Giblin P T
Wayne State University, Detroit, MI.
Public Health Rep. 1989 Jul-Aug;104(4):361-8.
The use of indigenous health care workers (IHCWs), who were key elements in community health care programs in the United States in the 1960s, has gone in and out of fashion in subsequent years. The author and his colleagues recently established a service program at Wayne State University's Institute of Maternal and Child Health that employs IHCWs. Characterizations of IHCWs in previous health care programs were reviewed in the process of developing criteria and guidelines for the recruitment, selection, training, employing, and evaluating these workers in the Institute's program. The unique applicability of indigenousness to the delivery of health care services is addressed in terms of the rationale for the use of IHCWs as well as criteria for their success, benefits and problems encountered in the use of these workers, and deficiencies in evaluations of IHCWs. A model of program evaluation, action research, is proposed that assesses the processes and outcomes of providing health services by indigenous paraprofessionals.
本土医护人员曾是20世纪60年代美国社区医疗保健项目的关键组成部分，在随后的几年里，其使用情况几经兴衰。作者及其同事最近在韦恩州立大学母婴健康研究所设立了一个服务项目，雇佣本土医护人员。在为该研究所项目中招募、选拔、培训、雇佣和评估这些工作人员制定标准和指导方针的过程中，回顾了以往医疗保健项目中对本土医护人员的描述。从使用本土医护人员的基本原理、其成功的标准、使用这些工作人员所带来的益处和问题，以及对本土医护人员评估中的不足之处等方面，探讨了本土特色在医疗保健服务提供中的独特适用性。本文提出了一种项目评估模式——行动研究，用于评估本土辅助医疗人员提供健康服务的过程和结果。
