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1.
s.l; MOH; dez. 2013. 45 p. tab, graf.
Não convencional em Inglês | LILACS, Repositório RHS, MedCarib | ID: biblio-875961

RESUMO

INTRODUCTION: The terms of reference required, inter alia, an analysis of the dynamics of the formation of health professionals in Belize, including available information on the immigration and emigration of these personnel into Belize and the resultant impact on HRH production, deployment, absorption, retention, performance and motivation. METHODS: To undertake the study, it was initially required to focus on the existing clinical science training institutions locally to obtain completion rates for health care professionals, the costs of training, the systems for certification of these professionals and issues regarding migration as a prime determinant of the existing stock of these health care professionals. Acknowledging that there are multiple categories of health care workers, the study focused mainly on nurses and doctors. The former are trained locally at the University of Belize in Belmopan, where after a four year course of study conservatively costing some $20,000 and sitting a regional examination, a student qualifies to practice as a nurse in Belize. Being a national university in receipt of a government subsidy that forms the single largest component of its budget, UB's student fees are deliberately maintained at below market costs. These costs exclude ancillary costs related to academia, such as boarding and lodging, which are substantially more market determined, and when included, costs are easily doubledthe various school fees. Doctors are not trained at UB, though Government does provide scholarships for locals to study medicine at the University of the West Indies, a regional institution also supported by GOB due to its membership in CARICOM. Globally, the market for health professionals is fluid, unregulated and largely undocumented, and Belize is impacted by its fluidity. Belizeans have a long history of emigrating mainly to the USA and while it is believed that health professionals have been among the migrants, there is a paucity of data in this regard. For these professionals immigrating into Belize though, a CSME Skills Certificate must be sought if the person is from any CSME country and if not, then a work permit must be sought. CONCLUSIONS: Most recent data from the Labour Department indicate that various categories of health professionals from as many as twelve countries spanning four continents are an integral component of Belize's existing health workforce. The reasons for the migration of health professionals continue to be many and varied, and there is an active and targeted recruitment programme in the USA. While the migration of these professionals must be regarded as a loss of much needed and scarce human resources in health, there are some positives. Capacity strengthening canoccur as the local health system can be enhanced by partnerships that contribute in specific areas, for example the DangrigaCancer Centre is owned and operated by a Belizean doctor who practices in the USA and occasionally brings fellow specialists to provide treatment services at minimal costs. Acknowledging though that health workers have an inherent right to migrate, the Government of Belize is advised to adopt the WHO's 2010 Code of Practice on the International Recruitment of Health Personnel. The Code of Practice seeks to regulate the migration of health personnel in a way that mitigates the damage to developing countries such as Belize. Other main recommendations focus on increasing the production of HRH. This can be accomplished via the provision of bursaries to students in these areas. Retention strategies are also required to provide pathways for these health professionals. Also being recommended is technical assistance to the Ministry of Health, the Belize Medical and Dental Council and the Nurses and Midwives Council to strengthen the regulatory framework so that they are all able to better keep abreast in tracking their members. At the present time, should a nurse or a doctor leave public employment, the Ministry of Health is not mandated to inform the respective council. Under a strengthened regulatory framework, this would be mandatory. Also mandatory would be the health professional informing in writing the respective council of any changes to his/her employment status or location of employment. This would greatly assist in tracking private doctors and nurses as they relocate to other areas of the country as well as if they migrate abroad. Finally, given Belize's focus on a primary health care model as the basis of its health care system, some consideration ought to be given to further strengthening of the Community Health Workers. These health volunteers are at the base of the local health system and are the most widely dispersed health worker. Consideration is justified because these unheralded workers are most unlikely to migrate since destination countries are selective in their recruitment efforts and exclusively require credentialed professionals as migrants. (AU)


Assuntos
Desenvolvimento de Pessoal/economia , Mão de Obra em Saúde/economia , Certificação/economia , Certificação/normas , Pessoal de Saúde/legislação & jurisprudência , Emigração e Imigração , Gestão de Recursos Humanos , Mão de Obra em Saúde/organização & administração
2.
BMC public health ; 10(185): [1-24], Apr. 2010. tab
Artigo em Inglês | MedCarib | ID: med-17708

