Societé d'Études et de Recherche en Santé Publique, Ouagadougou, Burkina Faso.
Institut Supérieur des Sciences de la Population, Université de Ouagadougou, Ouagadougou, Burkina Faso.
BMC Health Serv Res. 2019 Jul 10;19(1):472. doi: 10.1186/s12913-019-4299-3.
Since 2014, the Burkina Faso government has made Seasonal Malaria Chemoprevention (SMC) a priority in its strategic plan to fight against malaria among children aged from 3 to 59 months. Very few studies have examined the care provided by community health workers in the framework of this strategy. The purpose of this study was to evaluate the level of quality of care provided by the latter.
This was a mixed study. The quantitative component consisted of a non-participant observation of community health workers during the administration of care. The qualitative component consisted of one-on-one interviews with community health workers, child caregivers and head nurses. Five dimensions (organizational accessibility, interpersonal relationship, technical competence, safety of care and satisfaction of child caregivers) adapted from the Donabedian quality of care model were used to assess the quality level of care. The Corlien et al. Health Systems Research Program Implementation Scale was used to establish quality scores for each of the five dimensions. The study sites were the health centers located in the administrative centers of the 4 communes of the health district of Boulsa. The data were collected during the first cycle of the 2017 SMC campaign.
A total of 14 active pairs (28 CHWs) were observed and 40 in-depth interviews with community health workers, Head nurses in duty and community leaders were conducted. The results show that community health workers worked in pairs. They had all received SMC training and possessed equipment to do their job. The dimensions of organizational accessibility and satisfaction of the caregivers were rated as good. The dimensions of interpersonal relationship and technical competence were judged to be of an acceptable score. Safety of care was judged to be of a low-level score. The overall quality of care was considered acceptable.
The results of this study have shown that despite the difficulties faced by community health workers, they manage to deliver acceptable quality of care. Their use would be an asset for SMC in particular and for the health system in general.
自 2014 年以来，布基纳法索政府将季节性疟疾化学预防（SMC）作为其战略计划的重点，以对抗 3 至 59 个月儿童的疟疾。很少有研究检查过社区卫生工作者在该战略框架内提供的护理。本研究的目的是评估后者提供的护理质量水平。
这是一项混合研究。定量部分包括在护理管理过程中对社区卫生工作者进行非参与式观察。定性部分包括对社区卫生工作者、儿童照顾者和护士长进行一对一访谈。使用了五个维度（组织可及性、人际关系、技术能力、护理安全性和儿童照顾者满意度），这些维度来自 Donabedian 护理质量模型，用于评估护理质量水平。使用 Corlien 等人的卫生系统研究计划实施量表为五个维度中的每一个维度建立质量评分。研究地点是布尔萨卫生区行政中心的 4 个公社的卫生中心。数据是在 2017 年 SMC 运动的第一个周期中收集的。
共观察到 14 对（28 名 CHW）活动的社区卫生工作者，并对社区卫生工作者、值班护士长和社区领导进行了 40 次深入访谈。结果表明，社区卫生工作者成对工作。他们都接受过 SMC 培训，并拥有开展工作的设备。组织可及性和照顾者满意度这两个维度的评分良好。人际关系和技术能力这两个维度的评分被认为是可以接受的。护理安全性的评分被认为是低水平的。护理的整体质量被认为是可以接受的。
这项研究的结果表明，尽管社区卫生工作者面临困难，但他们仍能提供可接受的护理质量。他们的使用将是 SMC 特别是整个卫生系统的资产。
