Willingness of WHO staff to work in health emergencies in the African Region: opportunity for phased deployment of staff and ensure continuity of health services

A human resource base that ensures appropriate deployment of staff to emergencies, addressing different shock events in emergencies, without disrupting continuity of service is germane to a successful response. Consequently, the WHO Health Emergencies programme in the African Region, in collaboration with Africa Centre for Disease Control (ACDC) launched the African Volunteer Health Corps (AVoHC) and Strengthening and Utilization of Response Group for Emergencies (SURGE), an initiative aimed at ensuring a pool of timely responders. We explored the willingness of WHO staff to work in emergencies. A call for expression of interest to be part of the Elite Emergency Experts (Triple E) was published on 5th July 2022 via email and was open for 5 weeks. The responses were analyzed using simple descriptive statistics and presented with graphic illustrations. A total of 1253 WHO staff, from all the six WHO regions, cutting across all cadre, applied to the call. The applicants had various trainings and experiences in emergency and have responded to mostly disease outbreaks. Two-third of the applicants were males. This paper did not explore reasons for the willingness to work in emergencies. However, contrary to fears expressed in literature that health workers would not want to work in emergencies with potential for infections, the applicants have worked mostly in infectious emergencies. Literature identified some themes on factors that could impact on willingness of health workers to work in emergencies. These include concerns for the safety of the responders and impact of partners, child and elderly care, as well as other family obligations, which emergency planners must consider in planning emergency response.

Factors influencing recruitment and retention of healthcare workers in rural and remote areas in developed and developing countries: an overview

Shortage of healthcare workers in rural and remote areas remains a growing concern both in developed and developing countries. This review aims to synthesize the significant factors impacting healthcare professionals' recruitment and retention in rural and remote areas, and to identify those relevant for developing countries. This paper included the following steps: exploring scientific literature through predetermined criteria and extracting relevant information by two independents reviewers. The AMSTAR tool was used to assess the methodological quality. Of the 224 screened publications, 15 reviews were included. Four reviews focused on recruitment factors, and another four reviews focused on retention factors. The remaining focused both on recruitment and retention factors. The most important factors influencing recruitment were rural background and rural origin, followed by career development. Opportunities for professional advancement, professional support networks and financial incentives were factors impacting retention. While the main factors influencing recruitment and retention have been largely explored in the literature, the evidence on strategies to reduce the shortage of healthcare workers in rural area, particularly in developing countries, is low. Further research in this field is needed

Type 2 diabetes management: Patient knowledge and health care team perceptions, South Africa

Background: South African research indicates that the highest death rates between 2004 and 2005 were from diabetes mellitus.There is minimal research information on interactions between what patients know about their disease and what health professionals perceive that patients should know to control their disease well. Objectives: This study determined the knowledge that patients with type 2 diabetes have about the management of their disease; as well as the perceptions of the health care team about the services given to patients. Method: Qualitative data were collected using two focus groups and in-depth interviews. Patient focus group (n = 10) explored patients' knowledge about management of type 2 diabetes. Patients were recruited from Dr George Mukhari Hospital outpatients' diabetes clinic. Professional focus group (n = 8) explored the health care team's experiences; barriers and facilitators in managing the disease. Professional focus group participants were recruited because of their expertise in chronic disease management; working in the community (public health) or working directly with patients with type 2 diabetes. Five health care professionalswere interviewed using the same guide of questions as for the focus group. Results: Participants identified type 2 diabetes as a chronic disease that needs behaviour change for good control. Five major themes were identified: patients' knowledge; education programmes; behaviour change; support; and a patient-centred approach. Conclusion: Management of type 2 diabetes may be enhanced by reinforcing patients' knowledge; encouraging behaviour change whilst taking into consideration patients' backgrounds. The health care team needs to utilise a patient-centred approach

Perceptions of Health Care Professionals towards Pharmacogenomics in Nigeria: Preliminary Results

