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Objective@#To investigate the occupational delay of gratification among community healthcare workers and its influencing factors, so as to provide insights into the sustainable development of primary healthcare personnel.@*Methods@#The in-service community healthcare workers from 5-7 community health service centers in 9 cities (prefectures) of Guizhou Province were selected using a multi-stage stratified random sampling method. Gender, age, and educational level and other basic information were collected through questionnaire surveys. The status of occupational delay of gratification was investigated using the Occupational Delay of Gratification Scale. Multiple linear regression model was used to analyze the influencing factors of occupational delay of gratification.@*Results@#A total of 2 076 respondents were surveyed, including 367 males (17.68%) and 1 709 females (82.32%). There were 112 respondents (5.39%) with secondary vocational school degree or below, 872 respondents (42.00%) with junior college degree, 1 087 respondents (52.36%) with bachelor's degree, and 5 respondents (0.24%) with master's degree or above. There were 665 respondents (32.03%) with managerial positions. The monthly income of 1 705 respondents (82.13%) was ≤5 000 Yuan. The total score of occupational delay of gratification was (33.22±4.33) points, and the total average score was (2.77±0.36) points. The average scores of work delay, career delay and persistence were (2.67±0.48), (2.96±0.45) and (2.75±0.46) points, respectively. Multiple linear regression analysis identified educational level (junior college, β=0.089; bachelor's degree, β=0.088), management position (not have, β=-0.046) and monthly income (>6 000 Yuan, β=0.085) as factors affecting occupational delay of gratification (all P<0.05).@*Conclusion@#The community healthcare workers with an education below secondary vocational school, no management position and lower income have relatively lower level of occupational delay of gratification.

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Background: Community healthcare worker (CHW) training programs are becoming increasingly comprehensive (an expanded range of diseases). However, the CHWs that the program relies on have limited training. Since CHWs' activities occur largely during household visits, which often go unsupervised and unassessed, long-term, ongoing assessment is needed to identify gaps in CHW competency, and improve any such gaps. We observed CHWs during household visits and gave scores according to the proportion of health messages/activities provided for the health conditions encountered in households. We aimed to determine (1) messages/activities scores derived from the proportion of health messages given in the households by CHWs who provide comprehensive care in South Africa, and (2) the associated factors. Methods: In three districts (from two provinces), we trained five fieldworkers to score the messages provided by, and activities of, 34 CHWs that we randomly selected during 376 household visits in 2018 and 2020 using a cross-sectional study designs. Multilevel models were fitted to identify factors associated with the messages/activities scores, adjusted for the clustering of observations within CHWs. The models were adjusted for fieldworkers and study facilities (n = 5, respectively) as fixed effects. CHW-related (age, education level, and phase of CHW training attended/passed) and household-related factors (household size [number of persons per household], number of conditions per household, and number of persons with a condition [hypertension, diabetes, HIV, tuberculosis TB, and cough]) were investigated. Results: In the final model, messages/activities scores increased with each extra 5-min increase in visit duration. Messages/activities scores were lower for households with either children/babies, hypertension, diabetes, a large household size, numerous household conditions, and members with either TB or cough. Increasing household size and number of conditions, also lower the score. The messages/activities scores were not associated with any CHW characteristics, including education and training. Conclusion: This study identifies important factors related to the messages provided by and the activities of CHWs across CHW teams. Increasing efforts are needed to ensure that CHWs who provide comprehensive care are supported given the wider range of conditions for which they provide messages/activities, especially in households with hypertension, diabetes, TB/cough, and children or babies.

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Although the World Health Organization (WHO) recommends the use of a Community-Based Rehabilitation (CBR) model, little is known about how CBR has been applied in the hearing healthcare setting. The purpose of this scoping review was to identify and describe studies on Community-Based Hearing Rehabilitation (CBHR) programs within the applied context. The review was conducted in September 2020 with updated searches in November 2021 according to the Joanna Briggs Institute (JBI) methodology and reported using the guidelines and checklist for Preferred Reporting Items for Systematic Reviews and Meta Analyses-Extension for Scoping Reviews (PRISMA-ScR). Fifty-nine peer-reviewed research articles were included in the review. A narrative synthesis was conducted to map out the types of CBHR programs. Studies were classified into audiological themes: awareness, screening and assessment of hearing in newborn/infants, children and adults, training of community health workers, rehabilitation, cost-effectiveness and describing the service delivery models. Further categorisation was made based on CBR aspect matrices for each study. Most of the studies come from high-income countries in North America and Europe. CBHR studies predominantly focused on creating awareness, training and hearing screenings and/or assessments in communities and evaluating effectiveness in providing knowledge and access to hearing health services in rural or underserved communities. Further work is needed to examine the outcomes and effectiveness of CBHR using controlled studies. Moreover, more work is needed in low- and middle-income countries where the application of CBHR is critical for increased access and affordability.

