Reactions of community members regarding community health workers' activities as a measure of the impact of a training program in Amazonas, Brazil.
Reactions of community members regarding community health workers' activities as a measure of the impact of a training program in Amazonas, Brazil.
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DOI：
10.2185/jrm.2890
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Ohnishi M
中科院分区：
文献类型：
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作者：
Kawasaki R;Sadamori T;Ferreira de Almeida T;Akiyoshi M;Nishihara M;Yoshimura T;Ohnishi M
目的：本研究的目的是评估社区卫生工作者（CHW）培训的认可和满意度的社区成员在亚马逊，巴西，这是一个资源贫乏的地区，医疗卫生保健的可及性不足的表现。研究方法：基线和底线调查有关的认可和满意度方面的社区成员CHW的性能进行了采访，使用问卷调查之前和之后实施的一项计划，以加强在Manicoré，亚马逊，巴西的社区卫生项目。该项目的组成部分之一是社区卫生保健进修培训，重点是促进充分利用保健服务和提供初级保健，包括保健指导。基线调查于2004年2月项目开始时进行，终点调查于2006年2月项目结束时进行。在基线和基线调查时，分别有82名和120名社区保健工作者在Manicoré工作。进行统计分析，以确定基线和终点调查之间CHW活动经验变化的意义、CHW的预期功能以及对CHW绩效的满意度。此外，定性分析进行评估的可接受性，可行性和可持续性的CHW进修培训。结果如下：从基线到终点调查，社区成员对社区卫生福利工作的总体认可度和满意度都有所提高，无论居住区的类型如何，如城镇和/或偏远地区。社区成员逐渐不期望社区卫生工作者“提供强力药物”（P < 0.001）和“提供注射”（P < 0.001），并逐渐欣赏“陪病人去医院”（P = 0.031）作为社区卫生工作者的功能和角色。结论：本研究的结果表明，稳定的方法来激励和支持社区卫生工作者在资源有限的设置可以提高性能的社区卫生工作者和满意度的社区居民对社区卫生工作者的活动，以维持他们的健康。
Objectives: The aim of this study was to evaluate the impact of community health worker (CHW) training on recognition and satisfaction regarding the performance of CHWs among members of the community in Amazonas, Brazil, which is a resource-poor area underserved with regard to medical health-care accessibility. Methods: Baseline and endline surveys concerning recognition and satisfaction with respect to CHW performance among members of the community were conducted by interview using a questionnaire before and after implementation of a program to strengthen community health projects in Manicoré, Amazonas, Brazil. One of the components of the project was CHW refresher training, which focused on facilitating adequate use of health-care services and providing primary health care, including health guidance. The baseline survey was performed in February 2004 at the beginning of the project, and the endline survey was performed in February 2006 at the end of the project. There were 82 and 120 CHWs working in Manicoré at the times of the baseline and endline surveys, respectively. Statistical analysis was performed to determine the significance of changes in experience with CHW activities, expected functions of CHWs, and satisfaction regarding the performance of CHWs between the baseline and endline surveys. In addition, qualitative analysis was conducted to evaluate the acceptability, feasibility, and sustainability of CHW refresher training. Results: Overall recognition and level of satisfaction regarding CHW performance among members of the community were improved from the baseline to the endline survey, regardless of type of residential area, such as town and/or remote area. Members of the community came to not expect CHWs to “provide strong medicine” (P < 0.001) and “provide injections” (P < 0.001), and came to appreciate “go to hospital with a sick person” (P = 0.031) as a function and role of CHWs. Conclusions: The results of the present study indicated that steady approaches to motivate and support CHWs in resource-limited settings could improve performance of CHWs and satisfaction of people in the community regarding the activities of CHWs to sustain their health.