Community participation in malaria control in Tigray region Ethiopia
Community participation in malaria control in Tigray region Ethiopia
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DOI：
10.1016/0001-706x(95)00107-p
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发表时间：
1996-04-01
期刊：
影响因子：
2.7
通讯作者：
Teklehaimanot, A
中科院分区：
文献类型：
--
作者：
Ghebreyesus, TA;Alemayehu, T;Teklehaimanot, A
1974年至1991年埃塞俄比亚内战期间，提格雷人民解放阵线在提格雷建立了初级卫生保健系统，社区居民通过卫生委员会和社区卫生工作者帮助规划和实施卫生服务。为了加强和更新这一系统，1992年启动了一项以社区为基础的疟疾控制规划。该规划的主要目标是减少疟疾发病率和死亡率，并通过早期诊断和治疗病例、怀孕期间的化学预防以及通过环境管理控制病媒来预防孕妇的疟疾。第二个目标是为最终发展一个乡村循环基金引入一项费用分摊计划。社区选出的681名志愿人员接受了疟疾培训，为1,682,319名农村人口提供服务（CHW/人口比例为1:25 500）。该方案在这一阶段取得的主要成功是，很大一部分有疟疾危险的农村人口现在正在村一级接受治疗。在1993年9月至11月的最后一个主要传播季节，每个卫生保健中心每月平均治疗45 178例临床疟疾病例。已有记录表明，妇女和5岁以下儿童对治疗服务的利用不足，孕妇的化学预防覆盖率较低。在与社区成员和保健员进行焦点小组讨论，找出这些问题的原因后，我们改变了计划政策，以改善对这些群体的覆盖。自1992年以来，在实现方案目标方面取得了相当大的进展，继续进行评价将有助于采取干预措施，进一步加强该区域的疟疾控制努力。
During the Ethiopian civil war from 1974 to 1991, the Tigrean People's Liberation Front established a primary health care system in Tigray in which community residents helped to plan and implement health services through health committees and community health workers (CHWs). To strengthen and update this system, a Community-Based Malaria Control Programme was initiated in 1992. The primary objectives of the Programme are to reduce malaria morbidity and mortality and to prevent malaria in pregnant women through early diagnosis and treatment of cases, chemoprophylaxis during pregnancy, and vector control by environmental management. A secondary objective is to introduce a cost-sharing scheme for eventual development of a village revolving fund.A total of 681 volunteers chosen by their communities have received malaria training and serve a rural population of 1,682 319 (CHW/population ratio 1:2,500). The principal success of the programme at this stage is that a significant proportion of the rural population at risk for malaria is now being treated at the village level. During the last major transmission season from September through November 1993, each CHWs treated a mean of 45 178 clinical malaria cases per month. Under-utilization of treatment services by women and children under 5 years and low chemoprophylaxis coverage of pregnant women have been documented. After focus group discussions with community members and CHWs to identify the reasons for these problems, changes in programme policies were made to improve coverage of these groups. Since 1992, considerable progress toward meeting programme objectives has been made, and continued evaluation will allow for interventions that should further strengthen the malaria control efforts in the region.