The effect of a web-based training for improving primary health care providers' knowledge about diabetes mellitus management in rural China: A pre-post intervention study

Diabetes care and education training audit for primary care physicians across 47 counties of Kenya: A pre-post intervention study

INTRODUCTION

The purpose of the study was to evaluate the effectiveness of an online continuous medical education programme for Primary Care Physicians (PCPs) in improving diabetes management in Kenya.

METHODS

A pretest-post-test design was used to assess the change in knowledge across multiple modules and the overall change in the confidence level of the PCPs in managing people living with diabetes. The study was non-randomised. Course participants were nominated by local scientific associations.

RESULTS

Out of a total of 1750 nominated participants, 1286 completed the training. A statistically significant (p=<0.001) change in knowledge and overall confidence was observed for each of the 8 modules of the training programme. Cohen's D effect size was calculated as 2.20 and 1.40 for change in knowledge and confidence levels, respectively.

DISCUSSION

Web-based training is an effective way to improve the knowledge and self-reported confidence of PCPs involved in the management of diabetes. This web-based model can support the training needs of PCPs at a pace and time to suit their situation. Similar evidence-based programmes should be considered and field-tested for other healthcare professionals working in the management of diabetes.

Study on the determinants of health professionals' performance on diabetes management care in China

BACKGROUND

As the direct providers of diabetes management care in primary health care facilities (PHFs) in China, health professionals' performance on management care of diabetes determines the quality of services and patients' outcomes. This study aims to analyze the key determinants of health professionals' performance on diabetes management care in PHFs in China.

METHODS

We conducted a cross-sectional study in 72 PHFs in 6 cities that piloted the contracted family doctor service (CFDS). Self-developed questionnaire was used to measure three kinds of factors (capacity, motivation and opportunity) potentially influencing the performance of health professionals. The performance of diabetes management care in the study was measured as whether health professionals delivered 7 service items required by the National Basic Public Health Service Guideline with a total of 7 points and was divided into three grades of good, medium and bad. The questionnaire is self-administered by all the health professionals involved in the study with the number of 434. The Chi-square tests were used to compare differences of performance on diabetes management care among health professionals with different characteristics. The ordinal logistic regression was used to analyze the determinants on the performance of diabetes management care.

RESULTS

Health professionals who got higher score on diabetes knowledge test had odds of better performance on diabetes management care (OR = 1.529, P < 0.001). health professionals with higher degree of self-reported satisfaction on training (OR = 1.224, P < 0.05) and perception of decreasing workload (OR = 3.336, P < 0.01) had odds of better performance on diabetes management care. While health professionals with negative feeling on information system support had odds of worse performance on diabetes management care (OR = 0.664, P < 0.01).

CONCLUSIONS

Attention should be paid to the training of health professionals' knowledge on diabetes management capacity. Furthermore, measures to improve training for health professionals could satisfying their needs for self-growth and improve the motivation of health professionals. The information system supporting management care should be improved continuously to improve the health professionals' working opportunities and decrease the workload.

Are Rural Primary Care Providers Able to Competently Manage Common Illnesses? A Cross-Sectional Study in Rural Sichuan, Western China

Background: Strengthening primary care is a key focus of the latest healthcare reforms in China. However, many challenges, including the workforce competence, still exist. This study aimed to evaluate the common disease management competency of rural primary care providers in Sichuan Province, western China. Methods: A cross-sectional study was conducted in 9 township health centers and 86 village clinics in 3 counties. Diarrhea and respiratory infection were selected as the evaluation cases. General partitioners were assessed through their abilities to (1) take history; (2) make diagnoses; (3) propose treatment; and (4) deal with clinical cases. Results: In total, 362 healthcare workers were surveyed, and 130 general practitioners were enrolled into our study. On average, rural primary care providers could only answer 46.4% of questions absolutely correctly, with 29.7% partly correctly and 23.8% incorrectly. Conclusion: We suggest strengthening training to improve rural primary care providers’ competencies, especially their capacities of history taking. Policy action is also needed to address regional disparities.

Capacity building of primary care physician working at remote Uttarakhand, India: An integrated tertiary care approach during COVID 19 pandemic

Strengthening primary care during this unprecedented pandemic of COVID-19 is an urgent demand for public health. It needs to relook into the healthcare machinery and reenergize the much overlooked primary and secondary tier in healthcare delivery to effectively combat COVID-19 and other similar epidemics.

OBJECTIVES

Strengthening of primary care and enhance the skills and knowledge of primary care physician working at Community Health Center/Primary Health Center (CHC/PHC) in context of Family medicine and updating them in recent advancements in primary care management and COVID 19 guidelines for efficient delivery of primary care services.

METHODOLOGY

Director general health services of Uttarakhand was intimated with the aim and objectives of this one-day hands-on workshop going to be conducted at All India institute of medical sciences. All Chief Medical Officers of the various districts had been communicated and sensitized for this noble cause. Total 30 primary care physicians attended the certificate program. This session commenced with a pre-test followed by the lectures, discussions and hands-on skills and ended with a post-test.

RESULTS

Majority (60%) of the participants were male and 40% were female. A total of 30% had never attended any similar workshop in the past. 45% of them were never exposed to any hands-on training before. Only 10% of them were Postgraduates and the rest were only MBBS (undergraduate). As the scores were not normally distributed, Wilcoxon Signed-Ranks Test was applied for the dependent variable. There was a significant difference (p < 0.05) found between pre and post-test results.

CONCLUSION

Imparting continuing medical knowledge to the physicians has proved to be an effective tool in good clinical practice. The success of this intervention can be used to further develop and implement workshops and other training sessions to enhance the skills and knowledge of Primary Care Physicians in similar settings that face a shortage of well-equipped physicians.