Can public sector community health workers deliver a nurturing care intervention in South Africa? The Amagugu Asakhula feasibility study.
Can public sector community health workers deliver a nurturing care intervention in South Africa? The Amagugu Asakhula feasibility study.
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DOI：
10.1186/s40814-021-00802-6
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发表时间：
2021-02-27
影响因子：
1.7
通讯作者：
Draper CE
中科院分区：
文献类型：
--
作者：
Klingberg S;van Sluijs EMF;Jong ST;Draper CE
养育护理干预措施有可能促进幼儿期的健康和发展。Amagugu Asakhula旨在促进南非学龄前儿童（3-5岁）的重要饮食和运动行为。在开普敦进行的一项初步形成性研究发现，由与社区组织有联系的社区卫生工作者（CHW）提供的干预措施是可行和可接受的。本研究评估了与索韦托公共部门初级卫生保健设施相关的社区卫生工作者提供Amagugu Asakhula干预措施的情况，因为这种提供方式可能具有更大的可持续性和可扩展性。定性设计用于评估可行性，可接受性，采用，适当性，实施，保真度和上下文。社区卫生工作者（n = 14）在6周内向索韦托学龄前儿童的照顾者（n = 23）提供了干预措施。在完成干预后，与社区卫生工作者和护理人员进行了重点小组讨论。通过观察、研究记录和关键知情人访谈（n = 5）获得进一步数据。数据进行了分析，使用演绎主题分析的过程评价框架的指导下。通过与索韦托初级卫生保健设施相联系的社区卫生工作者提供Amagugu Asakhula干预措施被认为是不可行的，因为存在背景挑战，如延迟支付工资影响社区卫生工作者的绩效和提供干预措施的意愿。社区保健工作者对他们的一般工作条件表示不满，因此不愿意承担新的任务。尽管存在成功分娩的障碍，但社区卫生工作者和护理人员都很欢迎这种干预措施，并认为这种干预措施非常适合社区卫生工作者的工作范围。根据这些调查结果，不建议通过南非公共部门的社区卫生工作者提供Amagugu Asakhula干预措施。这项可行性研究为优化实施提供了信息，并支持进一步测试由与社区组织有联系的社区卫生工作者提供的干预措施的有效性。本研究报告进一步说明了如何通过定性可行性研究确定实施方面的挑战，并在大规模试验之前加以解决，避免浪费研究和资源。在线版本包含补充材料，可通过10.1186/s40814-021-00802-6获得。
Nurturing care interventions have the potential to promote health and development in early childhood. Amagugu Asakhula was designed to promote developmentally important dietary and movement behaviours among children of preschool age (3–5 years) in South Africa. An initial formative study in Cape Town found the intervention to be feasible and acceptable when delivered by community health workers (CHWs) linked to a community-based organisation. This study evaluated the delivery of the Amagugu Asakhula intervention by CHWs linked to a public sector primary health care facility in Soweto, as this mode of delivery could have more potential for sustainability and scalability. A qualitative design was utilised to assess feasibility, acceptability, adoption, appropriateness, implementation, fidelity and context. CHWs (n = 14) delivered the intervention to caregivers (n = 23) of preschool-age children in Soweto over 6 weeks. Following the completion of the intervention, focus group discussions were held with CHWs and caregivers. Further data were obtained through observations, study records and key informant interviews (n = 5). Data were analysed using deductive thematic analysis guided by a process evaluation framework. The delivery of the Amagugu Asakhula intervention through CHWs linked to a primary health care facility in Soweto was not found to be feasible due to contextual challenges such as late payment of salaries influencing CHW performance and willingness to deliver the intervention. CHWs expressed dissatisfaction with their general working conditions and were thus reluctant to take on new tasks. Despite barriers to successful delivery, the intervention was well received by both CHWs and caregivers and was considered a good fit with the CHWs’ scope of work. Based on these findings, delivery of the Amagugu Asakhula intervention is not recommended through public sector CHWs in South Africa. This feasibility study informs the optimisation of implementation and supports further testing of the intervention’s effectiveness when delivered by CHWs linked to community-based organisations. The present study further demonstrates how implementation challenges can be identified through qualitative feasibility studies and subsequently addressed prior to large-scale trials, avoiding the wasting of research and resources. The online version contains supplementary material available at 10.1186/s40814-021-00802-6.
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DOI：
10.1016/s0140-6736(16)31389-7
发表时间：
2017-01-07
期刊：
Lancet (London, England)
影响因子：
--
作者：
Black MM;Walker SP;Fernald LCH;Andersen CT;DiGirolamo AM;Lu C;McCoy DC;Fink G;Shawar YR;Shiffman J;Devercelli AE;Wodon QT;Vargas-Barón E;Grantham-McGregor S;Lancet Early Childhood Development Series Steering Committee
通讯作者：
Lancet Early Childhood Development Series Steering Committee
影响因子：
3.2
作者：
Kok MC;Dieleman M;Taegtmeyer M;Broerse JE;Kane SS;Ormel H;Tijm MM;de Koning KA
通讯作者：
de Koning KA
DOI：
10.7196/samj.9284
发表时间：
2015-06-01
期刊：
SAMJ: South African Medical Journal
影响因子：
--
作者：
le Roux, K W D P;Couper, I
通讯作者：
Couper, I
影响因子：
4
作者：
Bragstad, Line Kildal;Bronken, Berit Arnesveen;Kirkevold, Marit
通讯作者：
Kirkevold, Marit
影响因子：
1.7
作者：
Hallingberg B;Turley R;Segrott J;Wight D;Craig P;Moore L;Murphy S;Robling M;Simpson SA;Moore G
通讯作者：
Moore G