Argaw Daniel, Fanthahun Mesganaw, Berhane Yemane
WHO/Ethiopia, P.O.Box 3069, Addis Ababa, Ethiopia.
Afr J Reprod Health. 2007 Aug;11(2):79-88.
arious Community-Based Reproductive Health interventions were initiated in many developing countries but their effectiveness has not been evaluated as much as needed. A comparative cross sectional study was carried out in February 2002 among women who participated in community based reproductive health interventions in South Gondar zone, Ethiopia. The study was conducted in eight kebeles taking successful and weak program areas for comparison. Both quantitative and qualitative methods were used for data collection. The qualitative method included key informants interview, and Focus Group Discussions with Community-based reproductive health agents (CBRHAs). A multistage sampling technique was employed to select 792 study subjects for the quantitative part of the study. Awareness of the presence of the CBRHA in the locality, participation in selection of the agents, acceptance of the agent, and evertalking to CBRHA about reproductive health issues were significantly higher in successful than in weak program areas [OR(95% CI) = 2.32 (1.74, 3.08), 3.28 (1.22, 9.27), 6.65 (3.59, 12.43), and 5.05 (3.22, 7.96), respectively]. In multiple logistic regression analysis awareness of presence of CBRHA in the village, acceptance of the CBRHA, and having had discussion with CBRHA maintained significant associations with type of community-based reproductive health program (successful/weak). Focus Group Discussions and Key Informant Interviews revealed better involvement of community leaders and health workers in the process of selecting and supervising CBRHA in successful areas compared to weak areas. The sustainability score of the Community-Based Reproductive Health Program (CBRHP) graded by the program coordinators was 2.92 out of 5. Acceptance of the CBRHAs, communication of the agents with community members, level of Support to the agents, better involvement of community representatives in the selection process were found to be the major factors affecting CBRHP. Overall sustainability of the CBRHP was low which calls for an urgent action.
许多发展中国家都启动了各种基于社区的生殖健康干预措施，但对其效果的评估却未达到应有的程度。2002年2月，在埃塞俄比亚南贡德尔地区参与基于社区的生殖健康干预措施的妇女中开展了一项比较横断面研究。该研究在8个村进行，选取了成功和薄弱的项目地区进行比较。采用定量和定性方法收集数据。定性方法包括关键信息人访谈以及与基于社区的生殖健康工作者（CBRHA）进行焦点小组讨论。采用多阶段抽样技术为该研究的定量部分选取了792名研究对象。在成功的项目地区，对当地CBRHA存在的知晓度、参与工作者的选拔、对工作者的接受程度以及与CBRHA谈论生殖健康问题的情况均显著高于薄弱项目地区[比值比（95%置信区间）分别为2.32（1.74, 3.08）、3.28（1.22, 9.27）、6.65（3.59, 12.43）和5.05（3.22, 7.96）]。在多因素逻辑回归分析中，对村里CBRHA存在的知晓度、对CBRHA的接受程度以及与CBRHA进行过讨论与基于社区的生殖健康项目类型（成功/薄弱）仍保持显著关联。焦点小组讨论和关键信息人访谈显示，与薄弱地区相比，成功地区的社区领袖和卫生工作者在CBRHA的选拔和监督过程中的参与度更高。项目协调员对基于社区的生殖健康项目（CBRHP）的可持续性评分在5分制中为2.92分。发现对CBRHA的接受程度、工作者与社区成员的沟通、对工作者的支持水平、社区代表在选拔过程中的更好参与是影响CBRHP的主要因素。CBRHP的总体可持续性较低，这需要紧急采取行动。
