Dongre Amol R, Deshmukh Pradeep R, Garg Bishan S
Dr Sushila Nayar School of Public Health, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Maharashtra, India.
Indian J Pediatr. 2009 Jan;76(1):45-50. doi: 10.1007/s12098-009-0028-y. Epub 2009 Apr 18.
To find out the effect of community mobilization and health education effort on health care seeking behavior of families with sick newborns, and to explore the rationale behind the changed health care seeking behaviors of mothers in a rural Indian community.
In the present community based participatory intervention, a triangulated research design of quantitative (survey) and qualitative (Focus group discussions, FGDs) method was undertaken for needs assessment in year 2004. In community mobilization, women's self help groups; Kishori Panchayat (KP, forum of adolescent girls), Kisan Vikas Manch (Farmers' club) and Village Coordination Committees (VCC) were formed in the study area. The trained social worker facilitated VCCs to develop village health plans to act upon their priority maternal and child health issues. The pregnant women and group members were given health education. The Lot Quality Assurance Sampling (LQAS) technique was used to monitor awareness regarding newborn danger signs among pregnant women. In year 2007, a triangulation of quantitative survey and a qualitative study (free list and pile sort exercise) was undertaken to find out changes in health care seeking behaviors of mothers.
There was significant improvement in mothers' knowledge regarding newborn danger signs. About half of the mothers got information from CLICS doot (female community health worker). The monitoring over three years period showed encouraging trend in level of awareness among pregnant women. After three years, the proportion of mothers giving no treatment/home remedy for newborn danger signs declined significantly. However, there was significant improvement in mothers' health care seeking from private health care providers for sick newborns.
The present approach improved mothers' knowledge regarding newborn danger signs and improved their health care seeking behavior for newborn danger signs at community level. Due to lack of faith in government health services, women preferred to seek care from private providers.
了解社区动员和健康教育工作对患病新生儿家庭就医行为的影响，并探究印度农村社区母亲就医行为改变背后的原因。
在本次基于社区的参与性干预中，于2004年采用定量（调查）和定性（焦点小组讨论）相结合的三角研究设计进行需求评估。在社区动员方面，在研究区域成立了妇女自助小组、基肖里村务委员会（KP，少女论坛）、农民发展协会（农民俱乐部）和村庄协调委员会（VCC）。经过培训的社会工作者协助村庄协调委员会制定村庄健康计划，以应对其优先处理的孕产妇和儿童健康问题。对孕妇和小组成员进行了健康教育。采用批量质量保证抽样（LQAS）技术监测孕妇对新生儿危险信号的认知情况。2007年，进行了定量调查和定性研究（自由列举和分类练习）相结合的三角研究，以了解母亲就医行为的变化。
母亲对新生儿危险信号的认知有显著改善。约一半的母亲从社区女卫生工作者（CLICS doot）处获得信息。三年的监测显示孕妇的认知水平呈令人鼓舞的趋势。三年后，对新生儿危险信号不进行治疗/采用家庭疗法的母亲比例显著下降。然而，母亲为患病新生儿寻求私立医疗服务提供者帮助的情况有显著改善。
目前的方法提高了母亲对新生儿危险信号的认知，并在社区层面改善了她们针对新生儿危险信号的就医行为。由于对政府卫生服务缺乏信心，妇女更倾向于寻求私立医疗服务提供者的帮助。
