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

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          Abstract

          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.

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          Most cited references39

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          Quality criteria were proposed for measurement properties of health status questionnaires.

          Caroline Terwee, Sandra D M Bot, Michael de Boer … (2007)
          Recently, an increasing number of systematic reviews have been published in which the measurement properties of health status questionnaires are compared. For a meaningful comparison, quality criteria for measurement properties are needed. Our aim was to develop quality criteria for design, methods, and outcomes of studies on the development and evaluation of health status questionnaires. Quality criteria for content validity, internal consistency, criterion validity, construct validity, reproducibility, longitudinal validity, responsiveness, floor and ceiling effects, and interpretability were derived from existing guidelines and consensus within our research group. For each measurement property a criterion was defined for a positive, negative, or indeterminate rating, depending on the design, methods, and outcomes of the validation study. Our criteria make a substantial contribution toward defining explicit quality criteria for measurement properties of health status questionnaires. Our criteria can be used in systematic reviews of health status questionnaires, to detect shortcomings and gaps in knowledge of measurement properties, and to design validation studies. The future challenge will be to refine and complete the criteria and to reach broad consensus, especially on quality criteria for good measurement properties.
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            Correlation Coefficients

            Patrick Schober, Christa Boer, Lothar A Schwarte (2018)
            Correlation in the broadest sense is a measure of an association between variables. In correlated data, the change in the magnitude of 1 variable is associated with a change in the magnitude of another variable, either in the same (positive correlation) or in the opposite (negative correlation) direction. Most often, the term correlation is used in the context of a linear relationship between 2 continuous variables and expressed as Pearson product-moment correlation. The Pearson correlation coefficient is typically used for jointly normally distributed data (data that follow a bivariate normal distribution). For nonnormally distributed continuous data, for ordinal data, or for data with relevant outliers, a Spearman rank correlation can be used as a measure of a monotonic association. Both correlation coefficients are scaled such that they range from -1 to +1, where 0 indicates that there is no linear or monotonic association, and the relationship gets stronger and ultimately approaches a straight line (Pearson correlation) or a constantly increasing or decreasing curve (Spearman correlation) as the coefficient approaches an absolute value of 1. Hypothesis tests and confidence intervals can be used to address the statistical significance of the results and to estimate the strength of the relationship in the population from which the data were sampled. The aim of this tutorial is to guide researchers and clinicians in the appropriate use and interpretation of correlation coefficients.
            Article 0 comments Cited 1276 times – based on 0 reviews     Review now
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              A Review of Coronavirus Disease-2019 (COVID-19)

              Tanu Singhal (2020)
              There is a new public health crises threatening the world with the emergence and spread of 2019 novel coronavirus (2019-nCoV) or the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus originated in bats and was transmitted to humans through yet unknown intermediary animals in Wuhan, Hubei province, China in December 2019. There have been around 96,000 reported cases of coronavirus disease 2019 (COVID-2019) and 3300 reported deaths to date (05/03/2020). The disease is transmitted by inhalation or contact with infected droplets and the incubation period ranges from 2 to 14 d. The symptoms are usually fever, cough, sore throat, breathlessness, fatigue, malaise among others. The disease is mild in most people; in some (usually the elderly and those with comorbidities), it may progress to pneumonia, acute respiratory distress syndrome (ARDS) and multi organ dysfunction. Many people are asymptomatic. The case fatality rate is estimated to range from 2 to 3%. Diagnosis is by demonstration of the virus in respiratory secretions by special molecular tests. Common laboratory findings include normal/ low white cell counts with elevated C-reactive protein (CRP). The computerized tomographic chest scan is usually abnormal even in those with no symptoms or mild disease. Treatment is essentially supportive; role of antiviral agents is yet to be established. Prevention entails home isolation of suspected cases and those with mild illnesses and strict infection control measures at hospitals that include contact and droplet precautions. The virus spreads faster than its two ancestors the SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV), but has lower fatality. The global impact of this new epidemic is yet uncertain.
              Article 0 comments Cited 1206 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Prim Health Care Res Dev
                Journal ID (iso-abbrev): Prim Health Care Res Dev
                Journal ID (publisher-id): PHC
                Title: Primary Health Care Research & Development
                Publisher: Cambridge University Press (Cambridge, UK )
                ISSN (Print): 1463-4236
                ISSN (Electronic): 1477-1128
                Publication date (Electronic, collection): 2022
                Publication date (Electronic): 02 May 2022
                Volume: 23
                Electronic Location Identifier: e27
                Affiliations
                [1 ]Department of Sociology, Forman Christian College University , Lahore, Pakistan
                [2 ]Department of Psychology, Lahore College of Women University , Lahore, Pakistan
                [3 ]Institute of Public Health, King Edward Medical University
                [4 ]Department of Sociology, International Islamic University , Islamabad
                Author notes
                Author for correspondence: Professor Sara Rizvi Jafree, Department of Sociology, Forman Christian College University, Ferozepur Road, Lahore 54600, Pakistan. E-mail: sarajafree@ 123456fccollege.edu.pk .
                Author information
                https://orcid.org/0000-0001-5141-1107
                Article
                Publisher Item ID: S1463423622000081
                DOI: 10.1017/S1463423622000081
                PMC ID: 9112673
                PubMed ID: 35499097
                SO-VID: 7096ae16-d7d2-4a0a-95f9-2f971c9babf7
                Copyright © © The Author(s) 2022
                License:

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.

                History
                Date received : 09 December 2020
                Date revision received : 14 August 2021
                Date accepted : 14 January 2022
                Page count
                Figures: 1, Tables: 10, References: 40, Pages: 11
                Categories
                Subject: Research Article

                Keywords: community health workers,coronavirus preparedness,coronavirus responsiveness,employee satisfaction,maternal and neonatal health,pakistan
                Data availability:
                Keywords: community health workers, coronavirus preparedness, coronavirus responsiveness, employee satisfaction, maternal and neonatal health, pakistan

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