RESUMO

BACKGROUND: The Ministry of Health (hereafter, Ministry) of Trinidad and Tobago is responsible for delivery of all health services in the country. The Ministry takes responsibility for direct delivery of care in the public sector and has initiated a process whereby those seeking HIV test results could obtain confidential reports during a single-visit to a testing location. The Ministry requested technical assistance with this process from the Caribbean Epidemiology Centre (CAREC). The United States Centers for Disease Control and Prevention (CDC) played an important role in this process through its partnership with CAREC. METHODS: Under the technical guidance of CAREC and CDC, the Ministry organized a technical working group which included representatives from key national HIV program services and technical assistance partners. This working group reviewed internationally-recognized best practices for HIV rapid testing and proposed a program that could be integrated into the national HIV programs of Trinidad and Tobago. The working group wrote a consensus protocol, defined certification criteria, prepared training materials and oversaw implementation of "same-visit" HIV testing at two pilot sites. RESULTS: A Ministry-of-Health-supported program of "same-visit" HIV testing has been established in Trinidad and Tobago. This program provides confidential testing that is independent of laboratory confirmation. The program allows clients who want to know their HIV status to obtain this information during a single-visit to a testing location. Testers who are certified to provide testing on behalf of the Ministry are also counselors. Non-laboratory personnel have been trained to provide HIV testing in non-laboratory locations. The program includes procedures to assure uniform quality of testing across multiple testing sites. Several procedural and training documents were developed during implementation of this program. This report contains links to those documents. CONCLUSIONS: The Ministry of Health has implemented a program of "same-visit" HIV testing in Trinidad and Tobago. This program provides clients confidential HIV test reports during a single visit to a testing location. The program is staffed by non-laboratory personnel who are trained to provide both testing and counseling in decentralized (non-laboratory) settings. This approach may serve as a model for other small countries.


Assuntos
Humanos , Masculino , Feminino , Sorodiagnóstico da AIDS , Certificação , Protocolos Clínicos/normas , Infecções por HIV/diagnóstico , Pessoal de Saúde/educação , Implementação de Plano de Saúde/métodos , Política de Saúde , Visita a Consultório Médico , Desenvolvimento de Programas , Materiais de Ensino , Trinidad e Tobago , Estados Unidos
3.
Rev. panam. salud p£blica ; 18(2): 114-121, August 2005. tab
Artigo em Inglês | MedCarib | ID: med-17279

RESUMO

OBJECTIVE: To determine the prevalence of experiences with physical violence and psychological violence that health staff have had in the workplace in Jamaica, and to identify factors associated with those experiences of violence. DESIGN and METHODS: A total of 832 health staff answered the standardized questionnaire that was used in this cross-sectional study. Sampling was done at public facilities, including specialist, tertiary, and secondary hospitals in the Kingston Metropolitan Area; general hospitals in the rural parishes; and primary care centers in urban and rural areas. Sampling was also done in private hospitals and private medical centers. RESULTS: Psychological violence was more prevalent than was physical violence. Verbal abuse had been experienced in the preceding year by 38.6 percent of the questionnaire respondents, bullying was reported by 12.4 percent, and physical violence was reported by 7.7 percent. In multivariate analyses there was a lower risk of physical violence for health staff who were 55 years or older, worked during the night, or worked mostly with mentally disabled patients, geriatric patients or HIV/AIDS patients. Staff members working mostly with psychiatric patients faced a higher risk of physical assaults than did other health staff. Of the various health occupations, nurses were the ones most likely to be verbally abused. In terms of age ranges, bullying was more commonly experieced by health staff 40-54 years old. CONCLUSIONS: Violence in the health sector workplace in Jamaica is an occupational hazard that is of public health concern. Evaluation of the environment that creates risks for violence is necessary to guide the formulation of meaningful interventions for the country (AU)


Assuntos
Humanos , Adulto , Local de Trabalho/normas , Pessoal de Saúde , Violência/tendências , Ferimentos e Lesões/psicologia , Estresse Psicológico/complicações , Estresse Psicológico/diagnóstico , Estresse Psicológico/prevenção & controle , Saúde Ocupacional , Jamaica , Região do Caribe
4.
Rev. panam. salud p£blica ; 18(2): 114-121, Aug. 2005. tab
Artigo em Inglês | MedCarib | ID: med-17315

