Occupational Stress among Health Care Workers

Occupational stress is a harmful response particularly physical and emotional, due to a mismatch between job requirements and the qualifications, resources, and worker’s needs; its chronic form is termed “Burnout.” Stress among health care workers is multifactorial. Its prevalence among healthcare professionals ranges from 27−87.4%. Occupational stress is a significant reason for physical and mental health, substance use, work-related delay, absenteeism, and emigration rate. Additionally, it can lead to patient safety concerns and poor quality of care. The mismatch between job requirements and the available resources, work overload, working environment, work experience, workplace conflict, gender discrimination, marital status, educational status, job satisfaction, and not being rewarded were some of the factors significantly associated with occupational stress among health care professionals. Moreover, the coronavirus disease 2019 (COVID-19) pandemic introduced additional stressors, such as staff redeployment and the fear of infection. WHO identified good primary health care as fundamental for achieving universal health coverage without financial hardship. Healthcare professionals’ physical and mental well-being is crucial for attaining this. Developing culturally and organizationally appropriate early interventions is the need of the hour to prevent a health care worker from entering a stress level that is non-adaptable beyond their coping abilities

Financial incentive- Does this have impact on outcome of Tuberculosis?

Background: Although most public services provide tests and TB drugs free of charge worldwide, opportunity costs pose barriers to accessing TB services and treatment. 'Kumar Raajratna Bhimrao Ambedkar Vaidakiya Sahay Yojana (KRBAVSY)' popularly known as Free Medical Aid Scheme is in operation in Gujarat since early 70s for SC and since 1991 for SEBC to provide monetary incentive. Primary objective: Evaluation of utilization and effectiveness of Financial incentives given under Free Medical Aids scheme on RNTCP in Gujarat. Methodology: A retrospective cohort study was undertaken in which all TB patients registered under RNTCP in Gandhinagar district were evaluated for their eligibility for KRBAVSY scheme, and whether eligible patients got benefit or not. Also, treatment outcome of patients were compared. Results: Out of total 1430 patients inquired, 896 (62.7%) patients were found eligible for the scheme, while only 87 (9.7%) patients confirmed that they had got the benefit of scheme. Eligible patients who got benefit under scheme had almost five times higher odds of successful outcome of TB treatment. Conclusion: The TB patients who got benefit of KRBAVSY scheme had significantly better successful treatment outcome in comparison to the TB patients who did not get benefit

Scorecard - An innovative simplified tool to supplement the existing monitoring mechanism to assess and improve performance of antiretroviral treatment centers

Introduction: All 26 antiretroviral treatment (ART) centers of Gujarat were monitored by Gujarat State AIDS Control Society under the National AIDS Control Program. A comprehensive tool is needed to identify gap in service delivery and to prioritize monitoring visits. Objectives: To supplement the existing monitoring system, identify strengths/weakness of ART centers, and give recommendations. Methodology: Scorecard was developed in spreadsheet format with 17 scoring indicators on monthly base from March 2014 onward. The centers were classified in three color zones: green (score ≥80%), yellow (score <80% and ≥50%), and red (score <50%). Visits were prioritized at centers with more indicators in yellow/red zone. The performance of centers was compared for March 2014 and March 2015. Results: The statistically significant improvement was observed in indicator “ART initiation within 2 months of eligibility,” while after removing red zone from analysis, four more indicators named “eligible patients transferred out before ART initiation, general clients started on ART, antenatal women started on ART, and pre-ART follow-up CD4 done” reflect statistically significant improvement. Quadrant analysis was done for some indicators, which provide insight that less number of eligible patients may be a reason for low initiation of ART at one center, and at four other centers, the possible reasons for low retention are high death rate and high lost to follow-up rate. Based on these findings, the recommendations were made to regular mentoring centers, improve coordination between ART center and care and support centers (CSCs), and conduct verbal autopsy. Conclusion: Scorecard is a simple and cost-effective tool for monitoring, and by highlighting low-performing indicators, it helps in improving quality of services provided at ART centers

A study on the effect of occupational stress on job performance in the nursing staff of a tertiary care teaching hospital in Surendranagar district

Introduction: Occupational stress is a health hazard to the individual worker both physically and psychologically. Research for the past years shows that, signs of occupational stress appear to be rising amongst nursing profession. The ability of nurses to appropriately handle stress while on duty may have a significant impact on individual outcomes, especially job performance. Objective: This study was conducted to measure the work-related stress and its association with the job performance among nurses. Methods: A pilot study was done and&nbsp; prevalence of&nbsp; work related stress was 13 % on the basis of which sample size was calculated which was 102 (in open epi).&nbsp; The 102 nurses were selected randomly from&nbsp; a tertiary care teaching hospital of Surendranagar district. The data was collected using a structured self-administered questionnaire which included questionnaires on demographic variables, level of work stress and job performance. Results: The findings of the study revealed that moderate and severe level of work stress was present in&nbsp; 53% and 45% of nurses respectively. The mean job stress score was found to be higher among younger&nbsp; nurses than those of more than 40 years. There was a negative relationship between job stress and job performance (r = −0.01) among staff nurses. Conclusion: Based on study findings, it was concluded that all the nurses were suffering from mild to severe level of work stress. and it was negatively correlated with the job performance of the nurses. Hence, it is recommended that corrective measures may be planned by the authority to reduce the work stress of nurses to improve the job performance

Estimation of tuberculosis incidence at subnational level using three methods to monitor progress towards ending TB in India, 2015–2020

Objectives We verified subnational (state/union territory (UT)/district) claims of achievements in reducing tuberculosis (TB) incidence in 2020 compared with 2015, in India.Design A community-based survey, analysis of programme data and anti-TB drug sales and utilisation data.Setting National TB Elimination Program and private TB treatment settings in 73 districts that had filed a claim to the Central TB Division of India for progress towards TB-free status.Participants Each district was divided into survey units (SU) and one village/ward was randomly selected from each SU. All household members in the selected village were interviewed. Sputum from participants with a history of anti-TB therapy (ATT), those currently experiencing chest symptoms or on ATT were tested using Xpert/Rif/TrueNat. The survey continued until 30 Mycobacterium tuberculosis cases were identified in a district.Outcome measures We calculated a direct estimate of TB incidence based on incident cases identified in the survey. We calculated an under-reporting factor by matching these cases within the TB notification system. The TB notification adjusted for this factor was the estimate by the indirect method. We also calculated TB incidence from drug sale data in the private sector and drug utilisation data in the public sector. We compared the three estimates of TB incidence in 2020 with TB incidence in 2015.Results The estimated direct incidence ranged from 19 (Purba Medinipur, West Bengal) to 1457 (Jaintia Hills, Meghalaya) per 100 000 population. Indirect estimates of incidence ranged between 19 (Diu, Dadra and Nagar Haveli) and 788 (Dumka, Jharkhand) per 100 000 population. The incidence using drug sale data ranged from 19 per 100 000 population in Diu, Dadra and Nagar Haveli to 651 per 100 000 population in Centenary, Maharashtra.Conclusion TB incidence in 1 state, 2 UTs and 35 districts had declined by at least 20% since 2015. Two districts in India were declared TB free in 2020