Posts and Health Centers Improve Antenatal Care Quality in Rural Ethiopia?

BACKGROUND: Even though quality maternal care is crucial for the well-being of women and their newborns, the inferior quality of antenatal care in rural Ethiopia is a timely concern. This study aimed to investigate the effects of combining antenatal care visits at health posts and health centers on improving antenatal care quality in rural Ethiopia. METHODS: Using the 2019 Ethiopia Health Extension Program assessment done by MERQ, we extracted and analyzed the survey responses of 2,660 women who had received at least one antenatal visit from a primary health care unit. We measured the cumulative count of quality of antenatal care using the Donabedian model. To model the differences in the quality of antenatal care at health posts and health centers, we used zero truncated Poisson regression and reported incidence risk ratios with their 95% confidence intervals. RESULTS: The quality of antenatal care increased by 20% (adjusted IRR= 1.20 [1.12­1.28]) when antenatal care reception was mixed at health posts and health centers, compared to those who received all antenatal care only from health posts. Quality differences based on socioeconomic status and setting variations were observed as predictors of quality of care, even if women received antenatal care at both health posts and health centers. CONCLUSIONS: Combining antenatal care provision from health posts and health centers should be sustained as one of the antenatal care quality improvement strategies in rural parts of Ethiopia while ensuring the equitable provision of quality care across socioeconomic groups and between agrarian and pastoral settings.

HIVAIDS services quality in health centers of East Shoa zone, Oromia, Ethiopia

Background: HIV/AIDS is a major public health, social and economic problem in Ethiopia. However, little has been done on assessment of the quality of the services given to patients in this country. Objective: To assess the quality of HIV/AIDS services in health centers of East Shoa Zone, Oromia region, Ethiopia. Method: Cross sectional survey was undertaken in selected health centers of East Shoa Zone between February and May 2017. Data was collected using researcher administered structured questionnaire, logistics indicators assessment tool and observation check list. SPSS for windows version 20 was utilized in the analysis of the collected data. Results: The study facilities were providing various services to HIV/AIDS patients. All (100%) and 6(75%) facilities respectively had shortage of trained human power required to give ART and TB services. Regarding ARV medicines availability, majority of the study facilities, 5 (62.50%) reported that they had the stockout of AZT300/3TC150/NVP200 in six months prior to study while 4 (66.7%) of the facilities had the stockout of NVP 240ml (50mg/5ml) syrup on day of visit. Among anti-TB medicines, E100 was out of stock in three facilities (37.5%) on day of visit and INH100 had been out of stock in 4 (50%) of the facilities in six months prior to the study. From OIs medicines, Cotrimoxazole 960mg tablet stocked out in 4 (66.70%) on day of visit and in 5 (83.30%) health centers in six months prior to the study. Considerable number of study facilities, 4 (66.70%) had the stockout of tramadol 50mg tablet on day of visit and ibuprofen 400mg tablet in six months prior to the study, 5 (71.40%). Conclusion: The studied facilities were challenged by different factors including, scarcity of human power, stockout of various HIV/AIDS related medicines and inability to make patients adhere to the services given by the facilities. The consequences of these factors can be dangerous to the patients as well as to the wider public and hence making available the appropriate human resource and HIV/AIDS related commodities including medicines should be the priority for the health facilities and the region to improve the quality of HIV/AIDS services in the study area

Impact of COVID-19 on non-communicable disease management services at selected government health centers in Addis Ababa, Ethiopia

Background: The global pandemic of COVID-19 forced the world to divert resources and asked the public to shelter-in-place, so the diagnosis surveillance system and management of non-communicable diseases has become more challenging. Objective: To identify the impact of COVID-19 on non-communicable diseases management services at government health centers in Addis Ababa, Ethiopia. Methods: Health facility based cross-sectional study was conducted from August to September 2020. A total of 30 health centers were included in this study. Bivariate and multiple logistic regression models were used to assess association between the outcome and independent variables Results: The majority, 24 (80%), of the study participants perceived that the COVID-19 pandemic severely disrupted the non-communicable disease management services. There was a statistically significant association between a decrease in outpatient volume at non communicable disease (NCD) management services (25 (83.3%), P-value: 0.006), closure of population level screening programs of NCDs (22 (73.3%), P-value: 0.007), and closure of disease specific NCD clinics and the occurrence of the COVID-19 pandemic (23 (76.7%), P-value: 0.013). Conclusion: The most critical health-care services for non-communicable diseases management were severely disrupted by the COVID-19 pandemic. Therefore, during public health emergencies, policymakers should ensure continuation of critical clinical services and inform the public about proper service utilization

Facteurs associés au faible niveau de fréquentation du centre de santé intégré de Pondila en 2021 / Factors associated with low levels of attendance of the integrated health center of Pondila in 2021

Le système de santé de la République du Congo est caractérisé par un important gap dans l'offre des services de santé entre le milieu urbain et le milieu rural. La communauté rurale de Pondila, dans le département du Kouilou n'échappe pas à cette description, avec un faible taux de fréquentation du CSI de Pondila de 34,22%. Objectif: Cette étude avait pour objectif d'étudier les facteurs associés au faible taux de fréquentation du CSI de Pondila en 2021. Méthodologie : Il s'agit d'une étude transversale analytique qualitative et quantitative sur un échantillon probabiliste représentatif de 347 ménages dans toute l'aire de santé de Pondila. Un modèle de régression logistique a été construit par la méthode de sélection pas à pas descendante avec une probabilité d'entrée de 0,05 et IC à 95%. Résultats : 30,84% des enquêtés ont rapporté ne pas avoir consulté le CSI de Pondila dans les 03 mois précédant l'enquête dans de mauvaises conditions d'accès géographiques et financières. La régression logistique a permis d'établir le faible niveau de fréquentation du CSI et le chômage (OR=16,67 [14,67 à 18,67], p=0,000), le mauvais accueil des bénéficiaires par le personnel soignant (OR=3,15 [1,00 à 9,95], p=0,050) et l'absence de médicaments lors des consultations (OR=3,21 [0,26 à 39,24], p=0,000). Conclusion : Le faible niveau de fréquentation du CSI de Pondila est associé au chômage, au mauvais accueil et à la non disponibilité des médicaments au CSI, au coût élevé des soins et au mauvais état des routes.