Research article

Capacity building among frontline health workers (FHWs) in screening for cardiovascular diseases (CVDs): Findings of an implementation study from Bihar, India

  • These two authors contributed equally.
  • Received: 20 November 2022 Revised: 08 March 2023 Accepted: 21 March 2023 Published: 30 March 2023
  • Background

    Community-based screening is one of the key preventive strategies to tackle the ever-rising burden of non-communicable diseases (NCDs) under the National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS).

    Objective

    The current study was aimed to build capacity among frontline health workers (FHWs) in screening for cardiovascular diseases (CVDs) under NPCDCS in the selected districts of Bihar state.

    Methodology

    This was an implementation study with follow-up components, conducted among 75 FHWs [14 auxiliary nurse midwives (ANMs) and 61 accredited social health activists (ASHAs)] from 15 primary healthcare facilities across four districts of Bihar state from October 2019 to September 2021. The selected FHWs were initially trained on NPCDCS for a day, including pre- and post-training knowledge assessment. Then, supportive supervision (SS) visits using a predesigned questionnaire were done.

    Results

    The pre- and post-training mean knowledge scores of the FHWs were 12.9 and 22.1, respectively, with an overall effect size of 2.5. During SS visits, only 20.0% of the visited primary healthcare facilities had all the required logistics to conduct weekly NCD screening clinics for CVDs. Considering different measurements and operative skill proficiencies of FHWs, waist circumference skills (41.7% for ANMs and 50.8% for ASHAs), followed by blood pressure (BP) (41.7%) and random blood sugar (RBS) measurement (25.0%), were found to be the most deficient skills (among ANMs). Moreover, the quality of initial and follow-up home visits was found to be satisfactory for only 54.1% of the ASHAs. The reported barriers of NCD screening were reported to be non-cooperation, unawareness among community dwellers, lack of knowledge and skill of FHWs, logistic constraints and delayed honorarium credit.

    Conclusion

    One-day training on NCDs for FHWs was quite effective. However, for translating all the desired skills for CVD screening into action, periodic training needs assessment, and SS of FHWs might be fruitful.

    Citation: Neeraj Agarwal, CM Singh, Bijaya Nanda Naik, Abhisek Mishra, Shamshad Ahmad, Pallavi Lohani, Saket Shekhar, Bijit Biswas. Capacity building among frontline health workers (FHWs) in screening for cardiovascular diseases (CVDs): Findings of an implementation study from Bihar, India[J]. AIMS Public Health, 2023, 10(1): 219-234. doi: 10.3934/publichealth.2023017

    Related Papers:

  • Background

    Community-based screening is one of the key preventive strategies to tackle the ever-rising burden of non-communicable diseases (NCDs) under the National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS).

    Objective

    The current study was aimed to build capacity among frontline health workers (FHWs) in screening for cardiovascular diseases (CVDs) under NPCDCS in the selected districts of Bihar state.

    Methodology

    This was an implementation study with follow-up components, conducted among 75 FHWs [14 auxiliary nurse midwives (ANMs) and 61 accredited social health activists (ASHAs)] from 15 primary healthcare facilities across four districts of Bihar state from October 2019 to September 2021. The selected FHWs were initially trained on NPCDCS for a day, including pre- and post-training knowledge assessment. Then, supportive supervision (SS) visits using a predesigned questionnaire were done.

    Results

    The pre- and post-training mean knowledge scores of the FHWs were 12.9 and 22.1, respectively, with an overall effect size of 2.5. During SS visits, only 20.0% of the visited primary healthcare facilities had all the required logistics to conduct weekly NCD screening clinics for CVDs. Considering different measurements and operative skill proficiencies of FHWs, waist circumference skills (41.7% for ANMs and 50.8% for ASHAs), followed by blood pressure (BP) (41.7%) and random blood sugar (RBS) measurement (25.0%), were found to be the most deficient skills (among ANMs). Moreover, the quality of initial and follow-up home visits was found to be satisfactory for only 54.1% of the ASHAs. The reported barriers of NCD screening were reported to be non-cooperation, unawareness among community dwellers, lack of knowledge and skill of FHWs, logistic constraints and delayed honorarium credit.

    Conclusion

    One-day training on NCDs for FHWs was quite effective. However, for translating all the desired skills for CVD screening into action, periodic training needs assessment, and SS of FHWs might be fruitful.



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    Acknowledgments



    We are extremely thankful to Mr. Ashok and Mr. Xavier of Tata Institute of Social Sciences (TISS) who facilitated the NCD portal session during the trainings. We would also like to thank junior resident doctors of the department of CFM, AIIMS Patna, especially Dr. SSV Prasad, Dr. Anuvarshini Ramalingam, Dr. Amit Ranjan Jha, Dr. Haripriya Hari and Dr. Mohit Bhardwaj, who helped immensely during trainings and SS visits. The project was funded by state health society (SHS), Bihar.

    Conflict of interest



    The authors declare no conflict of interest.

