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Results for “Community Workers”

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At least 19 recordsLinked to original sources
PubMed1989

Hookworm and roundworm infections in farm-worker communities in the large-scale agricultural sector in Zimbabwe.

Surveys were carried out to assess the prevalences and intensities of hookworm and roundworm infections in 15 farm-worker communities in Zimbabwe with poor living conditions. Examination of 1635 faecal samples showed that hookworms (Necator americanus and Ancylostoma duodenale) were the commonest helminths (61.7% of infections). They were followed by Ascaris lumbricoides and Trichuris trichiura at less than 3%. There were striking differences in prevalences and intensities of infection of the different helminthic parasites among the 15 communities surveyed. In general, differences between males and females were not statistically significant. Age-prevalence and age-intensity profiles for hookworms showed that infection increased with age, with a peak in the adult age groups. A. lumbricoides prevalence was relatively high in children but declined to a very low plateau in adults. There were no significant relationships between number of households per latrine at each community and the prevalence and intensity of infection by hookworms and prevalence of roundworms. The relevance of the above findings is discussed in relation to the control of morbidity and transmission of the helminths.

Adolescent↗
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↗
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↗
PubMed1992

Assessment of therapeutic relationship of community-agency workers.

This article reports on the ratings of the personal and professional characteristics of community-based workers for children and adolescents who had recently been released from a psychiatric inpatient service. The child/adolescent's family members/caregivers and the community workers both responded to the same items of a questionnaire. Families/caregivers rated the community workers with whom they were the most and the least satisfied. Community workers rated themselves in relation to these study children and/or their families. Findings indicate that both family members/caregivers and the community workers themselves saw community workers performing relatively well in the areas of providing information and offering support to families. Likewise, both assessed the service providers as having the greatest deficits in the area of teaching skills for child/adolescent home management. Suggestions for meeting the needs of the families and for ensuring that a system of care for child/adolescents is child-centered and family-focused are discussed.

Adolescent↗
PubMed1988

Diagnosis and management of dysentery by community health workers.

To develop guidelines for community health workers in the treatment of patients with diarrhoea, diarrhoea prevalence was actively surveyed for a year in a remote rural community of 915,000 persons, and the enteric pathogens and clinical features associated with diarrhoeal illness were determined in a sample of 300 patients. Bloody diarrhoea accounted for 39% of all diarrhoea episodes and 62% of diarrhoea-associated deaths. 51 (50%) of 101 patients with a history of bloody diarrhoea had Shigella infection, compared with 31 (16%) of 199 patients with other types of diarrhoea. A history of bloody diarrhoea was as predictive of the presence of shigella infection (positive predictive value 50%, negative predictive value 86%) as more complex prediction schemes incorporating other clinical features or stool microscopic examination. In the area of Bangladesh where the study was done reduction of diarrhoea-related morbidity and mortality will depend on control and treatment of shigellosis, and community health workers have been instructed to provide antibiotics for patients with a history of bloody dysentery.

Anti-Infective Agents, Urinary↗
PubMed1990

Community health workers in Bolivia: adapting to traditional roles in the Andean community.

Community health workers (CHW) constitute an outreach program where community members become involved in their health concerns and elect someone to be trained and administer primary health care. A major problem is that CHWs do not fit into leadership roles of either modern or traditional medicine. CHWs of Oruro, Bolivia, are discussed to examine the success of this program in which CHWs adapted to political, economic, and cultural patterns of Andean communities.

Bolivia↗
PubMedDate not supplied

Employment in family planning and women's status in Bangladesh.

This study investigates how employment in family planning affects the status of community workers. The focus is on three critical variables: prestige, professional status, and social influence. The data are derived from a focus-group study conducted in 1987-88 in the Maternal and Child Health and Family Planning Project in Matlab, Bangladesh. Focus-group sessions were held with community workers, their husbands, community leaders, and community women. Results show that although community workers initially faced intense hostility in the community, they succeeded in maintaining the prestige that is traditionally accorded to women in their conservative, rural society. Moreover, they established themselves as valued health and family planning professionals in a social context where professional roles for women have been extremely circumscribed. Finally, they gained social influence by performing a range of functions in the community that exceed formally prescribed job responsibilities. The professional and social leadership roles that community workers now assume imply a degree of status that seemed inconceivable a decade ago. That such change could result from a well-designed and appropriately managed family planning project deserves careful attention.

