Marsh David R, Tesfaye Hailu, Degefie Tedbabe, Legesse Hailemariam, Abebe Hailu, Teferi Efrem, Ashenafi Addis, Ameha Agazi, Kebede Helina
Ethiop Med J. 2014 Oct;52 Suppl 3:27-35.
Analyzing complex health programs by their components and sub-components serves design, documentation, evaluation, research, and gap identification and prioritization. In 2012, we developed a rapid methodology to characterize integrated community case management (iCCM) programs, by assessing benchmarks for eight health system components in three program phases. OBJECTIVE. To assess iCCM benchmarks in Ethiopia three years after scale-up commenced, and to compare the benchmarks across the geographical region. METHODS. Six national iCCM experts scored each of 70 benchmarks (no, partial, or yes) and then were facilitated to reach consensus. RESULTS. Overall, iCCM benchmark achievement in Ethiopia was high (87.3%), highest for pre-introduction (93.0%), followed by introduction (87.9%) and scale-up (78.1%) phases. Achievement by system component was highest for coordination and policy (94.2%) and lowest for costing and finance (70.3%). Six regional, countries benchmark assessments, including two from Ethiopia 14 months apart, were highly correlated with program duration at scale (correlation coefficient: +0.88).
Ethiopia has a mature, broad-based iCCM program. Despite limitations, the method described here rapidly, systematically, and validly characterized a complex program and highlighted areas for attention through government or partners.
通过其组成部分和子组成部分来分析复杂的卫生项目有助于进行设计、记录、评估、研究以及差距识别和优先级确定。2012年，我们开发了一种快速方法，通过评估三个项目阶段中八个卫生系统组成部分的基准来描述综合社区病例管理（iCCM）项目。目的：在埃塞俄比亚扩大规模三年后评估iCCM基准，并比较不同地理区域的基准。方法：六位国家iCCM专家对70个基准（无、部分或有）中的每一个进行评分，然后促使他们达成共识。结果：总体而言，埃塞俄比亚iCCM基准的达成率很高（87.3%），引入前阶段最高（93.0%），其次是引入阶段（87.9%）和扩大规模阶段（78.1%）。系统组成部分的达成率方面，协调和政策最高（94.2%），成本核算和财务最低（70.3%）。六项区域、国家基准评估，包括来自埃塞俄比亚间隔14个月的两项评估，与扩大规模后的项目持续时间高度相关（相关系数：+0.88）。结论：埃塞俄比亚拥有一个成熟的、基础广泛的iCCM项目。尽管存在局限性，但本文所述方法快速、系统且有效地描述了一个复杂项目，并通过政府或合作伙伴突出了需要关注的领域。
