ANALISIS PERAN AKTOR DALAM IMPLEMENTASI KEBIJAKAN PEMBERIAN INSENTIF BAGI TENAGA KESEHATAN DAERAH YANG MENANGANI COVID-19

Background: In the policy of incentives for health workers in the regions that handle COVID-19 (Innakesda) is part of the health budget for handling COVID-19 which must be budgeted by the local government sourced from Refocusing funds of 8% DAU/DBH in 2021. There is differences in the results of the implementation of the Innakesda policy carried out by the Regional Government where there are local governments that have succeeded in implementing this policy and there are also local governments that have not succeeded in doing so Purpose: The success in thisimplementation can be seen from the availability of budgets in the regions and the realization of incentive budgets for health workers in these areas.Therefore, it is interesting to know the factors that influence a region's success in implementing this policy from the actor dimension in regional financial management. Method: This research was conducted using a qualitative approach using in-depth interviews with several key informants and a literature review. Walt and Gilson's policy triangle is used in analyzing policies. The analysis was conducted to see the successful implementation of the Innakesda policy from the actor dimension in regional financial management. The location of the research was carried out in one of the areas that have successfully implemented the Innakesda policy, namely the City of South Tangerang. Conclusion: The conclusion of the research illustrates that the involvement of actors at both the Central Government and Regional Government levels of South Tangerang City with their respective authorities and roles issues policies that are mutually synergistic and responsive to efforts to encourage the successful implementation of Innakesda policies, in the regional financial management process there is the Political will of the Mayor of Tangerang South in the form of alignments to prioritize the successful implementation of Innakesda in the 2021 APBD policy. (English) [ FROM AUTHOR] Latar Belakang : Dalam kebijakan insentif bagi tenaga kesehatan di daerah yang menangani COVID-19 (Innakesda) merupakan bagian dari anggaran kesehatan untuk penanganan COVID-19 yang harus dianggarkan oleh pemerintah daerah yang bersumber dari dana Refocusing 8% DAU/DBH pada Tahun 2021. Terdapat perbedaan hasil implementasi dari kebijakan Innakesda yang dilakukan oleh Pemerinah Daerah dimana terdapat pemerintah daerah yang berhasil melakukan implementasi kebijakan ini dan ada pula pemerintah daerah yang tidak berhasil melakukannya Tujuan : Keberhasilan dalam implementasi ini dilihat dari adanya ketersediaan anggaran di daerah serta terlaksananya realisasi anggaran insentif bagi tenaga kesehatan di daerah tersebut. Oleh karena itu, menjadi hal yang menarik untuk mengetahui faktorfaktor yang mempengaruhi suatu daerah berhasil mengimplentasikan kebijakan ini dari dimensi aktor dalam pengelolaan keuangan daerah. Metode : Penelitian ini dilakukan dengan pendekatan kualitatif menggunakan metode wawancara mendalam dengan beberapa informan kunci serta kajian literatur. Segitiga kebijakan Walt dan Gilson digunakan dalam menganalisis kebijakan Analisis dilakukan untuk melihat keberhasilan implementasi kebijakan Innakesda dari dimensi aktor dalam pengelolaan keuangan daerah. Lokasi penelitian dilakukan pada salah satu daerah yang berhasil melaksanakan implementasi kebijakan Innakesda yaitu Kota Tangerang Selatan. Kesimpulan: Kesimpulan penelitian memberikan gambaran bahwa Keterlibatan aktor baik di level Pemerintah Pusat dan Pemerintah Daerah Kota Tangerang Selatan dengan masing-masing kewenangan serta perannya mengeluarkan kebijakan yang saling sinergi dan responsif terhadap upaya mendorong keberhasilan implementasi kebijakan Innakesda, dalam proses pengelolaan keuangan daerah terdapat Political will Walikota Tangerang Selatan berupa keberpihakan untuk memprioritaskan keberhasilan implementasi Innakesda dalam kebijakan APBD tahun 2021. (Indonesian) [ FROM AUTHOR] Copyright of Jurnal Sosial dan Sains (SOSAINS) is the property of Green Publisher and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Impact of a social prescribing intervention in North East England on adults with type 2 diabetes: the SPRING_NE multimethod study.

