Volume 24, Issue 4 (July - August 2025)
Payesh 2025, 24(4): 547-561 |
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Ethics code: IR.SBMU.SME.REC.1402.023
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Mehdizad M, Ashktorab T, Zayeri F, Mehrabian F, Zarei E, Daneshkohan A. The role of primary health care workers in response to the COVID-19: A study based on the WHO guideline. Payesh 2025; 24 (4) :547-561
URL: http://payeshjournal.ir/article-1-2567-en.html
URL: http://payeshjournal.ir/article-1-2567-en.html
Mandana Mehdizad1 
, Tahereh Ashktorab2 , Farid Zayeri3 , Fardin Mehrabian4 , Ehsan Zarei1 , Abbas Daneshkohan *1
, Tahereh Ashktorab2 , Farid Zayeri3 , Fardin Mehrabian4 , Ehsan Zarei1 , Abbas Daneshkohan *1
1- Department of Health Management and Policy, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2- Department of Nursing, School of Nursing and Midwifery, Tehran Islamic Azad University of Medical Sciences, Tehran, Iran
3- Proteomics Research Center and Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4- Department of Health Education and Promotion, School of Health, Guilan University of Medical Sciences, Rasht, Iran
2- Department of Nursing, School of Nursing and Midwifery, Tehran Islamic Azad University of Medical Sciences, Tehran, Iran
3- Proteomics Research Center and Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4- Department of Health Education and Promotion, School of Health, Guilan University of Medical Sciences, Rasht, Iran
Abstract: (257 Views)
Objective(s): The ability of health systems to respond to complex challenges such as the current pandemic depends on the capacity of healthcare workers to fulfill their roles. The objective of this study was to ascertain the role of primary health care (PHC) workers in Rasht City (north of Iran) in response to the COVID-19, based on the World Health Organization (WHO) guidance document.
Methods: The descriptive cross-sectional study was conducted with the participation of 297 PHC workers. Data were collected using a 29-item questionnaire which was developed by the research team from the guideline of the World Health Organization on health workforce policy and management in response to the COVID-19 pandemic. The validity of the questionnaire was tested and confirmed by face and content validity. Reliability was confirmed by test-retest and Cronbach's alpha coefficients Data were analyzed using SPSS-26 software.
Results: Most PHC workers (98.6%) stated that they had taught preventive measures such as hand hygiene, respiratory etiquette and physical distancing to the clients; 92.9% had continued to provide other essential health services other than COVID-19; 46.5% of them were not provided with personal protective equipment (PPE) appropriate to their role and hazard exposure. Those who stated that have to collect and report too much data assessed their role status lower than those who said the task was appropriate.
Conclusion: To improve performance and provide more comprehensive health services, PHC workers need to be provided with the necessary supplies and equipment, especially PPE. Necessary measures should also be taken to provide training tailored to these workers needs and to determine the standard amount of data required for programs management.
Methods: The descriptive cross-sectional study was conducted with the participation of 297 PHC workers. Data were collected using a 29-item questionnaire which was developed by the research team from the guideline of the World Health Organization on health workforce policy and management in response to the COVID-19 pandemic. The validity of the questionnaire was tested and confirmed by face and content validity. Reliability was confirmed by test-retest and Cronbach's alpha coefficients Data were analyzed using SPSS-26 software.
Results: Most PHC workers (98.6%) stated that they had taught preventive measures such as hand hygiene, respiratory etiquette and physical distancing to the clients; 92.9% had continued to provide other essential health services other than COVID-19; 46.5% of them were not provided with personal protective equipment (PPE) appropriate to their role and hazard exposure. Those who stated that have to collect and report too much data assessed their role status lower than those who said the task was appropriate.
Conclusion: To improve performance and provide more comprehensive health services, PHC workers need to be provided with the necessary supplies and equipment, especially PPE. Necessary measures should also be taken to provide training tailored to these workers needs and to determine the standard amount of data required for programs management.
