Quantifying and Valuing Community Health Worker Time in Improving Access to Malaria Diagnosis and Treatment.
Quantifying and Valuing Community Health Worker Time in Improving Access to Malaria Diagnosis and Treatment.
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DOI：
10.1093/cid/ciw629
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发表时间：
2016-12-15
期刊：
影响因子：
--
通讯作者：
Gomes M
中科院分区：
文献类型：
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作者：
Castellani J;Mihaylova B;Ajayi IO;Siribié M;Nsungwa-Sabiiti J;Afonne C;Sermé L;Balyeku A;Kabarungi V;Kyaligonza J;Evers SM;Paulus AT;Petzold M;Singlovic J;Gomes M
背景： 社区卫生工作者(CHW)是社区的成员，他们被所在社区选为一线志愿卫生工作者。他们花在提供医疗保健上的时间和这段时间的价值往往没有被评估。我们的目标是量化在3个非洲国家实施发热疾病诊断和治疗综合计划之前和期间CHW在提供医疗保健方面所花费的时间。方法： 在布基纳法索、尼日利亚和乌干达，CHW接受了培训，以评估和管理发热患者，以符合儿童疾病综合管理的建议，使用快速诊断测试、基于青蒿素的联合疗法和直肠青蒿琥酯治疗疟疾。所有社区卫生工作者只向幼儿提供保健，通常为5岁，因此在干预前1天(疟疾高发期)和干预实施后的几个时间点记录了他们每天用于儿童保健的时间。花在提供儿童保健上的时间是根据有类似经历的人的收入来衡量的。结果： 在干预的疟疾高发季节，社区卫生工作者在日常保健服务上花费的时间增加了近50分钟(平均每天时间，干预前为30.2分钟，干预期间为79.5分钟；检验均值差异P<；.01)。平均而言，干预期间每天提供医疗保健的时间分别为55.8分钟(布基纳法索)、77.4分钟(尼日利亚)和72.2分钟(乌干达)。使用国家最低月薪，在布基纳法索，社区卫生工作者分配给儿童保健的1年时间价值为52美元，尼日利亚为295美元，乌干达为141美元。结论： 社区卫生工作者每天花在社区儿童保健上的时间长达一个半小时。这些数据有助于设计奖励制度，以激励社区卫生服务机构继续提供优质服务。临床试验注册。 ISRCTN13858170。
Background. Community health workers (CHWs) are members of a community who are chosen by their communities as first-line, volunteer health workers. The time they spend providing healthcare and the value of this time are often not evaluated. Our aim was to quantify the time CHWs spent on providing healthcare before and during the implementation of an integrated program of diagnosis and treatment of febrile illness in 3 African countries. Methods. In Burkina Faso, Nigeria, and Uganda, CHWs were trained to assess and manage febrile patients in keeping with Integrated Management of Childhood Illness recommendations to use rapid diagnostic tests, artemisinin-based combination therapy, and rectal artesunate for malaria treatment. All CHWs provided healthcare only to young children usually <5 years of age, and hence daily time allocation of their time to child healthcare was documented for 1 day (in the high malaria season) before the intervention and at several time points following the implementation of the intervention. Time spent in providing child healthcare was valued in earnings of persons with similar experience. Results. During the high malaria season of the intervention, CHWs spent nearly 50 minutes more in daily healthcare provision (average daily time, 30.2 minutes before the intervention vs 79.5 minutes during the intervention; test for difference in means P < .01). On average, the daily time spent providing healthcare during the intervention was 55.8 minutes (Burkina Faso), 77.4 minutes (Nigeria), and 72.2 minutes (Uganda). Using the country minimum monthly salary, CHWs’ time allocated to child healthcare for 1 year was valued at US Dollars (USD) $52 in Burkina Faso, USD $295 in Nigeria, and USD $141 in Uganda. Conclusions. CHWs spend up to an hour and a half daily on child healthcare in their communities. These data are informative in designing reward systems to motivate CHWs to continue providing good-quality services. Clinical Trials Registration. ISRCTN13858170.
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影响因子：
168.9
作者：
Gomes, M. F.;Faiz, M. A.;Gyapong, J. O.;Warsame, M.;Agbenyega, T.;Babiker, A.;Baiden, F.;Yunus, E. B.;Binka, F.;Clerk, C.;Folb, P.;Hassan, R.;Hossain, M. A.;Kimbute, O.;Kitua, A.;Krishna, S.;Makasi, C.;Mensah, N.;Mrango, Z.;Olliaro, P.;Peto, R.;Peto, T. J.;Rahman, M. R.;Ribeiro, I.;Samad, R.;White, N. J.
通讯作者：
White, N. J.
影响因子：
11.8
作者：
Ajayi, IkeOluwapo O.;Nsungwa-Sabiiti, Jesca;Gomes, Melba
通讯作者：
Gomes, Melba
影响因子：
168.9
作者：
Schellenberg, JA;Victora, CG;Bryce, J
通讯作者：
Bryce, J
DOI：
10.1093/cid/ciw625
发表时间：
2016-12-15
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Sanou AK;Jegede AS;Nsungwa-Sabiiti J;Siribié M;Ajayi IO;Turinde A;Oshiname FO;Sermé L;Kabarungi V;Falade CO;Kyaligonza J;Afonne C;Balyeku A;Castellani J;Gomes M
通讯作者：
Gomes M
DOI：
10.1093/cid/ciw630
发表时间：
2016-12-15
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Jegede AS;Oshiname FO;Sanou AK;Nsungwa-Sabiiti J;Ajayi IO;Siribié M;Afonne C;Sermé L;Falade CO
通讯作者：
Falade CO