RESUMO

OBJECTIVE: To determine the prevalence of experiences with physical violence and psychological violence that health staff had in the workplace in Jamaica, and to identify factors associated with those experiences of violence. DESIGN AND METHODS: A total of 832 health staff answered the standardized questionnaire that was used in this cross-sectional study. Sampling was done at public facilities, including specialist, tertiary, and secondary hospitals in the Kingston Metropolitan Area; general hospitals in the rural parishes; and primary care centres in urban and rural areas. Sampling was also done in private hospitals and private medical centres. RESULTS: Psychological violence was more prevalant than was physical violence. Verbal abuse has been experienced in the prceeding year by 38.6 percent of the questionnaire respondents, bullying was reported by 12.4 percent, and physical violence was reported by 7.7 percent. In multivariate analyses there was a lower risk of physical violence for health staff who were 55 years or older, worked during the night, or worked mostly with mentally disbled patients, geriatric patients, or HIV/AIDS patients. Staff members working mostly with psychiatric patients faced a higher risk of physical assaults that did other health staff. Of the various health occupations, nurses were the ones mostly likely to be verbally abused. In terms of age ranges, bullying was more commonly experienced by health staff 40-54 years old. CONCLUSION: Violence in the health sector workplace in Jamaica is an occupational hazard that is of public health concern. Evaluation of the environment that creates risks for violence is necessary to guide the formulation of meaningful interventions for the country(AU)


Assuntos
Humanos , Local de Trabalho , Pessoal de Saúde , Violência/tendências , Jamaica , Ferimentos e Lesões , Estresse Fisiológico , Região do Caribe , Saúde Ocupacional , Países em Desenvolvimento
5.
Mount Hope; The University of the West Indies, Faculty of Medical Sciences; 2001. 11 p.
Monografia em Inglês | MedCarib | ID: med-16239

RESUMO

In this paper, a critical review has been undertaken of recent scientific and clinical studies which describe a variety of herbal medicinal preparations. An evaluation also has been made of reports describing the knowledge, attitudes and practices of healthcare professionals towards herbal medicine. The findings have been translated into suggestions intended to encourage, and, to enable healthcare professionals to raise their awareness, and, to improve their knowledge of the established limitations and benefits of the various formulations of herbal medicinal products in current use (AU)


Assuntos
Humanos , Trinidad e Tobago , Plantas Medicinais/efeitos dos fármacos , Região do Caribe , Medicina Herbária , Pessoal de Saúde , Países em Desenvolvimento
7.
West Indian med. j ; 48(Suppl. 1): 18, Mar. 7, 1999.
Artigo em Inglês | MedCarib | ID: med-1259

RESUMO

The World Health Organisation defines health as a state of complete physical, mental and social well-bing, not merely the absence of disease and infirmity. Health education is any combination of learning experiences designed to facilitate voluntary adaptations or behaviour, or to sustain behaviour conducive to health. A health educator is an individual who facilities any planned combination of learning experiences designed to predispose, enable, and reinforce voluntary behaviour conducive to health in individuals, groups and communities. Misconceptions about health and diabetes education abound the health educator has to work to dispel the myths. Some of these myths are: *Health education is simply a transfer of knowledge, *Healthcare providers who teach patients are automatically effective educators, *Health educators are the experts and the patient is completely ignorant of his or her condition, *If a comprehensive health education programme is provided, patients will come because it is in their best interests. In providing individual, group or community helath education the health educator should first assess clinical needs as they related to health, financial resources, behaviours, health beliefs, cultural needs, knowledge levels, intellectual capabilities and support systems available. Thereafter, the process involves planning by developing objectives and strategies for implementation. Finally, the health educator must evaluate the work done, choosing appropriate instruments, interpreting results and measuring outcomes.(AU)


Assuntos
Humanos , Pessoal de Saúde/tendências , Educação em Saúde , Educação de Pacientes como Assunto
8.
Bull World Health Organ ; 77(4): 356-60, 1999. tab
Artigo em Inglês | MedCarib | ID: med-833

RESUMO

This paper endeavours to identify the background characteristics of health centre users in Trinidad and Tobago and their perceptions of the efficiency of the services provided. Multistage sampling was employed to select 1451 users. Data were obtained during structured interviews on regular clinic days. Of the people using health centres 80.4 percent were unemployed and 75.9 percent were women. People aged over 60 accounted for 25.4 percent of the sample. Users included a disproportionately high number of persons from the lower socioeconomic categories. The proportions of person of different ethnic and religious groups closely reflected those in the country's general population. Approximately 74 percent of the interviewees were satisfied with the performance of the doctors in the health centres. For nurses the satisfaction ratings was about 10 percent higher. The greatest needs for improvement were perceived to be in pharmacists' and doctors' services with particular reference to waiting times.(AU)


Assuntos
Adulto , Pessoa de Meia-Idade , Idoso , Feminino , Humanos , Masculino , Adolescente , Satisfação do Paciente , Determinação de Necessidades de Cuidados de Saúde , Pessoal de Saúde , Atenção Primária à Saúde/normas , Trinidad e Tobago , Coleta de Dados , Percepção
9.
Bull World Health Organ ; 77(4): 356-60, 1999.
Artigo em Inglês | MedCarib | ID: med-1330