Bangladesh↗
PubMed1989

Are large-scale volunteer community health worker programmes feasible? The case of Sri Lanka.

National community health worker (CHW) programmes supported by Ministries of Health have been introduced in a number of countries as part of their primary health care policy. Although in many of these programmes the CHWs are salaried or receive an honorarium, there are a number of large-scale programmes in which CHWs work as unpaid volunteers. This paper looks at one such programme in Sri Lanka, in order to understand the motivation of such volunteers and to consider the feasibility of relying on volunteers to support primary health care policies. The lessons from the Sri Lanka case are generalized to other studies. The conclusion is that large-scale community level volunteer programmes will be characterized by high attrition and low activity rates and will only be sustainable under particular enabling conditions.

Community Health Workers↗
PubMedDate not supplied

Community health workers in national programmes: the case of the family welfare educators of Botswana.

Community health worker programmes have become a prominent feature of many primary health care schemes in developing countries. This paper, which is based on a larger collaborative study undertaken in 3 countries, focuses on the experiences with such workers in Botswana, and concludes that many of the key issues that were highlighted in the Botswana study are similar to those in other countries. These can be summarized under four headings: unrealistic expectations, poor initial planning, problems of sustainability, and the difficulty of maintaining quality of care. The future success of these workers will depend on their being integrated more systematically into local services, with concomitant strengthening of management support and supervision.

Botswana↗
PubMed1989

National community health worker programs: how can they be strengthened?

This article is based on a collaborative research study of policy and practice in national community health worker (CHW) programs in developing countries. The study involved a review of the relevant literature, case studies in Botswana, Colombia and Sri Lanka, and an international workshop where the future of such programs was discussed. The findings of this research are discussed under four headings: unrealistic expectations, poor initial planning, problems of sustainability, and the difficulties of maintaining quality. It is clear that existing national community health worker programs have suffered from conceptual and implementation problems. However, given the interest and political will, governments can address these problems by adopting more flexible approaches within their CHW programs, by planning for them within the context of all health sector activities rather than as a separate activity, and by immediately addressing weaknesses in task allocation, training and supervision. CHWs represent an important health resource, whose potential in extending coverage and providing a reasonable level of care to otherwise underserved populations must be fully tapped.

Botswana↗
PubMed1989

The assertive community treatment worker: an emerging role and its implications for professional training.

Assertive community treatment programs are designed to prevent the rehospitalization or homelessness of long-term mental health consumers and to improve their quality of life through the provision of intensive, "in vivo" help with everyday activities. The role of the assertive community treatment worker begins with the identification and engagement of appropriate consumers; proceeds to the development and implementation of practical intervention plans; includes home visiting, in-the-field skill development, and resource brokering, with an emphasis on concrete problem solving; includes close collaboration with inpatient workers and families; and entails the assumption of ultimate professional responsibility for the consumers' well-being. To prepare students for this role, training programs should strengthen their curricula in the areas of professional attitudes, values, and beliefs; biological, psychological, sociological, and historical foundations; and intervention methods appropriate for long-term consumers.

Assertiveness↗
PubMed1992

[Community health workers are capable of determining reliably the target population for health programs].

The target population is a key concept for the planning and evaluation of health services. However, in developing countries, health professionals in the field are often uneasy with the determination of the population denominator. In Zaire, where reliable demographic data are hardly available, we make use of two different methods aimed to the determination of the size of the target population: (1) an exhaustive population based survey performed by trained interviewers, and (2) a rapid census of the target population performed by community health workers. This paper presents both the results of a demographic survey organized in 1984, and two consecutive census performed by community health workers in 1986 an 1988, in the same area (Northern-Kivu, Zaire). Our results suggest that community health workers under close supervision are able to perform rapidly and at low cost a reliable collection of the demographic data needed for the implementation and monitoring of health programmes at the local level.

Adolescent↗
PubMed1976

An introductory course in prescription drugs for community health workers developed by a systems approach.

A 16-hour introductory course in prescription drugs for community health workers was developed by a systems approach. It featured an emphasis on: (1) learning the broad indications, side effects, and adverse reactions of the 30 most commonly prescribed drugs in the outpatient clinic, and (2) aiding the workers in patient education. Teaching materials were simple and inexpensive. An evaluation based on a pretest of the course's objectives compared to a final test documented the success of the instruction.

Boston↗