Are clients satisfied with communication with health workers? A study among pregnant women attending primary health care centers in Nasarawa State, Nigeria

An effective communication between health workers and clients is known to improve clients' perception, compliance, and treatment outcomes. The main objective of this study was to determine the level of client satisfaction with health workers'-client communication among pregnant women attending ANC in selected PHC facilities Nasarawa State. The study was a cross-sectional design conducted among 450 respondents consenting pregnant women during their ANC sessions. Data was collected using a structured, interviewer-administered structured questionnaire. Analysis was done using SPSS software version 20. Chi-square test and logistic regression were used for the test of significance. Results showed that 132 (29.3%) of the respondents were completely satisfied with client health worker communication. The elements of communication with the highest satisfaction were: explanation of condition to clients: 193 (42.9%); use of appropriate language: 189 (42.0%) and courtesy and respect by the provider: 188 (41.0%). Conclusion. Clients with a secondary level of education and more were more likely to be satisfied with communication with health workers. There is a need to carry out regular reorientation of PHC workers on communication with clients. (Afr J Reprod Health 2022; 26[6]:55-63)

Patient preferences and expectation for feedback on adverse drug reaction reports submitted in Ghana

Background: Personalized feedback received for spontaneous adverse drug reaction (ADR) reports serves as motivation for future reporting and the effectiveness of the feedback is dependent on the medium used in delivering the information. Objective: Explore expectation for feedback from patients on ADR reports submitted to the National Pharmacovigilance Centre (NPvC) in Ghana and the preferred medium for receiving the feedback information.Methods: Cross-sectional study using structured questionnaire administered through face-to-face interview from August to September 2016 to patients selected by convenience sampling. Pearson chi-square (Χ2) or Fisher's exact test was used to determine associations between background variables such as age, gender and level of education. Results: The response rate was 86.7% (n=442). Of the participants interviewed, 96.5% expected to receive feedback for ADR reports submitted. Age and level of education were the two variables significantly associated with patients' expectation for feedback. The preferred medium for receiving feedback in decreasing order of preference were, telephone call (60.4%), mobile phone short messaging services (23.0%), email (8.3%), face-to-face meeting (3.4%), personalized letter (3.4%) and publication in a newsletter (1.4%). Conclusion: Patients' expectation for receiving feedback for ADR reports submitted to the NPvC is in line with modern trends in communication. NPvC should explore these alternatives for providing feedback to patients. Thisstudy is limited to what patients' expectations and preferences were for receiving feedback on ADR reports submitted, additional study to further explore the type of information patients expect to be contained in the feedback will be useful to National Pharmacovigilance Centres

Perceptions of patients regarding diabetes-related health communication strategies in the Free State, South Africa

Background: This study researched the perceptions of patients diagnosed with diabetes concerning diabetes-related health communication strategies in the Free State province in South Africa. The prolongation and quality of life of patients diagnosed with diabetes are affected by lifestyle choices. An enabler of risk reduction is health communication which informs, influences and motivates individuals to adopted health-focused lifestyles. Aim: This study sought to describe the perceptions of patients regarding diabetes-related health communication strategies in the Free State, South Africa. Setting: This study was carried out in primary health care centres and community health care centres within the Free State province in South Africa. Methods: A qualitative, descriptive and exploratory research design was used in this study. Thirty-four patients diagnosed with type two diabetes for at least a year were purposively included in this study. Semi-structured interviews in Afrikaans, English, Sotho and Xhosa were conducted. Data analysis was through inductive reasoning and thematic analysis. Results: The majority of the respondents were older women having been diagnosed with diabetes for more than 5 years, with at least primary school education and of diverse South African ethnicities. The main prompting questions operationalised the term 'perception', probing their feelings, experiences and knowledge of health-related communication strategies as presented by a variety of information sources. After recording interviews, data were analysed according to themes, categories and sub-categories. Conclusions: The study highlights factors that encourage patients to seek help and foster attitudes of compliance. Practical problems regarding the management of diabetes are underlined. The role of family, as well as the patient­caregiver relationship, in the acceptance and management of the disease is revealed. Societal perception of male symptomology is shown. The study offers information to stakeholders and health care workers for continued successful management of diabetes in communities

Perceptions of patients regarding diabetes-related health communication strategies in the Free State, South Africa