"Background: Pharmacogenomics/pharmacogenetics has the potential to mitigate adverse drug reactions and optimize pharmacotherapy in individuals. Over the past several years; there has been increasing attention towards the characterization of pharmacogenomic biomarkers in African populations; both locally and internationally. However; the perceptions of the African health care community towards pharmacogenomic testing have not been studied. Objectives: To assess knowledge and perceptions of pharmacogenomics among health care professionals in Benin City; Nigeria. Methods: In this preliminary and pilot investigation; we used a semi-structured qualitative survey methodology to understand the perceptions of pharmacists and pharmacologists towards pharmacogenomics in an academic care centre in Benin City; Nigeria. Three themes were explored: Knowledge and experience with pharmacogenetics; Expectations about how a pharmacogenetic testing service could be used; and Capacity building for pharmacogenetic service delivery. Results: Though none of the participants had received training or undertaken research in pharmaco- genomics; all participants were familiar with the field and listed beneficial outcomes associated with pharmacogenetic testing. Participants identified factors such as lack of funding; infrastructure; and manpower for limitations of pharmacogenomic testing in Nigeria. Participants listed numerous ethical issues and concerns in recruiting participants for research and introducing pharmacogenetics in the clinic; including the need to ""win the confidence of the people."" Conclusion: Pharmacists and pharmacologists in an academic centre in Nigeria are aware of the benefits of pharmacogenomics; but cite many hurdles to overcome before this field can become a routine part of patient care in their communities."

Knowledge, attitude and practice of cervical cancer screening - Papanicolaou test (Pap smear) among female health care providers in Port Harcourt

Background: Cervical cancer is the second most common malignancy affecting women globally and the commonest female genital cancer in Nigeria. It can be prevented through regular cytologic screening by Pap smear. The general public sees health care providers as models; therefore; their attitudes and actions would predictably influence societal health behaviour. Aim: To assess the knowledge; attitude and practices of female health workers in Port Harcourt; towards cervical cancer screening. Methods: A questionnaire-based survey of 133 female health care providers at the Braithwaite Memorial Specialist Hospital and the University of Port Harcourt Teaching Hospital; Port Harcourt; which evaluated the socio-demographic characteristics of respondents; knowledge of cervical cancer; attitude and utilization of cervical cancer screening service was carried out. The data were entered into SPSS version 11.0 which was used for analysis and results are presented as Frequency tables; percentages and means. The level of significance was set at p-value 0.05. Results: Up to 123 (92.2) respondents had knowledge of Pap smear as a screening tool for cervical cancer; and 96 (72.2) respondents recognized early sexual debut as a risk factor. Nine-three (70) respondents would be willing to have Pap smear. Only 17(12.8) had done a Pap smear previously. Conclusion: The high knowledge of cervical cancer screening and their positive attitudes towards it did not translate to service utilization by female health professionals in Port Harcourt.There is therefore need to improve uptake of Pap smear by health professionals in order to improve their effectiveness in encouraging the public to utilize this service

Exposure to Human Immunodeficiency Disease. What Precautions for the Healtcare Professional?

: The Human Immunodeficiency Virus (HIV) epidemic is more pronounced in sub- Saharan Africa. The ever-increasing prevalence of HIV infection and the continued improvement in clinical management has increased the likelihood of these patients being managed by healthcare workers. The aim of the review was to assess current literature on the risks of transmission of HIV infection and protection of the healthcare worker.Methods: A literature review was performed using MEDLINE articles addressing `human immunodeficiency virus'; `HIV'; `Acquired immunodeficiency syndrome'; `AIDS'; `HIV and Surgery'. We also manually searched relevant surgical journals and completed the bibliographic compilation by collecting cross references from published papers.Results: Transmission is by contamination with body fluids for example needle-stick injury and blood splashes. The risk of HIV transmission from patient to healthcare worker always exists. The risk of transmission is very small and depends on the type of discipline and type of procedure. Hollow needles are more dangerous than suture needles. Sero-conversion is; however; very minimal. Universal precautions are emphasised. In case of needle-stick injury or splash it is important that affected healthcare workers take post-exposure prophylaxis.Conclusion: Occupational HIV transmission is lower than that for other infections. However; protection of all health care personnel should be the prime objective. Universal infection control guidelines must be accepted and strictly enforced. A prompt response to blood contact is crucial and post-exposure prophylaxis is essential

