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Adapting a health video library for use in Afghanistan: provider-level acceptability and lessons for strengthening operational feasibility
BACKGROUND: Community health workers (CHWs) in Afghanistan are a critical care extender for primary health services, including reproductive, maternal, neonatal, and child health (RMNCH) care. However, volunteer CHWs face challenges including an ever-expanding number of tasks and insufficient time to...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236098/ https://www.ncbi.nlm.nih.gov/pubmed/32429956 http://dx.doi.org/10.1186/s12960-020-00477-9 |
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author | Lorenzetti, Lara Tharaldson, Jenae Pradhan, Subarna Rastagar, Sayed Haroon Hemat, Shafiqullah Ahmadzai, Sharif A. H. Dulli, Lisa S. Weissman, Amy Todd, Catherine S. |
author_facet | Lorenzetti, Lara Tharaldson, Jenae Pradhan, Subarna Rastagar, Sayed Haroon Hemat, Shafiqullah Ahmadzai, Sharif A. H. Dulli, Lisa S. Weissman, Amy Todd, Catherine S. |
author_sort | Lorenzetti, Lara |
collection | PubMed |
description | BACKGROUND: Community health workers (CHWs) in Afghanistan are a critical care extender for primary health services, including reproductive, maternal, neonatal, and child health (RMNCH) care. However, volunteer CHWs face challenges including an ever-expanding number of tasks and insufficient time to conduct them. We piloted a health video library (HVL) intervention, a tablet-based tool to improve health promotion and counseling by CHWs. We qualitatively assessed provider-level acceptability and operational feasibility. METHODS: CHWs implemented the HVL pilot in three rural districts of Balkh, Herat, and Kandahar provinces. We employed qualitative methods, conducting 47 in-depth interviews (IDIs) with male and female CHWs and six IDIs with community health supervisors. We used semi-structured interview guides to explore provider perceptions of program implementation processes and solicit feedback on how to improve the HVL intervention to inform scale-up. We conducted a thematic analysis. RESULTS: CHWs reported that the HVL increased time efficiencies, reduced work burden, and enhanced professional credibility within their communities. CHWs felt video content and format were accessible for low literacy clients, but also identified challenges to operational feasibility. Although tablets were considered easy-to-use, certain technical issues required continued support from supervisors and family. Charging tablets was difficult due to inconsistent electricity access. Although some CHWs reported reaching most households in their catchment area for visits with the HVL, others were unable to visit all households due to sizeable populations and gender-related barriers, including women’s limited mobility. CONCLUSIONS: The HVL was acceptable and feasible for integration into existing CHW duties, indicating it may improve RMNCH counseling, contributing to increased care-seeking behaviors in Afghanistan. Short-term challenges with technology and hardware can be addressed through continued training and provision of solar chargers. Longer-term challenges, including tablet costs, community coverage, and gender issues, require further consideration with an emphasis on equitable distribution. |
format | Online Article Text |
id | pubmed-7236098 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-72360982020-05-27 Adapting a health video library for use in Afghanistan: provider-level acceptability and lessons for strengthening operational feasibility Lorenzetti, Lara Tharaldson, Jenae Pradhan, Subarna Rastagar, Sayed Haroon Hemat, Shafiqullah Ahmadzai, Sharif A. H. Dulli, Lisa S. Weissman, Amy Todd, Catherine S. Hum Resour Health Research BACKGROUND: Community health workers (CHWs) in Afghanistan are a critical care extender for primary health services, including reproductive, maternal, neonatal, and child health (RMNCH) care. However, volunteer CHWs face challenges including an ever-expanding number of tasks and insufficient time to conduct them. We piloted a health video library (HVL) intervention, a tablet-based tool to improve health promotion and counseling by CHWs. We qualitatively assessed provider-level acceptability and operational feasibility. METHODS: CHWs implemented the HVL pilot in three rural districts of Balkh, Herat, and Kandahar provinces. We employed qualitative methods, conducting 47 in-depth interviews (IDIs) with male and female CHWs and six IDIs with community health supervisors. We used semi-structured interview guides to explore provider perceptions of program implementation processes and solicit feedback on how to improve the HVL intervention to inform scale-up. We conducted a thematic analysis. RESULTS: CHWs reported that the HVL increased time efficiencies, reduced work burden, and enhanced professional credibility within their communities. CHWs felt video content and format were accessible for low literacy clients, but also identified challenges to operational feasibility. Although tablets were considered easy-to-use, certain technical issues required continued support from supervisors and family. Charging tablets was difficult due to inconsistent electricity access. Although some CHWs reported reaching most households in their catchment area for visits with the HVL, others were unable to visit all households due to sizeable populations and gender-related barriers, including women’s limited mobility. CONCLUSIONS: The HVL was acceptable and feasible for integration into existing CHW duties, indicating it may improve RMNCH counseling, contributing to increased care-seeking behaviors in Afghanistan. Short-term challenges with technology and hardware can be addressed through continued training and provision of solar chargers. Longer-term challenges, including tablet costs, community coverage, and gender issues, require further consideration with an emphasis on equitable distribution. BioMed Central 2020-05-19 /pmc/articles/PMC7236098/ /pubmed/32429956 http://dx.doi.org/10.1186/s12960-020-00477-9 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Lorenzetti, Lara Tharaldson, Jenae Pradhan, Subarna Rastagar, Sayed Haroon Hemat, Shafiqullah Ahmadzai, Sharif A. H. Dulli, Lisa S. Weissman, Amy Todd, Catherine S. Adapting a health video library for use in Afghanistan: provider-level acceptability and lessons for strengthening operational feasibility |
title | Adapting a health video library for use in Afghanistan: provider-level acceptability and lessons for strengthening operational feasibility |
title_full | Adapting a health video library for use in Afghanistan: provider-level acceptability and lessons for strengthening operational feasibility |
title_fullStr | Adapting a health video library for use in Afghanistan: provider-level acceptability and lessons for strengthening operational feasibility |
title_full_unstemmed | Adapting a health video library for use in Afghanistan: provider-level acceptability and lessons for strengthening operational feasibility |
title_short | Adapting a health video library for use in Afghanistan: provider-level acceptability and lessons for strengthening operational feasibility |
title_sort | adapting a health video library for use in afghanistan: provider-level acceptability and lessons for strengthening operational feasibility |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236098/ https://www.ncbi.nlm.nih.gov/pubmed/32429956 http://dx.doi.org/10.1186/s12960-020-00477-9 |
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