Aim:
This study aimed to (i) identify community health workers’ (CHWs) perceived satisfaction for maternal and neonatal health services, with respect to (1) socio-demographic characteristics; (2) coronavirus preparedness; (3) coronavirus responsiveness; and (4) employee satisfaction and (ii) investigate the interplay among study variables to identify the role of direct effects and mediation.
Background:
Women CHWs are salient providers for maternal and neonatal services at the primary level, especially in conservative regions. Service delivery is a valuable indicator for mother and newborn wellbeing. There is need for empirical evidence to understand how CHWs may be supported in delivering maternal and neonatal health services during pandemics.
Methods:
Bivariate regression was used to identify the lower odds for CHWs’ perceived satisfaction for maternal and neonatal health services. In addition, structural equation modeling was used to investigate if coronavirus responsiveness and employee satisfaction as mediating variables influence the relationship between coronavirus preparedness and maternal and neonatal health services. Data were collected telephonically from 350 CHWs. The sample was representative of 35 districts of Punjab, which is the most populated province in the country.
Findings:
We found thirty predictors with respect to coronavirus preparedness, coronavirus responsiveness and employee satisfaction which contribute to lower odds of satisfaction for maternal and neonatal health services. We also found that coronavirus preparedness has a direct effect on maternal and neonatal health service satisfaction (β = .242, P < .001) and an indirect effect on maternal health satisfaction (β = .242, P < .001) via the mediation of employee satisfaction. We conclude with four critical recommendations to support CHWs in delivering optimal services, comprising of education and training, operational support, public acceptance, and employee support and benefits. The findings are important for the planning of primary health services and governance support for CHWs and poor women clients in Pakistan and other developing countries.
Aim: Community health workers (CHWs) have emerged as salient health team members in disadvantaged primary settings to provide critical services to disadvantaged mothers and their newborns. There is need for empirical evidence to understand how CHWs may be supported in delivering maternal and neonatal health services during pandemics. Subject and Methods: In this study we used bivariate regression to identify the lower odds for CHW perceived satisfaction for maternal and neonatal health services, with respect to client socio-demographic characteristics, coronavirus preparedness, coronavirus responsiveness, and employee satisfaction. In addition, we used structural equation modeling to investigate if coronavirus responsiveness and employee satisfaction as mediating variables influence the relationship between coronavirus preparedness and maternal and neonatal health services. Results: From a sample of 350 CHWs across 35 districts of Punjab, we found 30 predictors with respect to coronavirus preparedness, coronavirus responsiveness and employee satisfaction which contribute to lower odds of maternal and neonatal health services. We also identified that employee satisfaction is a key mediator in the relationship between coronavirus preparedness and maternal and neonatal health services. Conclusion: We conclude with 4 critical recommendations to support CMWs in delivering optimal services, comprising: education and training, operational support, public acceptance, and employee support and benefits.
Background
Pakistan has one of the highest rates of chronic liver disease (CLD) burden in the world. Poor and underserved patients of CLD in the country may suffer from limited health-seeking behaviors, but there is not much research in this area. The aim of this study is to identify the factors influencing health-seeking behaviors in CLD patients to better plan support for these patients.
Methods
We conducted a cross-sectional study. Data was collected over a four-month period from May 2022 to August 2022. A total of 850 patients visiting the Pakistan Kidney and Liver Institute and Research Centre were part of the study. We used correlation tests and multivariate logistic regression to investigate the relationship between the health-seeking behavior and the independent study domains (economic stability, health literacy, social support, experiencing grief, mental health, healthcare service quality, and coping strategies).
Results
Main results suggest that patients with hepatocellular carcinoma, non-viral liver disease, and cirrhosis have less health-seeking behavior, compared to patient with chronic viral hepatitis. Multivariate logistic regression results reveal that the following groups have lower odds for health-seeking behavior: (i) illiterate people; (ii) those living in rented homes; (iii) those belonging to nuclear families; and (iv) those with low monthly household income. The following study domains also show lower odds for health-seeking behavior: (i) health illiteracy; (ii) low health service quality; (iii) low ability to use coping strategies; (iv) grief; (v) lack of social support; (vi) mental health challenges; and (vii) economic instability.
Conclusions
Our study highlights that the majority of CLD patients are poor, illiterate, or semi-literate and in urgent need of holistic care with respect to health literacy, mental health counseling, financial help, and improved support from provider and families. This is only possible through the integration of social policy officers and social workers in the tertiary health sector of the country.
Background
Chronic liver disease (CLD) is one of the leading disease burdens in Pakistan. Until now, there has only been limited focus in the country on providing health services through tertiary services in urban cities, whereas there is almost no research in Pakistan on the mental health and quality of life of CLD patients. This study aimed to understand which predictors influence the mental health and quality of life of CLD patients in order to advise better policy protection.
Methods
Data was collected from CLD patients at the Pakistan Kidney and Liver Institute and Research Centre, Lahore, Pakistan. A total of 850 respondents were part of the final sample.
Results
Mean results reveal that female as well as illiterate patients need more support for mental health and communication with their physician; whereas men need more support to develop coping strategies. Structural equation modelling results reveal that the severity of symptoms (β = 0.24, p < 0.001), coping strategies (β=-0.51, p < 0.001), and doctor communication (β=-0.35, p < 0.001) predict mental health. Quality of life is associated with the severity of symptoms (β=-0.36, p < 0.001), coping strategies (β = 0.26, p < 0.05), and doctor communication (β = 0.09, p < 0.05).
Conclusions
A ‘bio-psycho-social-spiritual’ model is recommended for Pakistan’s CLD patients which includes the integration of social officers to provide support in four key areas to secure mental health and quality of life of patients.
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