Phatak Ajay Gajanan, Nimbalkar Somashekhar M, Prabhughate Abhijit S, Mahajani Anagha A, Bansal Satvik C
Central Research Services, Charutar Arogya Mandal, Karamsad, Gujarat, India.
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Gujarat, India.
J Family Med Prim Care. 2021 Aug;10(8):2865-2878. doi: 10.4103/jfmpc.jfmpc_1761_20. Epub 2021 Aug 27.
Ambuja Cement Foundation (ACF) started replicating the famous "Gadchiroli" model to reduce neonatal mortality in Chandrapur in 2005. ACF conducted the Home-Based Newborn Care (HBNC) model through trained female health workers, viz., "SAKHIs." In 2008, Government of India introduced community health worker, viz., Accredited Social Health Activist (ASHA). ACF withdrew its services steadily and few SAKHIs were hired as ASHAs.
We assessed and compared the knowledge level and skills of trained ASHA workers with SAKHIs in providing HBNC.
A cross-sectional study was conducted in three blocks of Chandrapur district of Maharashtra, India. A structured questionnaire consisting of 34 questions was used for knowledge assessment and checklists assessed hand washing, weight recording, temperature recording, kangaroo mother care (KMC) position, suction and bag and mask ventilation (BMV) skills on manikins.
135 healthcare workers participated. The mean (SD) score of current SAKHIs (23.89 (1.9) was significantly higher than former SAKHIs (currently ASHAs) (17.97 (2.92), former SAKHIs (currently not engaged in HBNC) (16.73 (2.95) and ASHAs not worked as SAKHIs in the past (16.19 (3.19) [all < 0.001]. Similar trend was seen in all skill sets. The skills of ASHAs not worked as SAKHIs previously were abysmal, with no ASHA being able to perform BMV and KMC skills, and only 4 (7.5%) who could perform suctioning. A typical trend was observed with current SAKHIs faring best followed by former SAKHIS (currently ASHAs), former SAKHIs (currently not in HBNC), and ASHAs not worked as SAKHIs faring worst.
The skills and knowledge of ASHA workers are far deficient compared to SAKHIs despite similar training components, potentially hampering neonatal mortality reduction. Quality of training and supportive supervision mechanism of ASHAs should be explored.
2005年，安布贾水泥基金会（ACF）开始在钱德拉布尔复制著名的“加德奇罗利”模式以降低新生儿死亡率。ACF通过训练有素的女性卫生工作者，即“萨基斯”开展家庭新生儿护理（HBNC）模式。2008年，印度政府引入了社区卫生工作者，即经认可的社会健康活动家（ASHA）。ACF逐步撤出其服务，少数萨基斯被聘为ASHA。
我们评估并比较了训练有素的ASHA工作者与萨基斯在提供HBNC方面的知识水平和技能。
在印度马哈拉施特拉邦钱德拉布尔区的三个街区进行了一项横断面研究。一份由34个问题组成的结构化问卷用于知识评估，检查表用于评估在人体模型上的洗手、体重记录、体温记录、袋鼠式护理（KMC）姿势、吸引以及面罩气囊通气（BMV）技能。
135名医护人员参与。现任萨基斯的平均（标准差）得分（23.89（1.9）显著高于前任萨基斯（现任ASHA）（17.97（2.92）、前任萨基斯（目前未从事HBNC）（16.73（2.95）以及过去未担任萨基斯的ASHA（16.19（3.19）[均<0.001]。在所有技能组中都观察到了类似趋势。以前未担任萨基斯的ASHA的技能非常糟糕，没有一名ASHA能够进行BMV和KMC技能操作，只有4名（7.5%）能够进行吸引操作。观察到一种典型趋势，现任萨基斯表现最佳，其次是前任萨基斯（现任ASHA）、前任萨基斯（目前未从事HBNC），而过去未担任萨基斯的ASHA表现最差。
尽管培训内容相似，但与萨基斯相比，ASHA工作者的技能和知识严重不足，这可能会阻碍新生儿死亡率的降低。应探索ASHA的培训质量和支持性监督机制。