Background: Link worker social prescribing enables health-care professionals to address patients' non-medical needs by linking patients into various services. Evidence for its effectiveness and how it is experienced by link workers and clients is lacking. Objectives: To evaluate the impact and costs of a link worker social prescribing intervention on health and health-care costs and utilisation and to observe link worker delivery and patient engagement. Data sources: Quality Outcomes Framework and Secondary Services Use data. Design: Multimethods comprising (1) quasi-experimental evaluation of effects of social prescribing on health and health-care use, (2) cost-effectiveness analysis, (3) ethnographic methods to explore intervention delivery and receipt, and (4) a supplementary interview study examining intervention impact during the first UK COVID-19 lockdown (April-July 2020). Study population and setting: Community-dwelling adults aged 40-74 years with type 2 diabetes and link workers in a socioeconomically deprived locality of North East England, UK. Intervention: Link worker social prescribing to improve health and well-being-related outcomes among people with long-term conditions. Participants: (1) Health outcomes study, approximately n = 8400 patients; EuroQol-5 Dimensions, five-level version (EQ-5D-5L), study, n = 694 (baseline) and n = 474 (follow-up); (2) ethnography, n = 20 link workers and n = 19 clients; and COVID-19 interviews, n = 14 staff and n = 44 clients. Main outcome measures: The main outcome measures were glycated haemoglobin level (HbA1c; primary outcome), body mass index, blood pressure, cholesterol level, smoking status, health-care costs and utilisation, and EQ-5D-5L score. Results: Intention-to-treat analysis of approximately 8400 patients in 13 intervention and 11 control general practices demonstrated a statistically significant, although not clinically significant, difference in HbA1c level (-1.11 mmol/mol) and a non-statistically significant 1.5-percentage-point reduction in the probability of having high blood pressure, but no statistically significant effects on other outcomes. Health-care cost estimates ranged from £18.22 (individuals with one extra comorbidity) to -£50.35 (individuals with no extra comorbidity). A statistically non-significant shift from unplanned (non-elective and accident and emergency admissions) to planned care (elective and outpatient care) was observed. Subgroup analysis showed more benefit for individuals living in more deprived areas, for the ethnically white and those with fewer comorbidities. The mean cost of the intervention itself was £1345 per participant; the incremental mean health gain was 0.004 quality-adjusted life-years (95% confidence interval -0.022 to 0.029 quality-adjusted life-years); and the incremental cost-effectiveness ratio was £327,250 per quality-adjusted life-year gained. Ethnographic data showed that successfully embedded, holistic social prescribing providing supported linking to navigate social determinants of health was challenging to deliver, but could offer opportunities for improving health and well-being. However, the intervention was heterogeneous and was shaped in unanticipated ways by the delivery context. Pressures to generate referrals and meet targets detracted from face-to-face contact and capacity to address setbacks among those with complex health and social problems. Limitations: The limitations of the study include (1) a reduced sample size because of non-participation of seven general practices; (2) incompleteness and unreliability of some of the Quality and Outcomes Framework data; (3) unavailability of accurate data on intervention intensity and patient comorbidity; (4) reliance on an exploratory analysis with significant sensitivity analysis; and (5) limited perspectives from voluntary, community and social enterprise. Conclusions: This social prescribing model resulted in a small improvement in glycaemic control. Outcome effects varied across different groups and the experience of social prescribing differed depending on client circumstances. Future work: To examine how the NHS Primary Care Network social prescribing is being operationalised; its impact on health outcomes, service use and costs; and its tailoring to different contexts. Trial registration: This trial is registered as ISRCTN13880272. Funding: This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme, Community Groups and Health Promotion (grant no. 16/122/33) and will be published in full in Public Health Research; Vol. 11, No. 2. See the NIHR Journals Library website for further project information.

Social prescribing happens when health-care staff refer patients to a link worker. Link workers support and help patients to access community services to improve their health and well-being. Social prescribing is popular within the NHS, but there is little evidence that it works. We looked at a social prescribing model being delivered in a disadvantaged area in north-east England.

Caring for community members during the COVID-19 pandemic: results of a statewide survey.

Aim: Community health workers (CHWs) and home visitors (HVs) are members of the public health workforce who are uniquely poised to support vulnerable populations during the COVID-19 pandemic. In this study, we assess the experiences of CHWs and HVs in Wisconsin during the early stages of the COVID-19 pandemic to learn about their experiences related to mitigation strategies and vaccination efforts. Subject and methods: Working closely with community partners, we recruited CHWs and HVs via email to complete an online survey between June 24 and August 10, 2021. Participants were eligible if they worked at any time since March 25, 2020, when the Safer at Home Order was put into place. The survey asked CHWs and HVs about their experiences during the COVID-19 pandemic and vaccination efforts. Results: Eligible respondents included 48 HVs and 26 CHWs. Most CHWs (96%) and HVs (85%) reported discussing the COVID-19 vaccine with clients, and 46% of HVs and 85% of CHWs said they planned to encourage their clients to vaccinate themselves against COVID-19. We found that many CHWs and HVs identified the COVID-19 pandemic as a threat to the health of the US population, and many reported that they thought mitigation strategies were effective at keeping people safe from COVID-19. There was inconsistency in regard to respondents plans to encourage their clients to receive vaccination for COVID-19. Conclusion: Future study, training, and support for CHWs and HVs should focus on facilitating vaccination efforts and other emerging public health interventions.