A Study of Health Workers' Knowledge and Practices Regarding Leprosy Care and Control at Primary Care Clinics in Eerstehoek area of Gert Sibande District in Mpumalanga Province; South Africa

Background: Leprosy is now a rare disease in South Africa. It does still occur; however; and it is an important cause of preventable disability. The target of eliminating leprosy as a public health problem has long been reached in the country in terms of the World Health Organization (WHO) definition of less than one case of leprosy per 10 000 population. However; there is still a commitment to the eradication of the disease in the country. 1 Also; as leprosy is a chronic communicable disease with an extraordinary long incubation period; it is expected that even in areas where the elimination target has been reached; a proportion of the population infected several years ago will show clinical disease; resulting in the occurrence of new cases for many years to come. There is; therefore; a continuing need for vigilance regarding leprosy in South Africa. The low prevalence of leprosy in South Africa is found mostly in the eastern coastal areas and the south-eastern Highveld region; comprising mostly the provinces of Eastern Cape; KwaZulu-Natal and Mpumalanga. The strategy of leprosy care and control programmes in the country is currently that of decentralisation and integration into the general health care services at the primary health care (PHC) level in accordance with the WHO recommendations. The low prevalence of leprosy is associated with a fear of the loss of leprosy-specific skills within the healthcare services that could result in considerable delay in the diagnosis and treatment of the disease. One of the goals of the South African leprosy care and control programme is the maintenance of a high level of awareness of leprosy by health workers (HWs) at the primary care level of the general healthcare services in order to ensure early diagnosis and treatment of the disease in the light of the low prevalence. A successful leprosy care and control programme within the general healthcare services at the PHC level is highly dependent upon the HWs having adequate knowledge of; and practical training on; leprosy.Methods: This study describes PHC workers' knowledge of leprosy; and their practical involvement in leprosy care and control activities at PHC clinics in the Eerstehoek area of Gert Sibande district in Mpumalanga Province; South Africa; where leprosy still occurs.Results: The results of the study reveal that the PHC workers have a general lack of basic clinical knowledge of leprosy; and a very low level of practical involvement in leprosy work at the PHC clinics in the area. A majority of the PHC workers expressed the desire for training on leprosy; and the willingness to provide care to leprosy patients at the PHC clinics.Conclusion: Training strategies that are recommended to improve the PHC workers' knowledge of leprosy and to promote their practical involvement in leprosy work at the PHC clinics include: more emphasis on leprosy teaching during the training of PHC workers at training institutions; more leprosy-specific in-service training of the PHC workers; special training of the PHC workers on practical leprosy work; and regular follow-up and supervision of the PHC workers at PHC clinics by specialised or experienced leprosy workers

Training; recruitment and development and deployment of health workers in Uganda; 1995 to 2000

Uganda has been implementing reforms in the public service since 1989(1). The provisions of the 1995 Constitution; the Local Governments Act (1997) and other recent legislations and policies have required restructuring of the ministries and local governments in order to meet their new mandates. Several studies and policy documents have outlined the structure; management; and functions of the Ministry of Health; hospitals and the district health services (2;3;4;5;6;7;8)

Knowledge of HIV by Health Professionals in Kampala; Uganda

Deficiencies in HIV knowledge among health care professionals is of concern because they play an instrumental role in counseling patients to reduce risk behaviors. We report here on the results of a pretest questionnaire which we administered to assess baseline levels of HIV knowledge among a group of health care providers in Kampala; Uganda; our educational intervention; and the results of the post-test questionnaire which we administered to detect changes in the level of HIV knowledge following intervention. Pre-test results indicated that the greater deficiencies in knowledge related to transmission and prevention and clinical manifes nottations of disease. Scores on the post-test; administered following a 15-hour course; indicated a significant improvement in knowledge of clinical manifestations and overall knowledge. Our findings underscore the need for ongoing HIV educational programs for health care workers