.
type of study: Descriptive |
Subject:
Helath Services Management
Received: 2024/06/24 | Accepted: 2024/11/16 | ePublished ahead of print: 2025/09/6 | Published: 2025/09/9
Received: 2024/06/24 | Accepted: 2024/11/16 | ePublished ahead of print: 2025/09/6 | Published: 2025/09/9
References
1. Sohrabi C, Alsafi Z, O'Neill N, Khan M, Kerwan A, Al-Jabir A, et al. World Health Organization declares global emergency: a review of the 2019 novel coronavirus (COVID-19). International Journal of Surgery 2020;76:71-76 [DOI:10.1016/j.ijsu.2020.02.034]
2. Blandenier E, Habibi Z, Kousi T, Sestito P, Flahault A, Rozanova L. Initial COVID-19 outbreak: an epidemiological and socioeconomic case review of Iran. International Journal of Environmental Research and Public Health 2020;17:9593 [DOI:10.3390/ijerph17249593]
3. World Health Organization (WHO) Regional Office for the Western Pacific, Asia-Pacific Parliamentarian Forum on Global Health. Ad hoc virtual meeting on COVID-19: managing the evolving COVID-19 pandemic and preparing primary health care to meet future health needs, virtual meeting, 2 December 2021: meeting report. 2021. Available at: https://iris.who.int/handle/10665/351112
4. World Health Organization (WHO). World Health Organization coronavirus (COVID-19) dashboard. (Cited: 1 March 2023) Available at: https://covid19.who.int/region/emro/country/ir
5. World Health Organization (WHO). Health workforce policy and management in the context of the COVID-19 pandemic response: interim guidance, 3 December 2020. Available at: https://iris.who.int/handle/10665/337333
6. Walpola R, Lucas C. Reflective practice: the essential competency for health systems and healthcare practitioners during the COVID-19 pandemic. Reflective Practice 2021;22:143-146 [DOI:10.1080/14623943.2020.1860925]
7. World Health Organization (WHO). Health Topics. defining of health workforce. (Cited: 28 May 2022) Available at: https://www.who.int/health-topics/health-workforce#tab=tab_1
8. Pan American Health Organization (PAHO). Impact of COVID-19 on human resources for health and policy response: the case of Belize, Grenada, and Jamaica. 2022. Available at: https://iris.paho.org/handle/10665.2/56262
9. World Health Organization (WHO), Pan American Health Organization (PAHO). Impact of COVID-19 on human resources for health and policy response: the case of plurinational state of Bolivia, Chile, Colombia, Ecuador and Peru: overview of findings from five Latin American countries. 2021. Available at: https://iris.paho.org/handle/10665.2/57155
10. World Health Organization (WHO), United Nations Children's Fund (UNICEF). Primary health care measurement framework and indicators: monitoring health systems through a primary health care lens. 2022. Available at: https://iris.who.int/handle/10665/352205
11. World Health Organization (WHO), United Nations Children's Fund (UNICEF). A vision for primary health care in the 21st century: towards universal health coverage and the sustainable development goals. 2018. Available at: https://iris.who.int/handle/10665/328065
12. Van Weel C, Kidd MR. Why strengthening primary health care is essential to achieving universal health coverage. Canadian Medical Association Journal 2018;190:463-466 [DOI:10.1503/cmaj.170784]
13. World Health Organization (WHO). Building health systems resilience for universal health coverage and health security during the COVID-19 pandemic and beyond: WHO position paper. 2021. Available at: https://iris.who.int/handle/10665/346515
14. Koolivand A, Amini S. The importance of PHC-based measures in controlling COVID-19 outbreak: implications for global health system. Ethics, Medicine, and Public Health 2020;14:100549 [DOI:10.1016/j.jemep.2020.100549]
15. Sarti TD, Lazarini WS, Fontenelle LF, Almeida A. What is the role of primary health care in the COVID-19 pandemic?. Epidemiology and Health Services 2020;29:e2020166.
