BACKGROUND

Worldwide, the WHO showed that stroke is the second leading cause of death for people above 60, and 5th among the aged 15 to 59 population. In the Philippines, statistics revealed that 500,000 Filipinos suffer from stroke annually. Although preventive efforts have brought about a steady decline in incidence over the last several years, stroke is still the third leading cause of death. Baguio-Benguet Chapter notes a rise in the number of stroke patients affecting both adult and younger age groups. The increasing cases of lifestyle diseases predispose people to stroke. Stroke prevention, management, and rehabilitation are essential in bringing back the normal functioning of stroke patients. Care for stroke clients is a challenging task because of the varied knowledge, practices, and attitudes (KAP) fostering the needs of a stroke client. In the Philippines, family members of the stroke client are more likely to be the preferred caregivers.

The study determined the knowledge, attitudes, and practices of the community members and the community resources on stroke prevention, management, and rehabilitation as a basis for program development.

This study utilized a mixed research design. Data were gathered from 275 residents of Camp 4, Tuba, Benguet using a structured questionnaire, and 10 FGD Groups. Frequency, percentage, and mean computations were done to analyze quantitative data, whereas descriptive analysis was done for qualitative data.

The majority of the respondents (76%) knew that stroke happens due to insufficient blood supply to the brain. Generally, the community agreed about their attitude on the prevention (2.89), management (2.68), and rehabilitation (2.75) of stroke. The community sometimes practices stroke prevention (3.17), management (2.83), and rehabilitation (2.92). Qualitative data revealed that experiences on stroke resulted in scientific knowledge, evidence-based practices, and utilization of existing resources that include personnel, infrastructure, and programs for stroke prevention, management, and rehabilitation.

The experience, social support, and maximized utilization of existing community resources have assisted the knowledge acquisition, favorable attitudes, and safe practices of the community on stroke.

BACKGROUND

This study explores the professional functions and experiences of male midwives in the Province of Aurora, highlighting their roles, challenges, and contributions to maternal and child healthcare in a traditionally female-dominated profession.

This study aims to investigate the professional functions and lived experiences of male midwives in the Province of Aurora.

This research employed a qualitative ethnographic design using semi-structured interviews to collect data. Participants were six male midwives practicing in Aurora. Data collection was conducted via mobile phone interviews from August to September 2024. A purposive sampling technique was utilized to select participants. The study adhered to ethical guidelines, receiving approval from the University of Northern Philippines Ethics Review Committee Code: 2024-251, and informed consent was obtained from all participants. Data were analyzed using qualitative content analysis. Qualitative inductive content analysis as described by Padgett was utilized to allow for data-driven analysis without pre-defined themes, making it suitable for exploring the diverse experiences of male midwives.

Analysis revealed six key themes: Diverse professional functions, gender bias and stereotyping, patient reluctance and shyness, cultural influences, experiences of discrimination and prejudice, and daily challenges and rewards in practice. The findings underscore the commitment of male midwives to providing quality care despite societal and professional barriers. Under the Functions theme, male midwives described their roles as not only caregivers but also as advocates for gender inclusivity in midwifery. In terms of experiences, some reported feelings of isolation and the need to prove their competence in a field dominated by women. However, they also shared empowering stories of camaraderie with female colleagues and the satisfaction derived from breaking down gender barriers.

Male midwives play a vital role in maternal and newborn healthcare, navigating challenges such as gender bias and patient hesitancy. Strengthening administrative support, promoting inclusivity, and updating policies can enhance their professional integration. Advocacy efforts from professional organizations are necessary to address workplace challenges and recognize their contributions to healthcare.

Objective To understand the willingness of general practitioner(GP) to enhance working competence in community healthcare centers in Shanghai and provide a basis for the competence training of GPs in community healthcare centers. Methods In August 2023,GPs were selected from some community healthcare centers in Shanghai and their willingness to enhance working competence were studied by a questionnaire survey.The survey included 39 secondary indicators in three dimensions:general practice theory,skills,and humanity. Results A total of 1 192 GPs completed the questionnaire,with an effective rate of 100%.The total score of GPs' willingness to enhance their working competence was 258.45±80.93,and the mean score of the three dimensions was 6.63±2.08.The score for the general practice theory was the highest (6.92±1.95),while that for general practice humanity was the lowest (6.44±2.34) among the three dimensions.The score of willingness to enhance working efficiency differed across different age ranges (P<0.001),professional titles (P<0.001),years of work (P<0.001),and educational backgrounds of GPs (P=0.039).Those with the age younger than 30 years old,junior professional titles,less than 5 years of work experience,and a college degree or below had the highest willingness score to enhance their working competence.Among the top three secondary indicators of willingness score in each dimension,the top three methods of working competence enhancement were community general practice and specialized healthcare services combined with outpatient learning,flexible further training,and continuing education courses.Conclusions There is an urgent need for young GPs in community healthcare centers in Shanghai to enhance their working competence.Targeted enhancement plans can be provided to different groups of GPs with different characteristics through community general practice and specialized healthcare services combined with outpatient learning,flexible further training,and continuing education courses,which can further enhance the ability and quality of the GP team.
Humans ; China ; General Practitioners/psychology* ; Surveys and Questionnaires ; Community Health Centers ; Clinical Competence ; Female ; Adult ; Male ; Attitude of Health Personnel ; Middle Aged