Mental Health of Health Workers during Covid-19 Pandemic: What Kind of System Support They Need?

This study aimed to determine the relationship between spiritual support and social support with the mental health of frontline health workers during September to November 2021 which was under the COVID-1 9 pandemic. This study used a cross-sectional analytical research method. The research samples were frontline health workers in the Lamongan Regency area, using purposive sampling. The variables of social support, spiritual support, and mental health were measured once using a questionnaire via a google form. Data were analyzed by bivariate (chi-square) and multivariate with logistic regression. The results showed that 64.2% of respondents had good spiritual support;52.8% had good social support;and 50.9% had good mental health. The results of the bivariate analysis showed that there was a relationship between mental health and spiritual support (p= 0.001), and between mental health and social support (p=0,005). The results of multivariate analysis show that spiritual support has significant assosiation with mental health (aOR 8.372;95% CI: 2.359-29.716, p= 0.001) while the social support has not (aOR 1.266;95% CI: 0.465-3.443, p=0.644). It is very important that during this COVID-1 9 pandemic, health workers, especially those on the front lines, receive good spiritual and social support so that their mental health remains good which will affect their physical health and work productivity.

Health worker registries: managing the health care workforce

Registries play an instrumental role in facilitating the transfer, aggregation, and analysis of standardized data in health information exchange (HIE). One such example is a health worker registry (HWR), a central, authoritative registry that maintains the unique identities of health workers according to a defined, minimum data set. Currently, data comprising workers' information—such as education, licensure, and place of employment—are collected through disparate methods and maintained in a variety of information systems. Harmonization of these data via an HWR can support interoperability and comparability of worker information across systems, thereby facilitating efficient workforce enumeration, planning, regulation and deployment, verification of training and education, identification of workforce shortages, and rapid communication and coordination of emergency response. In fact, HWR technologies played a role in coordinating response to both Ebola in West Africa in 2014 and more recently in response to COVID-19, making a HWR integral to nations' infrastructure upgrades postpandemic. This chapter identifies who is considered a "health worker” and why a registry of these individuals is a useful component of an HIE, especially in the wake of the COVID-19 pandemic. It also provides guidance on selection of data elements and standards to include in the development of an HWR. © 2023 Elsevier Inc. All rights reserved.

Health Professionals' Perspective in the Context of Social Media, Paranoia, and Working Autonomy During the COVID-19 Pandemic Period

Objective: The purpose of this study is to reveal the views of health professionals on social media use, paranoia, and work autonomy during the COVID-19 pandemic. For this purpose, a questionnaire was applied to the healthcare workers who accepted voluntary participation with the convenience sampling method, and the research data were collected. Methods: In the study, a sample of 302 healthcare workers in 3 tertiary level foundation university hospitals and a secondary-level private hospital, who accepted to participate in the survey voluntarily, is included by convenience sampling. Data were collected using a questionnaire prepared according to a 5-point Likert scale consisting of 3 different scales. Structural equation modeling was done with the help of AMOS program. Results: Data were analyzed statistically. The mediating role of Paranoia Scale sub-dimensions (F1 and F2) in the effect of social media utility and social media anxiety variables, which are Social Media Use scale sub-dimensions, on working autonomy variable was investigated. Cronbach's alpha values of the scales used in the study are at "high reliability level.” In the combined reliability values, since composite reliability > 0.70 was found for all variables, the combined reliability condition was met. The necessary condition (average variance extracted > 0.40) was considered sufficient for the mean explained variance values (average variance extracted > 0.50) for all variables or for convergent validity when it was present in all variables (composite reliability > 0.70). Conclusion: It was found that F1 variable, one of the sub-dimensions of paranoia Scale, had full mediating role on social media utility variable of working autonomy variable and that F2 variable had full mediating role in the effect of social media utility variable on working autonomy variable. It was also determined that the F1 variable did not have a mediating role in the effect of the social media anxiety variable on the working autonomy variable, and the F2 variable had a full mediation role in the effect of the social media anxiety variable on the working autonomy variable. Only healthcare professionals in Istanbul and 4 different private hospitals were included in the study. Expanding the study in public hospitals and with other private hospitals will provide more information on the subject. It is thought that this research will be an original study in terms of getting the opinions of healthcare professionals, especially during the COVID-19 pandemic process. There is no similar study in the literature using the variables and models which were used in this study. © 2023 Sociedad Madrinela de Neumologia y Cirugia Toracica. All rights reserved.

