Kuhn L, Zwarenstein M
Centre for Epidemiological Research, Medical Research Council, Tygerberg, South Africa.
Int J Epidemiol. 1990 Sep;19(3):685-92. doi: 10.1093/ije/19.3.685.
A village health worker (VHW) programme in a rural area in South Africa is evaluated, a year after the introduction of VHW-retained child record cards. The programme's success in promoting immunization and breastfeeding and the coverage of and contact with the community by the VHWs was investigated. A population survey on children under one year was matched to VHW records, showing that VHWs were reaching 70.8% of the target population. VHWs were more likely to visit a child with a Road to Health Card (RTHC) and who was born in the village. VHWs generally visit mothers once a month and make contact with most children in their first month of life. Children born before the start of the new VHW programme were compared with those born after, using survival analysis techniques and data from the RTHC on the first year of life of all children under two. An increase in polio immunization coverage was detected but there was a drop in measles immunization coverage. We conclude that a VHW-retained child record for the first year of life plays a valuable role in ongoing health care evaluation.
在南非农村地区引入由乡村保健员（VHW）留存的儿童记录卡一年后，对一个乡村保健员项目进行了评估。调查了该项目在促进免疫接种和母乳喂养方面的成效，以及乡村保健员对社区的覆盖范围和接触情况。针对一岁以下儿童的人口调查与乡村保健员的记录进行了匹配，结果显示乡村保健员覆盖了70.8%的目标人群。乡村保健员更有可能去探访持有健康成长卡（RTHC）且在村里出生的儿童。乡村保健员通常每月探访一次母亲，并在大多数儿童出生后的第一个月与其取得联系。利用生存分析技术以及来自健康成长卡上所有两岁以下儿童第一年生命的数据，对新的乡村保健员项目启动前出生的儿童与之后出生的儿童进行了比较。发现脊髓灰质炎免疫接种覆盖率有所提高，但麻疹免疫接种覆盖率有所下降。我们得出结论，乡村保健员留存的儿童一岁记录在持续的医疗保健评估中发挥着重要作用。
