Community health workers' quality of comprehensive care: a cross-sectional observational study across three districts in South Africa.
Community health workers' quality of comprehensive care: a cross-sectional observational study across three districts in South Africa.
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DOI：
10.3389/fpubh.2023.1180663
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发表时间：
2023
影响因子：
5.2
通讯作者：
Griffiths, Frances
中科院分区：
文献类型：
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作者：
Babalola, Olukemi;Levin, Jonathan;Goudge, Jane;Griffiths, Frances
社区卫生保健工作者（CHW）培训计划正变得越来越全面（扩大疾病范围）。然而，该项目所依赖的社区卫生工作者的培训有限。由于卫生工作者的活动主要是在家访中进行的，而家访往往没有受到监督和评估，因此需要进行长期、持续的评估，以确定卫生工作者能力方面的差距，并改善这些差距。我们在家庭访问期间观察了卫生工作者，并根据家庭遇到的健康状况提供的健康信息/活动的比例进行评分。我们的目的是确定(1)信息/活动得分，由在南非提供全面护理的卫生工作者在家庭中提供的健康信息的比例得出，以及(2)相关因素。在三个地区（来自两个省），我们培训了五名实地工作者，对2018年和2020年376次家庭访问中随机选择的34名卫生工作者提供的信息和活动进行评分，采用横断面研究设计。拟合多水平模型以确定与信息/活动得分相关的因素，并根据CHWs内观察结果的聚类进行调整。模型对现场工作者和研究设施（分别为n = 5）进行了调整，作为固定效应。调查了与CHW相关的（年龄、教育水平、参加/通过的CHW培训阶段）和与家庭相关的因素（家庭规模[每户人数]、每户病症数量以及患有高血压、糖尿病、艾滋病、结核病和咳嗽等病症的人数）。在最后的模型中，访问时间每增加5分钟，消息/活动得分就会增加。对于有儿童/婴儿、高血压、糖尿病、家庭规模大、家庭条件众多以及成员患有结核病或咳嗽的家庭，信息/活动得分较低。增加家庭规模和数量的条件下，也会降低得分。信息/活动得分与任何CHW特征无关，包括教育和培训。本研究确定了与CHW团队提供的信息和CHW团队活动相关的重要因素。鉴于提供全面护理的卫生保健员提供信息/活动的条件更广泛，特别是在患有高血压、糖尿病、结核病/咳嗽以及儿童或婴儿的家庭中，需要加大努力，确保他们得到支持。
Community healthcare worker (CHW) training programs are becoming increasingly comprehensive (an expanded range of diseases). However, the CHWs that the program relies on have limited training. Since CHWs’ activities occur largely during household visits, which often go unsupervised and unassessed, long-term, ongoing assessment is needed to identify gaps in CHW competency, and improve any such gaps. We observed CHWs during household visits and gave scores according to the proportion of health messages/activities provided for the health conditions encountered in households. We aimed to determine (1) messages/activities scores derived from the proportion of health messages given in the households by CHWs who provide comprehensive care in South Africa, and (2) the associated factors. In three districts (from two provinces), we trained five fieldworkers to score the messages provided by, and activities of, 34 CHWs that we randomly selected during 376 household visits in 2018 and 2020 using a cross-sectional study designs. Multilevel models were fitted to identify factors associated with the messages/activities scores, adjusted for the clustering of observations within CHWs. The models were adjusted for fieldworkers and study facilities (n = 5, respectively) as fixed effects. CHW-related (age, education level, and phase of CHW training attended/passed) and household-related factors (household size [number of persons per household], number of conditions per household, and number of persons with a condition [hypertension, diabetes, HIV, tuberculosis TB, and cough]) were investigated. In the final model, messages/activities scores increased with each extra 5-min increase in visit duration. Messages/activities scores were lower for households with either children/babies, hypertension, diabetes, a large household size, numerous household conditions, and members with either TB or cough. Increasing household size and number of conditions, also lower the score. The messages/activities scores were not associated with any CHW characteristics, including education and training. This study identifies important factors related to the messages provided by and the activities of CHWs across CHW teams. Increasing efforts are needed to ensure that CHWs who provide comprehensive care are supported given the wider range of conditions for which they provide messages/activities, especially in households with hypertension, diabetes, TB/cough, and children or babies.
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影响因子：
--
作者：
Diema Konlan K;Kossi Vivor N;Gegefe I;A Abdul-Rasheed I;Esinam Kornyo B;Peter Kwao I
通讯作者：
Peter Kwao I
影响因子：
4.5
作者：
Agarwal, Smisha;Sripad, Pooja;Warren, Charlotte E.
通讯作者：
Warren, Charlotte E.
影响因子：
4.3
作者：
Chaudhary, Nidhi;Mohanty, P. N.;Sharma, Minakshi
通讯作者：
Sharma, Minakshi
DOI：
10.1016/0271-7123(81)90096-1
发表时间：
1981-01-01
期刊：
SOCIAL SCIENCE & MEDICINE PART A-MEDICAL SOCIOLOGY
影响因子：
--
作者：
AMONOOLARTSON, R;DEVRIES, JA
通讯作者：
DEVRIES, JA
影响因子：
2.8
作者：
通讯作者：
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