撒哈拉以南非洲社区卫生工作者提供身体康复服务的证据:范围综述。

Evidence of community health workers' delivery of physical rehabilitation services in sub-Saharan Africa: a scoping review.

机构信息

Discipline of Public Health, School of Nursing and Public Health Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, KZN, South Africa

Research Unit, Lusaka Environmental Health University, Lusaka, Zambia, Zambia.

出版信息

BMJ Open. 2024 May 30;14(5):e079738. doi: 10.1136/bmjopen-2023-079738.

Abstract

OBJECTIVES

To map the evidence and scope of physical rehabilitation services delivered by community health workers (CHWs) in sub-Saharan Africa (SSA).

DESIGN

Scoping review DATA SOURCES: PubMed, Scopus, Cochrane Central and databases within the EBSCOhost platform. We also searched other literature sources including reference lists, conference presentations and organisational websites such as WHO, Ministries of Health and non-governmental organisations in SSA.

ELIGIBILITY CRITERIA FOR SELECTION OF STUDIES

Articles presenting evidence on CHWs' delivery of physical rehabilitation services in SSA from September 1978 to June 2023.

DATA EXTRACTION AND SYNTHESIS

Screening was conducted by two reviewers and was guided by the inclusion criteria. Thematic content analysis of data was employed. The results are presented according to the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews.

RESULTS

A total of 6996 articles were identified through various databases, with only 20 studies qualifying for data extraction. Evidence was presented by Eritrea, Ethiopia, Malawi, Mauritius, Namibia, South Africa and Uganda. Assessments, case management, health education, community liaison with support, health systems linkage and administration were the CHWs' scope of practice identified. The review identified home-based, community-based, community and facility-based, home and community-based and facility-based as modes of delivery. The barriers experienced are resources, societal and community attitudes, governance, geographical barriers and delivery capacity, while proximity to the community, positive job attitude and support with collaboration facilitated service delivery.

CONCLUSION

Training and integrating CHWs in national health care systems, with careful selection of existing CHWs, would minimise the barriers faced.

摘要

目的

绘制撒哈拉以南非洲(SSA)社区卫生工作者(CHWs)提供的物理康复服务的证据和范围。

设计

范围审查

数据来源

PubMed、Scopus、Cochrane 中央和 EBSCOhost 平台内的数据库。我们还搜索了其他文献来源,包括参考文献、会议演讲和 SSA 的世卫组织、卫生部和非政府组织等组织网站。

纳入研究的标准

自 1978 年 9 月至 2023 年 6 月发表的关于 CHWs 在 SSA 提供物理康复服务的证据的文章。

数据提取和综合

两名审查员进行了筛选,并根据纳入标准进行指导。对数据进行了主题内容分析。结果根据系统评价和荟萃分析扩展的首选报告项目呈现,以适应范围审查。

结果

通过各种数据库共确定了 6996 篇文章,只有 20 篇研究符合数据提取标准。证据来自厄立特里亚、埃塞俄比亚、马拉维、毛里求斯、纳米比亚、南非和乌干达。评估、病例管理、健康教育、社区联络支持、卫生系统联系和管理是 CHWs 的实践范围。审查确定了家庭为基础、社区为基础、社区和设施为基础、家庭和社区为基础以及设施为基础的交付模式。所经历的障碍包括资源、社会和社区态度、治理、地理障碍和交付能力,而接近社区、积极的工作态度和协作支持促进了服务的提供。

结论

将 CHWs 纳入国家卫生保健系统进行培训和整合,并谨慎选择现有 CHWs,可以最大限度地减少面临的障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66d0/11141183/9e31e66490ac/bmjopen-2023-079738f01.jpg

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