RESUMO

This paper endeavours to identify the background characteristics of health centre users in Trinidad and Tobago and their perceptions of the efficiency of the services provided. Multistage sampling was employed to select 1451 users. Data were obtained during structured interviews on regular clinic days. Of the people using the health centres, 80.4 percent were unemployed and 75.9 percent were women. People aged over 60 accounted for 25.4 percent of the sample. Users included a disproportionately high number of persons from the lower socioeconomic categories. The proportions of persons of different ethnic and religious groups closely reflected those in the country's general population. Approximately 74 percent of the interviewees were satisfied with the performance of the doctors in the health centres. For nurses the satisfaction rating was about 10 percent higher. The greatest needs for improvement were perceived to be in pharmacists' and doctors' services, with particular reference to waiting times.(Au)


Assuntos
Adulto , Pessoa de Meia-Idade , Feminino , Humanos , Masculino , Pessoal de Saúde/normas , Satisfação do Paciente/estatística & dados numéricos , Atenção Primária à Saúde/normas , Eficiência Organizacional , Emprego/estatística & dados numéricos , Pesquisa sobre Serviços de Saúde , Determinação de Necessidades de Cuidados de Saúde , Inquéritos e Questionários , Fatores Socioeconômicos , Trinidad e Tobago
10.
Kingston; s.n; 1999. v,55 p. tab.
Tese em Inglês | MedCarib | ID: med-1159

RESUMO

Child sexual abuse is a significant public health problem. Health care and social welfare professionals play a crucial role in the care and protection of children who have been abused. However several factors influence their duty. The aim of this study was to investigate the influence of personal experiences of childhood, training and job experiences of childhood, training and job experiences and demographic factors on the knowledge, attitude and practice of professionals who investigate cases of child sexual abuse. It consisted of a cross-sectional comparative study , designed to describe and to compare three groups of professionals within the Corporate Area of Kingston and St. Andrew who are attached to public institutions that offer immediate and long-term services to sexually abused children. The results showed that there were significant relationships between personal experiences of childhood, training and job experience and the knowledge level of the professionals. The professionals who were victims of childhood sexual abuse themselves demonstrated superior behaviour in all three parameters of knowledge, attitude and practice. Furthermore, those who acknowledged these experiences had superior scores compared to those who minimized their experiences. Although the medical doctors demonstrated superior knowledge scores the social workers had better attitude scores and the police officers the best practice scores. The high prevalence (68 percent) of childhood sexual abuse among this group of professionals further supports the social importance of this problem. These findings are interesting as they represent a positive outcome from an extremely negative situation. It allows public health authorities an opportunity to develop and implement services that not only attempt to treat acute situations but recognize and promote optimum health in care-givers. This study sheds light on the need for an integrated approach encompassing not only knowledge but also attitude and practice in the training of health care and social welfare professionals. It can be concluded also that further interaction among the various groups of professionals should have a positive influence on behaviour.(Au)


Assuntos
Pessoa de Meia-Idade , Feminino , Humanos , Masculino , Adulto , Estudo Comparativo , Idoso , Abuso Sexual na Infância/etnologia , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/educação , Estudos Transversais , Jamaica/etnologia
13.
West Indian med. j ; 47(Suppl. 4): 31-3, Dec. 1998.
Artigo em Inglês | MedCarib | ID: med-1290

RESUMO

Mental health is increasingly being recognised as contributing significantly to the burden of disease, particularly now that the indicators have shifted from measures of mortality to measures of morbidity. Psychiatric morbidity in the community, based on community surveys, is estimated at 20 to 30 percent of the population. Increasingly, patients needing health services prefer to be in a general health care setting than in specialized centres. Internationally and regionally, the general policy has been to move toward the development of comprehensive mental health programmes integrated within primary health care. This integration may be structural (use of shared facilities), administrative (shared administrative resources) or functional (complete integration of clinical services, with staff jointly responsible for patient welfare). This paper examines how this integration can be achieved, and the potential role of the Department of Community Health and Psychiatry, University of the West Indies in advancing this integrative process through research and training.(AU)


