Ashenafi Addis, Karim Ali Mehryar, Ameha Agazi, Erbo Amano, Getachew Nebiyu, Betemariam Wuleta
Ethiop Med J. 2014 Oct;52 Suppl 3:57-64.
In January 2011, Health Extension Workers (HEWs) of Ethiopia's Health Extension Program (HEP) began providing pneumonia case management for children less than five years of age through the integrated Community Case Management (iCCM) strategy.
To report the effect of HEP, following the introduction of iCCM, and other accessibility factors on care-seeking behaviors for common childhood illnesses (acute respiratory infection [ARI], diarrhea, and fever).
Three possible care-seeking outcomes for childhood illnesses were considered: not seeking appropriate care, seeking care from HEP sources, or seeking care from other appropriate sources. The baseline care-seeking outcomes from the Ethiopian Demographic and Health Survey, 2011, were compared with the care-seeking outcomes in a follow-up iCCM survey in December 2012. The effects of the HEP intensity and other factors on care-seeking outcomes were estimated using regression analyses.
Appropriate care-seeking for children with acute respiratory infection, ARI, diarrhea, or fever increased two-fold, from 19% at baseline to 38% at follow-up, mainly due to an increase in seeking care for common child- hood illnesses from HEWs. Higher intensity of the HEP and other accessibility factors were associated with higher care-seeking for childhood illnesses from HEP sources.
Incorporating iCCM within the HEP service package significantly improved the appropriate care-seeking behaviors for childhood illnesses in rural Ethiopia.
2011年1月，埃塞俄比亚卫生推广计划（HEP）的卫生推广工作者（HEW）开始通过综合社区病例管理（iCCM）策略为5岁以下儿童提供肺炎病例管理。
报告引入iCCM后HEP的效果以及其他可及性因素对常见儿童疾病（急性呼吸道感染[ARI]、腹泻和发热）就医行为的影响。
考虑了儿童疾病三种可能的就医结果：未寻求适当治疗、从HEP来源寻求治疗或从其他适当来源寻求治疗。将2011年埃塞俄比亚人口与健康调查的基线就医结果与2012年12月iCCM随访调查中的就医结果进行比较。使用回归分析估计HEP强度和其他因素对就医结果的影响。
急性呼吸道感染（ARI）、腹泻或发热儿童的适当就医率增加了两倍，从基线时的19%增至随访时的38%，这主要是由于向卫生推广工作者寻求常见儿童疾病治疗的人数增加。HEP的更高强度和其他可及性因素与从HEP来源寻求儿童疾病治疗的更高比例相关。
将iCCM纳入HEP服务包显著改善了埃塞俄比亚农村地区儿童疾病的适当就医行为。