    [1] Menon GR, Yadav J, John D (2022) Burden of non-communicable diseases and its associated economic costs in India. Soc Sci Humanit Open 5: 100256. https://doi.org/10.1016/j.ssaho.2022.100256
    [2] Non-communicable Diseases | National Health Portal of India. Available from: https://www.nhp.gov.in/healthlyliving/ncd2019.
    [3] Public Health Foundation of IndiaThe India State-Level Disease Burden Initiative (2018). Available from: https://phfi.org/the-work/research/the-india-state-level-disease-burden-initiative/.
    [4] Ross S, Chadha K, Mishra S, et al. (2022) The burden of risk factors for non-communicable disease in rural Bihar, India: a comparative study with national health surveys. BMC Public Health 22: 1538. https://doi.org/10.1186/s12889-022-13818-1
    [5] International Institute for Population SciencesNational Family Health Survey-5: State Fact Sheet; Bihar (2019). Available from: http://rchiips.org/nfhs/NFHS-5_FCTS/Bihar.pdf.
    [6] Ministry of Health & Family Welfare, Government of IndiaHandbook for Counselors Reducing Risk Factors for Noncommunicable Diseases: National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) (2017). Available from: https://main.mohfw.gov.in/sites/default/files/Handbook%20for%20Counselors%20-%20Reducing%20Risk%20Factors%20for%20NCDs_1.pdf.
    [7] Ministry of Health & Family Welfare, Government of India, Module for Multi-Purpose Workers (MPW) - Female/Male on Prevention, Screening and Control of Common Non-Communicable Diseases. Available from: https://main.mohfw.gov.in/sites/default/files/Module%20for%20Multi-Purpose%20Workers%20-%20Prevention%2C%20Screening%20and%20Control%20of%20Common%20NCDS_2.pdf.
    [8] Ministry of Health & Family Welfare, Government of IndiaTraining Module for Medical Officers for Prevention, Control and Population Level Screening of Hypertension, Diabetes and Common Cancer (Oral, Breast & Cervical) (2017). Available from: http://nhmodisha.gov.in/writereaddata/Upload/Documents/MOModuleforPBSforNCds.pdf.
    [9] Nebhinani M, Saini SK (2020) Knowledge, skills of female health workers regarding selected non communicable diseases risk reduction and client satisfaction: a pilot study from western part of Rajasthan, India. Int J Res Med Sci 8: 2802-2808. https://doi.org/10.18203/2320-6012.ijrms20203089
    [10] Meena S, Rathore M, Gupta A, et al. (2022) Knowledge and attitude of peripheral health workers regarding Non-Communicable diseases in a Rural area of Rajasthan. Indian J Community Health 34: 306-310. https://doi.org/10.47203/IJCH.2022.v34i02.029
    [11] Krishnan A, Mathur P, Kulothungan V, et al. (2021) Preparedness of primary and secondary health facilities in India to address major noncommunicable diseases: results of a National Noncommunicable Disease Monitoring Survey (NNMS). BMC Health Serv Res 21: 757. https://doi.org/10.1186/s12913-021-06530-0
    [12] Ministry of Health & Family Welfare, Government of IndiaFlipchart: My Health My Responsibility (2017). Available from: https://main.mohfw.gov.in/sites/default/files/Flip%20Chart%20-My%20Health%20is%20My%20Responsibility%20English_1.pdf.
    [13] Ministry of Health & Family Welfare, Government of India, CPHC NCD Solution NCD Application ANM User Manual. Available from: https://main.mohfw.gov.in/sites/default/files/CPHC%20NCD%20Solution%20-%20NCD%20Application%20ANM%20User%20Manual_0.pdf.
    [14] Abdel-All M, Abimbola S, Praveen D, et al. (2019) What do Accredited Social Health Activists need to provide comprehensive care that incorporates non-communicable diseases? Findings from a qualitative study in Andhra Pradesh, India. Hum Resour Health 17: 73. https://doi.org/10.1186/s12960-019-0418-9
    [15] Ministry of Health & Family Welfare, Government of IndiaScreening, Diagnosis, Assessment, and Management of Primary Hypertension in Adults in India (2016). Available from: https://nhm.gov.in/images/pdf/guidelines/nrhm-guidelines/stg/Hypertension_full.pdf.
    [16] World Health OrganizationWHO STEPwise Approach to Chronic Disease Risk-Factor Surveillance (2018). Available from: https://www3.paho.org/english/ad/dpc/nc/panam-steps-manual.pdf.
    [17] Abdel-All M, Putica B, Praveen D, et al. (2017) Effectiveness of community health worker training programmes for cardiovascular disease management in low-income and middle-income countries: a systematic review. BMJ Open 7: e015529. https://doi.org/10.1136/bmjopen-2016-015529
    [18] Monika M, Kaur S, Singh A (2019) Determine workload of ANMs in implementing Mother Child Tracking System and calculating required number of ANMs at Civil dispensary: Apilot study. Nurs Midwifery Res J 15: 1-10. https://doi.org/10.1177/0974150X20190101
    [19] Bhombe I, Raut A, Taywade M, et al. (2019) Time-motion study of auxiliary nurse midwives of a primary health center from Wardha District of Maharashtra. Int J Adv Med Health Res 6: 18-23. https://doi.org/10.4103/IJAMR.IJAMR_50_18
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