The effect of a roving nurse mentor on household coverage and quality of care provided by community health worker teams in South Africa: a longitudinal study with a before, after and 6 months post design.
The effect of a roving nurse mentor on household coverage and quality of care provided by community health worker teams in South Africa: a longitudinal study with a before, after and 6 months post design.
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DOI：
10.1186/s12913-023-09093-4
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发表时间：
2023-02-22
影响因子：
2.8
通讯作者：
中科院分区：
文献类型：
--
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社区卫生工作者（CHW）正在承担更复杂的任务，作为在许多低收入和中等收入环境中实现全民健康覆盖的一部分。他们应该提供促进和预防保健，转介到当地诊所，并跟进非与会者的一系列健康状况。社区妇女规划可以改善弱势社区获得医疗服务的机会，但由于监督不足、社区妇女识字率低以及社区妇女在卫生系统中的边缘化地位，许多此类规划举步维艰。在本文中，我们评估了流动护士导师对南非两个弱势社区CHW服务的覆盖范围和护理质量的影响。他们的主管，家庭成员。巡回专业护士导师，培养主管和卫生保健团队的技能。三次家庭调查，以评估家庭对卫生保健服务的覆盖率（基线、干预结束和干预结束后6个月）；对在家庭中工作的CHW进行结构化观察，以评估护理质量。在这项干预措施的推动下，在过去一年中，健康护理员探访的家庭数目持续增加了50%。虽然卫生保健妇女向家庭成员提供适当健康信息的比例保持在50%左右，但卫生保健妇女执行了更大范围的更复杂的任务。他们更有可能访问新家庭，以评估保健需求并在该方案中登记该家庭，为孕妇、儿童和退出护理的人提供护理。CHW更有可能与客户讨论他们在获得护理方面面临的障碍，并在访问期间做笔记。护士导师可以对卫生保健工作的数量和质量产生重大影响，使她们能够发挥自己的潜力，尽管她们在卫生系统中的边缘化地位和之前的教育成就有限。支持性监督对于实现在边缘化社区部署卫生干部的好处非常重要。在线版本包含补充材料，下载地址：10.1186/s12913-023-09093-4。
Community health workers (CHW) are undertaking more complex tasks as part of the move towards universal health coverage in many low- and middle-income settings. They are expected to provide promotive and preventative care, make referrals to the local clinic, and follow up on non-attendees for a range of health conditions. CHW programmes can improve access to care for vulnerable communities, but many such programmes struggle due to inadequate supervision, low levels of CHW literacy, and the marginalized status of CHW in the health system. In this paper, we assess the effect of a roving nurse mentor on the coverage and quality of care of the CHW service in two vulnerable communities in South Africa. CHW, their supervisors, household members. Roving professional nurse mentor to build skills of supervisors and CHW teams. Three household surveys to assess household coverage of the CHW service (baseline, end of the intervention, and 6 months after end of intervention); structured observations of CHW working in households to assess quality of care. The intervention led to a sustained 50% increase in the number of households visited by a CHW in the last year. While the proportion of appropriate health messages given to household members by CHW remained constant at approximately 50%, CHW performed a greater range of more complex tasks. They were more likely to visit new households to assess health needs and register the household in the programme, to provide care to pregnant women, children and people who had withdrawn from care. CHW were more likely to discuss with clients the barriers they were facing in accessing care and take notes during a visit. A nurse mentor can have a significant effect both on the quantity and quality of CHW work, allowing them to achieve their potential despite their marginalised status in the health system and their limited prior educational achievement. Supportive supervision is important in enabling the benefit of having a health cadre embedded in marginalised communities to be realised. The online version contains supplementary material available at 10.1186/s12913-023-09093-4.
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影响因子：
7.2
作者：
Biemba, Godfrey;Chiluba, Boniface;MacLeod, William B.
通讯作者：
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影响因子：
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作者：
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影响因子：
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