Malaria Community Health Workers in Eliminating Malaria in Banyumas Regency

Banyumas has not reached the elimination of malaria yet. One of the efforts is done by community empowerment by establishing malaria Community Health Workers (CHWs/JMD). JMD are people who conduct the discovery and medication of malaria in Active Case Detection (ACD). The research aims at describing JMDs attitude and knowledge towards the malaria elimination in Banyumas Regency in 2015. Quantitative research with cross sectional design was performed in the study. There were 15 JMDs spreading across in 7 public health centers/Puskesmas. The results show that most of JMDs were male with primary education background. They are mostly employed and do not join any training within 3 years. The average age of JMDs is 48.4 years old although there are some workers who are over 65 years old. 33.3% of JMDs are in low-medium categories, and there are 26.7% JMDs who have negative attitude to malaria. All JMDs have less skill such as not to do home visits as scheduled, not to do periodic reports, not to send blood preparations immediately and unstandardized of the blood preparation

Perceptions of Community Health Care Center Workers on National Health Insurance (JKN) Healthcare Services Payment System in Karangasem Regency

Background and purpose: National Health Insurance (JKN) healthcare services payment system is a financialcompensation given to employees of health centers through an allocation system implemented by the Ministry ofHealth Regulation (Permenkes No. 28 of 2014). This study aims to explore health care workers perception of the JKNhealth care services payment system.Methods: In-depth interviews conducted among 12 participants selected purposively namely heads of health centers(doctors and public health graduated), medical personnel, paramedics, other health professionals, non-healthpersonnel (both civil servants and non-civil servants). Data were analyzed using thematic analysis approach presentednarratively.Results: Participants intimated that the amount of points based on the variable of kind of personnel and/or positionswere not proportional/not in accordance with the actual condition of the health center. The use of attendance ratesmade for an unconducive atmosphere as it was evident that this variable was not applied to all employees but only tothe central health centers. The differentiation of employment status with the same workload, and the uneven amountof points and grouping of years of service rather than workload was viewed as unfair and bias by respondents thereforethey believed this needs further assessment.Conclusion: The allocation of the JKN health care services payment system was perceived as prejudicial by theemployees of the health centers in Karangasem Regency. The amount of points distributed were not proportional tothe type of personnel and/or position, and the use of the level of attendance, differentiation of employment status,grouping of years of service not based on workloads were all issues raised by respondents

Advancing Community Health Worker Practice and Utilization: The Focus on Financing

There is a growing interest in the use of community health workers in various roles in the US health care system. These workers go by various titles and names -- including promotora and community health advisor -- but all assist members of the communities they serve. As the role of these workers becomes more accepted and desirable in the overall system of care, they face the challenges of moving from being an exceptional add-on to the system to being more a part of the mainstream. Issues such as educational preparation, formal credentialing, licensure and compensation are all part of this process. In particular, various organizations are interested in but challenged by the need for sustainable financing of the CHW position. It is time to explore and develop viable financing arrangements that go beyond short-term grants.To address these concerns, this research was undertaken to study sustainable financing mechanisms for community health workers. The focus is on existing and emerging funding, reimbursement and payment policies for community health workers. The study seeks to identify promising examples and models of payment programs for community health workers generally in the United States. To the authors' knowledge, this is the first national project with this exclusive focus.The audiences for this report include community health workers, directors of programs that employ or work with community health workers, and administrators of public and private coverage programs such as health plans, insurance companies and state Medicaid programs seeking options for improving health care access and quality at the same or lower costs. Businesses, non-profit organizations and consumers exploring the possibilities of using the services community health workers could provide might also be interested in the findings

Community Health Workers: A Holistic Solution for Individual and Community Health

Community Health Workers (CHWs) go by many names, including outreach workers, patient navigators, peer health educators, and lay health advocates. CHWs help people overcome obstacles by accompanying them through treatment, monitoring needs for food and housing, leading education campaigns and empowering community members to take charge of their own health. As members of the communities they serve, CHWs establish relationships of trust with those they serve, bridging the gap between the clinic and community. Community Health Workers embrace a holistic conception of health, working not only in health care, but also with the social determinants of health such as poverty, education, and housing

Integrating community health workers into the formal health system to improve performance : a qualitative study on the role of on-site supervision in the South African programme

