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PubMed1992

Child health in farm workers' communities.

Black women who had borne one or more children in the 5 years preceding the study and who were resident on white-owned farms were sampled in a multistage cluster procedure from the population of two magisterial districts of the southern Transvaal, Ventersdorp and Balfour. The purpose of this study was to determine mothers' knowledge and behaviour regarding the health of their children, to correlate this with personal and social characteristics of the mothers, and to document aspects of their physical environment. Only 50% of mothers had completed 4 or more years of formal education. One in three had experienced the death of at least 1 of her children. Water and sanitation facilities were inadequate for most. Little was known about oral rehydration solution preparation or about growth monitoring. Most children were breast-fed. Between 50% and 63% of the children had vaccinations appropriate for their ages, depending on whether evidence from clinic cards or from mothers' memories was taken as valid. The single most important determinant of the appropriate knowledge and behaviour of mothers was education. Basic living and social conditions of farm workers require improvement and the health services must be re-orientated to deliver comprehensive primary care.

Black or African American↗
PubMed1995

Parvovirus B19 infection in hospital workers: community or hospital acquisition?

A suspected nosocomial outbreak of parvovirus B19 infection in a maternity ward was investigated in February 1994. Questionnaires were administered and sera collected from maternity ward staff (n = 91), other ward staff in the same hospital (n = 101), and maternity ward staff at a nearby hospital (n = 81). Blood donors (n = 265) were used as community controls. Recent infection (parvovirus B19 IgM positivity) in susceptible persons (parvovirus B19 IgG-negative or IgM-positive) was common among all 4 groups (23%-30%). This high rate of recent infection occurred during a large community outbreak of fifth disease. Environmental samples collected from a room where a stillborn parvovirus B19-infected fetus was delivered were positive for parvovirus B19 DNA. Thus, this suspected nosocomial outbreak actually reflected transmission outside the hospital, but contaminated environmental surfaces were identified as one potential source for transmission of parvovirus B19.

Antibodies, Viral↗
PubMed2006

On the front line of primary health care: the profile of community health workers in rural Quechua communities in Peru.

OBJECTIVE: To describe the profile of community health workers--health promoters, traditional birth attendants and traditional healers--in rural Quechua communities from Ayacucho, Peru. METHODS: Basic quantitative and qualitative information was gathered as part of a community health project implemented between 1997 and 2002 in 40 Andean communities with information from questionnaires, personal interviews and group discussions. RESULTS: The majority of current community health workers are men with limited education who are primarily Quechua speakers undertaking their work on a voluntary basis. Health promoters are mostly young, male, high school graduates. There exists a high drop-out rate among these workers. In contrast, traditional healers and traditional birth attendants possess an almost diametrically opposite profile in terms of age, education and drop-out rates, though males still predominate. At the community level the health promoters are the most visible community health workers. CONCLUSION: It is very important to consider and to be aware of the profile of community health workers in order to provide appropriate alternatives when working with these groups as well as with the indigenous population, particularly in terms of culture, language and gender issues.

Journal Article↗
PubMedDate not supplied

Training general practitioners.

Nationally there is no standardized system for the education and training of general practitioners (GPs) within the UK in relation to prevention, early detection and management of alcohol problems. A number of surveys over the past 20 years have confirmed GPs' role legitimacy concerning working with excessive drinkers, but identified a lack of role adequacy and role support for this work. However, there are considerable constraints present in current UK general practice which limit opportunities for education and training of GPs. A possible way ahead may be to encourage general practitioners to utilize a screening and early intervention programme, coupled with ongoing support and imaginative use of other primary health care workers, community workers and the secondary services.

Alcoholism↗
PubMed1990

[Multiple pregnancies. III. Therapeutic, psychologic and social aspects].

The authors analyse a series of 23 multiple pregnancies (19 triplet pregnancies, 3 quadruplets and 1 quintuplet). The first objective is to fight prematurity. Over and above all use of drugs as tocolytics (beta-mimetic drugs and progesterone) should routinely be advised and as soon as there is any threat of premature labour hospitalisation is needed. Twenty one of the 23 patients had prophylactic cerclage (Shirodkar's stitch). In 77% of the cases respiratory distress in the newborn was avoided by using cortico-therapy. Vaginal delivery can be carried out under certain conditions in triplet pregnancies. If certain precautions are taken there does not seem to be any immediate difference in the post delivery period of these children if they are born vaginally or by caesarean. Perinatal mortality is raised (at 5.6% for triplets and 58.3% for quadruplets). The psychological implications of these pregnancies are important. Problems appear as soon as the diagnosis is made and continue for years afterwards. On the social level, help given by the social services are usually inadequate. If the couples belong to the National Association for Mutual Aid of Parents of Children of Multiple Births, a system of mutual support is available. We recommend that these pregnancies should be looked after by several disciplines. These consist not only of obstetricians, paediatricians, anaesthetists, those who resuscitate together, but also psychologists, dietitians, social workers, community workers and physiotherapists.

