Setiawan Agus, Dignam Denise, Waters Cheryl, Dawson Angela
Faculty of Nursing, Universitas Indonesia, Jakarta, Indonesia.
Faculty of Health, University of Technology, Sydney, Australia.
Matern Child Health J. 2016 Nov;20(11):2254-2260. doi: 10.1007/s10995-016-2149-z.
Objectives In order to reduce infant mortality in Indonesia, community case management (CCM) was introduced. CCM is a community-based service delivery model to improve children's wellness and longevity, involving the delivery of lifesaving, curative interventions to address common childhood illnesses, particularly where there are limited facility-based services. This paper reports the findings of a qualitative study that investigated the implementation of CCM in the Kutai Timur district, East Kalimantan Indonesia from the perspective of mothers who received care. Methods Seven mothers and health workers were observed during a consultation and these mothers were interviewed in their home weeks after delivery. Field notes and the interview transcriptions were analysed thematically. Findings Mothers reported that their access to care had improved, along with an increase in their knowledge of infant danger signs and when to seek care. Family compliance with care plans was also found to have improved. Mothers expressed satisfaction with the care provided under the CCM model. The mothers expressed a need for a nurse or midwife to be posted in each village, preferably someone from that village. However two mothers did not wish their children to receive health interventions as they did not believe these to be culturally appropriate. Conclusion CCM is seen by rural Indonesian mothers to be a helpful model of care in terms of increasing access to health care and the uptake of lifesaving interventions for sick children. However there is a need to modify the program to demonstrate cultural sensitivity and meet cultural needs of the target population. While CCM is a potentially effective model of care, further integrative strategies are required to embed this model into maternal and child health service delivery.
目标 为降低印度尼西亚的婴儿死亡率，引入了社区病例管理（CCM）。CCM是一种基于社区的服务提供模式，旨在改善儿童健康状况和延长寿命，包括提供挽救生命的治疗性干预措施，以应对常见的儿童疾病，特别是在基于设施的服务有限的地区。本文报告了一项定性研究的结果，该研究从接受护理的母亲的角度调查了印度尼西亚东加里曼丹省库泰蒂穆尔区CCM的实施情况。方法 在一次咨询过程中观察了7位母亲和卫生工作者，并在她们产后几周在其家中对这些母亲进行了访谈。对实地记录和访谈转录本进行了主题分析。结果 母亲们报告说，她们获得护理的机会有所改善，同时她们对婴儿危险信号以及何时寻求护理的了解也有所增加。还发现家庭对护理计划的依从性有所提高。母亲们对CCM模式下提供的护理表示满意。母亲们表示需要在每个村庄派驻一名护士或助产士，最好是来自那个村庄的人。然而，有两位母亲不希望她们的孩子接受健康干预，因为她们认为这些干预在文化上不合适。结论 印度尼西亚农村母亲认为CCM是一种有益的护理模式，有助于增加获得医疗保健的机会，并为患病儿童采用挽救生命的干预措施。然而，有必要对该计划进行调整，以表现出文化敏感性并满足目标人群的文化需求。虽然CCM是一种潜在有效的护理模式，但需要进一步的综合策略将该模式纳入母婴健康服务提供中。
