Breastfeeding support at work: A comparison between career women in the public and private sectors in Trinidad and Tobago

OBJECTIVE: To evaluate knowledge and perceptions toward breastfeeding support at work among women in public and private sectors in Trinidad and Tobago. SUBJECTS AND METHODS: A purposive sampling design was used to select women employees from the public and private sectors. Employees were surveyed using a self administered 16-item structured questionnaire. Data were analysed using SPSS version 21. Independent t-test wasused to compare perceptions held by the public and private sectors. Pearson’s correlation was used to determine the relationship between the variables. The level of significance was set at the 0.05 level. RESULTS: The mean breastfeeding knowledge score for the participants was 2.31 ± 0.83, with the public sector employees having a mean score of 2.42 ± 0.759, which was statistically significant (p = 0.004) when compared to the private score of 2.14 ± 0.914. The mean readiness score 26to utilize breastfeeding support for the public and private sectors employees were 1.08 ± 0.482 and 1.14 ± 0.525, respectively; however, no significant difference was observed between the two groups (p = 0.294). The mean perception scores were 1.75 ± 0.985 for the public sector and 1.90 ± 0.950 for the private sector, with no significant difference between groups (p = 0.184). CONCLUSIONS: Participants had adequate breastfeeding knowledge and a positive attitude and perception toward breastfeeding at work. We recommend that an intervention programme be developed to increase the awareness of breastfeeding support at work so that employees and employers can become more aware of its purpose and benefits.

Workplace violence against medical staff in public primary healthcare facilities in Barbados

OBJECTIVE: To determine the prevalence of physical and psychological violence amongst the medical staff in the eight public polyclinics of Barbados. DESIGN AND METHODS: A cross sectional study was conducted utilising a modified version of the standard Workplace Violence Questionnaire by the World Health Organisation, designed to assess the prevalence, types and features of workplace violence. All nursing and physician staff on duty at the island’s eight polyclinics during the study period (June-July 2014) were invited to participate. Statistical analysis was performed using Epi info 7. RESULTS: Of the 102 respondents (72% response rate), a total of 63% (95% CI 53.0%-72.4%) of nursing and physician staff at the polyclinics in Barbados reported having suffered at least one incident of violence in the past 12 months. Verbal abuse was the most frequent (60%; 95% CI 50.1%- 69.7%). The one-year prevalence rates of physical violence, bullying, sexual harassment, and racial harassment were 2.9%, 18.8%, 6.9% and 2.9%, respectively. Logistic regression showed that females were more likely to experience verbal abuse than males (OR=11; 95% CI 2.8-43.1) and nurses more likely than physicians (OR=1.9; 95% CI 1.1-4.7). The client accounted for 64% of the incidents. CONCLUSIONS: More than half of all staff surveyed reported experiencing some type of violence in the past year, female gender being a significant predictor of abuse. This initial process of characterising the extent and type of violence present, can serve as a foundation for further qualitative research exploring reasons for violence experienced.

Non-communicable disease (NCD) risk factor survey 2014 among staff at one workplace in Barbados

OBJECTIVE: To investigate the prevalence of NCD risk factors at a specified workplace in Barbados. DESIGN AND METHODS: An interviewer administered questionnaire comprised of Core and some “Expanded” questions from the validated PAHO/WHO STEPS NCD Risk Factor Survey was conducted over a three-week period in June 2014 at a specified workplace. Standardized measurements were taken for height, weight, blood pressure, and hip and waist circumference. RESULTS: There was a 57.8% (70/121) response rate; 37.1% male and 62.9% female, with a mean age of 31.7 years (SD 8.0), age range 19 – 54. It was found that 95.7% of respondent staff had at least one of the identified risk factors; 76.9% of males and 54.5% of females were either overweight or obese. Most of the staff (91.4%) ate less than 5 servings of fruit and/or vegetables on average per day (88.5% males, 93.2% females). Comparison of study population with the Barbados population shows close correlations for most of the risk factors with some exceptions like binge drinking. Almost half of respondents (44.7%) (60.9% males, 29.2% females) engaged in binge drinking when compared to 25.3% and 5.4% in Barbadian males and females respectively in 2013. CONCLUSIONS: The study confirms a similar high prevalence of NCD risk factors among staff as observed among the Barbadian population. The study reveals opportunities to increase workplace health promotion and evidence-based national standards for the management of major NCDs through a primary care approach.

