Barriers in adult vitamin D service provision by health care workers: a qualitative study in three ecologies of Ethiopia

BMC Nutrition

Wubetsh Asnake¹  Tewabech Zewdie²  Yeweyenhareg Feleke³  Biruk Lambisso³  Wubegzier Mekonnen⁴  Jemal Haidar⁴  Yakob Desalegn⁴ 

[1] IDRC funded project on the cause of death, Ethiopian Public Health Association, Addis Ababa, Ethiopia;Sante Medical College, Addis Ababa, Ethiopia;School of Medicine, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia;School of Public Health, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia;

关键词: Barriers;    Health care providers;    Adult;    Vitamin D deficiency;   

DOI  :  10.1186/s40795-021-00492-6

来源: Springer

【 摘 要 】

BackgroundAdult vitamin D deficiency, which is a public health problem in low-income countries, is correlated with increased mortality. Although health care workers (HCWs) in Ethiopia are educated on important minerals their counseling on the uses of vitamin D and its possible sources was not witnessed since their knowledge and practice is low. The main aim of this study is to explore barriers to good knowledge, positive attitude, and practice of health care providers on adult vitamin D.MethodsAn exploratory qualitative study is done in three ecologies covering highland, midland, and lowland. The size of 27 participants was fixed by saturation of ideas. In-depth interviews were conducted among leaders and HCWs of different professional groups in health centers and hospitals. Moderators were Ph.D. holders. An interview guide was developed after reviewing research that was translated into the local language. Interviews were audio-taped, transcribed and, translated. Open Code software was used to code and categorize the data. Themes were developed using thematic analysis which is presented using themes and sub-themes.ResultThe main barriers are related to health systems, HCWs’ understandings, and the educational system. Lack of attention by the health systems’ leadership, missing adult vitamin D as a priority in health programs, lack of capacity building scheme and the absence of adult vitamin D management and treatment guidelines are barriers related to the health system. On the other hand, health care professionals believed that the prevalence of adult vitamin D deficiency is insignificant and vitamin D deficiency is only an issue related to children. Besides, the absence of studies,the focus of the medical curriculum on child vitamin D and the inadequacy of laboratory investigation are barriers related to the education system and research.ConclusionAdult vitamin D deficiency is a neglected public health problem with many barriers related to diagnosis and treatment. Barriers are related to the professionals themselves, their leadership, health facilities, and the education system. The government should give attention to adult vitamin D management and treatment, continuous on the job training, development of guidelines, purchase of laboratory equipment, the inclusion of adult vitamin D in pre-service and, in-service training curriculums.

【 授权许可】

CC BY