Increasing and sustaining diabetic retinopathy screening in Fiji by leveraging community health workers (CHWs) services: A qualitative study
Introduction: Inequities in access to diabetic retinopathy (DR) services particularly in rural and remote Fiji is concerning. This is because DR when left undiagnosed and untreated for long, can lead to vision loss and permanent blindness. Appropriate channels must be explored to strengthen services...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-11-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844022026676 |
| _version_ | 1798014483475464192 |
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| author | Sharan Ram Masoud Mohammadnezhad Komal Ram Kirti Prasad Moneeta Pal Prarthana Dalmia |
| author_facet | Sharan Ram Masoud Mohammadnezhad Komal Ram Kirti Prasad Moneeta Pal Prarthana Dalmia |
| author_sort | Sharan Ram |
| collection | DOAJ |
| description | Introduction: Inequities in access to diabetic retinopathy (DR) services particularly in rural and remote Fiji is concerning. This is because DR when left undiagnosed and untreated for long, can lead to vision loss and permanent blindness. Appropriate channels must be explored to strengthen services and ensure equitable access to healthcare for everyone. This study describes the development and implementation of DR awareness training for community health workers (CHWs) and their subsequent engagement to raise awareness and scale-up DR screening for communities throughout Fiji. Materials and method: As part of a programme to reduce the incidence of avoidable blindness due to diabetes amongst people living in the Pacific, DR training for primary level nurses was developed and implemented. As these primary level nurses were already inundated by clinical duties and competing health priorities, a shifting of the task was proposed to engage the CHWs who would instead educate communities on diabetes and DR and make referrals for DR screening. A one-day DR awareness training was developed and implemented by the Pacific Eye Institute with funding from the Fred Hollows Foundation New Zealand. Results: At the end of the DR programme in 2019, the team had achieved their target and trained a total of 823 CHWs giving an 81.32% coverage of the total 1012 registered CHW in the MHMS register. Anecdotal evidence showed a spike in DR referrals and screenings recorded at health facilities. Three key themes emerged related to the involvement of CHWs which include engagement of CHWs, benefits of the engagement, and health system-related challenges. Conclusion: The use of CHWs who are already integrated into the health system was considered a sustainable intervention to strengthen diabetes and DR services at the primary level of care, particularly if it involves community awareness, health education, and health services facilitation The future of the CHWs will depend on their being integrated more systematically into local health services with strengthened management and supervision. |
| first_indexed | 2024-04-11T15:18:03Z |
| format | Article |
| id | doaj.art-497ca63ad9d7473fb32762c35aa7ad66 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-04-11T15:18:03Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-497ca63ad9d7473fb32762c35aa7ad662022-12-22T04:16:26ZengElsevierHeliyon2405-84402022-11-01811e11379Increasing and sustaining diabetic retinopathy screening in Fiji by leveraging community health workers (CHWs) services: A qualitative studySharan Ram0Masoud Mohammadnezhad1Komal Ram2Kirti Prasad3Moneeta Pal4Prarthana Dalmia5Center for Public Health Research, Massey University, Wellington, New ZealandSchool of Nursing and Healthcare, University of Bradford, Bradford, UK; Corresponding author.The Fred Hollows Foundation New Zealand, Auckland, New ZealandThe Fred Hollows Foundation New Zealand, Auckland, New ZealandThe Fred Hollows Foundation New Zealand, Auckland, New ZealandThe Fred Hollows Foundation New Zealand, Auckland, New ZealandIntroduction: Inequities in access to diabetic retinopathy (DR) services particularly in rural and remote Fiji is concerning. This is because DR when left undiagnosed and untreated for long, can lead to vision loss and permanent blindness. Appropriate channels must be explored to strengthen services and ensure equitable access to healthcare for everyone. This study describes the development and implementation of DR awareness training for community health workers (CHWs) and their subsequent engagement to raise awareness and scale-up DR screening for communities throughout Fiji. Materials and method: As part of a programme to reduce the incidence of avoidable blindness due to diabetes amongst people living in the Pacific, DR training for primary level nurses was developed and implemented. As these primary level nurses were already inundated by clinical duties and competing health priorities, a shifting of the task was proposed to engage the CHWs who would instead educate communities on diabetes and DR and make referrals for DR screening. A one-day DR awareness training was developed and implemented by the Pacific Eye Institute with funding from the Fred Hollows Foundation New Zealand. Results: At the end of the DR programme in 2019, the team had achieved their target and trained a total of 823 CHWs giving an 81.32% coverage of the total 1012 registered CHW in the MHMS register. Anecdotal evidence showed a spike in DR referrals and screenings recorded at health facilities. Three key themes emerged related to the involvement of CHWs which include engagement of CHWs, benefits of the engagement, and health system-related challenges. Conclusion: The use of CHWs who are already integrated into the health system was considered a sustainable intervention to strengthen diabetes and DR services at the primary level of care, particularly if it involves community awareness, health education, and health services facilitation The future of the CHWs will depend on their being integrated more systematically into local health services with strengthened management and supervision.http://www.sciencedirect.com/science/article/pii/S2405844022026676InequityCommunity health workersFijiDiabetic retinopathyZone nurses |
| spellingShingle | Sharan Ram Masoud Mohammadnezhad Komal Ram Kirti Prasad Moneeta Pal Prarthana Dalmia Increasing and sustaining diabetic retinopathy screening in Fiji by leveraging community health workers (CHWs) services: A qualitative study Heliyon Inequity Community health workers Fiji Diabetic retinopathy Zone nurses |
| title | Increasing and sustaining diabetic retinopathy screening in Fiji by leveraging community health workers (CHWs) services: A qualitative study |
| title_full | Increasing and sustaining diabetic retinopathy screening in Fiji by leveraging community health workers (CHWs) services: A qualitative study |
| title_fullStr | Increasing and sustaining diabetic retinopathy screening in Fiji by leveraging community health workers (CHWs) services: A qualitative study |
| title_full_unstemmed | Increasing and sustaining diabetic retinopathy screening in Fiji by leveraging community health workers (CHWs) services: A qualitative study |
| title_short | Increasing and sustaining diabetic retinopathy screening in Fiji by leveraging community health workers (CHWs) services: A qualitative study |
| title_sort | increasing and sustaining diabetic retinopathy screening in fiji by leveraging community health workers chws services a qualitative study |
| topic | Inequity Community health workers Fiji Diabetic retinopathy Zone nurses |
| url | http://www.sciencedirect.com/science/article/pii/S2405844022026676 |
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