新冠疫情期间印度基层基本医疗服务所受影响
Effect on essential health services during COVID-19 at the Primary level in India.
作者信息
Ahmed Tarannum, Dumka Neha, Bhagat Deepak, Hannah Erin, Kotwal Atul
机构信息
Knowledge Management Division, National Health Systems Resource Centre, Munirka, New Delhi, India.
Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India.
出版信息
J Family Med Prim Care. 2022 Sep;11(9):5423-5429. doi: 10.4103/jfmpc.jfmpc_390_22. Epub 2022 Oct 14.
BACKGROUND
Coronavirus diesease (COVID-19) led to increased demand on the Indian health system due to the pandemic as well as other communicable and non-communicable diseases. Guidance was thus issued by the Ministry of Health and Family Welfare (MoHFW), India, in April 2020 to maintain the delivery of essential health services.
OBJECTIVES
To determine the extent of disruptions of essential healthcare services, identify associated factors, and establish pertinent correlations to address specific needs.
METHODS
The Mother and child tracking facilitation centre (MCTFC) conducted a telephonic survey with the front-line workers (FLWs) and beneficiaries in 21 Indian states. The sample size was determined using the infinite population sample size formula, and respondents were selected through a computer-generated random sequence technique. Data were quantitatively analysed using STATA-16. Descriptive univariate analysis was conducted using the Chi-square test.
FINDINGS
The majority of the essential health services were being satisfactorily delivered by FLWs ( = 1596; accredited social health activist (ASHA) = 798, auxiliary nurse midwife (ANM) = 798), where most of the beneficiaries ( = 1410; Pregnant Women = 708, Postnatal Women = 702) continued accessing services with minor issues concerning referral transport. FLWs reported issues in the provisioning of medicines = 0.000 for patients with non-communicable diseases and more ANMs than ASHAs reported it. FLWs commonly experienced challenges in extending services due to community resistance and unavailability of general health services at healthcare facilities, where a greater number of ASHAs faced it ( = 0.000). Both FLWs and beneficiaries ( = 3006; FLWs = 1596, beneficiaries = 1410) demonstrated appropriate COVID-19 knowledge and behavior.
CONCLUSION
Although overwhelmed, the Indian health system performed satisfactorily well during pandemic in terms of essential health services.
背景
由于新冠疫情以及其他传染病和非传染病，印度卫生系统的需求增加。因此，印度卫生和家庭福利部（MoHFW）于2020年4月发布了指导意见，以维持基本卫生服务的提供。
目的
确定基本医疗服务中断的程度，识别相关因素，并建立相关联系以满足特定需求。
方法
母婴跟踪促进中心（MCTFC）对印度21个邦的一线工作人员（FLWs）和受益人进行了电话调查。样本量使用无限总体样本量公式确定，受访者通过计算机生成的随机序列技术进行选择。使用STATA-16对数据进行定量分析。使用卡方检验进行描述性单变量分析。
结果
大多数基本卫生服务由一线工作人员（n = 1596；经认可的社会健康活动家（ASHA）= 798，辅助护士助产士（ANM）= 798）令人满意地提供，大多数受益人（n = 1410；孕妇 = 708，产后妇女 = 702）在转诊运输方面存在一些小问题的情况下仍继续获得服务。一线工作人员报告了非传染性疾病患者药品供应方面的问题（P = 0.000），报告此类问题的ANM比ASHA更多。由于社区抵制和医疗机构缺乏一般卫生服务，一线工作人员在提供服务方面普遍遇到挑战，更多的ASHA面临此类问题（P = 0.000）。一线工作人员和受益人（n = 3006；一线工作人员 = 1596，受益人 = 1410）都表现出适当的新冠病毒知识和行为。
结论
尽管不堪重负，但印度卫生系统在疫情期间基本卫生服务方面表现令人满意。
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