Marambire Edson T, Chingono Rudo M S, Calderwood Claire J, Larsson Leyla, Sibanda Sibusisiwe, Kavenga Fungai, Nzvere Farirai P, Olaru Ioana D, Simms Victoria, McHugh Grace, Bandason Tsitsi, Redzo Nicol, Gregson Celia L, Maunganidze Aspect J V, Pasi Christopher, Chiwanga Michael, Chonzi Prosper, Ndhlovu Chiratidzo E, Mujuru Hilda, Rusakaniko Simbarashe, Ferrand Rashida A, Kranzer Katharina
The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe.
CIHLMU Center for International Health, University Hospital, LMU Munich, Munich, Germany.
PLOS Glob Public Health. 2024 Jan 8;4(1):e0002328. doi: 10.1371/journal.pgph.0002328. eCollection 2024.
Health workers are essential for a functioning healthcare system, and their own health is often not addressed. During the COVID-19 pandemic health workers were at high risk of SARS-CoV-2 infection whilst coping with increased healthcare demand. Here we report the development, implementation, and uptake of an integrated health check combining SARS-CoV-2 testing with screening for other communicable and non-communicable diseases for health workers in Zimbabwe during the COVID-19 pandemic. Health checks were offered to health workers in public and private health facilities from July 2020 to June 2022. Data on the number of health workers accessing the service and yield of screening was collected. Workshops and in-depth interviews were conducted to explore the perceptions and experiences of clients and service providers. 6598 health workers across 48 health facilities accessed the service. Among those reached, 5215 (79%) were women, the median age was 37 (IQR: 29-44) years and the largest proportion were nurses (n = 2092, 32%). 149 (2.3%) healthcare workers tested positive for SARS-CoV-2. Uptake of screening services was almost 100% for all screened conditions except HIV. The most common conditions detected through screening were elevated blood pressure (n = 1249; 19%), elevated HbA1c (n = 428; 7.7%) and common mental disorder (n = 645; 9.8%). Process evaluation showed high acceptability of the service. Key enablers for health workers accessing the service included free and comprehensive service provision, and availability of reliable point-of-care screening methods. Implementation of a comprehensive health check for health workers was feasible, acceptable, and effective, even during a pandemic. Conventional occupational health programmes focus on infectious diseases. In a society where even health workers cannot afford health care, free comprehensive occupational health services may address unmet needs in prevention, diagnosis, and treatment for chronic non-communicable conditions.
卫生工作者对于正常运转的医疗保健系统至关重要,而他们自身的健康问题却常常得不到解决。在新冠疫情期间,卫生工作者在应对不断增加的医疗需求时,面临着感染新冠病毒的高风险。在此,我们报告在新冠疫情期间,为津巴布韦的卫生工作者开展的一项综合健康检查的开发、实施及采用情况,该检查将新冠病毒检测与其他传染病和非传染病筛查相结合。2020年7月至2022年6月期间,为公共和私立医疗机构的卫生工作者提供了健康检查。收集了使用该服务的卫生工作者数量及筛查结果的数据。举办了研讨会并进行了深入访谈,以探究服务对象和服务提供者的看法及经历。48家医疗机构的6598名卫生工作者使用了该服务。在这些人中,5215名(79%)为女性,年龄中位数为37岁(四分位间距:29 - 44岁),其中护士占比最大(n = 2092,32%)。149名(2.3%)医护人员新冠病毒检测呈阳性。除艾滋病毒外,所有筛查项目的筛查服务采用率几乎都达到了100%。筛查出的最常见病症为血压升高(n = 1249;19%)、糖化血红蛋白升高(n = 428;7.7%)和常见精神障碍(n = 645;9.8%)。过程评估显示该服务具有较高的可接受性。卫生工作者使用该服务的关键促成因素包括免费且全面的服务提供,以及可靠的即时检测筛查方法的可用性。即使在疫情期间,为卫生工作者实施全面健康检查也是可行、可接受且有效的。传统的职业健康项目侧重于传染病。在一个连卫生工作者都负担不起医疗保健费用的社会中,免费的全面职业健康服务可能会满足慢性非传染性疾病预防、诊断和治疗方面未得到满足的需求。