The Institute of Medicine's call to action revisited: assuring access to public health education for U.S. college students.

The Educated Citizen and Public Health initiative promotes that an understanding of public health issues is a principal component of an educated population and is necessary to develop social responsibility and promote civic dialog. This initiative supports the Institute of Medicine's (now the National Academy of Medicine) recommendation that "all undergraduates should have access to education in public health." The purpose of our work is to examine the extent to which 2- and 4-year U.S. state colleges and universities offer and/or require a public health course. Select indicators identified include the presence and type of public health curriculum, public health course requirement, presence of public health graduate program offering, pathways to public health, Community Health Worker training, as well as demographic information for each institution. An analysis was also conducted for the historically Black colleges and universities (HBCUs), and the same select indicators were examined. The data suggest that there is an imperative need for a public health curriculum across the nation's collegiate institutions with 26% of 4-year state institutions lacking a full undergraduate public health curriculum; 54% of 2-year colleges not offering a pathway to public health education; and 74% of HBCUs not offering a public health course or degree. In the age of COVID-19, syndemics, and considering the post-pandemic phase, we argue that expanding public health literacy at the associate and baccalaureate level can help prepare an educated citizenry who is both public health literate and one that can demonstrate resilience in the face of public health challenges.

Adoption of mHealth Technologies by Community Health Workers to Improve the Use of Maternal Health Services in Sub-Saharan Africa: Protocol for a Mixed Method Systematic Review.

BACKGROUND: Studies have shown that mobile health technologies (mHealth) enhance the use of maternal health services. However, there is limited evidence of the impact of mHealth use by community health workers (CHWs) on the use of maternal health services in sub-Saharan Africa. OBJECTIVE: This mixed method systematic review will explore the impact of mHealth use by CHWs on the use of the maternal health continuum of care (antenatal care, intrapartum care, and postnatal care [PNC]), as well as barriers and facilitators of mHealth use by CHWs when supporting maternal health services. METHODS: We will include studies that report the impact of mHealth by CHWs on the use of antenatal care, facility-based births, and PNC visits in sub-Saharan Africa. We will search 6 databases (MEDLINE, CINAHL, Web of Science, Embase, Scopus, and Africa Index Medicus), with additional articles identified from Google Scholar and manual screening of references of the included studies. The included studies will not be limited by language or year of publication. After study selection, 2 independent reviewers will perform title and abstract screening, followed by full-text screening to identify the final papers to be included. Data extraction and risk-of-bias assessment will be performed using Covidence software by 2 independent reviewers. We will use a Mixed Methods Appraisal Tool to perform risk-of-bias assessments on all included studies. Finally, we will perform a narrative synthesis of the outcomes, integrating information about the effect of mHealth on maternal health use and barriers and facilitators of mHealth use. This protocol follows the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines. RESULTS: In September 2022, we conducted an initial search in the eligible databases. After removing duplicates, we identified 1111 studies that were eligible for the title and abstract screening. We will finalize the full-text assessment for eligibility, data extraction, assessment of methodological quality, and narrative synthesis by June 2023. CONCLUSIONS: This systematic review will present new and up-to-date evidence on the use of mHealth by CHWs along the pregnancy, childbirth, and PNC continuum of care. We anticipate the results will inform program implementation and policy by highlighting the potential impacts of mHealth and presenting contextual factors that should be addressed to ensure the success of the programs. TRIAL REGISTRATION: PROSPERO CRD42022346364; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=346364. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/44066.

The Role of Community Health Workers in the Health and Well-Being of Vulnerable Older Adults during the COVID Pandemic.

The COVID-19 pandemic disrupted social support networks as well as resource access for participants. The purpose of this study was to: analyze the experiences of older adults enrolled in a geriatric-focused community health worker (CHW) support program, to gain a better understanding of how CHWs might enhance care delivery, and to further understand how COVID-19 affected the social and emotional needs and well-being of older adults during the first 18 months of the pandemic. Qualitative analysis was performed on notes entered by CHWs based on 793 telephone encounters with 358 participants between March 2020 and August 2021. Analysis was performed by two reviewers independently coding the data. Weighing the benefits of seeing family against the risks of COVID exposure was a source of emotional distress for participants. Our qualitative analysis suggests that CHWs were effective in providing emotional support and connecting participants to resources. CHWs are capable of bolstering the support networks of older adults and carrying out some of the responsibilities conventionally fulfilled by family supports. CHWs addressed participant needs that are frequently unmet by healthcare team members and provided emotional support to participants contributing to health and well-being. CHW assistance can fill gaps in support left by the healthcare system and family support structures.