16. World Health Organization (WHO) Regional Office for the Western Pacific. Role of primary care in the COVID-19 response. 2020. Available at: https://iris.who.int/handle/10665/331921
17. Rezapour R, Dorosti AA, Farahbakhsh M, Azami-aghdash S, Iranzad I. The impact of the COVID-19 pandemic on primary health care utilization: an experience from Iran. BMC Health Services Research 2022;22:404 [DOI:10.1186/s12913-022-07753-5]
18. Peters MA, Ahmed T, Azais V, Amor Fernandez P, Baral P, Drouard S, et al. Resilience of front-line facilities during COVID-19: evidence from cross-sectional rapid surveys in eight low- and middle-income countries. Health Policy and Planing 2023;38:789-798 [DOI:10.1093/heapol/czad032]
19. Bhaumik S, Moola S, Tyagi J, Nambiar D, Kakoti M. Community health workers for pandemic response: a rapid evidence synthesis. BMJ Global Health 2020;5:e002769 [DOI:10.1136/bmjgh-2020-002769]
20. World Health Organization (WHO). Maintaining essential health services: operational guidance for the COVID-19 context: interim guidance, 1 June 2020. Available at: https://iris.who.int/handle/10665/332240
21. World Health Organization (WHO). Learnings from COVID-19 for future respiratory pathogen pandemic preparedness: a summary of the literature. 2023. Available at: https://www.who.int/publications/i/item/9789240086531
22. Kaseje N, Ranganathan M, Magadi M, Oria K, Haines A. The effectiveness of rural community health workers in improving health outcomes during the COVID-19 pandemic: a systematic review. Global Health Action 2024;17:2292385 [DOI:10.1080/16549716.2023.2292385]
23. Salve S, Raven J, Das P, Srinivasan S, Khaled A, Hayee M, et al. Community health workers and Covid-19: cross-country evidence on their roles, experiences, challenges and adaptive strategies. PLoS Global Public Health 2023;3:e0001447 [DOI:10.1371/journal.pgph.0001447]
24. Rahman R, Ross A, Pinto R. The critical importance of community health workers as first responders to COVID-19 in USA. Health Promotion International 2021;36:1498-1507 [DOI:10.1093/heapro/daab008]
25. World Health Organization (WHO). Contact tracing in the context of COVID-19: interim guidance, 10 May 2020. Available at: https://iris.who.int/handle/10665/332049 [DOI:10.15557/PiMR.2020.0005]
26. Al Siyabi H, Al Mukhaini S, Kanaan M, Al Hatmi S, Al Anqoudi Z, Al Kalbani A, et al. Community participation approaches for effective national COVID-19 pandemic preparedness and response: an experience from Oman. Frontiers in Public Health 2020;8:616763 [DOI:10.3389/fpubh.2020.616763]
27. Sahoo KC, Sahay MR, Dubey S, Nayak S, Negi S, Mahapatra P, et al. Community engagement and involvement in managing the COVID-19 pandemic among urban poor in low-and middle-income countries: a systematic scoping review and stakeholders mapping. Global Health Action 2023;16:2133723 [DOI:10.1080/16549716.2022.2133723]
28. World Health Organization (WHO) Regional Office for the Western Pacific. Role of community engagement in situations of extensive community transmission of COVID-19. 2020. Available at: https://iris.who.int/handle/10665/332172
29. Gilmore B, Ndejjo R, Tchetchia A, de Claro V, Mago E, Diallo AA, et al. Community engagement for COVID-19 prevention and control: a rapid evidence synthesis. BMJ Global Health 2020;5:e003188 [DOI:10.1136/bmjgh-2020-003188]
30. Lotta G, Nunes J, Fernandez M, Garcia Correa M. The impact of the COVID-19 pandemic in the frontline health workforce: perceptions of vulnerability of Brazil's community health workers. Health Policy Open 2022;3:100065 [DOI:10.1016/j.hpopen.2021.100065]
31. Verhoeven V, Tsakitzidis G, Philips H, Van Royen P. Impact of the COVID-19 pandemic on the core functions of primary care: will the cure be worse than the disease? a qualitative interview study in Flemish GPs. BMJ Open 2020;10:e039674 [DOI:10.1136/bmjopen-2020-039674]
32. Turale S, Meechamnan C, Kunaviktikul W. Challenging times: ethics, nursing and the COVID-19 pandemic. International Nursing Review 2020;67:164-167 [DOI:10.1111/inr.12598]
33. Jabbari A, Salahi S, Hadian M, Khakdel Z, Hosseini E, Sheikhbardsiri H. Exploring the challenges of Iranian government hospitals related to COVID-19 pandemic management: a qualitative content analysis research from the nurses perspective. BMC Nursing 2022;21:226 [DOI:10.1186/s12912-022-01008-8]
