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Home Visiting Assignment

Home Visiting Assignment

Home visits are an essential component of Ghana’s primary health care delivery system. It is preventive and promotes health practice in which health professionals provide care to clients in their own environment and meet their healthcare and social support needs. This study examines home visit practices in a rural district of Ghana’s Volta Region. Methodology. In the Adaklu district, 375 households and 11 community health nurses participated in this descriptive cross-sectional study. To select 10 communities and study respondents, multistage sampling techniques and probability sampling methods were used. For data collection, a pretested self-designed questionnaire and an interview guide for household members and community health nurses, respectively, were used. Quantitative data were coded, cleaned, and analyzed into descriptive statistics using the Statistical Package for Social Sciences, whereas qualitative data were analyzed using the NVivo software. Thematic analysis was used, which includes three interconnected stages: data reduction, data display, and data conclusion.
Home visits are a regular duty for all CHNs. Community members’ education and attitude, supervision challenges, a lack of incentives and basic logistics, an uncooperative attitude, community inaccessibility, financial constraints, and a limited number of staff were all factors that influenced home visits. Household members (62.3%) reported that health workers did not adequately attend to minor ailments, despite the fact that 78% benefited from the service and that 24.5 percent wished more activities could be added to the home visiting package.

CHNs should receive specialized training in home visits so that they can broaden the scope of services they can offer. Additionally, community-based health workers such as community health volunteers, traditional birth attendants, and community clinic attendants can be trained to identify and address health issues in the home.

Visit: 1. Introduction
Home visit practice is a type of healthcare service provided by trained health professionals who visit clients in their homes to assess their home, environment, and family situation in order to provide appropriate healthcare needs and social support services. Because individuals and groups are at risk of exposure to health hazards, the home environment is where health is formed and can be maintained to improve or jeopardize the health of the family [1, 2]. The client feels free and relaxed during a home visit in a familiar environment, and is able to participate in the activity performed by the health professional [1]. It is possible to assess the client’s situation and provide family-specific health education on sanitation, personal hygiene, elderly care, and child care. The importance of the health professional’s role during home visits (HV) cannot be overstated, which led Ghana to make HV a key component of its preventive healthcare delivery system. Community health nurses (CHN) play a large part in this role [2]. Health education delivered during HVs is more effective at changing behavior than health education delivered through other channels such as the media [3].

In the home, health professionals, mostly CHN, monitor the growth, development, and immunization status of children under the age of five, as well as administer immunization to defaulters. Special populations are served, including the elderly, discharged tuberculosis and leprosy patients, and malnourished children [1, 2]. During HVs, contact tracing can also be performed [2]. These services may be used to prevent, postpone, or replace temporary or long-term institutional care [4, 5]. HV has the potential to bring health workers into contact with individuals and groups in the community who are at risk for diseases and who use preventive health services ineffectively or infrequently [2]. Several factors influence HV behavior. These factors include practice location, general practitioner age, training status, and the number of older patients on the list, and they predict the rate of home visits [6].
Home Visiting Assignment
The concept of HV has persisted in Ghana for decades, and its very essence is critical [3]. Home visits are one of the most important activities of CHN in Ghana. CHNs, as they were then known, went from house to house, educating people about sanitation and personal hygiene [3]. By increasing people’s understanding of healthy ways of living and their knowledge of health hazards, these nurses hope to promote positive health and prevent disease [7]. HVs continue to be critical to the successful prevention of deaths associated with women and children under the age of five; however, there are still some gaps in the successful implementation of this innovative intervention in Ghana [4]. Although nurses in Ghana’s Sekyere West district had knowledge of home visiting and a positive attitude toward the practice, they were unable to perform their home visiting tasks or functions to standard [8]. Home visiting practice among nurses in that district was found to be very low, despite community members’ desire for more [8]. The findings indicate that HV is required [9]. Several health hazards were also identified, including uncovered refuse containers, open fires, misplaced sharp objects, open defecation, and other unsanitary practices that a proper home visiting regiment can address [8]. At the service level, the challenges associated with this type of service were identified as a lack of publicity about the service, the cost of the service, failure to provide services that meet clients’ perceived needs, rigid eligibility criteria, inaccessible locations, a lack of public transportation, limited hours of operation, inflexible appointment systems, a lack of affordable child care, poor coordination between services, and a lack of an outreach capacity [9-13].

Home visits are an important tool for improving family healthcare and community health. Ghana Health Service has supported essential community health actions and addressed gaps in knowledge and community practices such as reproductive behavior, nutritional support for pregnant women and young children, illness recognition, home management of sick children, disease prevention, and care seeking behaviors through home visiting services [4]. While many interventions are implemented by health stakeholders to ensure that home visiting practices benefit community members, recent studies have not delved into the practices of home visiting in poor rural communities, particularly in Ghana’s Volta Region. This study examined home visiting practices in the Volta Region’s Adaklu district (AD).

1.1. Aim
The practice of home visiting as a primary healthcare (PHC) intervention was evaluated in a poor rural district of Ghana’s Volta Region.

Visit: 2. Methodology
2.1. Study Design Because the study involved a one-time interaction with CHNs and community members to assess HV practice, the study used a descriptive cross-sectional study design.

