Using community health workers to refer pregnant women and young children to health care facilities in rural West Bengal, India: A prospective cohort study
Using community health workers to refer pregnant women and young children to health care facilities in rural West Bengal, India: A prospective cohort study
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DOI：
10.1371/journal.pone.0199607
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发表时间：
2018-06-21
期刊：
影响因子：
3.7
通讯作者：
Mukherjee, Bhramar
中科院分区：
文献类型：
--
作者：
Wagner, Abram L.;Xia, Lu;Mukherjee, Bhramar
背景：印度在许多农村地区部署了社区卫生工作者（CHWs），以增加村民与基本预防保健的联系。在这项研究中，我们描述了孕妇和幼儿的母亲在卫生保健员告知她们或她们的孩子有妊娠相关并发症或早期儿童发育迟缓的高风险时的反应，并建议进行进一步的筛查和医生的保健。方法在印度西孟加拉邦的农村进行了一项纵向研究，对孕妇以及12-24个月儿童的母亲进行了高危并发症筛查。他们被重新联系，并被问及卫生保健员的访问如何以及在多大程度上改善了他们家庭的整体健康行为，以及他们寻求的额外护理的细节。这些反应是由不同的人口和医学特征呈现的。结果在231名孕妇中，所有人都表示她们在健康护理中心的访问中寻求了额外的护理，并且所有人都表示健康护理中心的反馈导致了她们健康行为的改善。大多数（90%）孕妇在医院分娩。在213位幼儿母亲的跟进中，所有母亲都因卫生保健专员的到访而寻求额外照顾。大多数人（67%）提到，他们的健康行为在卫生保健中心反馈后有了显著的改善，其余的人说他们有一些改善。结论通过适当的培训，卫生保健员不仅可以在印度农村地区，而且可以在其他发展中国家成为改善弱势群体健康的卫生保健伙伴。卫生保健员可以在其居住的村庄促进积极的健康结果。
BackgroundCommunity health workers (CHWs) have been placed in many rural areas in India to increase villagers' connections to basic preventive health care. In this study, we describe how pregnant women and mothers of young children react when CHWs inform them that they, or their child, are at high risk of pregnancy-related complications or early childhood developmental delays, and further screening and health care from a physician is recommended.MethodsIn this longitudinal study in rural villages in West Bengal, India, pregnant mothers, as well as mothers of children aged 12-24 months, were screened for high risk complications. They were re-contacted and asked questions regarding how and to what extent did visits by the CHWs improve their household's overall health behavior, along with details about what additional care, if any, they sought. These responses are presented by different demographic and medical characteristics.ResultsOf the 231 pregnant women, all said they had sought additional care in response to the CHW visit, and all stated that feedback from the CHW resulted in improvement to their health behaviors. Most (90%) pregnant women gave birth at an institution. Among the 213 mothers of young children who were followed up, all sought additional care in response to the CHW's visit. Most (67%) mentioned that they had a significant improvement in their health behaviors following feedback from the CHW, and the rest stated that they had some improvement.ConclusionsWith the proper training, CHWs can be partners in health care to improve the health of vulnerable populations, not only in rural areas of India, but also in other developing countries. CHWs can promote positive health outcomes in their villages of residence.