Office for Infectious Disease Control, Bureau of Health & Welfare, Osaka City, Japan 1-3-20, Nakanoshima, Kita-ku, 530-8201, Oseaka City, Japan.
Environ Health Prev Med. 2002 Sep;7(4):151-5. doi: 10.1007/BF02897943.
To ascertain the extent of under-utilization and insufficiency or inappropriateness in provision of health services as one of the possible causes of high mortality from pediatric pneumonia in pilot areas in Vietnam.
The household survey on morbidity and treatment of acute respiratory infections, simple cough, and cold and pneumonia, was conducted in two communities with 10% sampling of the child population.
Both under-treatment of "fast breathing", a proxy for pneumonia, and over-treatment of simple cough and cold with antimicrobials by health workers, mothers, and private practitioners were common.
A household survey on morbidity and treatment was found to be useful to clarify actual practices in the treatment of acute respiratory infections in the community, which cannot be obtained by mere interview with health workers or mothers. Since a change of knowledge did not automatically lead to change of practice, the training of health workers, health education of mothers and provision of antimicrobials at village health stations would not guarantee improved practice of health workers and mothers. Therefore, constant supervision for health workers, continued health education of mothers and involvement of private practitioners are needed to improve the situation.
确定卫生服务提供不足或不适当的程度，这是越南试点地区小儿肺炎高死亡率的可能原因之一。
在两个社区进行了急性呼吸道感染、单纯咳嗽和感冒以及肺炎的发病率和治疗情况的家庭调查，对儿童人口进行了 10%的抽样调查。
卫生工作者、母亲和私人医生都普遍存在对“呼吸急促”（肺炎的替代指标）治疗不足和对抗生素治疗单纯咳嗽和感冒过度治疗的情况。
家庭发病率和治疗情况调查被发现是有用的，可以澄清社区中急性呼吸道感染的实际治疗情况，而仅通过与卫生工作者或母亲面谈是无法获得的。由于知识的改变并不自动导致实践的改变，因此，培训卫生工作者、对母亲进行健康教育以及在村卫生站提供抗生素并不能保证卫生工作者和母亲实践的改善。因此，需要对卫生工作者进行持续监督、对母亲进行持续健康教育以及让私人医生参与，以改善这种情况。
