Laínez Yolanda Barberá, Wittcoff Alison, Mohamud Amina Issa, Amendola Paul, Perry Henry B, D'Harcourt Emmanuel
Am J Trop Med Hyg. 2012 Nov;87(5 Suppl):144-150. doi: 10.4269/ajtmh.2012.12-0106.
There is strong research evidence that community case management (CCM) programs can significantly reduce mortality. There is less evidence, however, on how to implement CCM effectively either from research or regular program data. We analyzed monitoring data from CCM programs supported by the International Rescue Committee (IRC), covering over 2 million treatments provided from 2004 to 2011 in six countries by 12,181 community health workers (CHWs). Our analysis yielded several findings of direct relevance to planners and managers. CCM programs seem to increase access to treatment, although diarrhea coverage remains low. In one country, the size of the catchment area was correlated with use, and increased supervision was temporally and strongly associated with improved quality. Planners should use routine data to guide CCM program planning. Programs should treat all three conditions from the outset. Other priorities should include use of diarrhea treatment and insurance of adequate supervision.
有强有力的研究证据表明，社区病例管理（CCM）项目可显著降低死亡率。然而，无论是从研究还是常规项目数据来看，关于如何有效实施CCM的证据都较少。我们分析了由国际救援委员会（IRC）支持的CCM项目的监测数据，这些数据涵盖了2004年至2011年期间12,181名社区卫生工作者（CHW）在六个国家提供的超过200万次治疗。我们的分析得出了一些与规划者和管理者直接相关的发现。CCM项目似乎增加了治疗的可及性，尽管腹泻治疗的覆盖率仍然较低。在一个国家，集水区的规模与治疗的使用相关，加强监督在时间上与质量改善密切相关。规划者应使用常规数据来指导CCM项目规划。项目应从一开始就对所有三种病症进行治疗。其他优先事项应包括腹泻治疗的使用和确保充分的监督。
