Utilisation of HIV services by female sex workers in Zimbabwe during the COVID-19 pandemic: a descriptive phenomenological study

This study focuses on female sex workers as a key population group that suffers a degree of vulnerability according to the World Health Organisation (WHO). Key populations refer to people at heightened risk of contracting the human immunodeficiency virus (HIV) due to specific behaviours and social and legal environments which increase their vulnerability to the virus. Key populations are disproportionately affected by HIV, yet they have less access to HIV services compared to the general population. The coronavirus (COVID-19) lockdown and its restrictive measures have further widened the inequalities and gaps in accessing HIV services for this group. A descriptive phenomenological study was undertaken to explore female sex workers' experiences of utilisation of HIV services during COVID-19. The study setting was the Bulawayo Metropolitan Province, Zimbabwe. Data were collected through in-depth individual interviews with 10 female sex workers. Purposive sampling coupled with snowballing was utilised for recruiting participants. Data were analysed guided by the seven-step Colaizzi technique. Rigour was ensured through adhering to Lincoln and Guba's trustworthiness criteria. The study found that the COVID-19 pandemic adversely affected the livelihoods of sex workers and their utilisation of HIV services. There was limited access to HIV services due to an initial lack of travel authorisation letters and financial challenges experienced by study participants. In addition, the quality of care in health care facilities was further compromised by poor screening processes and reduced provider-client interactions. Maintaining access to HIV services for female sex workers during pandemics is critical for the country to attain HIV epidemic control.

The Impact of telemedicine during the COVID-19 pandemic in Nigeria: A review

Background: Telemedicine practice is a rapidly evolving aspect of medicine in developed countries, though resource-limited countries like Nigeria are yet to embrace it fully. Moreover, the COVID-19 pandemic has limited patients' visits to hospitals in addition to the social distancing measures deployed by the government. In addition, with the challenges of a limited number of doctors, among other difficulties, it has become important that a radical approach to patient care and treatment should be explored. Methods: A comprehensive literature review of original articles was done using an internet search. Words such as Telemedicine, COVID-19, Pandemic, Requirements, History, Benefits, and Challenges were searched on Google scholar, EMBASE, PubMed, Medline, Web MD, and Scopusto check for various articles published or any probable link. The references of the relevant articles were searched. Results: The practice of telemedicine has evolved over the years. Also, the global telemedicine market has grown exponentially and is expected to grow even further in the next five years. Unfortunately, this exciting narrative is not obtainable in developing countries like Nigeria. Indeed, some healthcare providers in Nigeria need to prepare for this new technological advancement, and consequently, they struggle to evolve their practice to adopt this new technology. Furthermore, there is disinterest from most of the end users, particularly the patients. Conclusion: Modifications must involve telemedicine services with a view of getting ready and well-organized in the event of any future pandemic such as COVID-19, in addition to harnessing the benefits of this service in the future.

Incidental finding of COVID-19 infection amongst staff at a primary care facility in Ghana

The COVID-19 pandemic has affected nearly every country worldwide and all African countries. The issue of healthcare workers (HCWs) contracting the disease is a growing concern in Ghana, because of the risk of spreading infections amongst themselves and to vulnerable patients in their care. This article illustrates how 14 staff at the Korle Bu Polyclinic/Family Medicine Department were incidentally found to be Covid-19 positive with most of them being asymptomatic. This observation led to a modification of the personal protective equipment (PPE) used by clinical staff when attending to patients. Furthermore, this finding suggests that a different criteria or guideline may be needed for testing of HCWs during a pandemic where a significant proportion of infected people are asymptomatic. We conclude that in the primary care setting HCWs must be ready to see all the following cases safely: routine patients, asymptomatic COVID-19 patients and suspected COVID-19 patients

Preparing healthcare facilities to operate safely and effectively during the COVID-19 pandemic: The missing piece in the puzzle

The stated objective of the COVID-19 lockdown was to allow time to prepare healthcare facilities. Preparation must include administrative and environmental measures, which when combined with personal protective equipment, minimise the risk of the spread of infection to patients and healthcare workers (HCWs) in facilities, allowing HCWs to safely provide essential services during the pandemic and limit the indirect effects of COVID-19 caused by healthcare disruption. We present our model for facility preparation based on colour-coded zones, social distancing, hand hygiene, rapid triage and separate management of symptomatic patients, and attention to infection transmission prevention between HCWs in communal staff areas. This model specifically addresses the challenges in preparing a facility for COVID-19 in a low-resource setting and in rural areas. In addition, we include links to resources to allow workers in low-resource settings to prepare their facilities adequately

Awareness and coverage of the national health insurance scheme among formal sector workers in Ilorin, Nigeria

