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印度奥里萨邦一个部落地区的卫生系统准备情况和社区参与日本脑炎/急性脑炎综合征(JE/AES)预防

Health system preparedness & community participation in Japanese encephalitis/acute encephalitis syndrome (JE/AES) prevention in a tribal district of Odisha, India.

机构信息

HTA Regional Hub, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India.

Department of Microbiology and One Health, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India.

出版信息

Indian J Med Res. 2021 Mar;153(3):388-393. doi: 10.4103/ijmr.IJMR_645_21.

Abstract

BACKGROUND & OBJECTIVES: Japanese encephalitis/acute encephalitis syndrome (JE/AES) is one of the major zoonotic arbodiseases that has a significant effect on human and animal health. Though many studies have been published on the epidemiology and transmission mechanisms of JE/AES, but there is little evidence on health system preparedness, including community-based engagement. This study was undertaken to explore a multi-stakeholder perspective on health system preparedness for the prevention of JE/AES in a tribal district of Odisha, India.

METHODS

This study was conducted at Malkangiri district of Odisha. A total of nine focus group discussions (FGDs) among women having under-five children, community volunteers, and community health workers (CHWs), and 20 in-depth-interviews (IDIs) among community leaders, healthcare providers, and programme managers were conducted. The FGDs and IDIs were digitally recorded, transcribed, translated and analysed using content analysis approach.

RESULTS

Health system preparedness for the prevention of JE/AES was improved, including effective vector management, implementation of the surveillance system, and vaccination programme. The JE vaccine was introduced under Universal Immunization Programme in Odisha in 2016. Behavioural Change Communication activities were provided with the support of community volunteers on Village Health Nutrition and Sanitation Day (VHNSD) under Gaon Kalyan Samiti (GKS) platforms. The CHWs were actively involved in vector management and raising sanitation and hygiene awareness.

INTERPRETATION & CONCLUSIONS: Community participation and coordination between different stakeholders have a significant impact on the successful implementation of the programme. It was suggested that there was a need for a sustainability approach to active participation, orientation and capacity building training among CHWs and community volunteers to successfully implement the programme.

摘要

背景与目的

日本脑炎/急性脑炎综合征(JE/AES)是对人类和动物健康有重大影响的主要动物源性虫媒病之一。尽管已经有许多关于 JE/AES 的流行病学和传播机制的研究发表,但关于卫生系统准备情况的证据很少,包括基于社区的参与。本研究旨在探讨印度奥里萨邦一个部落地区预防 JE/AES 的多利益相关者视角下的卫生系统准备情况。

方法

本研究在奥里萨邦的马尔坎吉里区进行。共进行了 9 次焦点小组讨论(FGD),参与者为有 5 岁以下儿童的妇女、社区志愿者和社区卫生工作者(CHWs),以及 20 次社区领导、医疗保健提供者和计划管理人员的深入访谈(IDIs)。FGD 和 IDI 被数字记录、转录、翻译,并使用内容分析方法进行分析。

结果

JE/AES 预防的卫生系统准备情况得到了改善,包括有效的病媒管理、监测系统的实施和疫苗接种计划。JE 疫苗于 2016 年在奥里萨邦通过普遍免疫计划引入。在 Gaon Kalyan Samiti(GKS)平台下的 Village Health Nutrition and Sanitation Day(VHNSD)上,社区志愿者提供了行为改变沟通活动。CHWs 积极参与病媒管理和提高环境卫生和卫生意识。

解释与结论

社区参与和不同利益相关者之间的协调对计划的成功实施有重大影响。有人建议,需要采取可持续的方法,对 CHWs 和社区志愿者进行积极参与、定向和能力建设培训,以成功实施该计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6107/8204823/81a9cd3c2aa0/IJMR-153-388-g001.jpg

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