2.2. Study Environment
The AD is one of the districts in Ghana’s Volta Region, with approximately 40 communities. Adaklu Waya is the district capital and administrative center. Before the Oti Region was formed, the district’s estimated population was 36391, accounting for 1.7% of the Volta Region’s population [14]. The district is classified as rural [14] because no locality has a population greater than 5000 people. The economically active population (aged 15 and up) accounts for 67% of the total population [14]. The economically inactive population is in full-time education (55.1%), household duties (20.6%), or disabled or too sick to work (4.6%), whereas the employed population is skilled agricultural, forestry, and fishery workers (63.1%), service and sales (12.6%), craft and related trade (14.6%), and other professional duties (3.4%) [14]. The private, informal sector employs 93.9% of the district’s workforce [14]. There are 15 health facilities in district government health centers [4, 1 Christian Health Association of Ghana health center, and 10 community health-based planning services (CHPS), 5 of which are operational [15]. The housing stock is 5629, accounting for 1.4% of all houses in the Volta Region. The average number of people per house was 6.5 [14], and the majority of the houses were built with mud bricks [15]. The most common method of solid waste disposal by households (47.5%) is open-air dumping. Some households indiscriminately dump solid waste (17.3%), while others dispose of it by burning (13.3%) [14].

2.3. Research Population, Sample, and Sampling Method
In AD, there are approximately 36391 people and 6089 households [14]. This study primarily included adult household members and CHNs from randomly selected communities throughout the district. Abuadi, Anfoe, Ahunda, Dawanu, Goefe, Helekpe, Hlihave, Tsrefe, Waya, and Wumenu were among the communities studied. A person over the age of 18 who has the capacity to represent the household is considered an adult member of the household. CHN [11] from the district’s selected communities were recruited. A certified health practitioner (CHN) is a certified health practitioner who combines prevention and promotion health practices, works within the community to improve the overall health of the area, and participates in home visiting.

A sample of 375 households was computed using Yamane’s formula for calculating sample for finite populations, with a tolerable error of 5%, a confidence interval of 95%, and a study population of 6089 households, with a margin of error of 0.05. The sample size was increased to 390 to account for the possibility of participant nonresponse. To select study participants, a multistage sampling technique was used. Each community was divided into four geographical areas: north, south, east, and west, with respondents drawn from every other house using a systematic sampling method. The questionnaire was completed by an adult member of each household.

To select eleven [11] CHNs from the specific communities [10] where the study took place in the district, a whole population sampling method was used. The CHN that served the ten selected communities was chosen. Helekpe (18.2%), Waya (18.2%), Anfoe (9.1%), Tsrefe (27.3%), and Wumenu (27.3%) were the numbers chosen from each community. At the time of the study, this represented 42.3% of the district’s total CHN community.

Pretesting (2.4)
The questionnaire and interview guide were piloted at Klefe CHPS in the Ho municipality with 30 adult household members and 5 CHNs, respectively. SPSS was used to run a reliability test on the data collected via the questionnaire (version 22). The pretesting determined the respondent’s overall reaction, as well as their interest in answering the questionnaire. The questionnaire was tweaked until the Cronbach alpha coefficient reached 0.790. As a result, it is possible to conclude that the questionnaire was highly reliable in measuring the study’s objectives. Pretesting assisted in identifying ambiguous questions and revising them as needed. It also aided in the organization and estimation of the time the respondents spent answering questionnaires and responding to the interview.

2.5. Data Gathering
Data was gathered by researchers from the University of Health and Allied Sciences School of Nursing and Midwifery. Prior to the start of data collection, five researchers received two days of training in data collection, study tools, and research ethics for social sciences. All of the researchers had a bachelor’s degree in CHN and at least three years of data collection experience.

Respondents were assisted in completing a questionnaire in the comfort of their own homes. The household questionnaire had four [4] sections that included personal information as well as information about how HV practice is carried out in the home, such as frequency of visits, duration, and activities. Respondents were asked to answer questions about the challenges, benefits, and factors that could promote the HV practice in subsequent sections. A single questionnaire took about 15 minutes to complete on average.

CHNs were interviewed using a semistructured interview guide. This guide was divided into four sections: personal information, practice of home visits, constraints to the practice, benefits, and factors that promote HVs. An interview section took between 20 and 25 minutes to complete.

2.6. Data Examination
2.6.1. Quantitative Information Before entering each individual questionnaire into Microsoft Excel, cleaning it, and transferring it to the Statistical Package for Social Sciences (version 22) for analysis, it was checked for completeness and appropriateness of responses. The data was essentially broken down into descriptive statistics of proportions. There were also central tendencies measures for continuous variables.
2.6.2 Qualitative Information Thematic analysis was used in data analysis, which includes three interconnected stages: data reduction, data display, and data conclusion [16]. The perspectives of CHNs were summarized and collated as frequencies and proportions based on the conclusions driven. The process of thematic analysis is summarized by Guest, Macqueen, and Namey as constructing through textual data, identifying data themes, coding the themes, and then interpreting the structure and content of the themes [17]. Using this scheme, the authors first established, discussed, and accepted a codebook. The codebook was then used to create the nodes within the NVivo software. The various transcripts were coded line by line as either free or tree nodes. Two of the researchers performed double coding on each transcript. To compare the coding, a coding comparison query was used, and a kappa coefficient (the measurement of intercoder reliability) was generated to compare the coding performed by the two authors. The matrix coding query was used to compare the coding against the nodes and attributes, allowing the researchers to compare and contrast within-group and between-group responses.
Ethical Consideration 2.7
On September 19, 2018, the Research and Scientific Ethics Committee of the Institute of Health Research, University of Health and Allied Sciences granted ethical clearance (UHAS-REC A.2 [13] 18-19). Permission was obtained from each study community’s district health authorities, chiefs, and assembly members. Prior to administering the questionnaires, informed consent was obtained by having respondents sign/thumb print a consent form before being enrolled in the study. Participants had the option to withdraw from the study at any time.
For this activity, you will select either an older adult or pregnant/post-partum mom and infant
individual/family to complete your 3 virtual or in-person home visits. To ensure timely completion of
conducting the home visits, it is important to identify an individual and schedule these visits early in the
semester. The three home visits are summarized below:

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