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Introduction: community healthcare workers are members of the community affiliated with community-based organisations to implement Primary Health Care (PHC) in the district health services of South Africa. Among other roles, they are expected to care for clients on antiretroviral therapy (ART) in the community. The purpose of this study was to explore how community healthcare workers describe their experience regarding the management of ART clients in the community environment. Methods: a qualitative phenomenological approach was used. Semistructured focus group discussion, observations, and document analysis were conducted with 39 community healthcare workers who had ART clients in their register. Inductive coding was used to determine invariant constituents, reduce constituents to categories, and cluster categories into themes. Reliability and validity were accomplished through intercoder agreement, audio recording, triangulation, bracketing, and member checking. Results: results identified five core themes related to what community healthcare workers experience during the management of HIV clients in the community environment. They explained a wide-ranging insight into their experiences in providing care to ART clients. They described a number of concerning situations that included meaningful roles, feelings about the clients´ engagement, clients´ improper linkage to care, perceived barriers and perceived influences. Conclusion: several challenges were encountered by community healthcare workers while implementing the HIV programme in the community. The study saw the need for health departmental awareness for community acceptance of community healthcare workers work. This will thus impact positively in community healthcare workers programmes and thus improving the provision of primary health care services particularly in HIV programme.

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COVID 19 pandemic has posed challenges for public mental healthcare delivery, particularly in LAMI countries such as India. However, this unique situation has also brought in opportunities to revisit the health system and optimally utilize the available resources. In this brief report, we report one such new initiative in which existing community health workers (CHWs), known as ASHAs (Accredited Social Health Activist) acted as a bridge between patients with mental illness and the District Mental Health Program (DMHP) of Ramanagara district of Karnataka State, India. They maintained continuity of care of 76 patients by delivering mental healthcare services to the patients' doorstep. This has paved the way to rethink and revisit their role in public mental healthcare delivery not only during COVID 19 times, but also beyond.

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OBJECTIVE: To explore the impact of workplace violence on job performance and quality of life of community healthcare workers in China, especially the relationship of these three variables. METHODS: From December 2013 to April 2014, a total of 1404 healthcare workers were recruited by using the random cluster sampling method from Community Health Centers in Guangzhou and Shenzhen. The workplace violence scale, the job performance scale and the quality of life scale (SF-36) were self-administered. The structural equation model constructed by Amos 17.0 was employed to assess the relationship among these variables. RESULTS: Our study found that 51.64% of the respondents had an experience of workplace violence. It was found that both job performance and quality of life had a negative correlation with workplace violence. A positive association was identified between job performance and quality of life. The path analysis showed the total effect (ß = -0.243) of workplace violence on job performance consisted of a direct effect (ß = -0.113) and an indirect effect (ß = -0.130), which was mediated by quality of life. CONCLUSIONS: Workplace violence among community healthcare workers is prevalent in China. The workplace violence had negative effects on the job performance and quality of life of CHCs' workers. The study suggests that improvement in the quality of life may lead to an effective reduction of the damages in job performance caused by workplace violence.

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OBJECTIVES: Another one million community healthcare workers are needed to address the growing global population and increasing demand of health care services. This paper describes a cost comparison between two training approaches to better understand costs implications of training community health workers (CHWs) in Sub-Saharan Africa. METHODS: Our team created a prospective model to forecast and compare the costs of two training methods as described in the Dalburge Report - (1) a traditional didactic training approach ("baseline") and (2) a blended eLearning training approach ("blended"). After running the model for training 100,000 CHWs, we compared the results and scaled up those results to one million CHWs. RESULTS: A substantial difference exists in total costs between the baseline and blended training programs. RESULTS indicate that using a blended eLearning approach for training community health care workers could provide a total cost savings of 42%. Scaling the model to one million CHWs, the blended eLearning training approach reduces total costs by 25%. DISCUSSION: The blended eLearning savings are a result of decreased classroom time, thereby reducing the costs associated with travel, trainers and classroom costs; and using a tablet with WiFi plus a feature phone rather than a smartphone with data plan. CONCLUSION: The results of this cost analysis indicate significant savings through using a blended eLearning approach in comparison to a traditional didactic method for CHW training by as much as 67%. These results correspond to the Dalberg publication which indicates that using a blended eLearning approach is an opportunity for closing the gap in training community health care workers.