Tigray Regional Health Bureau, Mekelle, Tigray, Ethiopia.
School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia.
PLoS One. 2021 Sep 23;16(9):e0257602. doi: 10.1371/journal.pone.0257602. eCollection 2021.
Community health workers and volunteers are vital for the achievement of Universal Health Coverage also in low-income countries. Ethiopia introduced community volunteers called women's development group leaders in 2011. These women have responsibilities in multiple sectors, including promoting health and healthcare seeking.
We aimed to explore women's development group leaders' and health workers' perceptions on these volunteers' role in maternal, neonatal and child healthcare.
A qualitative study was conducted with in-depth interviews and focus group discussions with women's development group leaders, health extension workers, health center staff, and woreda and regional health extension experts. We adapted a framework of community health worker performance, and explored perceptions of the women's development group program: inputs, processes and performance. Interviews were recorded, transcribed, and coded prior to translation and thematic analysis.
The women's development group leaders were committed to their health-related work. However, many were illiterate, recruited in a sub-optimal process, had weak supervision and feedback, lacked training and incentives and had weak knowledge on danger signs and care of neonates. These problems demotivated these volunteers from engaging in maternal, neonatal and child health promotion activities. Health extension workers faced difficulties in managing the numerous women's development group leaders in the catchment area.
The women's development group leaders showed a willingness to contribute to maternal and child healthcare but lacked support and incentives. The program requires some redesign, effective management, and should offer enhanced recruitment, training, supervision, and incentives. The program should also consider continued training to develop the leaders' knowledge, factor contextual influences, and be open for local variations.
在低收入国家，社区卫生工作者和志愿者对于实现全民健康覆盖也至关重要。埃塞俄比亚于 2011 年引入了社区志愿者，称为妇女发展小组组长。这些妇女在多个领域承担着责任，包括促进健康和寻求医疗保健。
我们旨在探讨妇女发展小组组长和卫生工作者对这些志愿者在孕产妇、新生儿和儿童保健方面作用的看法。
我们开展了一项定性研究，对妇女发展小组组长、卫生推广工作者、卫生中心工作人员、以及 woreda 和地区卫生推广专家进行了深入访谈和焦点小组讨论。我们采用了社区卫生工作者绩效框架，并探讨了妇女发展小组方案的看法：投入、过程和绩效。访谈在翻译和主题分析之前进行了记录、转录和编码。
妇女发展小组组长致力于她们的与健康相关的工作。然而，许多人是文盲，招聘过程不理想，监督和反馈薄弱，缺乏培训和激励，对新生儿的危险信号和护理知识薄弱。这些问题使这些志愿者不愿意参与孕产妇、新生儿和儿童健康促进活动。卫生推广工作者在管理该地区众多的妇女发展小组组长方面面临困难。
妇女发展小组组长愿意为孕产妇和儿童保健做出贡献，但缺乏支持和激励。该方案需要进行一些重新设计，需要有效的管理，并应提供更好的招募、培训、监督和激励措施。该方案还应考虑继续培训以提高领导者的知识，考虑到背景影响，并允许进行地方调整。