Spatial Heterogeneity in the Severity of COVID-19 Pandemic in India

The coronavirus disease (COVID-19) pandemic has affected all states and union territories in India, but the spread of infections and the fatality rate across regions have been disproportionate. In this study, inequalities in the severity of the pandemic are examined for a 15-month period, covering both the first and second waves of the virus, using alternate measures based on the official estimates of deaths from COVID-19 as a ratio of all-cause mortality. The observed differences in the severity indicators are explained using socioeconomic, meteorological, and geographical factors. A comparison of severity ratios across states and over time gives a region-specific flavor of the severity of the pandemic and increases understanding of the pressure points in the health system. Our findings are helpful for public health professionals to develop control measures and plan environmental and health policies as an alternative strategy to respond to new COVID-19 outbreaks and prevent future crises. © 2023 Asian Development Bank.

A mixed methods study of Aboriginal health workers' and exercise physiologists' experiences of co-designing chronic lung disease 'yarning' education resources.

BACKGROUND: Despite the high incidence of chronic obstructive pulmonary disease (COPD) in Aboriginal communities in Australia, Aboriginal Health Workers (AHWs) have limited knowledge about effective management. AIM: To evaluate an online education program, co-designed with AHWs and exercise physiologists (EPs) or physiotherapists (PTs), to increase knowledge about COPD and its management. METHODS: AHWs and EPs from four Aboriginal Community Controlled Health Services (ACCHS) were recruited. An Aboriginal researcher and a physiotherapist experienced in COPD management and pulmonary rehabilitation (PR) delivered seven online education sessions. These sessions used co-design principles and an Aboriginal pedagogy framework '8 Ways of learning', which incorporates Aboriginal protocols and perspectives to realign teaching techniques and strengthen learning outcomes. Topics covered were: How the lungs work; What is COPD; Medications and how to use inhalers and COPD Action Plans; Why exercise is important; Managing breathlessness; Healthy eating; Managing anxiety and depression. After each session, AHWs with support from EPs, co-designed education 'yarning' resources using Aboriginal ways of learning to ensure topics were culturally safe for the local Aboriginal community and practiced delivering this at the following session. At the end of the program participants completed an anonymous online survey (5-point Likert scale) to assess satisfaction, and a semi-structured interview about their experience of the online education. RESULTS: Of the 12 participants, 11 completed the survey (7 AHWs, 4 EPs). Most (90%) participants strongly agreed or agreed that the online sessions increased knowledge and skills they needed to support Aboriginal patients with COPD. All (100%) participants felt: their cultural perspectives and opinions were valued and that they were encouraged to include cultural knowledge. Most (91%) reported that delivering their own co-designed yarning scripts during the online sessions improved their understanding of the topics. Eleven participants completed semi-structured interviews about participating in online education to co-design Aboriginal 'yarning' resources. Themes identified were: revealing the Aboriginal lung health landscape; participating in online learning; structuring the online education sessions; co-designing with the facilitators. CONCLUSIONS: Online education using co-design and 8 Ways of learning was rated highly by AHWs and EPs for improving COPD knowledge and valuing cultural perspectives. The use of co-design principles supported the cultural adaptation of COPD resources for Aboriginal people with COPD. TRIAL REGISTRATION: PROSPERO (registration number: CRD42019111405).

Feasibility and acceptability of home-based neonatal hyperbilirubinemia screening by community health workers using transcutaneous bilimeters in Bangladesh.

BACKGROUND: Universal screening for neonatal hyperbilirubinemia risk assessment is recommended by the American Academy of Pediatrics to reduce related morbidity. In Bangladesh and in many low- and middle-income countries, there is no screening for neonatal hyperbilirubinemia. Furthermore, neonatal hyperbilirubinemia may not be recognized as a medically significant condition by caregivers and community members. We aimed to evaluate the acceptability and operational feasibility of community health worker (CHW)-led, home-based, non-invasive neonatal hyperbilirubinemia screening using a transcutaneous bilimeter in Shakhipur, a rural subdistrict in Bangladesh. METHODS: We employed a two-step process. In the formative phase, we conducted eight focus group discussions with parents and grandparents of infants and eight key informant interviews with public and private healthcare providers and managers to explore their current knowledge, perceptions, practices, and challenges regarding identification and management of neonatal hyperbilirubinemia. Next, we piloted a prenatal sensitization intervention and home-based screening by CHWs using transcutaneous bilimeters and evaluated the acceptability and operational feasibility of this approach through focus group discussions and key informant interviews with parents, grandparents and CHWs. RESULTS: Formative findings identified misconceptions regarding neonatal hyperbilirubinemia causes and health risks among caregivers in rural Bangladesh. CHWs were comfortable with adoption, maintenance and use of the device in routine home visits. Transcutaneous bilimeter-based screening was also widely accepted by caregivers and family members due to its noninvasive technique and immediate display of findings at home. Prenatal sensitization of caregivers and family members helped to create a supportive environment in the family and empowered mothers as primary caregivers. CONCLUSION: Adopting household neonatal hyperbilirubinemia screening in the postnatal period by CHWs using a transcutaneous bilimeter is an acceptable approach by both CHWs and families and may increase rates of screening to prevent morbidity and mortality.

