Knowledge and performance of the Ethiopian health extension workers on antenatal and delivery care: a cross-sectional study
Knowledge and performance of the Ethiopian health extension workers on antenatal and delivery care: a cross-sectional study
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DOI：
10.1186/1478-4491-10-44
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发表时间：
2012-11-21
影响因子：
4.5
通讯作者：
Blanco, Roman
中科院分区：
文献类型：
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作者：
Medhanyie, Araya;Spigt, Mark;Blanco, Roman
背景：鉴于卫生服务领域人力资源严重短缺，发展中国家已培训并部署社区卫生工作者提供初级卫生保健服务。然而，很少有研究调查这些卫生工作者是否能够提供高质量的护理。本研究调查了卫生推广工作者（HEWs）在产前和分娩护理方面的知识和表现。该研究还探讨了卫生推广工作者在提供孕产妇保健方面的障碍和促进因素。
方法：在进行这项研究时，采用了横断面研究方法。对在39个卫生站工作、覆盖约19.5万人口的共50名卫生推广工作者进行了访谈。使用了描述性统计方法，并根据埃塞俄比亚教育评分系统对卫生推广工作者的知识综合得分进行了计算和解读。
结果：几乎一半的受访者有至少5年的卫生推广工作者工作经验。超过一半（27人，占54%）的卫生推广工作者对产前护理咨询内容了解甚少，大多数（44人，占88%）对怀孕的危险症状、危险体征和并发症了解不足。作为卫生推广工作者工作场所的卫生站，没有诸如供水、供电以及供临产妇女使用的候诊室等基本基础设施。平均在6个月内，一名卫生推广工作者协助了5.8次分娩。只有少数分娩（10%）是在卫生站协助进行的，大多数（82%）是在家中进行的，并且只有20%的卫生推广工作者得到了助产士的专业协助。
结论：考虑到卫生推广工作者知识匮乏、卫生站设备简陋以及转诊系统不完善，卫生推广工作者很难在通过早期识别危险体征来提高医疗机构分娩率、熟练助产以及及时转诊方面发挥关键作用。因此，迫切需要制定适当的策略，通过提高卫生推广工作者的知识和能力，并创造适当的工作条件来改善其工作表现。
Background: In recognition of the critical shortage of human resources within health services, community health workers have been trained and deployed to provide primary health care in developing countries. However, very few studies have investigated whether these health workers can provide good quality of care. This study investigated the knowledge and performance of health extension workers (HEWs) on antenatal and delivery care. The study also explored the barriers and facilitators for HEWs in the provision of maternal health care.Methods: In conducting this research, a cross-sectional study was performed. A total of 50 HEWs working in 39 health posts, covering a population of approximately 195,000 people, were interviewed. Descriptive statistics was used and a composite score of knowledge of HEWs was made and interpreted based on the Ethiopian education scoring system.Results: Almost half of the respondents had at least 5 years of work experience as a HEW. More than half (27 (54%)) of the HEWs had poor knowledge on contents of antenatal care counseling, and the majority (44 (88%)) had poor knowledge on danger symptoms, danger signs, and complications in pregnancy. Health posts, which are the operational units for HEWs, did not have basic infrastructures like water supply, electricity, and waiting rooms for women in labor. On average within 6 months, a HEW assisted in 5.8 births. Only a few births (10%) were assisted at the health posts, the majority (82%) were assisted at home and only 20% of HEWs received professional assistance from a midwife.Conclusion: Considering the poor knowledge of HEWs, poorly equipped health posts, and poor referral systems, it is difficult for HEWs to play a key role in improving health facility deliveries, skilled birth attendance, and on-time referral through early identification of danger signs. Hence, there is an urgent need to design appropriate strategies to improve the performance of HEWs by enhancing their knowledge and competencies, while creating appropriate working conditions.