Kim Y M, Banda J, Hiner C, Tholandi M, Bazant E, Sarkar S, Andrade A S A, Makwala C
Jhpiego/USA, an affiliate of Johns Hopkins University, 1615 Thames Street, Baltimore MD 21231, USA.
Int J STD AIDS. 2013 May;24(5):365-70. doi: 10.1177/0956462412472811. Epub 2013 Jun 14.
After rapidly scaling up HIV/AIDS-related health services, the Zambian Defence Force (ZDF) has become concerned with assuring their quality. This evaluation assesses provider performance at eight ZDF facilities based on direct observations of 191 antenatal care (ANC) consultations and 175 follow-up consultations for antiretroviral therapy (ART). In addition, 43 ZDF health providers were interviewed about the work environment and service quality. On-the-job performance varied widely: providers completed as few as 0% and as many as 100% of tasks associated with each performance standard. Overall scores averaged 66% (range: 47-93%) for ANC consultations and 60% (range: 37-100%) for ART consultations. Perceptions of the work environment were generally positive, but 57% of providers lack confidence in their clinical skills and 42% think staffing is insufficient. These findings, which point to the unique opportunities and challenges in the military setting, will be used to guide a quality improvement initiative.
在迅速扩大与艾滋病毒/艾滋病相关的卫生服务规模后，赞比亚国防军开始关注服务质量的保障。本次评估基于对191次产前护理（ANC）咨询和175次抗逆转录病毒治疗（ART）后续咨询的直接观察，对赞比亚国防军的八家医疗机构的服务提供者表现进行了评估。此外，还就工作环境和服务质量对43名赞比亚国防军卫生服务提供者进行了访谈。在职表现差异很大：服务提供者完成与每项绩效标准相关任务的比例低至0%，高至100%。产前护理咨询的总体得分平均为66%（范围：47%-93%），抗逆转录病毒治疗咨询的总体得分平均为60%（范围：37%-100%）。对工作环境的看法总体上是积极的，但57%的服务提供者对自己的临床技能缺乏信心，42%的人认为人员配备不足。这些发现指出了军事环境中的独特机遇和挑战，将用于指导质量改进举措。
