儿童常见疾病社区综合病例管理对卫生站健康推广工作者提供的疟疾病例管理质量的影响。

Effect of integrated community case management of common childhood illnesses on the quality of malaria case management provided by health extension workers at health posts.

作者信息

Wogi Ajema, Teno Dedefo, Bulto Tesfaye, Deressa Wakgari, Alemu Hibret, Nigussie Mesfin

出版信息

Ethiop Med J. 2014 Oct;52 Suppl 3:99-108.

DOI:
Abstract

INTRODUCTION

The Integrated Family Health Program supported the government of Ethiopia to implement the Integrated Community Case Management (iCCM) strategy to control childhood illness of which malaria is a major cause.

OBJECTIVE

To assess the effect of ICCM training on quality of malaria case management at health posts.

METHODS

. A comparative cross-sectional study was conducted among 170 Health Extension Workers (HEW) providing either integrated or vertical malaria case management for children less than five years of age in 14 woredas (districts) of West Hararghe Zone using a multi-stage sampling procedure. HEWs in seven intervention woredas were trained in malaria case management and rapid diagnostic test (RDT) procedures through iCCM, and HEWs in comparison woredas were trained vertically through the national malaria control program. Performance was assessed using interview, review of registers, and observation of RDT procedure.

RESULTS

Intervention HEWs performed better than their counterparts in correct drug prescription (90.8 vs. 81.0%, p = 0.03), treatment duration (97.7 vs. 89.9%, p = 0.001), and treatment schedule (95.4 vs. 75.9%, p = 0.000). Intervention HEWs recorded case management with more consistency than their counterparts (≥ 80% consistency between: classification and assessment [23.0 vs. 3.8%; p = 0.000], classification and treatment [24.1 vs. 7.6%; p = 0.003], and classification and follow up [24.1% vs. 0.0%; p = 0.000]); however, there is room for improvement.

CONCLUSION

ICCM training has a positive effect on the quality of malaria case management at the community level.

摘要

引言

综合家庭健康项目支持埃塞俄比亚政府实施综合社区病例管理(iCCM)战略,以控制儿童疾病,其中疟疾是主要病因。

目的

评估iCCM培训对卫生站疟疾病例管理质量的影响。

方法

采用多阶段抽样程序,在西哈拉尔格地区14个沃雷达(区)为5岁以下儿童提供综合或垂直疟疾病例管理的170名健康推广工作者(HEW)中开展了一项比较横断面研究。7个干预沃雷达的HEW通过iCCM接受了疟疾病例管理和快速诊断检测(RDT)程序培训,对照沃雷达的HEW通过国家疟疾控制项目接受垂直培训。通过访谈、查阅登记册和观察RDT程序对工作表现进行评估。

结果

干预组HEW在正确开药(90.8%对81.0%,p = 0.03)、治疗持续时间(97.7%对89.9%,p = 0.001)和治疗方案(95.4%对75.9%,p = 0.000)方面比对照组表现更好。干预组HEW记录的病例管理比对照组更具一致性(分类与评估之间的一致性≥80%:23.0%对3.8%;p = 0.000,分类与治疗之间:24.1%对7.6%;p = 0.003,分类与随访之间:24.1%对0.0%;p = 0.000);然而,仍有改进空间。

结论

iCCM培训对社区层面疟疾病例管理质量有积极影响。

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