The Critical Role and Evaluation of Community Mobilizers in Polio Eradication in Remote Settings in Africa and Asia.
The Critical Role and Evaluation of Community Mobilizers in Polio Eradication in Remote Settings in Africa and Asia.
复制标题
社区动员者在非洲和亚洲偏远地区根除脊髓灰质炎中的关键作用和评价。
DOI：
10.9745/ghsp-d-20-00024
复制
发表时间：
2020-09-30
期刊：
影响因子：
--
通讯作者：
Arale A
中科院分区：
文献类型：
--
作者：
Lewis J;LeBan K;Solomon R;Bisrat F;Usman S;Arale A
关键的社区卫生工作者标准对于所有社区计划都很重要，包括那些专注于单一疾病的计划。重要领域包括社区参与、当地适应以及与卫生系统的联系——当前和未来流行病的关键领域。数据使用、社区参与、当地适应、与卫生系统的联系以及强大的社区平台对于成功的社区规划至关重要。利用当地志愿者进行的基于社区的疾病监测加强了国家和地区的努力。项目经理应考虑使用社区卫生工作者评估和改进矩阵 (AIM) 工具的更新项目功能矩阵来优化社区卫生项目，以开发、实施和评估社区卫生工作者项目。政策制定者应支持和加强疾病根除计划中强大的社区平台，让社区参与进来，促进当地所有权并使用社区一级的工作人员。新出现的传染病需要通过当地动员者进行社区参与，以实施成功的政府预防和应对工作。本文评估了 CORE Group 脊髓灰质炎项目 (CGPP) 20 年来在 5 个国家的经验。它研究了旨在提供社会动员以根除一种疾病的计划如何在社区卫生工作者 (CHW) 的总体框架内有效运作。垂直健康计划通常对更广泛的社区健康影响有限。 CGPP 在社会动员和有效的项目干预方面拥有 20 年的历史。这段历史为评估 CGPP 社区动员者 (CM) 在脊髓灰质炎和妇幼健康方面的作用提供了机会。 CHW 评估和改进矩阵 (AIM) 的用于优化社区健康计划工具的更新计划功能矩阵用于检查 CGPP CM 在不同背景下的角色。分析确定 CGPP CM 满足 AIM 工具 10 个组件中 6 个组件的基本功能级别（3 级）。对 CGPP 的跨国描述性分析证明了采用全系列 CHW AIM 组件的重要性，即使是在垂直计划中也是如此。数据的使用、社区参与、当地适应以及与卫生系统的联系对于成功尤为关键。这个一般性的教训可以应用于其他社区动员和疾病/流行病控制举措，特别是当我们面临 COVID-19 大流行的问题时。
Critical community health worker criteria are important for all community programs, including those focused on a single disease. Areas of importance include community engagement, local adaptation, and linkage with the health system—critical areas for current and future epidemics. Data use, community engagement, local adaptation, linkage with the health system, and a strong community platform are critical for successful community programming. Community-based disease surveillance using local volunteers enhanced national and district efforts. Program managers should consider using the Updated Program Functionality Matrix for Optimizing Community Health Programs of the Community Health Worker Assessment and Improvement Matrix (AIM) tool to develop, implement, and assess community health worker programs. Policy makers should support and strengthen strong community platforms in disease eradication programs that engage communities, promote local ownership, and use community-level workers. Emerging infectious diseases will require community engagement through local mobilizers to implement successful government prevention and response efforts. This article assesses the CORE Group Polio Project (CGPP) experience over a 20-year period in 5 countries. It examines how a program designed to provide social mobilization to eradicate one disease, and which did so effectively, functioned within the general framework of community health workers (CHWs). Vertical health programs often have limited impact on broader community health. CGPP has a 20-year history of social mobilization and effective program interventions. This history provided an opportunity to assess how CGPP community mobilizers (CMs) functioned in polio and maternal and child health. The Updated Program Functionality Matrix for Optimizing Community Health Programs tool of the CHW Assessment and Improvement Matrix (AIM) was used to examine CGPP CM roles across different contexts. The analysis determined that CGPP CMs met the basic level of functioning (level 3) for 6 of the 10 components of the AIM tool. This cross-country descriptive analysis of the CGPP demonstrates the importance of embracing the full range of CHW AIM components, even in a vertical program. Use of data, community involvement, local adaptation, and linkage with the health system are especially critical for success. This general lesson could be applied to other community mobilization and disease/epidemic control initiatives, especially as we face the issues of the COVID-19 pandemic.