Addition of mental health to the lady health worker curriculum in Pakistan: now or never.

The technical advisory group of the World Health Organization (Geneva, Switzerland) has suggested person-centered and community-based mental health services in response to the long-term and far-reaching mental health impacts of the COVID-19 pandemic. Task shifting is a pragmatic approach to tackle the mental health treatment gap in low- and middle-income countries. Pakistan is dismally resourced to address the mental health challenges. Pakistan's government has established a lady health worker's program (LHW-P) which can be effectively utilized to provide some basic mental health services at community doorsteps. However, lady health workers' current curriculum does not include mental health as a subject. WHO's Mental Health Gap Intervention Guide (mhGAP-IG) Version 2.0 for mental, neurological, and substance use disorders in non-specialist health settings can be adapted and utilized to be included as part of the LHW-P curriculum in Pakistan. Thus, the historical lack of access to mental health support workers, counsellors, and specialists can be addressed. Additionally, this will also help to reduce the stigma associated with seeking mental health care outside the boundaries of home, mostly at a huge cost.

Personal protective equipment wearing in the context of COVID-19 in a hospital in Burkina Faso / Port des équipements de protection individuelle dans le contexte de la COVID-19 dans un centre hospitalier du Burkina Faso

INTRODUCTION: Personal protective equipment (PPE) is used by health care workers to protect themselves and patients from various exposures such as infectious agents. However, the wearing of this equipment is not always optimal, especially in an epidemic context of COVID-19 transmission. AIM OF THE STUDY: The aim of this study, in the specific context of COVID-19, is to contribute to the improvement of PPE wearing practices by health workers. METHODS: This is a descriptive cross-sectional study conducted in 2020 at the Charles De Gaulle Pediatric University Hospital in Burkina Faso. All health workers in the care units and the laboratory were included. Data were collected using an observation grid during the first situation indicating the wearing of PPE. The assessment of the indications for wearing PPE was based on the recommendations of the French Society of Hospital Hygiene and on the technical guide for the prevention and control of healthcare-associated infections in Burkina Faso. RESULTS: Out of 350 targeted agents, 296 were observed. Gowns, masks and gloves were worn in 95.60%, 96.58% and 97.63% of cases respectively. However, PPE such as goggles (1.56%), apron (11.54%), and tunic and pants (46.28%) were poorly used during medical care. CONCLUSION: The practices of health workers with regard to the wearing of certain PPE are still insufficient. A training and awareness program on PPE should be considered to improve patient and staff safety.

Introduction: Les équipements de protection individuelle (EPI) sont utilisés par le personnel de santé dans le cadre des soins pour se protéger et protéger les patients contre les expositions diverses telles que les agents infectieux. Toutefois, le port de ces équipements n'est pas toujours optimal, surtout dans un contexte épidémique de transmission de la COVID-19. But de l'étude: La présente étude vise, dans le contexte spécifique de la COVID-19, à contribuer à l'amélioration des pratiques de port des EPI des agents de santé. Méthodes: Il s'agit d'une étude transversale descriptive conduite en 2020 au centre hospitalier universitaire pédiatrique Charles-de-Gaulle du Burkina Faso. Tous les agents de santé des unités de soins et du laboratoire ont été inclus. Les données ont été recueillies au moyen d'une grille d'observation lors de la première situation indiquant le port d'un EPI. L'appréciation des indications de port des EPI s'est basée sur les recommandations de la Société française d'hygiène hospitalière et sur le Guide technique de prévention et contrôle des infections associées aux soins au Burkina Faso. Résultats: Sur 350 agents ciblés, 296 ont été observés. Le port de la blouse, du masque et des gants était observé respectivement dans 95,60 %, 96,58 % et 97,63 % des cas. Cependant, les EPI tels que les lunettes de protection (1,56 %), le tablier (11,54 %) et la tenue professionnelle composée d'une tunique et d'un pantalon (46,28 %) étaient faiblement utilisés lors des soins médicaux. Conclusion: Les pratiques des agents de santé vis-à-vis du port de certains EPI restent insuffisantes. Un programme de formation et de sensibilisation sur les EPI doit être envisagé afin de renforcer la sécurité des patients et du personnel.