Assuntos
Humanos , Serviços Comunitários de Saúde Mental , Prestação Integrada de Cuidados de Saúde , Atenção Primária à Saúde , Medicina Comunitária/educação , Serviços Comunitários de Saúde Mental/organização & administração , Psiquiatria Comunitária/educação , Assistência Integral à Saúde/organização & administração , Prestação Integrada de Cuidados de Saúde/organização & administração , Instalações de Saúde , Pessoal de Saúde , Política de Saúde , Recursos em Saúde , Transtornos Mentais/epidemiologia , Atenção Primária à Saúde/organização & administração , Faculdades de Medicina , Índias Ocidentais/epidemiologia
14.
West Indian med. j ; 47(suppl. 2): 49, Apr. 1998.
Artigo em Inglês | MedCarib | ID: med-1836

RESUMO

A systematic AIDS Education Programme for health care workers in the Queen Elizabeth Hospital, Barbados, was implemented in 1992. Between February 1993 and September 1997, 33 seminars and 6 workshops were conducted in the Queen Elizabeth Hospital. Participants were drawn from all aspects of the health care team, with the greatest numbers, 57 percent being nurses. The process of selection for attendance was by nursing administration and other heads of departments who were invited to nominate participants. Priority for training was given to front line health professionals from the accident & emergency department, as the gateway to the hospital for all emergency admissions, and also to workers on the medical wards, where most AIDS patients were treated for opportunistic infections and the terminally ill cared for. The major focus of the seminars was the care and treatment of affected individuals and the prevention of transmission of HIV. However, fear characterised the concerns of participants. A review of post workshop evaluations showed a marked difference in general attitudes which would most assist participants in performing their duties in the care of HIV affected patients.(AU)


Assuntos
Humanos , Pessoal de Saúde/educação , Síndrome de Imunodeficiência Adquirida , Barbados , Estudo de Avaliação , Estudos Transversais
15.
Kingston; s.n; Sept. 7, 1998. 72 p.
Tese em Inglês | MedCarib | ID: med-1677

RESUMO

This is a cross sectional study conducted in the parish of Trelawny which investigated the knowledge and attitude of Primary Health Care (PHC) workers and care givers of schizophrenic patients towards schizophrenia, and the impact of schizophrenia on the family. The study population comprised the total population of care givers of schizophrenic patients and primary health care workers in the parish of Trelawny. Care givers numbered 84 and primary health care workers numbered 60. It was observed that the majority of care givers were females and over 50 percent were over the age of 50 years. PHC workers were all female with a wide range of working experience of under one year to over 34 years. Community Health Aides accounted for 57.7 percent of these PHC workers. On the average, knowledge and attitude of PHC workers could be regarded as fair. Knowledge of PHC workers when compared with that of care givers differed significantly but attitude scores did not. It was observed that the knowledge and attitude of PHC workers with family members affected with schizophrenia, when compared with PHC workers without, scores did not differ significantly statistically.(AU)


Assuntos
Adulto , Pessoa de Meia-Idade , Feminino , Humanos , Esquizofrenia , Cuidadores , Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Família , Agentes Comunitários de Saúde , Jamaica
16.
In. United Medical and Dental Schools of Guy's & St. Thomas' Hospitals; King's College School of Medicine & Dentistry of King's College, London; University of the West Indies. Center for Caribbean Medicine. Research day and poster display. s.l, s.n, Jun. 30, 1997. p.1.
Não convencional em Inglês | MedCarib | ID: med-785

RESUMO

One hundred and forty nine patients (35 British, 114 non-white or non-British) with at least a two year history of psychotic illness, were recruited into a project designed to compare different levels of community care interventions. At recruitment into the study patients were allocated a case manager. Twelve months after recruitment patients were asked whether they had a preference for same race case managers and same race psychiatrists. Patients were also asked whether they had a preference for same sex case managers and same sex psychiatrists. Results indicate that 25.3 percent of the white British group have a preference for same race case managers, and 25.8 percent of the non-white or non-British group have a preference for same race case manager. When the non-white or non-British group is broken down it appears that second generation African-Caribbean patients are more likely than other ethnic groups to express a preference for same race case manager (p=.046). Results also indicate that 25 percent of the non-white or non-British sample have a preference for same race psychiatrist, this however, did not reach statistical significance. Although there was a trend for patients to express a preference for female case managers, this also did not reach statistical significance. Results will be discussed in terms of implications for service provision.(AU)


Assuntos
Humanos , Satisfação do Paciente , Sexo , Transtornos Psicóticos , Pessoal de Saúde , Pessoal de Saúde , Etnicidade
18.
In. Jamaica. Ministry of Health. Bureau of Health. Adolescent Health Workshop: Presentations and Group Reports January 1997. Kingston, s.n, 1997. p.30-4.
Monografia em Inglês | MedCarib | ID: med-572
20.
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