Sahel Regional Health Directorate, Ministry of Health and Public Hygiene, Dori, Burkina Faso.
Department of Public Health, Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso.
Glob Health Sci Pract. 2023 Oct 30;11(5). doi: 10.9745/GHSP-D-23-00044.
Faced with the frequent disruptions to the health care system and provision of immunization services caused by terrorist attacks that began in 2015, the Sahel region in Burkina Faso initiated resilience strategies, including the task-shifting of immunization activities to community health workers (CHWs). This strategy was designed to involve more CHWs in the vaccination delivery process and ultimately to improve the performance of the health care system.
The task-shifting strategy began as a pilot in Djibo health district in 2019 and then extended to all 4 districts of the Sahel region. CHWs included both personnel recruited through the Ministry of Health and Public Hygiene processes at the national level and other community members who support the operation of health facilities. They were trained on standardized immunization modules and provided with vaccines by functional health facilities teams. Implementation initiated with the administration of oral antigens by CHWs. Subsequently, their service delivery was expanded to include injectable vaccines in the context of the worsening terrorist attacks and the urgent need to protect the health of local populations affected by the security and humanitarian crisis.
The intervention was evaluated through an internal programmatic review conducted as a descriptive cross-sectional study implemented from August 1 to October 28, 2022, in the Sahel region, including a survey in Dori health district. CHWs involved in implementing the strategy were considered for interviews. Performance indicators for all antigens have shown an upward trend since the strategy's inception in 2019.
The task-shifting of immunization activities to CHWs has been implemented successfully in a region seriously affected by terrorism-related insecurity. It holds the promise of maintaining or even improving performance if institutionalized and scaled up while improving the monitoring of adverse events following immunization by the CHWs.
自 2015 年恐怖袭击开始以来，布基纳法索萨赫勒地区的医疗保健系统和免疫服务经常受到干扰，该地区启动了弹性战略，包括将免疫活动任务转移给社区卫生工作者（CHWs）。这项策略旨在让更多的 CHW 参与疫苗接种过程，最终提高医疗保健系统的绩效。
任务转移策略于 2019 年在 Djibo 卫生区开始试点，然后扩展到萨赫勒地区的所有 4 个区。CHW 包括通过卫生部和公共卫生部门在国家层面招聘的人员，以及支持卫生设施运作的其他社区成员。他们接受了标准化免疫模块的培训，并由功能齐全的卫生设施团队提供疫苗。该策略的实施从 CHW 管理口服抗原开始。随后，在恐怖袭击恶化以及迫切需要保护受安全和人道主义危机影响的当地民众健康的情况下，他们的服务范围扩大到包括注射疫苗。
该干预措施通过内部方案审查进行评估，作为 2022 年 8 月 1 日至 10 月 28 日在萨赫勒地区进行的描述性横断面研究实施，包括在多里卫生区进行的调查。考虑对参与实施该策略的 CHW 进行访谈。自 2019 年该策略启动以来，所有抗原的绩效指标均呈上升趋势。
在一个深受恐怖主义相关不安全局势影响的地区，将免疫活动任务转移给 CHW 已成功实施。如果制度化并扩大规模，同时改善 CHW 对疫苗接种后不良反应的监测，该策略有望维持甚至提高绩效。
