Integrated management of childhood illness (IMCI) follow-up of basic health workers
Integrated management of childhood illness (IMCI) follow-up of basic health workers
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DOI：
10.1007/bf02734143
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发表时间：
2005-09-01
影响因子：
4.3
通讯作者：
Sharma, Minakshi
中科院分区：
文献类型：
--
作者：
Chaudhary, Nidhi;Mohanty, P. N.;Sharma, Minakshi
目标：评估基础卫生工作者在儿童疾病综合管理培训后4 - 8周和一年内所学技能的实践情况，并查明由于各种制约因素而在实践中存在的差距。方法：采用WHO的培训方案，对安干瓦迪工作人员（AWWS）和管理人员进行为期5天的IMCI培训。监督员使用根据世卫组织材料改编的标准化后续表格对AWW进行后续访问。在儿童疾病综合管理培训1年后，监督员对第一批AWW进行了随访，并在第一次随访后4-8周进行了第二次随访。在IMCI培训后4-8周对2批AWWs进行随访。结果如下：随访前4 ~ 6周进行AWWs训练的病例正确处理能力优于训练结束后1年随访的病例（分别为81.8%和47.9%）。同时，在第二次随访期间，正确治疗的表现显示出显著改善（分别为47.9%和83.8%）。咨询表现从第1次随访的15.6%提高到第2次随访的52.1%。AWWs观察到的平均病例数从第1次随访时的6.6例增加到第2次随访时的9.3例。结论：基层卫生工作者（AWWs）能够使用IMCI指南对患病儿童进行正确的病例管理。第一次随访访视不应延迟，因为延迟会导致技能丧失。卫生工作者受益于监督人员经常和定期的后续行动。提供必要的用品是基本保健工作人员在接受儿童疾病综合管理培训后练习技能的必要条件。
Objective: To assess the practice of skills learnt by basic health workers for 4 - 8 weeks and one year after IMCI training, and to identify the gaps in practices due to various constraints. Methods: The anganwadi workers (AWWS) and the supervisory staff were given 5 days IMCI training using WHO package. The supervisors gave follow up visits to AWWs using standardized follow up forms adapted from WHO material. The supervisors gave follow up visit to the 1(st) batch of AWWs 1 year after training in IMCI and a second visit was given 4-8 weeks after the 1(st) visit. The 2 Id batch of AWWs was followed up 4-8 weeks after training in IMCI. Results : The performance on correct treatment of cases by AWWs weeks were trained 4 - 6 weeks prior to follow up was better than group followed up one year after the completion of training (81.8% and 47.9% respectively). At the same time, the performance on correct treatment showed significant improvement during the second follow up (47.9% and 83.8% respectively). Performance on counseling improved from 15.6% during 1(st) follow up to 52.1% during 2(nd) follow up visit. The average number of cases seen by AWWs increased from 6.6 in 1(st) follow up to 9.3 during second follow up of the same AWWs. Conclusion : The basic health workers (AWWs) are capable of correct case management of sick children using the IMCI guidelines. The first follow up visit should not be delayed as delay leads to loss of skills. The health workers benefit from frequent and regular follow up by supervisors. Provision of requisite supplies is essential for practice of skills after training in IMCI by basic health worker.