Supporting and retaining Village Health Teams: an assessment of a community health worker program in two Ugandan districts.
Supporting and retaining Village Health Teams: an assessment of a community health worker program in two Ugandan districts.
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DOI：
10.1186/s12939-017-0619-6
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发表时间：
2017-07-20
影响因子：
4.8
通讯作者：
Talib ZM
中科院分区：
文献类型：
--
作者：
Mays DC;O'Neil EJ Jr;Mworozi EA;Lough BJ;Tabb ZJ;Whitlock AE;Mutimba EM;Talib ZM
乌干达的国家社区卫生工作者方案包括提供基本卫生服务和教育的志愿者村卫生队。有证据表明，它们对健康成果产生了积极影响，特别是对乌干达人，否则他们将无法获得保健服务。尽管他们的影响，VHTs没有得到最佳的支持和自然减员是一个日益严重的问题。在这项研究中，我们研究了乌干达两个地区的VHTs的支持需求和现有的挑战，并评估了与长期保留相关的具体因素。我们报告的结果，从一个标准化的调查VHTs和探索性访谈的主要利益相关者，并得出结论，为努力加强和维持社区卫生保健提供在乌干达。采用混合方法的方法，通过对134个人的VHT成员和半结构化的访谈与六个关键利益相关者的调查。定量调查数据的描述性和双变量回归分析，以及调查和访谈的定性数据的专题分析。在回归分析中，因变量是VHT中的10年预期寿命，该分析询问受访者，如果他们目前的情况保持不变，他们是否预计继续作为VHT志愿者至少10年。志愿人员小组希望得到额外的支持，主要是资金（如交通补贴）和物资（如胶靴）。VHT通常报告工作条件困难，并描述缺乏社区和其他卫生工作者的尊重。如果他们目前的情况保持不变，57%的VHT预计将在其职位上至少工作10年。预期的10年寿命与与当地健康中心工作人员更强的伙伴关系以及更容易进行家访呈正相关。通过在自愿保健小组和其他保健工作者之间建立更强有力的伙伴关系，并定期提供用品和交通津贴，将加强对乌干达自愿保健小组的支持和留住。推行这些措施可能会改善所有乌干达人获得医疗保健的公平性。本文的在线版本（doi：10.1186/s12939 - 017 - 0619 - 6）包含补充材料，可供授权用户使用。
Uganda’s national community health worker program involves volunteer Village Health Teams (VHTs) delivering basic health services and education. Evidence demonstrates their positive impact on health outcomes, particularly for Ugandans who would otherwise lack access to health services. Despite their impact, VHTs are not optimally supported and attrition is a growing problem. In this study, we examined the support needs and existing challenges of VHTs in two Ugandan districts and evaluated specific factors associated with long-term retention. We report on findings from a standardized survey of VHTs and exploratory interviews with key stakeholders and draw conclusions that inform efforts to strengthen and sustain community health care delivery in Uganda. A mixed-methods approach was employed through a survey of 134 individual VHT members and semi-structured interviews with six key stakeholders. Descriptive and bivariate regression analysis of quantitative survey data was performed along with thematic analysis of qualitative data from surveys and interviews. In the regression analysis, the dependent variable is 10-year anticipated longevity among VHTs, which asked respondents if they anticipate continuing to volunteer as VHTs for at least 10 more years if their current situation remains unchanged. VHTs desire additional support primarily in the forms of money (e.g. transportation allowance) and material supplies (e.g. rubber boots). VHTs commonly report difficult working conditions and describe a lack of respect from their communities and other health workers. If their current situation remains unchanged, 57% of VHTs anticipate remaining in their posts for at least 10 years. Anticipated 10-year longevity was positively associated with stronger partnerships with local health center staff and greater ease in home visiting. Supporting and retaining Uganda’s VHTs would be enhanced by building stronger partnerships between VHTs and other health workers and regularly providing supplies and transportation allowances. Pursuing such measures would likely improve equity in access to healthcare for all Ugandans. The online version of this article (doi:10.1186/s12939-017-0619-6) contains supplementary material, which is available to authorized users.
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影响因子：
4.5
作者：
Bertone, Maria Paola;Witter, Sophie
通讯作者：
Witter, Sophie
DOI：
10.9745/ghsp-d-13-00140
发表时间：
2014-02
期刊：
Global health, science and practice
影响因子：
--
作者：
Brunie A;Wamala-Mucheri P;Otterness C;Akol A;Chen M;Bufumbo L;Weaver M
通讯作者：
Weaver M
影响因子：
5.4
作者：
Glenton, Claire;Scheel, Inger B.;Shrestha, Vijaya
通讯作者：
Shrestha, Vijaya
影响因子：
4.5
作者：
Miller JS;Musominali S;Baganizi M;Paccione GA
通讯作者：
Paccione GA
DOI：
10.2471/blt.11.087825
发表时间：
2011-12-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Nkonki, Lungiswa;Cliff, Julie;Sanders, David
通讯作者：
Sanders, David