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肯尼亚北部社区卫生志愿者对急性营养不良管理的看法。

Perceptions towards management of acute malnutrition by community health volunteers in northern Kenya.

作者信息

Wambui Elizabeth, Wilunda Calistus, Donfouet Hermann Pythagore Pierre, Mwangi Bonventure, Zerfu Taddese Alemu, Daniel Tewoldeberha, Agutu Olivia, Samburu Betty, Kavoo Daniel, Karimurio Lydia, Cuellar Pilar Charle, Keane Emily, Schofield Lilly, Njiru James, Chabi Martin, Maina Lucy Gathigi, Okoth Peter, Raburu Judith, Gichohi Grace, Mutua Alex, Matanda Charles, Kimani-Murage Elizabeth

机构信息

African Population and Health Research Center, Nairobi, Kenya.

The World Bank Health Nutrition and Population Global Practice, Washington, DC, United States of America.

出版信息

PLOS Glob Public Health. 2024 May 16;4(5):e0002564. doi: 10.1371/journal.pgph.0002564. eCollection 2024.

Abstract

Child undernutrition is a persistent challenge in arid and semi-arid areas due to low and erratic rainfall, recurrent droughts and food insecurity. In these settings, caregivers face several challenges in accessing health services for sick and/or malnourished children, including long distances to health facilities, harsh terrain, and lack of money to pay for transportation costs to the health facilities, leading to low service coverage and sub-optimal treatment outcomes. To address these challenges and optimize treatment outcomes, the World Health Organization recommends utilizing community health volunteers (CHVs) to manage acute malnutrition in the community. This study explored the perceptions of community members regarding acute malnutrition treatment by CHVs in Turkana and Isiolo counties in Kenya. The study utilized a cross-sectional study design and included a purposive sample of caregivers of children, CHVs, officers who trained and supervised CHVs and community leaders in the intervention area. Focus group discussions and key informant interviews were used to explore perceptions towards the management of acute malnutrition by CHVs. Generally, caregivers and CHVs perceived the intervention to be beneficial as it readily addressed acute malnutrition treatment needs in the community. The intervention was perceived to be acceptable, effective, and easily accessible. The community health structure provided a platform for commodity supply and management and CHV support supervision. This was a major enabler in implementing the intervention. The intervention faced operational and systemic challenges that should be considered before scale-up.

摘要

由于降雨稀少且不稳定、旱灾频发以及粮食不安全问题,儿童营养不良在干旱和半干旱地区一直是一项严峻挑战。在这些地区,照顾患病和/或营养不良儿童的看护者在获得医疗服务方面面临诸多挑战,包括前往医疗机构的路途遥远、地形崎岖,以及缺乏支付前往医疗机构交通费用的资金,这导致了医疗服务覆盖率低和治疗效果不理想。为应对这些挑战并优化治疗效果,世界卫生组织建议利用社区卫生志愿者在社区管理急性营养不良问题。本研究探讨了肯尼亚图尔卡纳县和伊西奥洛县社区成员对社区卫生志愿者治疗急性营养不良的看法。该研究采用横断面研究设计,纳入了儿童看护者、社区卫生志愿者、培训和监督社区卫生志愿者的官员以及干预地区社区领袖的目的抽样。焦点小组讨论和关键信息访谈被用于探究对社区卫生志愿者管理急性营养不良的看法。总体而言,看护者和社区卫生志愿者认为该干预有益,因为它能迅速满足社区急性营养不良的治疗需求。该干预被认为是可接受的、有效的且易于获得的。社区卫生结构为物资供应和管理以及社区卫生志愿者的支持监督提供了一个平台。这是实施该干预的一个主要推动因素。该干预面临一些操作和系统方面的挑战,在扩大规模之前应予以考虑。

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