Clinical Protocols↗
PubMed1983

Primary health care provision in terms of community need in South Africa.

In South Africa, early lessons in primary health care were lost to sight and have been rediscovered only recently. Priorities need to be reassessed in order to better allocate resources to community needs. Developing and developed communities require different primary care services. Simple and effective epidemiological methods should be used to gather information required for planning and evaluation of services. In developing communities, where there is a shortage of doctors, trained nurses operate local clinics with the help of community workers. Community participation and the cooperation of the traditional healers are necessary. Appropriate training of personnel for an effective role in public health care is essential.

Community Health Services↗
PubMed1994

Qualities of an ideal volunteer community malaria worker: a comparison of the opinions of community residents and national malaria service staff.

Since the late 1950s, most malaria surveillance and treatment in rural areas of Latin America has been carried out by networks of unpaid community malaria workers, known as Volunteer Collaborators, who are selected and supervised by staff of the national malaria services (NMSs) in each country. In spite of the free and readily accessible antimalarial treatment available at these Volunteer Collaborator posts, many residents continue to seek treatment elsewhere and in most cases take doses of antimalarials that are insufficient to cure their infections. To identify ways in which the Volunteer Collaborator Network could be made more attractive to residents and to improve the process of selection of new workers, we asked community residents and Guatemalan NMS workers to rank order, according to their importance, 11 qualities or characteristics of an 'ideal' volunteer malaria worker. Community residents preferred someone who is available to take care of patients at all times of the day, is a responsible person, and has a general knowledge of medicine. No significant differences were noted in the rank orders of male and female residents or literate and illiterate residents. National Malaria Service workers also preferred someone who takes care of patients at all times of the day, even when busy. In addition, they wanted individuals who recognize the importance of their work as a Volunteer Collaborator, but choosing volunteers who had a general knowledge of medicine was not important. By modifying the procedures used to select Volunteer Collaborators so as to identify candidates with the qualities preferred by residents, it should be possible to increase acceptance and improve the performance of these volunteer workers.

Adolescent↗
PubMed1994

A shotgun marriage--community health workers and government health services. Qualitative evaluation of a community health worker project in Khayelitsha.

In 1988 the Western Cape Regional Services Council (RSC) initiated a community health worker (CHW) project in Khayelitsha in order to extend its preventive services to people in the community and promote 'community upliftment'. An evaluation of this project was undertaken in 1991 and 1992 in order to examine the potential of this local health authority-run CHW project to be an appropriate primary health care model. Qualitative research methods were used to explore the nature of the work done by the CHWs, whether they were accepted in their communities, and whether the project functioned as part of an integrated health service infrastructure in Khayelitsha. The CHWs were found to provide the basis for a potentially effective, community-responsive service. However, several structural problems mitigated against this service. Relations between the CHWs and nurses in all the formal public health services in the area were superficial and fraught with problems. There were significant differences and conflicting policies between the RSC's CHW project and other neighbouring non-government CHW projects, and these posed various threats to both the RSC and the non-government projects. One of the most serious of these differences was that the RSC project had no structures or plans for community involvement in the running of the project. Before a CHW project is initiated, several critical issues need to be carefully considered and discussed with all the relevant stakeholders. Furthermore, CHWs need to be flexible, and accountable to the communities in which they work. Before employing CHWs, formal public health authorities need to consider carefully whether they are able to meet these criteria.

Community Health Services↗
PubMed1998

An extraordinary role for village community development workers in diagnosing blindness in the community.

OBJECTIVE: To determine the reliability of village community development workers in screening for blindness in the community and to suggest an extraordinary role for these cadres. DESIGN: Diagnostic study. SETTING: Chivi District, Zimbabwe. SUBJECTS: A simple random sample of 148 out of 886 people selected from notification forms. MAIN OUTCOME MEASURE: Sensitivity, specificity and predictive values. RESULTS: The screening method employed was found to have a sensitivity of 93% (95% CI), specificity of 32% (95% CI) and a predictive value for a positive result of 75%. CONCLUSION: The use of village community development workers to screen for blindness in the community has proved to be a reliable alternative when there is shortage of both ophthalmic trained personnel and funds.

Blindness↗
PubMed2004

CHWs get credit: a 10-year history of the first college-credit certificate for community health workers in the United States.

Community health workers have become increasingly important in the U.S. health care system, playing a significant role in basic health promotion and care coordination; however, their status and visibility have not kept pace with their wider use. A major impediment has been the absence of systematic preparation-the field needs standardized education in programs that emphasize the actual skills and knowledge used by community health workers, programs that attract and retain nontraditional students from underserved communities and that foster professional advancement. This article chronicles the 10-year history of the first college credit-bearing community health worker certificate program in the country to address this need. Systematic research resulted in a program centered on the core competencies universally practiced by community health workers regardless of their topical focus. The certificate program combines performance-based methods with popular education into an innovative pedagogical approach that teaches skills, while solidifying, contextualizing, and enhancing crucial experiential knowledge. Program outcomes validate the approach.

California↗