Background: This study researched the perceptions of patients diagnosed with diabetes concerning diabetes-related health communication strategies in the Free State province in South Africa. The prolongation and quality of life of patients diagnosed with diabetes are affected by lifestyle choices. An enabler of risk reduction is health communication which informs, influences and motivates individuals to adopted health-focused lifestyles.Aim: This study sought to describe the perceptions of patients regarding diabetes-related health communication strategies in the Free State, South Africa.Setting: This study was carried out in primary health care centres and community health care centres within the Free State province in South Africa.Methods: A qualitative, descriptive and exploratory research design was used in this study. Thirty-four patients diagnosed with type two diabetes for at least a year were purposively included in this study. Semi-structured interviews in Afrikaans, English, Sotho and Xhosa were conducted. Data analysis was through inductive reasoning and thematic analysis.Results: The majority of the respondents were older women having been diagnosed with diabetes for more than 5 years, with at least primary school education and of diverse South African ethnicities. The main prompting questions operationalised the term 'perception', probing their feelings, experiences and knowledge of health-related communication strategies as presented by a variety of information sources. After recording interviews, data were analysed according to themes, categories and sub-categories.Conclusions: The study highlights factors that encourage patients to seek help and foster attitudes of compliance. Practical problems regarding the management of diabetes are underlined. The role of family, as well as the patient­caregiver relationship, in the acceptance and management of the disease is revealed. Societal perception of male symptomology is shown. The study offers information to stakeholders and health care workers for continued successful management of diabetes in communities

Writing therapy

In the distant past I started to suggest to patients that they might like to write down their stories as a form of therapy.1 They could write me a letter or write a letter to some significant person in their lives that would help them coordinate their thoughts and emotions

Perceptions of why Malawians engage in concurrent sexual partnerships among a select population of radio listeners: findings from an exploratory study

Concurrent sexual partnerships have been identified as a potential driver in the HIV epidemic in Southern Africa. This study utilised an innovative approach to explore perceptions of why Malawians may engage in these relationships, and their suggestions for reducing the practice among a select population of radio listeners. Using radio listener feedback in the form of text messages, we analysed approximately 1 000 text messages sent by individuals who listened to a reality radio programme that included real stories, told by Malawians, on topics related to HIV/AIDS. Listeners suggested that lack of satisfaction with one's partner was the overarching reason why individuals had concurrent sexual partnerships. Within the context of lack of satisfaction, listeners cited alcohol use, poor communication and gendered norms as factors related to satisfaction. Listeners suggested that couple communication could increase satisfaction, which, in turn, could reduce concurrent sexual partnerships. Prevention efforts should consider how to utilise couple communication to improve satisfaction as an approach to reduce HIV risk in Southern Africa

Déterminants communicationnels de la persistance de la malnutrition aigüe sévère sans complication chez les enfants de 6 à 59 mois admis au CRENAS du CSI Dan Issa (Maradi) de Décembre 2017 à Mars 2018

Nonobstant, les multiples interventions de l'Etat et de ses partenaires, la malnutrition aiguë sévère sans complication, sévit de manière quasi permanente au centre de santé intégré de Dan Issa/Maradi. En effet, en fin 2017, ce centre a totalisé à lui seul plus de 48,77% des malnutris aigus sévères sans complication notifiés au district sanitaire de Madarounfa. Entre autres facteurs expliquant cette situation, l'on note certains comportements/pratiques des mères/gardiennes d'enfants malnutris. Notre étude s'est déroulée au centre de santé intégré de Dan Issa sis dans le chef-lieu de la commune rurale. Ce centre se situe à 35 km au sud de la ville de Maradi. Comme méthodologie de recherche, nous avons mené une étude descriptive transversale avec comme population de référence : les mères/gardiennes d'enfants malnutris aigus sévères sans complication âgés de 6 à 59 mois, les prestataires de services au poste de prise en charge et les leaders communautaires. Les principaux résultats auxquels nous sommes parvenu sont : seul un (1) prestataire a pu notifier les conditions de la réussite d'une communication efficace, 72,92% des femmes admises sont venues d'elles même à la prise en charge avec la certitude d'être enrôlées,78,12% des mères enquêtées ont indiqué l'inexistence de relais communautaire dans leurs localités, 66,67% des enfants admis sont sevrés avant deux (2) ans et vivent avec leurs mères, 66,67% des utilisatrices n'ont pas l'intention de fréquenter la consultation nourrisson après la décharge, 40,63% des mères/gardiennes méconnaissent les pratiques familiales essentielles et 3 enfants enrôlés sur 10 risquent de ne pas bénéficier du ''plumpy net'' en dehors du site de prise en charge, 53,13% des clientes semblent ne pas écouter activement les prestataires, Aucune femme n'a lavé les mains pendant le test d'appétit. Face à cette situation, nous formulons des recommandations : - instaurer un circuit unique au niveau du centre de santé intégré conformément aux instructions nationales ; - renforcer les assemblées villageoises sur les conséquences à long terme de la malnutrition chez les enfants ; - renforcer les capacités des prestataires du centre de récupération nutritionnelle ambulatoire pour malnutris sévères en communication (interpersonnelle et pour le changement de comportement) - et renforcer la mise en œuvre de la stratégie à base communautaire notamment en augmentant le nombre des relais communautaires dans les localités. Les principaux mots clés employés