Non-communicable diseases risk factors survey 2014 among University of the West Indies staff, St. Augustine Campus, Trinidad & Tobago

OBJECTIVE: To determine the prevalence of NCD risk factors among University of the West Indies staff in Trinidad and Tobago. To compare these results with the country’s 2011 NCD risk factor survey. DESIGN AND METHODS: A cross sectional prevalence survey utilizing a self-administered questionnaire conducted during April-May 2014. The target population was all staff. Standardized measurements of cardiovascular fitness, weight, height and blood pressure were taken. Data was analyzed and results were compared to the national 2011 NCD survey. RESULTS: Participation was 24.9% (522/2100), 32.4% males (n=169) and 67.6% females (n=353). Among participants, 65.7% (95% CI 58.4, 72.9) of males and 64.7% (95% CI 59.6, 69.7) of females were either overweight or obese, 86.9% (95% CI 83.9, 90.0) ate <5 fruits and vegetables/day. Smoking prevalence was 13.1% (95% CI 7.9, 18.2) and 2.8% (95% CI 1.1, 4.6) for among males vs. females respectively while 39.1% and 7.6% were binge drinkers; One fifth of the participants had blood pressures >140/90, while 6.4% had blood pressures >160/100. The results were similar to the 2011 national risk factor profile. UWI staff smoked less but drank alcohol more frequently. UWI males were more obese and UWI women had higher blood pressure and higher cholesterol compared to the general Trinidad and Tobago population. CONCLUSION: The results confirmed a high prevalence of NCD risk factors among these staff as among the Trinidad and Tobago population. The study revealed opportunities to inform policy on strategies to positively impact the risk factors.

Workplace Nutrition

The importance of good nutrition is understood by most, if not all people, even those without access to scientific studies and proofs. It is widely believed, and rightly so, that poor nutrition is linked to poor academic performance, lack of energy, less favourble behaviour and poor growth in children. Studies have shown that when a child who previously did not have access to a health breakfast is regularly fed a healthy breakfast, overall performance in school improves.

Physical and psychological violence in Jamaica's health sector

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)

Physical and psychological violence in Jamaica's health sector

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)

Antigua: HIV in the workplace

The Cabinet of Antigua and Barbuda has approved a policy on HIV in the workplace. The policy states that HIV-infected employees should be treated in a positive and nondiscriminatory manner. No HIV-infected employee should be dismissed on the basis of his/her HIV status, nor should HIV testing be required as a basis for employment

Drug use and syphilis: co-factors for HIV transmission among commercial sex workers in Guyana

A cross-sectional survey was conducted among 124 street-and brothel-based female commercial sex workers (CSWs) in Georgetown in January and February 1997 to determine the seroprevalence of human immunodeficiency virus (HIV) infection and describe the sexual practices and drug use patterns. Their median age was 30 years (range 17 to 52 years). 119 (88 percent) reported regular alcohol consumption while looking for clients, 27 (22 percent) said they smoked cocaine and 51 (42 percent) reported use of marijuana. Street-based CSWs were significantly more likely to report marijuana use (p = 0.033). 72 percent reported that they never used condoms with regular sex partners and 35 percent reported that they never used condoms with clients. Brothel-based women were significantly more likely to report consistent condom use with their clients (p = 0.05). 46 percent (54/118) tested HIV positive and 28 percent (33/118) had a positive serological test for syphilis. Factors that were significantly associated with HIV infection included a positive serological test for syphilis (OR = 7.56; 95 percent CI = 2.7-21.97; p < 0.01) and a history of having received treatment for syphilis (OR = 2.93; 95 percent CI = 1.12-7.8). Weak associations were also found between HIV infection and a history of cocaine use (OR = 2.57; 95 percent CI = 0.95-7.11; p = 0.039); having more than four clients per night (OR = 5.14; 95 percent CI = 1.65-16.74; p = 0.04; and a history of receiving treatment for salpingitis (OR = 2.31; 95 percent CI = 0.93-5.75; p = 0.0035). No statistically significant association was found between HIV infection and marijuana use nor any sociodemographic variables (age, place of work, and duration of sex work). There is an urgent need for a community based behavioural intervention programme targetting this high risk population (AU)

