Public Health Foundation of India, New Delhi, India
Public Health Foundation of India, New Delhi, India.
BMJ Open. 2024 Aug 12;14(8):e084416. doi: 10.1136/bmjopen-2024-084416.
The COVID-19 pandemic strained India's healthcare system and health workers unprecedentedly.
The extent of the contribution by peer educators (PEs) from India's National Adolescent Health Programme-Rashtriya Kishor Swasthya Karyakram (RKSK) to COVID-19 response activities remains uncertain necessitating an imperative investigation. Within the overarching objective of the 'i-Saathiya' study ('i' signifies implementation science and Saathiya represents PEs in Madhya Pradesh), a key focus was to understand the role of PEs recruited under RKSK during COVID-19 in two Indian states, namely Madhya Pradesh and Maharashtra. The study states differ in sociodemographic characteristics and peer education implementation models.
In-depth interviews (IDIs) were conducted with stakeholders (n=110, Maharashtra: 57; Madhya Pradesh: 53) engaged in the implementation of RKSK's peer education programme at state, district, block and village levels. Focus group discussions (FGDs) (n=16 adolescents, Maharashtra: 8; Madhya Pradesh: 8) were conducted with adolescents, part of the peer group of PEs (n=120 adolescents, Maharashtra: 66; Madhya Pradesh: 54). IDIs and FGDs were audio-recorded, translated, transcribed verbatim and analysed thematically. Adopting inductive and deductive approaches, a data-driven open coding framework was developed for thematic analysis.
The PE recruited under RKSK took a central role that extended beyond their predefined responsibilities within the RKSK. They provided crucial support to healthcare workers in curbing the spread of COVID-19. Their diverse contributions, including COVID-19 pandemic response support, addressing community and adolescent needs, role in COVID-19 vaccination efforts, navigating access to the health system and facilitating health workers in the implementation of various national health programmes and campaigns during COVID-19.
The findings underscore the potential of PEs in bolstering the health system. Despite their unpreparedness for the context (COVID-19), PEs demonstrated tenacity and adaptability, extending their roles beyond their predefined responsibilities. Recognising PEs through awards and incentives, skill courses and additional grades, can enhance their visibility, sustaining impactful work within RKSK and beyond.
新冠疫情大流行使印度的医疗系统和卫生工作者面临前所未有的压力。
印度国家青少年健康计划- Rashtriya Kishor Swasthya Karyakram（RKSK）的同伴教育者（PEs）在新冠疫情应对活动中的贡献程度尚不确定，这需要进行迫切的调查。在“i-Saathiya”研究的总体目标（“i”表示实施科学，Saathiya 代表 Madhya Pradesh 的 PEs）中，一个重点是了解在新冠疫情期间在印度两个邦（Madhya Pradesh 和 Maharashtra）招募的 RKSK 下的 PEs 的作用。研究州在社会人口特征和同伴教育实施模式方面存在差异。
对参与州、地区、街区和村庄各级 RKSK 同伴教育计划实施的利益攸关者（n=110，马哈拉施特拉邦：57；中央邦：53）进行了深入访谈（IDIs）。与青少年进行了焦点小组讨论（FGDs）（n=16，马哈拉施特拉邦：8；中央邦：8），他们是 PEs 的同伴群体的一部分（n=120 名青少年，马哈拉施特拉邦：66；中央邦：54）。对 IDI 和 FGD 进行了录音、翻译、逐字转录和主题分析。采用归纳和演绎方法，为主题分析开发了一个基于数据的开放式编码框架。
RKSK 招募的 PEs 发挥了核心作用，超出了他们在 RKSK 中的既定职责。他们为卫生工作者遏制新冠疫情的传播提供了重要支持。他们的各种贡献包括新冠疫情应对支持、满足社区和青少年的需求、在新冠疫苗接种工作中的作用、解决获得卫生系统的途径以及在新冠疫情期间促进卫生工作者实施各种国家卫生计划和运动。
研究结果强调了 PEs 在加强卫生系统方面的潜力。尽管他们对新冠疫情的背景没有准备，但 PEs 表现出了坚韧和适应性，超越了他们的既定职责。通过奖励、技能课程和额外的等级来认可 PEs，可以提高他们的知名度，维持他们在 RKSK 内外的有影响力的工作。
