Table 2.
Challenges faced by community health nurses to achieve universal health coverage (n = 30).
| Questionnaires | Agree | Disagree |
|---|---|---|
| 1. Inadequate and unsupportive working condition and environment | ||
| 1.1 CHN workforce is inadequate in delivering essential CHN services. | 29 (96.7) | 1 (3.3) |
| 1.2 Financial and supplies are limited in delivering CHN services. | 28 (93.3) | 2 (6.7) |
| 1.3 Accommodation and transportation facilities are insufficient. | 28 (93.3) | 2 (6.7) |
| 1.4 Mentoring and guidance from senior colleagues are inadequate. | 11 (36.7) | 19 (63.3) |
| 1.5 Teamwork and collaboration among health care providers are insufficient. | 15 (50.0) | 15 (50.0) |
| 1.6 Interpersonal communication among community health care providers is sufficient. | 13 (43.3) | 17 (56.7) |
| 2. Absence of educational standard at entry to public health setting | ||
| 2.1 Specific educational criteria are absent to become CHNs. | 16 (53.3) | 14 (46.7) |
| 2.2 The educational entry level requirements for CHN program are varied. | 19 (63.3) | 11 (36.7) |
| 2.3 Training exposure to international or regional updates in CHN services are limited. | 23 (76.7) | 7 (23.3) |
| 2.4 Short term trainings for updated procedures are inaccessible. | 16 (53.3) | 14 (46.7) |
| 2.5 Advanced courses for CHN (e.g. Master’ s courses) are unavailable. | 18 (60.0) | 12 (40.0) |
| 2.6 Absence of structured learning environment leads to experiential learning through action. | 26 (86.7) | 4 (13.3) |
| 3. Lack of consensus on the scope of practice for CHNs | ||
| 3.1 Complete autonomy in performing CHN activities is not permitted. | 20 (66.7) | 10 (33.3) |
| 3.2 Role conflict exists among BHSPs in implementing community health care services. | 22 (73.3) | 8 (26.7) |
| 3.3 Obligating to perform non-CHN activities interferes with achievement of targeted activities. | 24 (80.0) | 6 (20.0) |
| 3.4 Utilization of findings from evaluating health services is still lacking in policy formulation. | 21 (70.0) | 9 (30.0) |
| 3.5 Conducting community health nursing research by self is limited. | 29 (96.7) | 1 (3.3) |
| 4. Limited availability for career opportunities | ||
| 4.1 Appropriate tenure based on working expertise is necessary for effective CHN services. | 28 (93.3) | 2 (6.7) |
| 4.2 High rivals across the organizations exist in career advancement opportunity for CHNs. | 27 (90.0) | 3 (10.0) |
| 4.3 A system to retain experienced CHNs along the career path needs to be developed. | 28 (93.3) | 2 (6.7) |
| 5. Low recognition for CHNs | ||
| 5.1 Service recognition from community residents is unavailable. | 10 (33.3) | 20 (66.7) |
| 5.2 Service recognition from local administrative persons is unavailable. | 13 (43.3) | 17 (56.7) |
| 5.3 Service recognition among BHSPs is unsatisfactory. | 16 (53.3) | 14 (46.7) |
| 6. Suggestions to improve CHN services | ||
| 6.1 Community health care services need to be sustainable. | 29 (96.7) | 1 (3.3) |
| 6.2 Policies and standards of CHN practice should be developed. | 29 (96.7) | 1 (3.3) |
| 6.3 CHNs should involve in members of policy makers and health leaders. | 29 (96.7) | 1 (3.3) |
| 6.4 CHNs should conduct research for developing evidence-based practice in CHN. | 29 (96.7) | 1 (3.3) |
| 6.5 CHNs should be members of multidisciplinary teams to provide services that meet local needs and government priorities. | 28 (93.3) | 2 (6.7) |
| 6.6 CHNs should be empowered and motivated to bridge the gaps in delivering community health care services and help achieve UHC. | 29 (96.7) | 1 (3.3) |
Note:Data are n (%). CHN = community health nursing. CHNs = community health nurses. BHSPs = basic health staff professionals.