Effectiveness of community health workers delivering preventive interventions for maternal and child health in low- and middle-income countries: a systematic review.
Effectiveness of community health workers delivering preventive interventions for maternal and child health in low- and middle-income countries: a systematic review.
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DOI：
10.1186/1471-2458-13-847
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发表时间：
2013-09-13
影响因子：
4.5
通讯作者：
McAuliffe E
中科院分区：
文献类型：
--
作者：
Gilmore B;McAuliffe E
社区卫生工作者在低收入和中等收入国家得到广泛利用，可能是降低孕产妇和儿童死亡率的重要工具;然而，缺乏证据表明其对特定类型的计划，特别是预防性计划的有效性。本综述报告了一项系统性综述的结果，该综述分析了低收入和中等收入国家社区妇幼保健工作者提供的预防干预措施的有效性。根据政策与实践信息和协调中心（EPPI-中心）指南制定了检索策略，并在2012年6月8日至11日期间对以下数据库进行了系统检索：CINAHL、Embase、奥维德护理数据库、PubMed、Scopus、Web of Science和POPLINE。还检索了Google、Google Scholar和WHO搜索引擎，以及纳入文章的相关系统综述和参考文献列表。入选标准为：㈠目标受益人应是孕妇或最近怀孕的妇女和/或5岁以下儿童和/或5岁以下儿童的照顾者; ㈡干预措施必须是预防性的，并由社区卫生工作者在家庭一级提供。未规定比较/对照或结局的排除标准。使用数据表和同行测试质量评估提取纳入文献的研究特征。对纳入的研究进行叙述性综合，并对文章进行编码，以综合结果并得出结论。最初共识别出10，281项研究，通过筛选过程，共有17篇文章详细介绍了19项研究。研究来自10个不同的国家，包括随机对照试验、整群随机对照试验、治疗前后、病例对照和横断面研究。证据的总体质量被认为是中等的。出现了五个主要的预防性干预类别：预防疟疾、健康教育、促进母乳喂养、新生儿基本护理和心理社会支助。所有类别都显示出社区卫生工作者的有效性的一些证据;然而，他们被认为是特别有效的促进母亲执行的战略（皮肤到皮肤护理和纯母乳喂养）。社区卫生工作者被证明为低收入和中等收入国家的孕产妇和儿童健康提供了一系列预防性干预措施，并有一些有效战略的证据，但没有足够的证据来得出大多数干预措施的结论，需要进一步研究。
Community Health Workers are widely utilised in low- and middle-income countries and may be an important tool in reducing maternal and child mortality; however, evidence is lacking on their effectiveness for specific types of programmes, specifically programmes of a preventive nature. This review reports findings on a systematic review analysing effectiveness of preventive interventions delivered by Community Health Workers for Maternal and Child Health in low- and middle-income countries. A search strategy was developed according to the Evidence for Policy and Practice Information and Co-ordinating Centre’s (EPPI-Centre) guidelines and systematic searching of the following databases occurred between June 8 – 11th, 2012: CINAHL, Embase, Ovid Nursing Database, PubMed, Scopus, Web of Science and POPLINE. Google, Google Scholar and WHO search engines, as well as relevant systematic reviews and reference lists from included articles were also searched. Inclusion criteria were: i) Target beneficiaries should be pregnant or recently pregnant women and/or children under-5 and/or caregivers of children under-5; ii) Interventions were required to be preventive and delivered by Community Health Workers at the household level. No exclusion criteria were stipulated for comparisons/controls or outcomes. Study characteristics of included articles were extracted using a data sheet and a peer tested quality assessment. A narrative synthesis of included studies was compiled with articles being coded descriptively to synthesise results and draw conclusions. A total of 10,281 studies were initially identified and through the screening process a total of 17 articles detailing 19 studies were included in the review. Studies came from ten different countries and consisted of randomized controlled trials, cluster randomized controlled trials, before and after, case control and cross sectional studies. Overall quality of evidence was found to be moderate. Five main preventive intervention categories emerged: malaria prevention, health education, breastfeeding promotion, essential newborn care and psychosocial support. All categories showed some evidence for the effectiveness of Community Health Workers; however they were found to be especially effective in promoting mother-performed strategies (skin to skin care and exclusive breastfeeding). Community Health Workers were shown to provide a range of preventive interventions for Maternal and Child Health in low- and middle-income countries with some evidence of effective strategies, though insufficient evidence is available to draw conclusions for most interventions and further research is needed.
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3.8
作者：
Agrasada, GV;Gustafsson, J;Ewald, U
通讯作者：
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