Suchergebnisse

Background In the context of a growing appreciation for the wellbeing of the health workforce as the foundation of high-quality, sustainable health systems, this paper presents findings from two complementary studies to explore occupational stress and professional quality of life among health workers that were conducted in preparation for a task-shifting intervention to improve antenatal mental health services in Cape Town. Methods This mixed-methods, cross-sectional study was conducted in public sector Midwife Obstetric Units and associated Non-Profit Organisations in Cape Town. Semi-structured interviews and a quantitative survey were conducted among facility-and community-based professional and lay health workers. The survey included demographic as well as effort–reward imbalance (ERI) and professional quality of life (PROQOL) questionnaires to examine overall levels of work-related psychosocial stress and professional quality of life, as well as differences between lay and professional health workers. Qualitative data was analysed using a thematic content analysis approach. Quantitative data was analysed using STATA 12. Results Findings from 37 qualitative interviews highlighted the difficult working conditions and often limited reward and support structures experienced by health workers. Corroborating these findings, our quantitative survey of 165 professional and lay health workers revealed that most health workers experienced a mismatch between efforts spent and rewards gained at work (61.1% of professional and 70.2% of lay health workers; p = 0.302). There were few statistically significant differences in ERI and PROQOL scores between professional and lay health workers. Although Compassion Satisfaction was high for all health worker groups, lay health workers also showed elevated levels of burnout and compassion fatigue, with community-based health workers particularly affected. Conclusions Findings of this study add to the existing evidence base on adverse working conditions faced by South African public-sector health workers that should be taken into consideration as national and local governments seek to 're-engineer' South Africa's Primary Health Care system. Furthermore, they also highlight the importance of taking into consideration the wellbeing of health workers themselves to develop interventions that can sustainably foster resilient and high-quality health systems.

Abstract. The Faroe Islands in the North Atlantic Ocean are highly susceptible to landslides. Following recent landslide incidents, Jarðfeingi (Faroese Earth and Energy Directorate) has pointed out, that the risk of human lives or of property being lost or affected by landslides may be increasing. This paper aims at presenting and testing a simple qualitative approach for mapping regional landslide susceptibility in the Faroe Islands, using few key parameters. The susceptibility model holds information about both landslide initiation areas and runout zones. Landslide initiation areas are determined from slope angle thresholds (25°–40°) and soil cover data, while runout zones are delineated using the angle of reach approach taking into account the presence/absence of geological benches in the runout path, which has not been considered in earlier studies. Data input is obtained from a landslide database containing 67 debris flows throughout the Faroe Islands. Angle of reach values differ significantly with the presence/absence of geological benches in the runout path. Two values of angle of reach, 21.5° and 27.6°, are used for calculating runout zones. The landslide susceptibility model is tested in a study area at the town of Klaksvík in the northern part of the Faroe Islands. A map validation comparing predicted susceptibility zones with a validation-dataset of 87 actual landslides in the study area reveal that 69% and 92%, respectively, of actual landslide initiation areas and runout zones are correctly predicted. Moreover 87% of the actual landslides are included in the overall predicted landslide susceptibility areas.

Abstract. Background: Health services in Europe face the challenge of delivering care to a heterogeneous group of irregular migrants (IM). There is little empirical evidence on how health professionals cope with this challenge. This study explores the experiences of health professionals providing care to IM in three types of health care service across 16 European countries. Results: Semi-structured interviews were conducted with health professionals in 144 primary care services, 48 mental health services, and 48 Accident & Emergency departments (total n = 240). Although legal health care entitlement for IM varies across countries, health professionals reported facing similar issues when caring for IM. These issues include access problems, limited communication, and associated legal complications. Differences in the experiences with IM across the three types of services were also explored. Respondents from Accident & Emergency departments reported less of a difference between the care for IM patients and patients in a regular situation than did respondents from primary care and mental health services. Primary care services and mental health services were more concerned with language barriers than Accident & Emergency departments. Notifying the authorities was an uncommon practice, even in countries where health professionals are required to do this. Conclusions: The needs of IM patients and the values of the staff appear to be as important as the national legal framework, with staff in different European countries adopting a similar pragmatic approach to delivering health care to IM. While legislation might help to improve health care for IM, more appropriate organisation and local flexibility are equally important, especially for improving access and care pathways. © 2012 Dauvrin et al; licensee BioMed Central Ltd.