Mayombana C, Jenkins J, de Savigny D, Tayari S, Lubomba G, Burnier E, Tanner M
Swiss Tropical Institute Field Laboratory, Ifakara, Tanzania.
Trop Doct. 1990 Apr;20(2):63-7. doi: 10.1177/004947559002000205.
The paper compares the costs of training for two groups of Village Health Workers (VHWs) in Tanzania, where the policy of developing a system based on Primary Health Care principles will require the training of more than 16,000 VHWs during the next decade. In the Kilombero District, one group of VHWs was trained according to the guidelines of the National Programme of the Ministry of Health, and another group followed the training programme of the Kilombero Project, based on the Swiss Tropical Institute Field Laboratory. The training scheme of the Kilombero project cost almost 80% less for one VHW, largely because it depended on on-the-spot training by local staff. The results of a first investigation of the efficacy of the training were encouraging; a long-term evaluation is in progress. The curricula for the two programmes also differed; the Kilombero programme had shorter blocks of theory, interspersed with supervised practical work, and introduced curative medicine earlier in the course. The advantage and disadvantages of the two programmes are discussed, not only in terms of cost but also in terms of their efficacy in training VHWs who will be motivated, efficient and accepted by the community.
本文比较了坦桑尼亚两组乡村卫生工作者（VHWs）的培训成本。在坦桑尼亚，基于初级卫生保健原则建立一个系统的政策要求在未来十年培训超过16000名乡村卫生工作者。在基洛梅罗区，一组乡村卫生工作者按照卫生部国家计划的指导方针进行培训，另一组则遵循基于瑞士热带研究所实地实验室的基洛梅罗项目的培训计划。基洛梅罗项目的培训方案对一名乡村卫生工作者的成本几乎低80%，这主要是因为它依赖当地工作人员的现场培训。对培训效果的首次调查结果令人鼓舞；长期评估正在进行中。这两个项目的课程也有所不同；基洛梅罗项目的理论课程较短，穿插有监督下的实践工作，并且在课程中更早地引入了治疗医学。文章不仅从成本方面，还从培训出有积极性、高效且被社区认可的乡村卫生工作者的效果方面，讨论了这两个项目的优缺点。
