米塔宁（女性健康志愿者）参与印度恰蒂斯加尔邦部落聚居的疟疾流行村庄的疟疾主动监测、决定因素及挑战。
Involvement of Mitanins (female health volunteers) in active malaria surveillance, determinants and challenges in tribal populated malaria endemic villages of Chhattisgarh, India.
作者信息
Chourasia Mehul Kumar, Raghavendra Kamaraju, Bhatt Rajendra Mohan, Swain Dipak Kumar, Dutta G D P, Kleinschmidt Immo
机构信息
National Institute of Malaria Research (ICMR) IIR-WHO Project, Field Unit, Kondagaon, Chhattisgarh, India.
National Institute of Malaria Research (ICMR), Sector-8, Dwarka, New Delhi, 110077, India.
出版信息
BMC Public Health. 2017 Jul 11;18(1):9. doi: 10.1186/s12889-017-4565-4.
BACKGROUND
Accredited Social Health Activists (ASHA), female health volunteers working at village level have become an integral component of National Health Mission (NHM) in India in the past two decades. Mitanin (meaning female friend in local dialect), a precursor of ASHA, play an indispensable role in early detection of health related problems and are helping in improving overall community health status in Chhattisgarh state. The current study was carried out to evaluate the feasibility of involving Mitanin in active malaria surveillance work in 80 tribal villages of Chhattisgarh and to explore the challenges and determinants to perform malaria surveillance activities by the Mitanins.
METHODS
A total of 162 Mitanins were selected and divided into two age and village matched groups. The first group (training plus) of Mitanins were given additional training in malaria surveillance activities in whilst the second (standard) group received routine training. All Mitanins were interviewed using a structured questionnaire. In-depth interviews were also conducted among randomly selected sub groups of Mitanins (five from each group) after the completion of the quantitative survey. Performance of Mitanins was evaluated using pre-defined grading scores (A-E) which included various factors such as educational qualifications and knowledge about malaria, its signs and symptoms and knowledge, attitude and treatment practices.
RESULTS
More number of Mitanins in training plus group has showed better performance (≥ B) than those in the standard group of Mitanins (80% vs 43.5%, p = 0.001) after adjusting for socio-demographic factors. Based on the outcome of in-depth interviews, Mitanin's lack of adequate support from supervisors, delayed payment of incentives and lack of appreciation were the major challenges mentioned.
CONCLUSION
Mitanins can play an effective role in active fever surveillance for malaria besides performing other health related tasks at sub-village level after focused education on malaria related activities and proper supervision.
背景
经过认证的社会健康活动家（ASHA）是在村级工作的女性健康志愿者，在过去二十年里已成为印度国家健康使命（NHM）不可或缺的一部分。米塔宁（在当地方言中意为女性朋友）是ASHA的前身，在健康相关问题的早期发现中发挥着不可或缺的作用，并有助于改善恰蒂斯加尔邦的整体社区健康状况。本研究旨在评估让米塔宁参与恰蒂斯加尔邦80个部落村庄的疟疾主动监测工作的可行性，并探讨米塔宁开展疟疾监测活动的挑战和决定因素。
方法
共挑选了162名米塔宁，并将其分为两个年龄和村庄匹配的组。第一组（培训加强组）的米塔宁接受了疟疾监测活动的额外培训，而第二组（标准组）接受常规培训。所有米塔宁都使用结构化问卷进行了访谈。在定量调查完成后，还对随机挑选的米塔宁子组（每组5人）进行了深入访谈。使用预先定义的评分（A - E）对米塔宁的表现进行评估，评分包括教育程度、对疟疾及其体征和症状的了解、知识、态度和治疗实践等各种因素。
结果
在调整社会人口学因素后，培训加强组中表现较好（≥B）的米塔宁人数多于标准组的米塔宁（80%对43.5%，p = 0.001）。根据深入访谈的结果，米塔宁提到的主要挑战包括缺乏来自上级的充分支持、激励金支付延迟和缺乏认可。
结论
在接受关于疟疾相关活动的重点教育和适当监督后，米塔宁除了在村以下层面执行其他与健康相关的任务外，还可以在疟疾主动发热监测中发挥有效作用。
Zotero 插件