Gadsden Thomas, Maharani Asri, Sujarwoto Sujarwoto, Kusumo Budiarto Eko, Jan Stephen, Palagyi Anna
The George Institute for Global Health, University of New South Wales, Sydney, Australia.
Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK.
SSM Popul Health. 2022 Sep;19:101141. doi: 10.1016/j.ssmph.2022.101141. Epub 2022 Jun 7.
Community health workers (CHWs) are the first point of contact with the primary health care system in many low- and middle-income countries and are situated to play a critical role in the public health response to the COVID-19 pandemic. The knowledge, attitude and practices of CHWs regarding COVID-19 may be influenced by their level of trust and participation in the community, collectively defined as their level of social capital. To assess whether social capital influences CHWs' knowledge, attitude and practices related to COVID-19, we conducted a web-based survey of CHWs (n = 478) in Malang district, Indonesia between October 2020 and January 2021. CHW social capital was measured using the Shortened Adapted Social Capital Assessment Tool. Multiple logistic regression results show that cognitive social capital was associated with higher self-reported knowledge of COVID-19, more confidence in answering COVID-related questions from the community and feeling safe from COVID-19 when working. Membership of community organisations was associated with a higher number of COVID-related tasks conducted. Thus, CHWs in Malang district with higher levels of cognitive social capital were more likely to be confident in their knowledge and ability to respond to COVID-19, and CHWs embedded in their community were more likely to be engaged in pandemic response duties. Our findings suggest that policies aimed at promoting CHW embeddedness, targeted recruitment and addressing training needs hold promise in strengthening the positive contribution of the community health workforce to the COVID-19 response.
在许多低收入和中等收入国家，社区卫生工作者（CHW）是与初级卫生保健系统的首个接触点，并且在针对2019冠状病毒病疫情的公共卫生应对中发挥着关键作用。CHW对2019冠状病毒病的知识、态度和实践可能会受到他们在社区中的信任程度和参与程度的影响，这两者统称为他们的社会资本水平。为了评估社会资本是否会影响CHW与2019冠状病毒病相关的知识、态度和实践，我们于2020年10月至2021年1月期间对印度尼西亚马朗地区的CHW（n = 478）开展了一项基于网络的调查。使用简化的适应性社会资本评估工具来衡量CHW的社会资本。多项逻辑回归结果显示，认知社会资本与自我报告的更高的2019冠状病毒病知识、回答社区与2019冠状病毒病相关问题时更高的信心以及工作时对2019冠状病毒病的安全感相关。社区组织成员身份与开展的与2019冠状病毒病相关任务的数量更多相关。因此，马朗地区认知社会资本水平较高的CHW更有可能对自己应对2019冠状病毒病的知识和能力充满信心，而融入社区的CHW更有可能履行疫情应对职责。我们的研究结果表明，旨在促进CHW融入、有针对性地招募和满足培训需求的政策有望加强社区卫生工作队伍对2019冠状病毒病应对的积极贡献。
