About: The adequacy of health system measures in reducing vulnerability to COVID 19 among the health care providers working in primary health care in Rajasthan, India A Cross sectional Study

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	The adequacy of health system measures in reducing vulnerability to COVID 19 among the health care providers working in primary health care in Rajasthan, India A Cross sectional Study
Creator	Gupta, Rajan Bhargava, Ruchi Das, Arup Ghosh, Saswata Singh, Rajesh »more»
source	MedRxiv
abstract	Background This paper examines the role of individual, facility and system level preparedness in reducing the physiological and psychological vulnerability among primary-level health care providers (HCPs) of COVID19 pandemic in Rajasthan, India. Method and Material Online and telephonic interviews are conducted among 274 HCPs working in 24 PHCs (17 rural and 7 urban), across 13 districts of Rajasthan. Five dimensions of vulnerability covering awareness, exposure to infection (daily contact; contact with high risk individuals), physical and mental health conditions, while three aspects of preparedness at individual (personal care) and facility (provider safety; management and supervision) level are measured by employing factor analysis. Generalized ordered logit regression model is used to measure the effect of preparedness on COVID19 related vulnerability. Result: Among the 274 HCPs, majority of the staff are from rural PHCs (76 %), less than 35 years (87%), female (57%) and married (57 %). Almost half have high level exposure to COVID19, with mean contact rate is 90. Overall, 26% have comprehensive knowledge on COVID19, and 32% have any mental health issues. Although more than 70% of HCPs have reported more than one individual level preparedness, mental health measures adopted by the HCPs are comparably low. The facility level preparedness for enhancing safety are high such as social distance (79%) and maintaining record of each visitor (75%). However, management related measures adopted by the PHCs are perceived to be lower than the safety measures. The regression analyses suggest that safety related preparedness is significantly associated with reduction of vulnerability by 50%. The management-level preparedness has statistically no significant effect in explaining the variations in level of vulnerability. Conclusion: The facility-level safety measures, which lowers chances of acquiring infection has a positive effect on reducing vulnerability of COVID19. However, the HCPs do not have adequate preparedness at individual, facility management (PHC) and system level to reduce COVID19 vulnerability. Findings suggest that there is a need for a non-conventional approach of monitoring and supervision, in the absence of such measures there is a chance of moral injury that will make the HCPs at the primary level vulnerable to both physiologically and psychologically.
has issue date	2020-07-26(xsd:dateTime)
bibo:doi	10.1101/2020.07.21.20149443
has license	medrxiv
sha1sum (hex)	1ce5707520280cf408b4e9d8473ce511106551c2
schema:url	https://doi.org/10.1101/2020.07.21.20149443
resource representing a document's title	The adequacy of health system measures in reducing vulnerability to COVID 19 among the health care providers working in primary health care in Rajasthan, India A Cross sectional Study
resource representing a document's body	covid:1ce5707520280cf408b4e9d8473ce511106551c2#body_text
is schema:about of	named entity 'system' named entity 'PANDEMIC' named entity 'ROLE' named entity 'INDIVIDUAL' named entity 'physiological' »more»

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