Work environment factors and provider performance in health houses: a case study of a developing country
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RESEARCH NOTE
Work environment factors and provider performance in health houses: a case study of a developing country Hasan Yusefzadeh1 and Bahram Nabilou2*
Abstract Objective: Primary Health Care has determined the path to the goal of "Health for All". Defining standards in health facilities play a crucial role in achieving acceptable performance by Community Health Workers. The study aimed to assess the relationship between physical Work environment factors and performance in primary healthcare facilities named health houses in Urmia district health network in North West of Iran. Thirty-five health houses were selected and studied with simple random sampling method. Data collection instrument were a standard checklist. Results: The results highlighted a statistically significant and positive correlation between technical equipment layout (P = 0.01, r = 0.641) with the performance of CHWs and the area of workplace (P = 0.05, r = 0.359) in health houses. Correlation between office equipment layout and performance was negative (P = 0.01, r = − 0.44). Multiple linear regression analysis showed that the performance level was influenced by the staff-mix of CHWs in health houses, layout of technical equipment and layout of office equipment. Keywords: Equipment layout, Performance, Community Health Worker, Urmia Introduction Better health outcomes, improved access to health care, efficiency, and users’ satisfaction are the features of the health systems with a Primary Health Care (PHC) approach, which determined the path to the goal of “Health for All” [1]. Member states of the World Health Organization (WHO) agreed to PHC policy in 1978 and in the last decade have been invited by WHO to revive the PHC [2]. In this regard Iran has gained a position in providing PHC services through District Health Networks. These networks cover above 18,000 health houses and 6500 urban and rural health centers across the country [3, 4]. *Correspondence: [email protected] 2 Department of Management and Health Economics, School of Public Health, Urmia University of Medical Sciences, Nazloo Paradise, Sero Road, Urmia, West Azerbaijan 575611611, Iran Full list of author information is available at the end of the article
Health houses have been known responsible for improving health indicators in Iran [5, 6]. Community Health Workers (CHWs) called Behvarz, manage a health house as the most peripheral state facility in Iran [7, 8]. CHWs are in charge of promotional, preventive and curative tasks [8], including census, health education, maternal and child health, reproductive health, management of communicable and non-communicable diseases, immunization, and so on [9, 10]. Some studies have demonstrated the effectiveness of CHWs in delivering key health interventions [11]. Good outcomes for patients depend on the competent and sufficient number of healthcare workers with appropriate resources [12]. The "environment" has three broad areas: people, culture, and physical space [13]. Physical space is one of t
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