Challenges faced by community health nurses to achieve universal health coverage in Myanmar:A mixed methods study

Objective:This study aimed to identify the challenges of community health nurses(CHNs)in delivering effective community health care to achieve universal health coverage(UHC)in Myanmar.Methods:A total of 30 CHNs from township health centers in the northeastern,southern,and western parts of Myanmar were purposefully recruited for quantitative and qualitative interviews.Quantitative data were processed using Microsoft Excel software,and qualitative data were analyzed using thematic analysis.This study is registered with researchregistry6201.Results:Around the country,30 CHNs uncovered their hardships in implementing primary health care to achieve UHC.Over 90%of the participants agreed to the problem of inadequate health infrastructure,while half of them felt unmotivated when they encountered role conflicts among various cadres of healthcare providers and poor opportunities for career promotion.Major problems arose from the lack of standard professional education at the entry point to community settings because most CHNs did not achieve specialized training in providing public health services.Complications are incapable of evaluating health services for policy-making and the inability to conduct health research to develop evidencebased practices.Insecure work and living conditions,unsupportive community relationships,and undereducation in professional practices were supportive major themes explored by CHNs to achieve a deeper understanding of the barriers to UHC.Not only the health system itself but also the population and other geographical factors have contributed to many challenges to CHNs.Conclusion:Myanmar’s CHNs face many challenges in achieving UHC.These challenges are not confined to the health sector.Some situations,such as geographical barriers and transportation problems,remain persistent challenges for healthcare providers.This study highlights the fact that current health systems should be strengthened by qualified healthcare providers and sufficient infrastructure.Meanwhile,public empowerment plays a critical role in promoting health development.

Role of community health nurse in the prevention of elderly dehydration:A mini-review

As dehydration is related to negative health outcomes in the elderly,including an increased risk of disability and death,prevention may help improve health,functional status,and quality of life.Dehydration diagnosis can be challenging in the elderly as the traditional physical indications of dehydration may be absent or ambiguous.Numerous etiologies place the elderly at an increased risk.The role of the community health nurse(CHN)derives from the responsibilities attached to her,and the Betty Neuman’s Systems Model of health care with three levels of protection is usually applied to the CHN.In this mini-review,we try to integrate the Betty Neuman’s Systems Model with the results of identified articles.This study includes a literature search of reputable international databases such as SpringerLink,PubMed,Embase,and Wanfang,particularly for the period 2005 to the present.Ten articles that met the qualifying criteria were included in this study.The findings of this study draw a picture of the role of CHN in preventing dehydration across the three levels of prevention as mentioned by Betty Neuman.

Assessment of Knowledge and Practices of Community Health Nurses on Data Quality in the Ho Municipality of Ghana

Background: High data quality provides correct and up-to-date information which is critical to ensure, not only for the maintenance of health care at an optimal level, but also for the provision of high-quality clinical care, continuing health care, clinical and health service research, and planning and management of health systems. For the attainment of achievable improvements in the health sector, good data is core. Aim/Objective: To assess the level of knowledge and practices of Community Health Nurses on data quality in the Ho municipality, Ghana. Methods: A descriptive cross-sectional study was employed for the study, using a standard Likert scale questionnaire. A census was used to collect 77 Community Health Nurses’ information. The statistical software, Epi-Data 3.1 was used to enter the data and exported to STATA 12.0 for the analyses. Chi-square and logistic analyses were performed to establish associations between categorical variables and a p-value of less than 0.05 at 95% significance interval was considered statistically significant. Results: Out of the 77 Community Health Nurses studied, 49 (63.64%) had good knowledge on data accuracy, 51 (66.23%) out of the 77 Community Health Nurses studied had poor knowledge on data completeness, and 64 (83.12%) had poor knowledge on data timeliness out of the 77 studied. Also, 16 (20.78%) and 33 (42.86%) of the 77 Community Health Nurses responded there was no designated staff for data quality review and no feedback from the health directorate respectively. Out of the 16 health facilities studied for data quality practices, half (8, 50.00%) had missing values on copies of their previous months’ report forms. More so, 10 (62.50%) had no reminders (monthly data submission itineraries) at the facility level. Conclusion: Overall, the general level of knowledge of Community Health Nurses on data quality was poor and their practices for improving data quality at the facility level were woefully inadequate. Therefore, Community Health Nurses need to be given on-job training and proper education on data quality and its dimensions. Also, the health directorate should intensify its continuous supportive supervisory visits at all facilities and feedback should be given to the Community Health Nurses on the data submitted.

The effect of a urinary incontinence selfmanagement program for older women in South Korea:A pilot study

Background:Although self-management approaches have shown strong evidence of positive outcomes for urinary incontinence prevention and management,few programs have been developed for Korean rural communities.Objectives:This pilot study aimed to develop,implement,and evaluate a urinary incontinence self-management program for community-dwelling women aged 55 and older with urinary incontinence in rural South Korea.Methods:This study used a one-group pre-post-test design to measure the effects of the intervention using standardized urinary incontinence symptom,knowledge,and attitude measures.Seventeen community-dwelling older women completed weekly 90-min group sessions for 5 weeks.Descriptive statistics and paired t-tests and were used to analyze data.Results:The mean of the overall interference on daily life from urine leakage(pre-test:M=5.76±2.68,post-test:M=2.29±1.93,t=4.609,p<0.001)and the sum of International Consultation on Incontinence Questionnaire scores(pre-test:M=11.59±3.00,post-test:M=5.29±3.02,t=-5.881,p<0.001)indicated significant improvement after the intervention.Improvement was also noted on the mean knowledge(pre-test:M=19.07±3.34,post-test:M=23.15±2.60,t=7.550,p<0.001)and attitude scores(pre-test:M=2.64±0.19,post-test:M=3.08±0.41,t=5.150,p<0.001).Weekly assignments were completed 82.4%of the time.Participants showed a high satisfaction level(M=26.82±1.74,range 22e28)with the group program.Conclusions:Implementation of a urinary incontinence self-management program was accompanied by improved outcomes for Korean older women living in rural communities who have scarce resources for urinary incontinence management and treatment.Urinary incontinence self-management education approaches have potential for widespread implementation in nursing practice.