Development of a tool for assessing quality of comprehensive care provided by community health workers in a community-based care programme in South Africa
Development of a tool for assessing quality of comprehensive care provided by community health workers in a community-based care programme in South Africa
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DOI：
10.1136/bmjopen-2019-030677
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发表时间：
2019-09-01
期刊：
影响因子：
2.9
通讯作者：
Goudge, Jane
中科院分区：
文献类型：
--
作者：
Griffiths, Frances;Babalola, Olukemi;Goudge, Jane
Objective开发一种工具，供非临床现场工作者使用，用于评估低收入和中等收入国家家庭中提供全面护理的社区卫生工作者提供的护理质量。设计我们使用多种信息来源确定了该工具的内容，包括与地区管理者的互动，国家培训手册和一项探索性研究，其中包括对70名社区卫生工作者进行的518次家庭访问的观察，这些访问是更广泛研究的一部分。我们还回顾了相关文献，选择相关领域和质量标记。为了完善工具和手册，我们与进行观察的实地工作人员合作。我们构建了两个分数，总结了护理的关键方面：（1）在家庭访问期间提供信息和行动，以及（2）与家庭沟通;我们还收集了上下文数据。实地工作者与不同地区的社区卫生工作者一起使用该工具来测试可行性。设置南非，社区卫生工作者已被纳入公共卫生系统，以解决医疗保健工作者短缺和医疗保健有限的问题。它是嵌入在一项干预研究，以提高社区卫生工作者supervisory.Primary和secondary outcomes质量我们的主要成果是完成的工具和用户manual.Results该工具包括四个部分，在不同阶段完成社区卫生工作者家访：出发前，在进入一个家庭，在家庭访问和离开后的家庭。工具完善后，我们没有发现任何问题，现场测试tool.Conclusions，我们已经开发出一种工具，用于评估社区卫生工作者在家访，往往是一个未观察到的一部分，他们的作用提供的护理质量。该工具是为评估干预措施而开发的，但也可用于支持社区卫生工作者的培训和管理。
Objective To develop a tool for use by non-clinical fieldworkers for assessing the quality of care delivered by community health workers providing comprehensive care in households in low- and middle-income countries.Design We determined the content of the tool using multiple sources of information, including interactions with district managers, national training manuals and an exploratory study that included observations of 70 community health workers undertaking 518 household visits collected as part of a wider study. We also reviewed relevant literature, selecting relevant domains and quality markers. To refine the tool and manual we worked with the fieldworkers who had undertaken the observations. We constructed two scores summarising key aspects of care: (1) delivering messages and actions during household visit, and (2) communicating with the household; we also collected contextual data. The fieldworkers used the tool with community health workers in a different area to test feasibility.Setting South Africa, where community health workers have been brought into the public health system to address the shortage of healthcare workers and limited access to healthcare. It was embedded in an intervention study to improve quality of community health worker supervision.Primary and secondary outcomes Our primary outcome was the completion of a tool and user manual.Results The tool consists of four sections, completed at different stages during community health worker household visits: before setting out, at entry to a household, during the household visit and after leaving the household. Following tool refinement, we found no problems on field-testing the tool.Conclusions We have developed a tool for assessing quality of care delivered by community health workers at home visits, often an unobserved part of their role. The tool was developed for evaluating an intervention but could also be used to support training and management of community health workers.