Asnake M K, Ahmed M, Genebo T, Dawit M W, Mekebib B
Pathfinder International, Addis Ababa, Ethiopia.
Int J Lepr Other Mycobact Dis. 2000 Sep;68(3):299-306.
Since the introduction of multidrug therapy for leprosy patients, the integration of leprosy control in the general health service (GHS) system has been an issue of debate. In Ethiopia, the present policy stresses integrated management of diseases. In spite of the policy, however, leprosy control was a vertical program until 1998 in most parts of the country. A descriptive cross-section study was conducted in the southern region of Ethiopia from October 1996 to March 1997 to determine the levels of involvement of the GHS staff and to identify obstacles to their involvement in the management of leprosy patients. Through a written questionnaire, data were collected from 240 GHS staff, including doctors, nurses and health assistants. It was found that 6% of the GHS staff was involved in leprosy control activities, mainly case finding and health education. Negative attitudes toward leprosy workers were held by 13% of the GHS staff while 40% had intermediate attitudes and the remaining 47% had positive attitudes. Statistically significant differences were found with regard to the level of knowledge among different health professionals, type of health institutions and years of service. The levels of involvement, knowledge and attitude of GHS staff showed that lack of integration and training were core problems. Hence, policy makers should give due attention to promoting the involvement of the GHS staff by integrating the program into the GHS system using the approach already in place in certain parts of the country.
自从对麻风病人采用多药联合治疗以来,麻风病防治工作融入综合卫生服务(GHS)体系一直是一个备受争议的问题。在埃塞俄比亚,现行政策强调疾病的综合管理。然而,尽管有这项政策,但在该国大部分地区,直到1998年麻风病防治仍是一项垂直项目。1996年10月至1997年3月,在埃塞俄比亚南部地区开展了一项描述性横断面研究,以确定综合卫生服务工作人员的参与程度,并找出他们参与麻风病人管理工作的障碍。通过书面问卷,从包括医生、护士和卫生助理在内的240名综合卫生服务工作人员那里收集了数据。结果发现,6%的综合卫生服务工作人员参与了麻风病防治活动,主要是病例发现和健康教育。13%的综合卫生服务工作人员对麻风病防治人员持消极态度,40%持中立态度,其余47%持积极态度。在不同卫生专业人员、卫生机构类型和服务年限方面,知识水平存在统计学上的显著差异。综合卫生服务工作人员的参与程度、知识水平和态度表明,缺乏整合和培训是核心问题。因此,政策制定者应给予应有的重视,通过采用该国某些地区已经实施的方法,将该项目纳入综合卫生服务体系,以促进综合卫生服务工作人员的参与。