Infection preparedness of community health workers: implications for maternal and neonatal health services in Pakistan

Jafree, Sara Rizvi; Khawar, Amna; Momina, Ain ul; Mahmood, Qaisar Khalid

doi:10.1017/s1463423622000081

Cited by 3 publications

(3 citation statements)

References 33 publications

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“…The LHWs are responsible for services related to reproductive and maternal health, vaccination and immunization, promoting health awareness, referral to secondary and tertiary sector, and routine counseling [30]. With the coronavirus pandemic, the additional burden of infection control and preventive education has been placed on LHW shoulders [31].…”

Section: Majority Of Women In Pakistan Are Dependent On Primary Healt...mentioning

confidence: 99%

Health and Social Literacy Intervention to Improve Maternal Health: Study Protocol for a Randomized Pre-Post Test Design with a team-building intervention for primary healthcare teams and community needs assessment

Jafree

Ahsan

Zakar

et al. 2023

Preprint

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Background: The majority of poor, illiterate women of reproductive years in Pakistan are living in underdeveloped regions and are solely dependent on free primary health services provided by the state. This project aims 1) to collect baseline health and social data, 2) to deliver a health and social literacy intervention, 3) to deliver a team-building intervention for primary-level healthcare providers, and 4) to conduct a community needs assessment. Methods: Electronic health and social data will be collected at baseline, which will be used to develop a comprehensive database and develop an index for Maternal Health and Wellbeing. A 24-month intervention will be delivered which will have 6 modules related to health and social literacy. The principal investigators will train the data collectors and intervention facilitators. Lady Health Workers will collect the electronic data and pre-post test data, and Community Social Workers will deliver the health and social literacy intervention. Cluster randomized sampling will be used to sample 6 BHUs across 6 different cities of Punjab, Pakistan. A total of 360 women will be sampled and assigned randomly to the experiment and control groups. The principal investigators will deliver the team-building intervention and conduct the community needs assessment. The participants for the latter will include doctors, nurses and community health workers; and for the former will include women from the community, women community health providers, community elders and religious leaders, and local government officials. Discussion: Pakistan is falling behind on its sustainable development goals for maternal health, mainly due to the limitations of the existing services and literacy of women. There is critical need to support understaffing of current providers by partnering them with community social workers and training them for better care delivery. Similarly, women need support for gaps in both health and social literacy. Development of an index and community needs assessment report can support better identification of environmental and socio-cultural needs in the community and to advise policy makers and stakeholders about issues wider which directly and indirectly impact women’s health. Trial registration: This study has been registered with ClinicalTrials.gov. The identification number is: NCT05389501.

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Section: Majority Of Women In Pakistan Are Dependent On Primary Healt...mentioning

confidence: 99%

Health and Social Literacy Intervention to Improve Maternal Health: Study Protocol for a Randomized Pre-Post Test Design with a team-building intervention for primary healthcare teams and community needs assessment

Jafree

Ahsan

Zakar

et al. 2023

Preprint

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“…As members of the community they serve, CHWs play a crucial role as health educators who perform house visits (Scharff et al, 2022). In Pakistan, CHWs are known as Lady Health Workers, and there are four important suggestions to help them provide the best services possible: education and training, operational assistance, public acceptability, and employee support and incentives (Jafree et al, 2022). Interventions might be used in place of, or in addition to, financial incentives to promote LHW participation in service delivery (Khan et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Community Factors Facilitating or Hampering Service Delivery of Lady Health Workers: Views and Experiences of Beneficiaries

Salah ud Din,

Jabeen

2023

PJASS

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The community level factors are essential to consider for the improved performance of Community Health Workers (CHWs) in service delivery, including community acceptance of CHWs and support of local health care institutions. The CHW acts as a connection between the community and the healthcare system, and by serving in this role, CHWs greatly improve the health condition of community members. Locally known as Lady Health Workers (LHWs) in Pakistan, Community Health Workers are women who offer maternity and pediatric healthcare at the community scale. The current study's objective was to investigate which community circumstances influence the performance of LHWs in service delivery. A quantitative research method was utilized to achieve the objective with the social ecology model acting as the theoretical base. Respondents of the study were from 398 households in the Lahore District and were in the age group of 15 to 49 years. An interview schedule was employed as the tool for gathering data, and participants were selected using a proportional systematic random sample. The study discovered a strong relationship between beneficiaries' use of LHW services and community factors. Based on these findings, it is suggested that community level factors be improved or strengthened to enhance LHWs' performance for offering services.

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“…27 During the recent pandemic, the LHWs were additionally assigned responsibility for promoting infection preparedness and prevention, without any additional compensation or staff allocation, contributing to inefficiencies. 28 …”

Section: Introductionmentioning

confidence: 99%

Narrative synthesis systematic review of Pakistani women’s health outcomes from primary care interventions

Jafree

Mahmood

Mujahid³

et al. 2022

BMJ Open

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ObjectiveWomen living in Pakistan have complex health problems including infectious and non-communicable diseases, accident and injuries, and mental health problems. While a majority of these women rely on primary healthcare services for all of their healthcare needs, there has to date been no overview of the extent of their effectiveness. The objective of this review was to (1) synthesise the available evidence regarding the effectiveness of primary care based interventions aimed at improving women’s mental and physical health and (2) identify the factors that promote effectiveness for women’s health outcomes.MethodsFive academic databases were searched, including PubMed, BMC Medicine, Medline, CINAHL and the Cochrane Library. A search was also made of the grey literature. The quality of included studies was assessed using a standardised critical appraisal tool, and the findings summarised using a narrative synthesis.ResultsIn total, 18 studies were included in the review. Eight involved evaluations of counselling interventions, three health education and awareness interventions, two social and psychosocial interventions, and five were evaluations of combination interventions. Twelve of the included studies were randomised controlled trials. Of these 14 reported significant outcomes, and 4 further interventions showed partially favourable results. However, interventions mostly targeted women’s mental or reproductive health.ConclusionsWhile the evidence is limited in terms of quality and what has been evaluated, a number of interventions appear to be effective in improving outcomes for women. The three key approaches include the adoption of an active door-to-door and group-based approach; utilisation of community peers who can deliver care cost-effectively and who are more accepted in the community; and the integration of financial vouchers to support uptake in poor populations.PROSPERO registration numberCRD42020203472.

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Infection preparedness of community health workers: implications for maternal and neonatal health services in Pakistan

Cited by 3 publications

References 33 publications

Health and Social Literacy Intervention to Improve Maternal Health: Study Protocol for a Randomized Pre-Post Test Design with a team-building intervention for primary healthcare teams and community needs assessment

Health and Social Literacy Intervention to Improve Maternal Health: Study Protocol for a Randomized Pre-Post Test Design with a team-building intervention for primary healthcare teams and community needs assessment

Community Factors Facilitating or Hampering Service Delivery of Lady Health Workers: Views and Experiences of Beneficiaries

Narrative synthesis systematic review of Pakistani women’s health outcomes from primary care interventions

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