Integrating community outreach into a quality improvement project to promote maternal and child health in Ghana
Integrating community outreach into a quality improvement project to promote maternal and child health in Ghana
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DOI：
10.1080/17441692.2014.952656
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发表时间：
2014-11-26
影响因子：
3.3
通讯作者：
Barker, Pierre M.
中科院分区：
文献类型：
--
作者：
Cofie, Leslie E.;Barrington, Clare;Barker, Pierre M.
质量改进（QI）用于促进和加强中低收入国家的孕产妇和儿童保健服务。很少有研究审查卫生设施范围以外的社区一级的因素，这些因素创造了对卫生服务的需求并影响了卫生结果。我们研究了社区外展在“五个活着的项目”中的作用，一个旨在改善加纳孕产妇和5岁以下儿童状况的质量保证项目。对加纳六个地区的质量保证小组进行了定性案例研究。我们使用叙述和主题技术分析数据。QI小组成员采用了两种不同的外展方法：社区一级的外展，包括通过团体活动和大众媒体传播开展健康促进和教育工作;以及直接外展，包括卫生工作者、孕妇和5岁以下儿童的母亲之间一对一的人际活动。社区外展的具体障碍包括结构、文化和QI团队层面的因素。农村和城市环境中的QI工作应考虑包括特定环境的社区外展活动，以发展与社区的联系，并解决卫生服务的障碍。作为QI工作的一部分，维持社区外展需要改善基础设施，加强QI团队，并与社区成员进行持续合作。
Quality improvement (QI) is used to promote and strengthen maternal and child health services in middle- and low-income countries. Very little research has examined community-level factors beyond the confines of health facilities that create demand for health services and influence health outcomes. We examined the role of community outreach in the context of Project Fives Alive!, a QI project aimed at improving maternal and under-5 outcomes in Ghana. Qualitative case studies of QI teams across six regions of Ghana were conducted. We analysed the data using narrative and thematic techniques. QI team members used two distinct outreach approaches: community-level outreach, including health promotion and education efforts through group activities and mass media communication; and direct outreach, including one-on-one interpersonal activities between health workers, pregnant women and mothers of children under-5. Specific barriers to community outreach included structural, cultural, and QI team-level factors. QI efforts in both rural and urban settings should consider including context-specific community outreach activities to develop ties with communities and address barriers to health services. Sustaining community outreach as part of QI efforts will require improving infrastructure, strengthening QI teams, and ongoing collaboration with community members.