A prepayment scheme for health through the National Health Insurance Scheme (NHIS) was commenced in Nigeria about ten years ago. Nigeria operates a federal system of government. Sub-national levels possess a high degree of autonomy in a number of sectors including health. It is important to assess the level of coverage of the scheme among the formal sector workers in Nigeria as a proxy to gauge the extent of coverage of the scheme and derive suitable lessons that could be used in its expansion. This is a cross-sectional; descriptive survey carried out among formal sector workers in Ilorin Kwara State; Nigeria. A stratified sampling technique was used to select study participants. A self-administered questionnaire was used to collect data from respondents. Data was analysed with the SPSS. Ethical approval to conduct the study was obtained from the Bowen University Teaching Hospital Research Ethics Committee. A total of 370 people participated in the study. Majority; (78.9%) of the respondents were aware of the NHIS; however only 13.5 % paid for health care services through the NHIS. Logistic regression analysis shows that respondents with post-secondary education (OR = 9.032; CI = 2.562 - 31.847; p = 0.001) and in federal civil service (OR = 2.679; CI = 1.036 - 6.929; p = 0.042) were over nine and three times more likely to be aware of the scheme than others. Coverage of the scheme among the respondents was unimpressive. A lot still need to be done to fast-track the expansion of the scheme among this sector of the population

A snapshot of noncommunicable disease profiles and their prescription costs at ten primary healthcare facilities in the in the western half of the Cape Town Metropole

Objectives: There has been a rapid increase in the prevalence of noncommunicable diseases globally. It is thought that this increase will have the greatest impact on developing countries; such as South Africa; where it will adversely affect quality of life and increase healthcare costs. This research was conducted to determine the disease profile and cost of treating patients at 10 facilities in the western half of the Cape Town Metropole.Design: An analytical; cross-sectional study was carried out in order to interpret the cost of the medication in relation to the patient disease profile. Setting and subjects: Data were collected from 10 facilities in the western half of the Cape Town Metropole over a three-month period.Outcome measure: The outcome measure was the disease profile of patients attending the facilities and the cost of prescriptions for these patients.Results: Most patient visits to the community health centres were to treat chronic diseases (82). The disease profile of patients was as follows: 58.96 had hypertension; 19.67 diabetes; 12.14 asthma and chronic obstructive pulmonary disease; and 21.80 arthritis. It was found that 65 of patients with a chronic condition had co-morbidities. The cost of prescriptions was significantly higher (p-value 0.001) for chronic conditions than for acute conditions. The number of comorbidities per patient also influenced the cost of the prescriptions.Conclusion: The results indicated that most of the adults attending public sector facilities in the western half of the Cape Town Metropole have chronic diseases and that the cost of treating these conditions is significantly greater than that of treating acute conditions. An integrated approach to the management of chronic diseases is important in low-resource settings for the efficient utilisation of limited resources

Profile of institutional infrastructure for implementing universal precautions in primary health care facilities in Sokoto State, Nigeria: Implication for occupational safety

Background: The adoption of primary health care in Nigeria has led to the expansion of health care delivery frontiers especially at the rural level. At this level is the most critical health services delivery point, with an attendant increase in contact between primary health care providers and patients. There is however also a simultaneous increased exposure to occupational and related health risks and hazards. Methods: The objectives of this study were to assess the universal precaution profile of primary health care facilities and determine those factors that inform their prevailing safety status. Using a structured checklist, 23 representative primary health care facilities from the 23 local government areas in Sokoto State were randomly selected for the study, one from each of the local government areas. Results: The facilities were found to have poor universal precaution profile that could guarantee effective control of infection transmission and safety of their personnel. The facilities' mean score on measures and frameworks for ensuring the implementation of Universal Precautions was 53.12% ± 21.68% with only 56.52% scoring above 50%. Conclusion: Safety protocol and facilities for ensuring safe environment were inadequate and poorly developed. None of the facilities had full complement of facilities or resources for ensuring safety of working environment and for personnel's implementation of Universal Precautions. Policy for safety practice was poor, and post exposure intervention programmes for staff in event of accidental exposure grossly underdeveloped. Interventions to improve safety environment and creation of safe climate are essential to protect primary health care workers against occupational hazards

Economic activities, illness pattern and utilisation of health care facilities in the rural population of KwaZulu-Natal, South Africa

Background: The study was undertaken among the rural and black communities of the Uthungulu health district of the KwaZulu-Natal province; South Africa. Methods: A cross-sectional community-based descriptive study was conducted. A multi-stage sampling strategy was adopted to obtain a representative sample of the communities. Results: The mean age of the population was 27 years and majority was female (54). Among the adult population only 30were educated; 19were engaged in some form of economic activities while 9were in the formal employment sector. The average monthly income per household was R1 301 (95CI; R1 283; R1 308). The illnesses were reported by 27of the total population over a period of one month. Notably higher rates of female individuals (29) were sick compared to males (24; p 0.001). The rates of illnesses among adult females (39) were also significantly higher than among males (31; p 0.009). Most of them (69) attended primary health care (PHC) clinics for medical services; while 67reported chronic conditions. Age (OR = 1.4); gender (OR = 0.711); education (OR = 0.64) and economic activities (OR = 1.9) were found to be associated with being ill or not. Conclusion: The rural black communities are underdeveloped and deprived; which results in higher prevalence of illnesses; however; the utilisation of PHC facilities is comparatively higher than in the rest of the province and other parts of the country. Interventions to improve community health care services among the deprived population should be focused through public health strategies such as all-encompassing PHC that includes health promotion; education and basic essential amenities