Jaeger Fabienne N, Bechir Mahamat, Harouna Moumini, Moto Daugla D, Utzinger Jürg
Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.
University of Basel, Basel, Switzerland.
BMC Health Serv Res. 2018 Jan 8;18(1):7. doi: 10.1186/s12913-017-2799-6.
Trained healthcare workers are an essential resource for effective health systems. However, healthcare workers' perspective on healthcare, the challenges they face to provide quality health services, and opportunities to improve motivation and providing adequate care are rarely investigated in resource-constrained settings of sub-Saharan Africa.
All reachable nurses of Abou Deia, a primarily rural district in the south-eastern part of Chad, were invited to participate. In-depth interviews were conducted to assess current challenges and opportunities faced in daily work, including factors that influence motivation and social wellbeing. Particular emphasis was placed on paediatric care.
Eight nurses were interviewed. Main work challenges pertained to overall workload, a lack of training and support regarding a serious case mix to be managed on their own, adverse working conditions, issues related to the local communities, and the impact of postings on nurses' private life. Poor working conditions and perceived lack of recognition emerged as the main demotivating factors. Motivation to improve nurses' skills so that they can provide good care, coupled with small, suggested changes in working conditions and health care organisation provide opportunities worth exploring to improve health workers' satisfaction, motivation and the care they can provide.
Health workers in a predominantly rural district in Chad face a wide variety of challenges, and hence their perspectives need to be taken into account to improve health services interventions that aim at enhancing quality of care. Nurses' willingness to further develop skills and knowledge, proactive search of solutions to remedy stock-outs of drugs and other medical devices, and motivational factors to improve the quality of care represent important opportunities for improving health services for all.
训练有素的医护人员是有效卫生系统的重要资源。然而，在撒哈拉以南非洲资源有限的环境中，很少有人调查医护人员对医疗保健的看法、他们在提供高质量卫生服务时面临的挑战，以及提高积极性和提供充分护理的机会。
邀请了乍得东南部主要为农村地区的阿布代亚所有能联系到的护士参与。进行了深入访谈，以评估日常工作中面临的当前挑战和机会，包括影响积极性和社会福祉的因素。特别强调了儿科护理。
采访了8名护士。主要工作挑战包括总体工作量、缺乏对自行管理的严重病例组合的培训和支持、恶劣的工作条件、与当地社区相关的问题以及轮调对护士私人生活的影响。恶劣的工作条件和缺乏认可被认为是主要的消极因素。提高护士技能以使其能够提供优质护理的积极性，以及对工作条件和医疗保健组织进行的一些小的改进建议，为提高卫生工作者的满意度、积极性和他们所能提供的护理提供了值得探索的机会。
乍得一个主要为农村地区的卫生工作者面临着各种各样的挑战，因此在改进旨在提高护理质量的卫生服务干预措施时，需要考虑他们的观点。护士进一步发展技能和知识的意愿、积极寻求解决药品和其他医疗设备短缺问题的方法，以及提高护理质量的激励因素，是改善全民卫生服务的重要机会。