To explore the role of on-site supervision in community health worker (CHW) programmes and CHW integration into the health system. We compared the functioning of CHW teams reporting to a clinic-based nurse with teams supervised by a community-based nurse. We also consider whether a junior nurse can provide adequate supervision, given the shortage of senior nurses. A case study approach to study six CHW teams with different configurations of supervision and location. We used a range of qualitative methods: observation of CHW and their supervisors (126 days), focus group discussions (12) and interviews (117). South Africa where a national CHW programme is being implemented with on-site supervision. CHWs, their supervisors, clinic managers and staff, district managers, key informants from the community and CHW clients. Effective supervisors supported CHWs through household visits, on-the-job training, debriefing, reviewing CHWs' daily logs and assistance with compiling reports. CHWs led by senior nurses were motivated and performed a greater range of tasks; junior nurses in these teams could better fulfil their role. Clinic-based teams with senior supervisors were better integrated and more able to ensure continuity of care. In contrast, teams with only junior supervisors, or based in the community, had less engagement with clinic staff, and were less able to ensure necessary care for patients, resulting in lower levels of trust from clients. Senior supervisors raised CHW skills, and successfully negotiated a place for CHWs in the health system. Collaboration with clinic staff reduced CHWs' marginalisation and increased motivation. Despite being clinic-based, teams without senior supervisors had lower skill levels and were less integrated into the health system

Community Health Workers and Promotores in California

Provides an overview of, and describes the challenges facing, the emerging workforce of public health professionals who carry out a variety of health promotion, case management, and service delivery activities at the community level

Primary Health Care in Practice: Is It Effective?

Primary health care is accepted as the model for delivering basic health care to low income populations in developing countries. Using El Salvador as a case study, the paper draws on three data sets and a qualitative survey to assess health care access and utilization across public and private sector options (including NGOs). Multivariate analysis is used to estimate the quantitative determinants of health seeking behavior. Physical and financial access is generally good. Households do not value the community health workers, and prefer high cost private care, even the poorest families, because of the lower waiting times and higher probability of successful treatment. Similarly, higher level public facilities—health centers and hospitals—are preferred because they are less costly in terms of time as they offer "one stop shopping" and do not require multiple visits, and treatment success is higher than among health posts, health units or community health workers. These results combined with the small size of El Salvador suggest that alternative strategies to community health workers may be a more cost effective approach. While prevention is desirable, community health workers do not have the skills or services that the communities value, which makes them less effective in promoting prevention. Alternative modes of reaching the community could reduce costs and raise the effectiveness of public health spending.health care, El Salvador, public health spending

Sources of Cardiovascular Health Information and Channels of Health Communication Among Urban Population in Nigeria

This study employed mixed methods to investigate the preferred sources of health information and later explored the views of community healthcare workers on the enablers, barriers and ways of overcoming barriers to health communication. The study found that majority of the participants preferred their source of CV (cardiovascular) health information from the healthcare workers including the medical doctors, nurses, and pharmacists. On the other hand, the least preferred source of health information was from friends, family members, and community leaders. Some of the identified enablers to community health communication include awareness programme via Non-Governmental Organisations (NGOs), community-based organisations such as faith-based organisations and healthcare facilities. Others are traditional media and social media. The identified barriers to community-based health communication include lack of knowledge and poverty, language barriers, and other miscellaneous issues including misuse of internet, lack of basic amenities and religious beliefs. The community-based healthcare providers articulated ways to overcome the identified barriers, including enlightenment programmes, using the language of the target audience, funding health awareness programmes, and monitoring of health education interventions. This study concludes that dissemination of health information using numerous channels is essential in ensuring population-wide primary prevention of diseases

Developing Primary Liaison Psychiatric Services for HIV/AIDS Patients in Community

In Indonesia, the number of HIV/AIDS patients has grown at significant level. HIV can be a source of major stress which can lead to changes in mental health, such as persistent sadness, feeling empty and anxiety. The ability of liaison officer could help patients reduce their psychiatric problems and at the same time it can greatly affect patients' risks for transmission of HIV to others. This study aimed to analyze the effect of developing primary liaison psychiatric services for HIV/AIDS patients on the abilities of health care workers to provide treatments. This study used a quasi experimental design with one group pretest-posttest which included 64 health care workers aged between 20 and 50 years from the Community-Integrated Health Care in East Java. The inclusion criteria were nurses and physician in Community-Integrated Health Care. The respondents were assessed using the Abilities of Health Care Workers Checklist pre-treatment and post-treatment. The outcomes were analyzed using the Wilcoxon signed rank test. There was a significant increased in the abilities of health care workers to provide psychiatric services after treatment (p<0.05). The liaison psychiatric services were considered to be effective in increasing the abilities of health care workers in improving the treatment of HIV/AIDS