College of Nursing, The Pennsylvania State University, University park, PA, USA.
Centre for the Study of Adolescence, Nairobi, Kenya.
Malar J. 2021 Feb 18;20(1):102. doi: 10.1186/s12936-021-03640-2.
BACKGROUND: Malaria continues to be the leading cause of morbidity and mortality in Africa. Community Case Management of malaria (CCMm) which is undertaken by engaging Community Health Workers (CHWs) to effectively address management of malaria cases in some endemic communities was explored in this study. The aim was to assess the needs of CHWs that would help sustain and retain their services to enhance the efficient delivery of CCMm. METHODS: Using semi-structured questionnaires, data on the needs of CHWs was gathered through a qualitative study consisting of in-depth interviews and focus group discussions (FGDs) conducted among study participants in five districts in western Kenya. The study participants comprised of 100 CHWs, 100 mothers of children under five years and 25 key informants made up of public health officers and clinicians involved in the CCMm. The interviews were conducted in English and Swahili or Dholuo, the local language. The recorded audio interviews were transcribed later. The analysis was done using NVivo version 7 software and transcripts were coded after which themes related to the objectives of the study were identified. RESULTS: All the study participants recognized the need to train and update CHWs on their work as well as remunerating them for their services to enhance efficient delivery of services. The CHWs on their part perceived the provision of gloves, rapid diagnostic test kits (RDTs), lancets, cotton wool and ethanol, bins (to dispose of RDTs and lancets), together with drugs for treating clients as the essential needs to undertake CCMm in the communities. Other logistical needs and incentives mentioned by CHWs and key informants for the successful delivery of CCMm included: gumboots, raincoats, torch lights, mobile phones, means of transportation (bicycles and motorbikes), uniforms and ID cards for identification. CONCLUSIONS: CHWs would perform tasks better and their services retained for a sustainable CCMm if: properly incentivized; offered refresher trainings (and updates) on malaria; and equipped with the requisite tools identified in this study.
背景：疟疾仍然是非洲发病率和死亡率的主要原因。本研究探讨了在一些流行地区，通过聘请社区卫生工作者（CHWs）来有效管理疟疾病例的社区病例管理（CCMm）。目的是评估 CHWs 的需求，以帮助维持和保留他们的服务，从而提高 CCMm 的有效提供。
方法：使用半结构化问卷，通过在肯尼亚西部五个地区进行的包括深入访谈和焦点小组讨论（FGDs）的定性研究，收集了 CHWs 的需求数据。研究参与者包括 100 名 CHWs、100 名五岁以下儿童的母亲和 25 名关键信息员，包括参与 CCMm 的公共卫生官员和临床医生。访谈以英语和斯瓦希里语或当地语言 Dholuo 进行。录制的音频访谈随后被转录。使用 NVivo 版本 7 软件进行分析，对转录本进行编码后，确定与研究目标相关的主题。
结果：所有研究参与者都认识到需要培训和更新 CHWs 的工作，并为他们的服务提供报酬，以提高服务的提供效率。CHWs 认为，提供手套、快速诊断测试试剂盒（RDTs）、采血针、棉花和乙醇、垃圾桶（用于处理 RDTs 和采血针）以及用于治疗客户的药物是在社区中开展 CCMm 的基本需求。CHWs 和关键信息员提到的其他后勤需求和激励措施，包括：胶靴、雨衣、手电筒、手机、交通工具（自行车和摩托车）、制服和 ID 卡，以确保 CCMm 的成功交付。
结论：如果正确激励 CHWs、为疟疾提供复习培训（和更新）、并提供本研究中确定的必要工具，CHWs 将更好地履行任务，并且他们的服务将得到保留，以实现可持续的 CCMm。
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