Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa.
Bull World Health Organ. 2011 Dec 1;89(12):919-23. doi: 10.2471/BLT.11.087825. Epub 2011 Oct 24.
Lay health workers are key to achieving universal health-care coverage, therefore measuring worker attrition and identifying its determinants should be an integral part of any lay health worker programme. Both published and unpublished research on lay health workers has largely focused on the types of interventions they can deliver effectively. This is an imperative since the main objective of these programmes is to improve health outcomes. However, high attrition rates can undermine the effectiveness of these programmes. There is a lack of research on lay health worker attrition. Research that aims to answer the following three key questions would help address this knowledge gap: what is the magnitude of attrition in programmes? What are the determinants of attrition? What are the most successful ways of reducing attrition? With community-based interventions and task shifting high on the United Nations Millennium Development Goals' policy agenda, research on lay health worker attrition and its determinants requires urgent attention.
初级卫生保健工作者是实现全民医保覆盖的关键，因此衡量工作人员流失率并确定其决定因素应成为任何初级卫生保健工作者方案的一个组成部分。针对初级卫生保健工作者的已发表和未发表的研究主要集中在他们能够有效提供的干预措施类型上。这是必要的，因为这些方案的主要目标是改善健康结果。然而，高离职率可能会影响这些方案的效果。关于初级卫生保健工作者离职率的研究很少。旨在回答以下三个关键问题的研究将有助于填补这一知识空白：方案中的离职率有多大？离职的决定因素是什么？减少离职率最成功的方法是什么？随着以社区为基础的干预措施和任务转移成为联合国千年发展目标政策议程的重点，对初级卫生保健工作者离职率及其决定因素的研究需要引起紧急关注。