Work site heart health promotion and practice: a pilot project of the Heart Foundation of Barbados

The workplace has long been recognised as an important setting in which to promote the practice of healthy living since most individuals spend more than one-third of their day in such situations which might be considered a "captive environment". The Heart Foundation of Barbados, aware of the significantly high prevalence of lifestyles related illnesses and the opportunities and potential for effecting positive change in the workplace, embarked on a worksite heart pilot project aimed at determining the feasibility of establishing such a programme in Barbados and determining its impact and effect on health practices of workers in the workplace and elsewhere. The study was conducted among the staff of a local professional services firm. It consisted of risk factor screening of staff members, teaching of and certification in Cardiopulmonary Resuscitation (CPR), and facilitating regular related activities. Two years after the initiation of the project an anonymous knowledge, attitudes and practice questionnaire was administered to participants. 116 (88 percent) members of staff was taught and certified in CPR, and a further 3 persons were trained and certified as CPR instructors. Anthropometric and blood pressure measurements were performed on the 116 participants. Over the two years of the project the company developed a significantly enhanced health consciousness and profile, as evidenced by the formation of a health club, active participation in national healthy lifestyles activities and the conducting of a regular related seminars, lectures and associated and related activities. Finally, among those responding to the knowledge attitudes and practices survey 60 percent of 60 participants returning completed questionnaires reported a positive change in their lifestyle as a direct result of the programme. Among 63 percent there was an enhanced personal attitude to the company. 36 participants (60 percent), reported that they would provide assistance in an emergency situation, of which 64 percent expressed confidence in doing so, and 58 percent attributed their confidence to their involvement in the programme. Preliminary results suggest that the introduction and implementation of a work site heart health promotion and practice programme is acceptable to workers in Barbados, is feasible, and results in improvement of worker health attitudes and practices.(AU)

Work, gender, and culture in the Jamaican community health aide programme

This dissertation explores the relationship among the organization of work in primary health care, the workplace culture of the Jamaican community health aides, and their domestic culture. Collected during twelve months of fieldwork in St. James parish in 1987 and 1988, the data include field notes from participant observation with community health aides, transcrips of tape recorded interviews with twenty aides, and information found in manuals and reports of the Ministry of Health and the Department of Social and Preventive Medicine at the University of the West Indies. National and international political and economic forces, the position of women in Jamaica, and contradictions in primary health care policy coverage in the Jamaican health service where they shape the organization of work in primary health care and give rise to the constraints and possibilities the community health aides find in their work. Fraught with conflicts and ambiguities, the organization of work in primary health care provides the space for, and necessitates, the workplace culture that emerges in the ideology and daily practices of the community health aides. With women predominating at every level in primary health care in Jamaica, domestic culture is a resource in the aides' response to the organization of their work and the workplace culture that emerges. Four features define the community health aides' workplace culture: 1) the aides'ability to construct an identity as mediators between the health service and the community from their marginal position in the hierarchial organization of primary health care; 2) the aides' ability to negotiate a compromise between the competing demands for staff in the health centers and community work, a compromise they turn to advantage in maintaining their claim to unique knowledge of their communities; 3) the aides' ability to cope, on the basis of their commitment to primary health care and their empathy with people, with material contradictions in their workplace; the permeability of the aides' workplace to their domestic culture which supports them in their struggle for control over their work and a better daily life while it enhances the delivery of primary health care. (AU)