利用社区卫生工作者应对刚果民主共和国、尼日利亚、塞内加尔和乌干达的 COVID-19：角色、障碍和促进因素。

Leveraging community health workers for COVID-19 response in Democratic Republic of Congo, Nigeria, Senegal, and Uganda: roles, barriers, and facilitators.

机构信息

Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, Makerere University, P. BOX 7072, Kampala, Uganda.

Makerere University School of Public Health, Kampala, Uganda.

出版信息

BMC Prim Care. 2024 Jul 24;25(1):269. doi: 10.1186/s12875-024-02531-0.

DOI:10.1186/s12875-024-02531-0

PMID:39049006

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11267811/

Abstract

BACKGROUND

The Corona Virus Disease 2019 (COVID-19) pandemic overwhelmed health systems and disrupted the delivery of health services globally. Community Health Workers (CHWs) play a critical role in linking communities to health systems, supporting the prevention and control of diseases in many low- and middle-income countries. However, their roles, barriers, and facilitators in the response and control of the COVID-19 pandemic have not been well documented. We described the roles of CHWs in the COVID-19 response, including the barriers and facilitators.

METHODS

A cross-sectional study design was used to assess the COVID-19 response in the Democratic Republic of Congo (DRC), Nigeria, Senegal, and Uganda. This involved 110 key informant interviews with policymakers, health facility managers, district health managers, and CHWs to understand the role of CHWs in the COVID 19 response, selected purposively. The total sample size was based on information saturation in each of the countries. A document review on the COVID-19 response was also conducted. We searched Google, Google Scholar, and PubMed for published and grey literature. Data from the selected documents were extracted into a Google master matrix in MS Excel and analyzed thematically.

RESULTS

In COVID-19 Control, CHWs supported community-based surveillance, contact tracing, risk communication, community mobilization, and home-based care. To support the continuity of other non-COVID-19 services, the CHWs conducted community mobilization, sensitizations, outreaches, referrals, and patient follow-ups. CHWs were challenged by movement restrictions, especially in the initial stages of the lockdown, inadequate PPE, increased workload, low allowances, and motivation. CHW were facilitated by trainings, the development of guidelines, development partners' support/funding, and the provision of personal protective equipment (PPE) and tools.

CONCLUSION

CHWs supported both the COVID-19 control and continuity of non-COVID-19 health care during the COVID-19 pandemic. CHWs are a critical resource that must be adequately supported to build resilient health systems.

摘要

背景

2019 年冠状病毒病（COVID-19）大流行使卫生系统不堪重负，在全球范围内扰乱了卫生服务的提供。社区卫生工作者（CHW）在将社区与卫生系统联系起来，支持许多低收入和中等收入国家的疾病预防和控制方面发挥着关键作用。然而，他们在应对和控制 COVID-19 大流行方面的作用、障碍和促进因素尚未得到很好的记录。我们描述了 CHW 在 COVID-19 应对中的作用，包括障碍和促进因素。

方法

我们使用横断面研究设计评估了刚果民主共和国（DRC）、尼日利亚、塞内加尔和乌干达的 COVID-19 应对情况。这涉及与政策制定者、卫生机构管理人员、地区卫生管理人员和 CHW 进行 110 次关键知情人访谈，以了解 CHW 在 COVID-19 应对中的作用，这些访谈是有针对性选择的。总样本量基于每个国家的信息饱和度。还对 COVID-19 应对的文件进行了审查。我们在 Google、Google Scholar 和 PubMed 上搜索了已发表和灰色文献。从选定的文件中提取数据到 MS Excel 中的 Google 主矩阵中，并进行主题分析。

结果

在 COVID-19 控制方面，CHW 支持基于社区的监测、接触者追踪、风险沟通、社区动员和家庭护理。为了支持其他非 COVID-19 服务的连续性，CHW 进行了社区动员、宣传、外展、转诊和患者随访。CHW 受到行动限制的挑战，尤其是在封锁的初始阶段，个人防护装备（PPE）不足、工作量增加、津贴低和动力不足。CHW 得到了培训、准则制定、发展伙伴的支持/资金以及个人防护设备（PPE）和工具的提供的促进。