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2016年乌干达医护人员关于扩大综合疾病监测与应对(IDSR)培训的经历:横断面定性研究

Healthcare workers' experiences regarding scaling up of training on integrated disease surveillance and response (IDSR) in Uganda, 2016: cross sectional qualitative study.

作者信息

Nakiire Lydia, Masiira Ben, Kihembo Christine, Katushabe Edson, Natseri Nasan, Nabukenya Immaculate, Komakech Innocent, Makumbi Issa, Charles Okot, Adatu Francis, Nanyunja Miriam, Nsubuga Peter, Woldetsadik Solomon Fisseha, Tusiime Patrick, Yahaya Ali Ahmed, Fall Ibrahima Socé, Wondimagegnehu Alemu

机构信息

Public Health Emergency Operation Centre, Ministry of Health, P.O BOX 7072, Kampala, Uganda.

Epidemiology and Surveillance Division, Ministry of Health Kampala, Kampala, Uganda.

出版信息

BMC Health Serv Res. 2019 Feb 13;19(1):117. doi: 10.1186/s12913-019-3923-6.

Abstract

BACKGROUND

The Integrated Disease Surveillance and Response (IDSR) strategy was adopted as the framework for implementation of International Health Regulation (2005) in the African region of World Health Organisation (WHO AFRO). While earlier studies documented gains in performance of core IDSR functions, Uganda still faces challenges due to infectious diseases. IDSR revitalisation programme aimed to improve prevention, early detection, and prompt response to disease outbreaks. However, little is known about health worker's perception of the revitalised IDSR training.

METHODS

We conducted focus group discussions of health workers who were trained between 2015 and 2016. Discussions on benefits, challenges and possible solutions for improvement of IDSR training were recorded, transcribed, translated and coded using grounded theory.

RESULTS

In total, 22/26 FGDs were conducted. Participants cited improved completeness and timeliness of reporting, case detection and data analysis and better response to disease outbreaks as key achievements after the training. Programme challenges included an inadequate number of trained staff, funding, irregular supervision, high turnover of trained health workers, and lack of key logistics. Suggestions to improve IDSR included pre-service and community training, mentorship, regular supervision and improving funding at the district level.

CONCLUSION

Health workers perceived that scaling up revitalized IDSR training in Uganda improved public health surveillance. However, they acknowledge encountering challenges that hinder their performance after the training. Ministry of Health should have a mentorship plan, integrate IDSR training in pre-service curricula and advocate for funding IDSR activities to address some of the gaps highlighted in this study.

摘要

背景

综合疾病监测与应对(IDSR)策略被采纳为世界卫生组织(WHO)非洲区域实施《国际卫生条例(2005)》的框架。虽然早期研究记录了IDSR核心功能在绩效方面的提升,但乌干达仍面临传染病带来的挑战。IDSR振兴计划旨在改善对疾病暴发的预防、早期发现和迅速应对。然而,关于卫生工作者对振兴后的IDSR培训的看法却知之甚少。

方法

我们对2015年至2016年期间接受培训的卫生工作者进行了焦点小组讨论。使用扎根理论记录、转录、翻译并编码了关于IDSR培训的益处、挑战及改进的可能解决方案的讨论。

结果

总共进行了22/26次焦点小组讨论。参与者指出,培训后的关键成就是报告的完整性和及时性、病例检测和数据分析得到改善,以及对疾病暴发的应对更好。该计划面临的挑战包括受过培训的工作人员数量不足、资金、监督不规律、受过培训的卫生工作者流动率高以及缺乏关键后勤保障。改进IDSR的建议包括职前培训和社区培训、指导、定期监督以及改善地区层面的资金状况。

结论

卫生工作者认为,在乌干达扩大振兴后的IDSR培训改善了公共卫生监测。然而,他们承认在培训后遇到了阻碍其工作表现的挑战。卫生部应制定指导计划,将IDSR培训纳入职前课程,并倡导为IDSR活动提供资金,以解决本研究中突出的一些差距。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c0a/6374884/081d00f3abdd/12913_2019_3923_Fig1_HTML.jpg

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