Community-Based Surveillance: Knowledge and skills of Community Health Workers in epidemics setting in Ganjuwa LGA, Nigeria.

INTRODUCTION: Community-based surveillance (CBS) is essential for early detection and prompt response to epidemic-prone diseases (EPD). Community Health Workers (CHWs), trained in basic healthcare services, can play a vital role in this process. Like many Local government Areas (LGA) in Nigeria, between January and September 2023, Ganjuwa LGA in Bauchi state was facing a simultaneous outbreak of measles, pertussis, Diphtheria, and Lassa Fever. METHODS: Descriptive cross-sectional study among the CHWs in the Ganjuwa LGA to assess their knowledge and skills in CBS of EPD by using a questionnaire. Exhaustive sampling of CHWs implicated in CBS in Ganjuwa LGA and who gave verbal consent were included. Stata 16.0 software was used for analysis. The final score of knowledge of CHWs on CBS was calculated with the rate of the total best answers given by the CHWs based on five questions fixed. RESULTS: The study enrolled 71 CHWs with a majority being male (61.97%) and an average age of 27 years. The education level of the CHWs varied, with 61.97% having completed secondary school, 29.58% having a university education, and 8.45% having completed primary school. In terms of experience, the majority of CHWs had 1 year of experience (73.24%), followed by 2 years (15.49%). The findings revealed that only a small percentage of CHWs (23.94%) recognized that Ganjuwa LGA was affected by four outbreaks, and 35.21% were aware that EPD could be transmitted through various means in communities. The overall knowledge score of the CHWs was relatively low, with a mean score of 0.4 (ranging from 0 to 1). Most CHWs had a score of 0.2, while only 5.63% achieved a score of 1. On the positive side, a significant majority of CHWs felt comfortable conducting home visits to identify suspected cases of EPD (76.06%) and expressed confidence in their ability to educate community members about disease surveillance and reporting (71.83%). Additionally, a majority of CHWs were familiar with the process of collecting and recording data related to EPD at the community level (64.79%). Most CHWs also expressed willingness to undergo additional training to improve their knowledge and skills in CBS (64.79%) and reported working well with local health facilities and authorities for information sharing and collaboration on disease surveillance efforts (73.24%). CONCLUSION: Overall, these findings highlight both strengths and areas for improvement in the knowledge, skills, and attitudes of CHWs regarding disease surveillance and reporting in the community. Targeted training interventions can help address the gaps identified and further enhance the effectiveness of CHWs in their roles.

Knowledge, attitudes, and practices of violence in hospitals: the case of users of the reception and emergency service of the Ebolowa Regional Hospital.

INTRODUCTION: The phenomena of incivility and violence are increasingly recurrent within health facilities in Cameroon. This study examines the knowledge, attitudes, and practices of violence by users in the reception and emergency departments of the Ebolowa Regional Hospital (ERH). METHODS: This was a qualitative study of a non-random sample of users encountered in the reception and emergency department at the ERH in southern Cameroon. The principle of saturation was used to determine the sample size. An interview guide was used to collect the data. Demographic data were analyzed by EPI Info 7 and qualitative data by thematic analysis. RESULTS: Acts of violence in hospitals are perceived as the use of intense and brutal force that affects the physical and/or moral integrity of others. The forms of violence cited include physical, moral, verbal, and psychological violence. The most frequently cited reasons for the violence were: negligence, the insolence of the nurse, abandonment of the patient without care or information, care not explained and not mentioned in the care booklet, lack of speed in care, insufficient communication about the illness of a relative and ineffective care despite the patient's fatigue. According to the participants, the circumstances that could lead individuals to do violence to nursing staff on duty include theft of medicines, contempt, rudeness, negligence in care, late care, abandonment of patients and poor hospital hygiene, refusal to answer questions, deception or professional incompetence, lack of welcome, attempts to extort or overcharge for prescriptions, and swindling and adultery. The consequences of violence mentioned in the responses mainly included: fighting, injuries, as well as staff reluctance, low hospital attendance, self-medication, and loss of life. Most respondents did not know or had no idea about legal sanctions after an act of violence, but one response mentioned the existence of sanctions such as police custody and blame. CONCLUSION: Violence in hospitals is a major problem that can have serious consequences for patients, health care staff, and the health care system. The reasons given for the violence highlight the importance of clear and effective communication between patients and healthcare staff, as well as prompt and quality medical care.