OBJECTIVES: To study the epidemiological characteristics of respiratory syncytial virus (RSV) infection in hospitalized children with community-acquired pneumonia (CAP) in Hebei Province. METHODS: Hospitalized children with CAP who tested positive for RSV and were admitted to Hebei Children's Hospital from various cities and counties across Hebei Province between January 2019 and December 2023 were included in the study. Clinical data were collected and analyzed to assess epidemiological characteristics. RESULTS: The clinical data of 43 978 children with CAP were collected, with an overall RSV detection rate of 25.98%. The detection rate was higher during the implementation of non-pharmaceutical interventions (NPIs) (30.60%) than in the non-NPIs period. Winter and spring were the primary epidemic seasons for RSV each year except in 2022. The detection rate in males (26.62%) was higher than in females (25.06%) (P<0.001). The highest detection rate (59.18%) was found in infants aged 29 days to <1 year. Single RSV infection was more common, with rhinovirus being the most frequent co-infection. CONCLUSIONS The overall RSV detection rate in Hebei Province is influenced by NPIs, being higher during their implementation. RSV predominantly circulates in winter and spring. The detection rate of RSV is higher in males and infants. RSV infection is primarily single, most often co-occurring with rhinovirus.
Humans ; Respiratory Syncytial Virus Infections/epidemiology* ; Female ; Male ; Infant ; Child, Preschool ; Seasons ; China/epidemiology* ; Infant, Newborn ; Community-Acquired Infections/epidemiology* ; Child

BACKGROUND AND OBJECTIVE

Community-based rehabilitation (CBR) represents a multifaceted social intervention designed to tackle issues related to access, equity, and service quality. Within the framework of CBR, participation stands as a pivotal principle, albeit one that frequently goes unnoticed, particularly concerning children with disabilities. Consequently, this realist synthesis embarks on an exploration of the present landscape, participation mechanisms, and resulting outcomes within CBR initiatives tailored for children with disabilities in low and low-middle-income countries.

The realist approach is utilized to explain the causal mechanisms and explore the context, mechanism, and outcome of participation in CBR programs. A systematic search was conducted across ten databases up to April 2021. Studies were included if they involved children with disabilities aged 17 years and below, were implemented in World Bank-classified low-income or low-middle-income countries, discussed implementation mechanisms and community participation, and described outcomes. No language restrictions or publication type limitations were applied. The search process employed double screening of title, abstract, and full-text levels, followed by a snowballing technique. Quality assessment followed the RAMESES standards for realist reviews. Data extraction and analysis yielded context-mechanism-outcome configurations.

Thirteen articles were included in the synthesis, from which three context-mechanism-outcome configurations were identified: (1) family-facilitated intervention through training in the immediate environment of children with disabilities leads to knowledge translation of caregivers, (2) inaccessible healthcare services require establishing a referral system and augmenting human resource to ensure the system’s capacity to accommodate the magnified need, and (3) established collaboration of researcher, professionals, and community with stakeholder involvement in the CBR management leads to program adoption and documented effectiveness. Both training and establishing referral systems as implementation mechanisms pose sustainability challenges due to dependency on funding. Overall, participation as a form of agency is more often an implied concept. Training is a common mechanism of implementation, where women play a critical role as proxies of children with disabilities, being their caregivers and advocates. Positive and negative outcomes focus on the condition of children with disabilities and the trainees’ knowledge and awareness.

A critical analysis of children's and community's participation in the context, mechanism, and outcome unravels the non-participation of children with disabilities and tokenism of the community stakeholders in the CBR programs. Maximizing the contribution of children with disabilities and community stakeholders is called for, aligned with the ladder of participation, toward their democratic participation. Study limitations include the paucity of published CBR programs reporting participation mechanisms in low and low-middle-income countries and the exclusion of studies from economically disadvantaged communities in high-income countries.

BACKGROUND

LGBTQ+ populations worldwide bear a disproportionate burden of health disparities aggravated by stigma and discrimination in healthcare. This struggle is worsened in the Philippines due to systemic barriers, outdated medical curricula, and the pervasive stigma in society, making it harder for LGBTQ+ individuals to access healthcare.

A community-based participatory research (CBPR) approach using the photovoice method was used to describe and co-construct perspectives from LGBTQ+ individuals related to healthcare access in the Philippine healthcare system. The LGBTQ+ participants who resided in Metro Manila were asked to capture photographs representing their healthcare experiences. Focused group discussions (FGD) were then utilized as a platform for collective discussions and interpretations of these photos, enabling the participants to voice their stories and views about healthcare access.

The results are represented in seven photographs, symbolizing seven key themes that are illustrative of the importance of narrating LGBTQ+ stories in healthcare, solidarity among the community for better access, the urgent need for a call to make healthcare spaces inclusive, navigation through intersecting identities, interaction between healthcare professionals and LGBTQ+ individuals, the call for systemic change to be fitted to the needs of LGBTQ+ people, and diverse healthcare challenges among transgender people.