Implementation of the Road-to-Health-Booklet health promotion messages at primary health care facilities, Western Cape Province, South Africa

Background: Age-specific health promotion messages appear in the Road-to-Health-Booklet, an assessment and monitoring tool for child health in South Africa. Healthcare workers should communicate health promotion messages to caregivers at each clinic visit.Objective: This investigation, part of a larger Road-to-Health-Booklet survey, assessed the implementation of health promotion messages and identified barriers to its successful implementation.Methods: A cross-sectional descriptive study with analytical components was conducted in the Western Cape Province. Knowledge and practices of caregivers and healthcare workers were assessed at 143 randomly selected primary health care facilities. Information was obtained through questionnaires; direct observation of consultations and recording of health promotion material in facilities.Results: In total, 2442 children (0-36 months; mean age 6.26 ± 6.24 months.); 2481 caregivers and 270 healthcare workers were included. Caregivers' educational level varied, with only 24.3% completing Grade 12. Healthcare workers had a median of five years (0.5 - 37.0 years) work experience in primary health care. All healthcare workers indicated that health promotion messages are important, however, messages were only conveyed in 51% of consultations observed. If communicated, health promotion messages were age-appropriate in 97% of cases. Barriers to the implementation of health promotion messages hinged on time and staff constraints, workload and language barriers.Various forms of health promotion material were available in facilities.Conclusions: Sub-optimal implementation of the health promotion messages in the Road-to-Health-Booklet are apparent despite healthcare workers realising the importance of health promotion.Barriers to optimal implementation must be urgently addressed by the National Department of Health and healthcare workers in partnership with caregivers and supported by society to promote child health and care

Perceptions of caring for children with disabilities: experiences from Moshi, Tanzania

Background: Although there exist laws; policies and standards in Tanzania that serve to protect and improve the lives of children with disabilities; the individual human experiences and feelings of the carers and parents still remain the realities of caring for children with disabilities. There is a lack of qualitative studies examining experiences in a developing context. This research aimed to fill that gap. Objectives: The objective of this research was to gain an insight into how having a child with a disability impacts upon participants lives and to examine both negative and positive experiences of care through the use of qualitative methods. Method: This was a qualitative; exploratory study and followed a phenomenological method. Purposive convenience sampling methods were used to recruit 14 carers in Moshi; Tanzania. Qualitative; semi-structured interviews were undertaken with all 14 participants. Results: Five main themes emerged from the data which shed light on the carers experiences; namely; objective challenges in terms of financial challenges; employment issues and demands of care; subjective challenges in the form of stigma; isolation and pity; positive experiences such as the child's progress; respect and happiness; material and financial needs; and coping mechanisms which included beliefs; support and attitudes. Conclusion: The findings of this research were that objective challenges are common and more significant than subjective challenges. Positive experiences were not as easily identified by the participants as the challenges faced. However; having analysed the data; carers do not experience their roles as entirely negative. They simply need the resources to deal with objective challenges which in a developing context are not easily attainable

The social and gender context of HIV disclosure in sub-saharan Africa: a review of policies and practices

This paper reviews the legal and policy context of HIV disclosure in sub-Saharan Africa; as well as what is known about rates; consequences and social context of disclosure; with special attention to gender issues and the role of health services. Persistent rates of nondisclosure by those diagnosed with HIV raise difficult ethical; public health and human rights questions about how to protect the medical confidentiality; health and well-being of people living with HIV on the one hand; and how to protect partners and children from HIV transmission on the other. Both globally and within the sub-Saharan African region; a spate of recent laws; policies and programmes have tried to encourage or - in some cases - mandate HIV disclosure. These policies have generated ethical and policy debates. While there is consensus that the criminalization of transmission and nondisclosure undermines rights while serving little public health benefit; there is less clarity about the ethics of third party notification; especially in resource-constrained settings. Despite initiatives to encourage voluntary HIV disclosure and to increase partner testing in sub-Saharan Africa; health workers continue to grapple with difficult challenges in the face of nondisclosure; and often express a need for more guidance and support in this area. A large body of research indicates that gender issues are key to HIV disclosure in the region; and must be considered within policies and programmes. Taken as a whole; this evidence suggests a need for more attention to the challenges and dilemmas faced by both clients and providers in relation to HIV disclosure in this region and for continued efforts to consider the perspectives and rights of all those affected

Directrizes e opcoes para estrategia de comunicacao em saude sexual e reprodutica integrada

Este documento apresenta as directrizes e opcoes para estrategias de comunicacao em saude sexual e reprodutiva integrada que deverao ser desenhadas e implementadas nos niveis nacional; provincial; distrital e mesmo no nivel local