Robust Design Optimization of Powered Air Purifying Respirator System by Iterative Process

The personal protective equipment (PPE) has protected the frontline health workers from getting affected in COVID 19 spread situations to a certain level. Among the PPEs, PAPRs (Powered Air Purifying Respirators) are considered as one of the most efficient equipment for protection purposes. In pandemic spread situations, the PAPR becomes very much essential considering its protection. The PAPR is mainly imported to India. But the cost of PAPR being on the higher side (Rupees (Rs) 100000) becomes unaffordable to many frontline health workers. This paper focuses on the development of a cost-effective PAPR that is affordable to them. This paper projects a detailed step-by-step process of design and development of PAPR, and its evolution in each iteration. The study was conducted with the medical officers from AIMS Hospital and engineers from AMMACHI labs to bring out effective solutions for frontline health workers during a pandemic. © 2022 IEEE.

COVID-19: Relationship between stress management and emotional intelligence in working environment

This study aimed to assess the association between emotional and stress intelligence in the work of health employees in times of pandemic. The main purpose of this study is to measure the level of emotional intelligence and stress to health workers during the pandemic and to interconnect between these variables. In the study, 150 health workers were attended by UCCK (University Clinical Center of Kosovo), from 63 men and 87 females. The sample is randomly selected, from two employee shifts. The methodology of this study is used quantitative methods. In this study two instruments were used, the one who measures emotional intelligence as well as the instrument that measures stress at work. The findings of this study have resulted that there is no significant link between emotional intelligence and stress at work during the pandemic time at Health Workers in UCCK, also from the results we understand that the level of emotional intelligence and the level of stress reaches the highest average in males than in women but that these differences are not significant. In the end, it can be said that the findings of the study will be important to health workers to take steps to stress management during the Covid-19 pandemic and apply different methods for the development of emotional intelligence during this time. © 2023, SRAC - Romanian Society for Quality. All rights reserved.

Relationship among leadership styles, employee's well-being and employee's safety behavior: an empirical evidence of COVID-19 from the frontline healthcare workers

The study investigates the association among leadership styles, employee well-being and employee's safety behavior of healthcare workers. The study used social learning theory (SLT) for examining the relationship between leadership styles and employee safety behavior. Moreover, social exchange theory (SET) has been incorporated to narrate the moderating effect of employee well-being on the relationship between leadership styles and employee safety behavior. Data have been collected with the help of questionnaires from 515 healthcare workers working in the public hospitals of Punjab, Pakistan. Structural equation modeling has been utilized to test the study hypothesis. Findings indicate that both transactional and transformational leaderships have significant and positive relationship with employee safety behavior. Interestingly, employee well-being negatively moderates the relationship between transformational leadership and employee safety behavior. Furthermore, no moderation was found on the relationship between transactional leadership and employee safety behavior. The findings propose that healthcare management should invest to aware employees regarding their well-being. The findings also suggest that leaders should influence their followers to adopt safety measures at workplace. Furthermore, leaders must be role models in order to attain a competitive advantage and make a balance between management and workers. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Exploring the impact of COVID-19 on frontline health workers through a photovoice study in Kaduna, Kwara and Ogun States, Nigeria.

