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    Increasing and sustaining diabetic retinopathy screening in Fiji by leveraging community health workers (CHWs) services: A qualitative study.

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    Mohammadnezhad_et_al_Heliyon (233.9Kb)
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    Publication date
    2022-11
    Author
    Ram, S.
    Mohammadnezhad, Masoud
    Ram, K.
    Prasad, K.
    Pal, M.
    Dalmia, P.
    Keyword
    Inequity
    Community health workers
    Fiji
    Diabetic retinopathy
    Zone nurses
    Rights
    © 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
    Peer-Reviewed
    Yes
    Open Access status
    openAccess
    
    Metadata
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    Abstract
    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. 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. 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. 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.
    URI
    http://hdl.handle.net/10454/19260
    Version
    Published version
    Citation
    Ram S, Mohammadnezhad M, Ram K et al (2022) Increasing and sustaining diabetic retinopathy screening in Fiji by leveraging community health workers (CHWs) services: A qualitative study. Heliyon. 8(11): E11379.
    Link to publisher’s version
    https://doi.org/10.1016/j.heliyon.2022.e11379
    Type
    Article
    Collections
    Health Studies Publications

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