[TimorLesteStudies] New article: Application of standard treatment guidelines in rural community health centres, Timor-Leste
bu.wilson at anu.edu.au
Fri Aug 19 06:55:23 EST 2011
Michiyo Higuchi, Junko Okumura, Atsuko Aoyama, Sri Suryawati, and John Porter, 2011
Application of standard treatment guidelines in rural community health centres, Timor-Leste
Health Policy and Planning.
Objective To analyse nurses’ and midwives’ knowledge of and attitudes towards standard treatment guidelines (STGs), which were developed
to help their practices at rural community health centres (CHCs) in Timor-Leste.
Methods Fifty-five nurses and midwives were individually interviewed. Data were analysed qualitatively using the Framework approach.
Results Overall, the
standard treatments for acute respiratory tract infections, malaria and
diarrhoea were well known by the respondents.
Clinical nurses showed precise and detailed
knowledge, especially for antibiotic use. The respondents were willing
STGs and believed that they ‘should’ follow them.
This feeling arose due to their self-awareness as frontline health
and, at the same time, as peripheral civil
servants. The changes brought about by the introduction of STGs were
perceived. Three components of the change were
observed: the concept, daily practice and perceived patient
respondents had previously felt a lack of
confidence and hoped to improve their capacity as health care workers;
confident in their practices by using STGs.
Self-confidence was identified more clearly in the clinical nurse
Few difficulties in using STGs were indicated, and
the respondents suggested ways to deal with these difficulties.
Discussion By using the
STGs, the nurses/midwives gained knowledge and self-confidence. The
positive perception of the changes promoted
further use of the STGs. Clinical nurse training
positively influenced the knowledge of and attitudes towards the STGs.
difficulties in applying STGs in daily practice
were identified, which is contrary to previous studies that targeted
in the Western world. Development of STGs within a
health policy framework was considered a key factor. The STGs exist
related policies and various programmes, which are
interconnected. The Timor-Leste experience indicates the value of STGs
for non-physician health care providers at the
primary health care level.
First published online:
July 11, 2011
Dr Bu V.E. Wilson
T: Australia +61 0 407 087 086
T: Timor-Leste + 670 744 0011
E: buvewilson at gmail.com
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