BACKGROUND: Described as the 'backbone of health systems', particularly in low- and middle-income countries, community health workers (CHWs) are a critical cadre on the frontline of any outbreak response. However, it is widely recognised that CHWs are frequently lacking in appropriate support from the health system due to inadequate physical, social and financial resources. Furthermore, despite their critical role in service delivery, the health and well-being of CHWs is seldom considered and the additional emotional and physical burdens that health systems shocks can present are frequently ignored. Thus a critical step in strengthening health systems to manage disease outbreaks or other system shocks is to ensure that CHWs are adequately supported. Within this study we document the experiences of CHWs within Nigeria during the coronavirus disease 2019 (COVID-19) outbreak to understand the impact of the pandemic on CHW well-being with a view to identifying strategies that could support CHWs during COVID-19 and subsequent health system shocks. METHODS: This study was based in Ogun, Kaduna and Kwara States, Nigeria. We used the creative participatory methodology of photovoice with 30 CHWs (10 in each state). Participants were asked to take photos documenting their experiences of working and living through the pandemic. Participants sent photos with captions to the research team via WhatsApp following one-on-one discussions. Photos were co-analysed among participants in focus group discussions using thematic analysis. RESULTS: Our findings reveal similar experiences of CHWs across Ogun, Kwara and Kaduna States in Nigeria, providing a unique insight into how the Nigerian health system was impacted and how this closely aligns to the performance and well-being of CHWs. CHW experiences related to three overarching themes: major stressors and challenges experienced due to COVID-19 (fear of contracting COVID-19, food insecurity, personal and gendered impacts), the impact of COVID-19 on providing routine care (stigma from community members, heavy workloads and inadequate equipment provision) and motivation and support from the community (pride in their roles and valued support from community leaders). The challenges highlighted through photovoice led to developing recommendations to address some of the challenges. This included training, adequate resource provision, routine supervision and peer support. CONCLUSIONS: COVID-19 highlighted the burden health workers often face. Photovoice allowed a space for frontline health workers to come together to share common experiences, particularly the psychosocial impact of working during health system shocks and its impact on performance. This underlines the need to acknowledge mental health and prioritise the well-being of healthcare staff. Sharing stories from the perspectives of health workers provides a platform to share learning and strategies on how to best support health workers holistically, particularly during health system shocks.

Using the Pan American Health Organization Digital Conversational Agent to Educate the Public on Alcohol Use and Health: Preliminary Analysis.

BACKGROUND: There is widespread misinformation about the effects of alcohol consumption on health, which was amplified during the COVID-19 pandemic through social media and internet channels. Chatbots and conversational agents became an important piece of the World Health Organization (WHO) response during the COVID-19 pandemic to quickly disseminate evidence-based information related to COVID-19 and tobacco to the public. The Pan American Health Organization (PAHO) seized the opportunity to develop a conversational agent to talk about alcohol-related topics and therefore complement traditional forms of health education that have been promoted in the past. OBJECTIVE: This study aimed to develop and deploy a digital conversational agent to interact with an unlimited number of users anonymously, 24 hours a day, about alcohol topics, including ways to reduce risks from drinking, that is accessible in several languages, at no cost, and through various devices. METHODS: The content development was based on the latest scientific evidence on the impacts of alcohol on health, social norms about drinking, and data from the WHO and PAHO. The agent itself was developed through a nonexclusive license agreement with a private company (Soul Machines) and included Google Digital Flow ES as the natural language processing software and Amazon Web Services for cloud services. Another company was contracted to program all the conversations, following the technical advice of PAHO staff. RESULTS: The conversational agent was named Pahola, and it was deployed on November 19, 2021, through the PAHO website after a launch event with high publicity. No identifiable data were used and all interactions were anonymous, and therefore, this was not considered research with human subjects. Pahola speaks in English, Spanish, and Portuguese and interacts anonymously with a potentially infinite number of users through various digital devices. Users were required to accept the terms and conditions to enable access to their camera and microphone to interact with Pahola. Pahola attracted good attention from the media and reached 1.6 million people, leading to 236,000 clicks on its landing page, mostly through mobile devices. Only 1532 users had a conversation after clicking to talk to Pahola. The average time users spent talking to Pahola was 5 minutes. Major dropouts were observed in different steps of the conversation flow. Some questions asked by users were not anticipated during programming and could not be answered. CONCLUSIONS: Our findings showed several limitations to using a conversational agent for alcohol education to the general public. Improvements are needed to expand the content to make it more meaningful and engaging to the public. The potential of chatbots to educate the public on alcohol-related topics seems enormous but requires a long-term investment of resources and research to be useful and reach many more people.

Community Engagement Alliance (CEAL) Against COVID-19 Disparities: Academic-community partnership to support workforce capacity building among Arizona community health workers.

The COVID-19 pandemic has both highlighted and worsened existing health inequities among communities of color and structurally vulnerable populations. Community Health Workers, inclusive of Community Health Representatives (CHW/Rs) have entered the spotlight as essential to COVID-19 prevention and control. To learn about community experiences and perspectives related to COVID-19 and inform CHW/R workforce capacity building efforts, a series of focus groups were conducted with CHW/Rs throughout Arizona at two time points in 2021. Throughout the data collection and analysis process, researchers and community partners engaged in ongoing and open dialogue about what CHW/Rs on the ground were reporting as priority community concerns, needs, and challenges. Thus, CHW/Rs informed the development of culturally and linguistically relevant health education messages, materials, and training for CHW/Rs. In this community case study, we detail the efforts of partnership between a statewide CHW professional association and an academic research team that facilitated rapid decision-making and knowledge sharing to create community-grounded tools and resources supportive of CHW/R workforce capacity building in the context of the COVID-19 pandemic.