Novel approaches to measuring knowledge among frontline health workers in India: Are phone surveys a reliable option?
Novel approaches to measuring knowledge among frontline health workers in India: Are phone surveys a reliable option?
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DOI：
10.1371/journal.pone.0234241
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发表时间：
2020-06-29
期刊：
影响因子：
3.7
通讯作者：
LeFevre, Amnesty
中科院分区：
文献类型：
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作者：
Shah, Neha;Mohan, Diwakar;LeFevre, Amnesty
2017年，印度占全球孕产妇和儿童死亡人数的近20%。经认可的社会卫生活动家（ASHAs）在印度充当卫生服务提供的前线，提供一系列生殖、孕产妇、新生儿、儿童健康和营养（RMNCH&N）服务。关于卫生保健服务机构知识的经验证据有限，但这是所提供卫生服务质量的关键决定因素。我们评估了asha中RMNCH&N知识的决定因素，并检查了调查交付的替代方式的可靠性，包括面对面和来电者参加的电话访谈（电话调查）在印度中央邦的4个地区。方法：我们在随机抽样的asha患者中进行面对面调查（n = 1552），并在首次调查后2周内对asha患者的子样本（n = 173）进行随访测试-再测试调查。在2周的电话面对面访谈中，我们采访了一个单独的ASHAs子样本（n = 155）。分析包括双变量分析、多变量线性回归、患病率和偏差校正kappa分析。ASHA知识的平均得分为64%，从基本新生儿护理的71%、WASH/腹泻的71%、婴儿喂养的64%、计划生育的61%和孕产妇保健的60%不等。知识的主要决定因素包括地理位置、年龄
Background In 2017, India was home to nearly 20% of maternal and child deaths occurring globally. Accredited social health activists (ASHAs) act as the frontline for health services delivery in India, providing a range of reproductive, maternal, newborn, child health, and nutrition (RMNCH&N) services. Empirical evidence on ASHAs' knowledge is limited, yet is a critical determinant of the quality of health services provided. We assessed the determinants of RMNCH&N knowledge among ASHAs and examined the reliability of alternative modalities of survey delivery, including face-to-face and caller attended telephone interviews (phone surveys) in 4 districts of Madhya Pradesh, India. Methods We carried out face-to-face surveys among a random cross-sectional sample of ASHAs (n = 1,552), and administered a follow-up test-retest survey within 2 weeks of the initial survey to a subsample of ASHAs (n = 173). We interviewed a separate sub-sample of ASHAs 2 weeks of the face-to-face interview over the phone (n = 155). Analyses included bivariate analyses, multivariable linear regression, and prevalence and bias adjusted kappa analyses. Findings The average ASHA knowledge score was 64% and ranged across sub-domains from 71% for essential newborn care, 71% for WASH/ diarrhea, 64% for infant feeding, 61% for family planning, and 60% for maternal health. Leading determinants of knowledge included geographic location, age