34. World Health Organization (WHO). COVID-19: occupational health and safety for health workers: interim guidance. 2021. Available at: https://iris.who.int/handle/10665/339151
35. World Health Organization (WHO), International Labour Organization (ILO). Preventing and mitigating COVID-19 at work: policy brief, 19 May 2021. Available at: https://iris.who.int/handle/10665/341328
36. Zarei E, Chavosh Sani K, Saadati M, Khodakarim S. Public trust in health system: a study in Rasht county. Payavard Salamat 2022;16:296-306 [Persian]
37. Gebreselassie A, Peiris D, Abimbola S, Ajisegiri W, Narasimhan P, Mulugeta A, et al. Community health extension workers' training and supervision in Ethiopia: exploring impact and implementation challenges for non-communicable disease service delivery. PLoS Global Public Health 2022;2:e0001160 [DOI:10.1371/journal.pgph.0001160]
38. World Health Organization (WHO). WHO guideline on health policy and system support to optimize community health worker programmes. 2018. Available at: https://iris.who.int/handle/10665/275474
39. World Health Organization (WHO). What do we know about community health workers? a systematic review of existing reviews. 2020. Available at: https://iris.who.int/handle/10665/340717
40. African Health Initiative Partnership Collaborative for Supportive Supervision and Mentoring. Improving primary care quality through supportive supervision and mentoring: lessons from the african health initiative in Ethiopia, Ghana, and Mozambique. Global Health: Science and Practice 2022;10:e2100667 [DOI:10.9745/GHSP-D-21-00667]
41. Daneshkohan A, Foruzanfar F, Zarei E, Ramezankhani A, Damiri S. Supportive supervision in health centers of Shahid Beheshti university of medical sciences. Journal of Health in the Field 2020;7:32-44 [Persian]
42. World Health Organization (WHO). Occupational health: stress at the workplace. 2020. (Cited: 1 June 2024) Available at: https://www.who.int/news-room/questions-and-answers/item/ccupational-health-stress-at-the-workplace
43. Agyapong VI, Osei A, McLoughlin DM, McAuliffe E. Task shifting-perception of stake holders about adequacy of training and supervision for community mental health workers in Ghana. Health Policy and Planing 2016;31:645-655 [DOI:10.1093/heapol/czv114]
44. Health Metrics Network (HMN), World Health Organization (WHO). Framework and standards for country health information systems. 2nd Edition, World Health Organization: Geneva, 2008
45. Majidi S, Daneshkohan A, Zarei E, Ashktorab T. Perspectives of health workers on annual performance appraisal: a study in primary health care. International Journal of Healthcare Management 2021;14:1-8 [DOI:10.1080/20479700.2020.1755810]
46. World Health Organization (WHO). Optimizing community health worker programmes for HIV services: a guide for health policy and system support. 2021. Available at: https://iris.who.int/handle/10665/350197
47. Daneshkohan A, Alimoradi M, Ahmadi M, Alipour J. Data quality and data use in primary health care: a case study from Iran. Informatics in Medicine Unlocked 2022;28:100855 [DOI:10.1016/j.imu.2022.100855]
48. World Health Organization (WHO). Strategy for optimizing national routine health information systems: strengthening routine health information systems to deliver primary health care and universal health coverage. 2023. Available at: https://iris.who.int/handle/10665/376094
49. Agarwal S, Sripad P, Johnson C, Kirk K, Bellows B, Ana J, et al. A conceptual framework for measuring community health workforce performance within primary health care systems. Human Resources for Health 2019;17:86 [DOI:10.1186/s12960-019-0422-0]
50. European Observatory on Health Systems and Policies, Ziemann M, Chen C, Forman R, Sagan A, Pittman P. Global health workforce responses to address the COVID-19 pandemic: what policies and practices to recruit, retain, reskill, and support health workers during the COVID-19 pandemic should inform future workforce development?. 2023. Available at: https://iris.who.int/handle/10665/371358
51. World Health Organization (WHO) Country Office for India. Build back better: role of frontline health workers in managing the COVID-19 pandemic and delivery of essential health services in Assam. 2022. Available at: https://iris.who.int/handle/10665/365312
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