Challenges to paediatric tuberculosis care as perceived by health workers in Kano, North-western Nigeria

uberculosis (TB) remains the world's deadliest infectious disease that affects a third of the world's population and newly infected an estimated 10 million people in 2018. The number of TB infected Nigerians ranks sixth in the world and first in Africa. Kano State has the highest Nigerian TB prevalence. I aimed to identify Paediatric TB care challenges as perceived by Kano Medical and DOT health care providers. The study design was prospective, descriptive and cross sectional involving structured questionnaire interviews of 43 healthcare providers, during TB supervision visits of 10 Health facilities in Kano. Generated data was entered, validated and analysed using the STATA 13 statistical software package. The sample size was convenient, since it is the number of all the health providers working in the facilities assigned to the author for supervision under a supervision contract with KNCV in 2017. Of the 43 respondents, there were 26 males, with a M: F ratio of 1.5: 1. Those health workers aged from 30 and 40 years constituted 58% of respondents. The staff cadre of respondents comprised of Community Health Extension Workers [CHEW] (40%), doctors (30%) and nurses (3%). Up to 51% of respondents had over 10 years health worker experience and greater than 36 months Child TB DOT care provision. The most commonly identified challenges to paediatric TB care included poor health knowledge (97.7%), poor health seeking behaviour (95.4%), poverty (95.4%), the inability of children to cough up sputum 95.4%, late presentation (90.7%), contact tracing logistics (90.7 %), patient and community factors of stigma and discrimination (86%) and poor health worker paediatric TB knowledge (70%). Perceived health worker challenges to effective Paediatric TB care were the adult orientation of the TB programme and its contact tracing logistic challenges, inadequate health worker Paediatric TB knowledge, children's inability to cough up sputum, poverty, poor patient TB health knowledge, community stigma and discrimination, poor health seeking behaviour and late presentation.

Os significados da reforma psiquiátrica para os trabalhadores de saúde mental de Goiânia / The meaning of the psychiatric reform to mental health workers in Goiânia, Brazil

Este trabalho teve como objetivo geral investigar a percepção dos trabalhadores de serviços de saúde mental do município de Goiânia sobre a reforma psiquiátrica. Foram entrevistados 180 profissionais que trabalham em serviços de saúde mental de Goiânia. Os questionários foram aplicados individualmente no local e horário de trabalho dos profissionais, com tempo médio de trinta minutos para responder. Para a análise dos dados, realizou-se a categorização das respostas abertas, tendo sido encontrada, nos dois tipos de serviços, uma maior ênfase em aspectos técnico-assistenciais, o que reduz a uma prática todos os construtos e embates pertinentes ao campo da reforma psiquiátrica. Os trabalhadores referem-se à política da humanização dos serviços, que apenas provoca a maquilagem da assistência, mas não consegue se aproximar da desinstitucionalização proposta pelo paradigma psicossocial.

This study main goal was to investigate mental health workers' perception about the psychiatric reform in Goiânia (Brazil). The participants were 180 professionals who work at Goiânia's mental health services. The questionnaires were individually applied at the working place, and it took 30 minutes to be answered. To analyze the data, firstly the results were categorized. There has been an emphasis towards the technical and assistance aspects, and it reduces all the constructs and struggles concerned in the psychiatric reform ideals into one practice. According to the workers, mental health services humanization politics only makes the assistance up but does not get close to the non-institutionalization psychosocial paradigm.