Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, Maharashtre, India.
Disaster Med Public Health Prep. 2022 Dec 23;17:e270. doi: 10.1017/dmp.2022.232.
Due to constraints in the dedicated health work force, outbreaks in peri-urban slums are often reported late. This study explores the feasibility of deploying Accredited Social Health Activists (ASHAs) in outbreak investigation and understand the extent to which this activity gives a balanced platform to fulfil their roles during public health emergencies to reduce its impact and improve mitigation measures.
Activities of ASHAs involved in the hepatitis E outbreak were reviewed from various registers maintained at the subcenter. Also, various challenges perceived by ASHAs were explored through focus group discussion (FGD). During March to May 2019, 13 ASHAs involved in the hepatitis outbreak investigation and control efforts in a peri-urban slum of Nagpur with population of around 9000. In total, 192 suspected hepatitis E cases reported.
During the outbreak, ASHAs performed multiple roles comprising house-to-house search of suspected cases, escorting suspects to confirm diagnosis and referral, community mobilization for out-reach investigation camps, risk communication to vulnerable, etc. During the activity, ASHAs faced challenges such as constraints in the logistics, compromise in other health-related activities, and challenges in sustaining behavior of the community.
It is feasible to implement the investigation of outbreaks through ASHAs. Despite challenges, they are willing to participate in these activities as it gave them an opportunity to fulfil the role as an activist, link worker, as well as a community interface.
由于专门的卫生工作人员的限制，城市周边贫民窟的疫情爆发往往报告较晚。本研究探讨了在疫情调查中部署认证社会卫生活动家（ASHA）的可行性，并了解这项活动在多大程度上为他们在突发公共卫生事件中履行职责提供了一个平衡的平台，以减轻其影响并改善缓解措施。
从基层中心维护的各种登记册中审查了 ASHA 在戊型肝炎疫情中的活动。此外，还通过焦点小组讨论（FGD）探讨了 ASHA 所面临的各种挑战。2019 年 3 月至 5 月，在那格浦尔市一个人口约 9000 人的城市周边贫民窟，有 13 名 ASHA 参与了戊型肝炎疫情的调查和控制工作。总共报告了 192 例疑似戊型肝炎病例。
在疫情期间，ASHA 发挥了多种作用，包括对疑似病例的逐户搜索、护送疑似病例进行确诊和转介、动员社区参加外展调查营、对弱势群体进行风险沟通等。在活动期间，ASHA 面临着后勤方面的限制、其他与健康相关的活动受到影响以及维持社区行为方面的挑战等困难。
通过 ASHA 实施疫情调查是可行的。尽管存在挑战，但他们愿意参与这些活动，因为这使他们有机会履行活动家、联络人以及社区接口的角色。
