Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
RTI International, Department of Global Health, Washington, DC, United States of America.
PLoS Negl Trop Dis. 2018 Sep 18;12(9):e0006699. doi: 10.1371/journal.pntd.0006699. eCollection 2018 Sep.
The World Health Organization (WHO) in collaboration with partners is developing a toolkit of resources to guide lymphatic filariasis (LF) morbidity management and disability prevention (MMDP) implementation and evaluation. Direct health facility inspection is the preferred method for documenting the readiness of a country programme to provide quality lymphoedema management services, one of the three MMDP criteria used to demonstrate the elimination of LF as a public health problem.
METHODOLOGY/PRINCIPAL FINDINGS: As component of tool development, a Delphi consultation was implemented to gain consensus on six proposed domains and fourteen proposed tracer indicators to measure national programme readiness to provide quality health facility-based lymphoedema management services. A seven-point Likert-type scale was used to rank the importance of proposed domains and tracer indicators. Consensus for inclusion of the indicator was defined a priori as 70% or more of respondents ranking the proposed indicator in the top three tiers (5-7). Purposive sampling was used to select 43 representative experts including country representatives, programme implementers, and technical experts. A 55.8% response rate (n = 24) was achieved for the survey. Analysis of the responses demonstrated that consensus for inclusion had been reached for all proposed domains including trained staff (mean = 6.9, standard deviation (SD) = 0.34), case management and education materials (mean = 6.1, SD = 0.65), water infrastructure (mean = 6.3, SD = 0.81), medicines and commodities (mean = 6.3, SD = 0.69), patient tracking system (mean = 6.3, SD = 0.85), and staff knowledge (mean = 6.5, SD = 0.66).
The Delphi consultation provided an efficient and structured method for gaining consensus among lymphatic filariasis experts around key lymphoedema management quality indicators. The results from this analysis were used to refine the indicators included within the direct inspection protocol tool to ensure its ability to assess health facility readiness to provide quality lymphoedema management services.
世界卫生组织（世卫组织）与合作伙伴合作，正在开发一套资源工具包，以指导淋巴丝虫病（LF）发病率管理和残疾预防（MMDP）的实施和评估。直接卫生机构检查是记录国家规划方案准备情况的首选方法，以提供优质的淋巴水肿管理服务，这是用于证明消除 LF 作为公共卫生问题的三个 MMDP 标准之一。
方法/主要发现：作为工具开发的一部分，实施了德尔菲咨询，以就六个拟议领域和十四个拟议示踪指标达成共识，这些指标用于衡量国家规划方案提供基于卫生机构的优质淋巴水肿管理服务的准备情况。使用七点李克特量表对拟议领域和示踪指标的重要性进行排名。事先确定指标纳入的共识标准为 70%或以上的受访者将拟议指标排在前三个等级（5-7）。采用目的抽样选择了 43 名有代表性的专家，包括国家代表、规划实施者和技术专家。调查的回复率为 55.8%（n=24）。对回复的分析表明，所有拟议领域都达成了纳入共识，包括培训人员（平均值=6.9，标准差（SD）=0.34）、病例管理和教育材料（平均值=6.1，SD=0.65）、水基础设施（平均值=6.3，SD=0.81）、药品和商品（平均值=6.3，SD=0.69）、患者跟踪系统（平均值=6.3，SD=0.85）和员工知识（平均值=6.5，SD=0.66）。
德尔菲咨询为淋巴丝虫病专家就关键的淋巴水肿管理质量指标达成共识提供了一种高效和结构化的方法。该分析的结果用于改进直接检查协议工具中包含的指标，以确保其评估卫生机构提供优质淋巴水肿管理服务的准备情况的能力。
