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实施世卫组织非洲初级眼保健一揽子计划所需的技术能力:德尔菲法研究结果。

Technical capacities needed to implement the WHO's primary eye care package for Africa: results of a Delphi process.

机构信息

International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK

Department of Ophthalmology, University of Nigeria Faculty of Medical Sciences, Enugu, Nigeria.

出版信息

BMJ Open. 2021 Mar 19;11(3):e042979. doi: 10.1136/bmjopen-2020-042979.

Abstract

OBJECTIVE

The aim of the study was to establish the technical capacities needed to deliver the WHO African Region's primary eye care package in primary healthcare facilities.

DESIGN

A two-round Delphi exercise was used to obtain expert consensus on the technical complexity of each component of the package and the technical capacities needed to deliver them using Gericke's framework of technical feasibility. The panel comprised nine eyecare experts in primary eyecare in sub-Saharan Africa. In each round panel members used a 4-point Likert scale to indicate their level of agreement. Consensus was predefined as ≥70% agreement on each statement. For round 1, statements on technical complexity were identified through a literature search of primary eyecare in sub-Saharan Africa from January 1980 to April 2018. Statements for which consensus was achieved were included in round 2, and the technical capacities were agreed.

RESULTS

Technical complexity statements were classified into four broad categories: intervention characteristics, delivery characteristics, government capacity requirements and usage characteristics. 34 of the 38 (89%) statements on health promotion and 40 of the 43 (93%) statements on facility case management were considered necessary technical capacities for implementation.

CONCLUSION

This study establishes the technical capacities needed to implement the WHO Africa Office primary eye care package, which may be generalisable to countries in sub-Saharan Africa.

摘要

目的

本研究旨在确定在初级保健设施中提供世卫组织非洲区域初级眼保健一揽子计划所需的技术能力。

设计

采用两轮 Delphi 法,就一揽子计划中每个组成部分的技术复杂性以及使用 Gericke 技术可行性框架提供这些服务所需的技术能力,获取专家共识。该小组由撒哈拉以南非洲地区初级眼保健方面的 9 名眼保健专家组成。在每一轮中,小组成员均使用 4 分李克特量表表示对各项声明的同意程度。共识的定义为:对每个声明的同意率≥70%。在第一轮中,通过对 1980 年 1 月至 2018 年 4 月期间撒哈拉以南非洲地区初级眼保健的文献检索,确定了关于技术复杂性的声明。在第二轮中,纳入达成共识的声明,并就技术能力达成一致。

结果

技术复杂性声明分为四大类:干预特征、交付特征、政府能力要求和使用特征。关于健康促进的 38 项声明中有 34 项(89%),关于设施病例管理的 43 项声明中有 40 项(93%)被认为是实施该一揽子计划所需的必要技术能力。

结论

本研究确定了实施世卫组织非洲区域初级眼保健一揽子计划所需的技术能力,这可能适用于撒哈拉以南非洲国家。

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