Health policy and system support to optimise community health worker programmes: an abridged WHO guideline
Health policy and system support to optimise community health worker programmes: an abridged WHO guideline
复制标题
优化社区卫生工作者规划的卫生政策和系统支持：世卫组织删节指南
DOI：
10.1016/s2214-109x(18)30482-0
复制
发表时间：
2018-12-01
影响因子：
34.3
通讯作者：
Taylor, David
中科院分区：
文献类型：
--
作者：
Cometto, Giorgio;Ford, Nathan;Taylor, David
优化社区卫生工作者(CHW)计划需要关于他们的教育、部署和管理的循证政策。该指导方针旨在为规划者、政策制定者和管理人员改进CHW方案的努力提供信息，作为加强初级卫生保健和卫生系统的综合方法的一部分。该指南的制定遵循了世卫组织制定全球指南的标准方法。我们对审查进行了一次概述，进行了15次系统审查(每次审查都涉及一个具体的政策问题)，并调查了利益攸关方对正在审议的干预措施的可接受性和可行性的看法。我们使用AMSTAR工具评估了系统评价的质量，并使用评分方法评估了证据的确定性。综述确定了122篇符合条件的文章，系统评价确定了137项符合条件的初级研究。利益相关者认知调查从96名受访者那里获得了意见。S在社区卫生工作人员选拔、职前教育、认证、监督、薪酬和职业发展、规划、社区嵌入和卫生系统支持等方面提出了建议。这是第一个以证据为基础的全球卫生政策和系统支持指南，以优化社区卫生工作者方案。实施的主要考虑因素包括需要界定卫生和妇女事务相对于其他卫生工作者的作用，并为整个卫生工作人员而不是按具体的职业群体进行规划；将卫生工作方案适当地纳入一般卫生系统和现有的社区系统；确保影响卫生工作人员的不同政策和方案的内部一致性和一致性。
Optimising community health worker (CHW) programmes requires evidence-based policies on their education, deployment, and management. This guideline aims to inform efforts by planners, policy makers, and managers to improve CHW programmes as part of an integrated approach to strengthen primary health care and health systems. The development of this guideline followed the standard WHO approach to developing global guidelines. We conducted one overview of reviews, 15 systematic reviews (each one on a specific policy question), and a survey of stakeholders' views on the acceptability and feasibility of the interventions under consideration. We assessed the quality of systematic reviews using the AMSTAR tool, and the certainty of the evidence using the GRADE methodology. The overview of reviews identified 122 eligible articles and the systematic reviews identified 137 eligible primary studies. The stakeholder perception survey obtained inputs from 96 respondents. Recommendations were developed in the area s of CHW selection, preservice education, certification, supervision, remuneration and career advancement, planning, community embeddedness, and health system support. These are the first evidence-based global guidelines for health policy and system support to optimise community health worker programmes. Key considerations for implementation indude the need to define the role of CHWs in relation to other health workers and plan for the health workforce as a whole rather than by specific occupational groups; appropriately integrate CHW programmes into the general health system and existing community systems; and ensure internal coherence and consistency across different policies and programmes affecting CHWs.