The findings point to the strong call for systemic reforms in the Philippine healthcare system to better support the needs of LGBTQ+ people. This study highly recommends that lived experiences should be included in health practices and policies as a basis for inclusivity and equity.

Human ; Residence Characteristics ; Community

BACKGROUND AND OBJECTIVE

Within a decentralized health system, barangay health workers (BHWs) are often the first point of contact for Filipinos seeking care. Despite their importance, BHWs are neglected in the health value chain. The study seeks to examine the lived experiences of BHWs, particularly their journey in navigating their roles within the community and the health system that encompasses their day-to-day realities, challenges, motivations, and the meanings they derive from their work.

The study draws on seven focus group discussions (FGDs) with BHWs (n=50), residents (n=7), and local government officials and health workers (n=7) of San Miguel, Bulacan. The qualitative data collected were analyzed using thematic analysis.

Findings show that BHWs perform many roles, which are not limited to health and are dependent on orders from their superiors. Guidelines are vague in appointing BHWs, with personal connections valued more than technical qualifications. Their accreditation is hardly conferred any significance. There is also a lack of formal and structured training. The informality of these processes leads to an absence of quality assurance on rendered health services. The non-provision of incentives and benefits stipulated in RA 7883 also places their health and lives at risk. Furthermore, BHW’s commitment to serve is used to excuse the inadequacy of their compensation and excessive workload.

BHWs take on diverse roles, from community organizers to healthcare providers, and are confronted with significant challenges encompassing politicization, inadequate training, and insufficient compensation. The study concludes with policy recommendations to improve the conditions of the neglected BHWs, with particular attention to coordinating, capacitating, compensating, career pathing, and connecting them to the health system.

BACKGROUND

Community Health Workers (CHWs) play a vital role in addressing community healthcare needs, yet little is known about their psychosocial status and job satisfaction. This study aimed to describe the psychosocial status and job satisfaction of CHWs, and examine the factors associated with their job satisfaction.

A cross-sectional study was conducted among 440 CHWs aged 25-60 years working in urban and rural areas of Batangas, Philippines. Linear regression models were used to examine the association between psychosocial factors and job satisfaction. Other factors associated with job satisfaction were also examined.

Despite 90.0% of CHWs reporting high perceived stress and 52.1% experiencing high depressive symptoms, they demonstrated relatively high job satisfaction (mean [standard deviation]= 80.05 [17.56]; range= 0-100) and high perceived social support (mean [standard deviation]= 25.09 [2.93]; range= 10-30). Among psychosocial factors, only perceived social support was associated with job satisfaction (unstandardized beta [B] 0.93; 95% confidence interval [CI] 0.44, 1.41). Other factors associated with job satisfaction include fixed working hours (B 4.71; 95% CI 0.49, 8.94), work amenities (B 7.37; 95% Cl 0.03, 14.72), ≥21 years of work experience (B 5.64; 95% CI 0.35, 10.93), and working in rural areas (B 5.88; 95% CI 2.77, 8.99).

Psychological factors such as perceived stress and depressive symptoms were not found to be associated with job satisfaction among CHWs. However, factors such as greater perceived social support, fixed working hours, work amenities, longer work experience, and working in rural areas were identified as contributors to higher levels of job satisfaction among CHWs.

BACKGROUND

Worldwide, the WHO showed that stroke is the second leading cause of death for people above 60, and 5th among the aged 15 to 59 population. In the Philippines, statistics revealed that 500,000 Filipinos suffer from stroke annually. Although preventive efforts have brought about a steady decline in incidence over the last several years, stroke is still the third leading cause of death. Baguio-Benguet Chapter notes a rise in the number of stroke patients affecting both adult and younger age groups. The increasing cases of lifestyle diseases predispose people to stroke. Stroke prevention, management, and rehabilitation are essential in bringing back the normal functioning of stroke patients. Care for stroke clients is a challenging task because of the varied knowledge, practices, and attitudes (KAP) fostering the needs of a stroke client. In the Philippines, family members of the stroke client are more likely to be the preferred caregivers.

The study determined the knowledge, attitudes, and practices of the community members and the community resources on stroke prevention, management, and rehabilitation as a basis for program development.

This study utilized a mixed research design. Data were gathered from 275 residents of Camp 4, Tuba, Benguet using a structured questionnaire, and 10 FGD Groups. Frequency, percentage, and mean computations were done to analyze quantitative data, whereas descriptive analysis was done for qualitative data.

The majority of the respondents (76%) knew that stroke happens due to insufficient blood supply to the brain. Generally, the community agreed about their attitude on the prevention (2.89), management (2.68), and rehabilitation (2.75) of stroke. The community sometimes practices stroke prevention (3.17), management (2.83), and rehabilitation (2.92). Qualitative data revealed that experiences on stroke resulted in scientific knowledge, evidence-based practices, and utilization of existing resources that include personnel, infrastructure, and programs for stroke prevention, management, and rehabilitation.

The experience, social support, and maximized utilization of existing community resources have assisted the knowledge acquisition, favorable attitudes, and safe practices of the community on stroke.