Joshi Anjali, Marasini Sabina, Sharma Sudim, Paneru Bandana, Kunwar Surakshya, Shrestha Archana, Shrestha Akina, Karmacharya Biraj Man
Department of Public Health, Kathmandu University School of Medical Sciences, Kathmandu, Nepal
Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.
BMJ Open. 2024 Dec 20;14(12):e082363. doi: 10.1136/bmjopen-2023-082363.
To determine the perception of female community health volunteers (FCHVs) in terms of their scope of work, impact of work on their professional experiences and their coping strategies and stakeholders' perception of FCHVs programme, their contribution to the health sector and its sustainability.
A qualitative study involving in-depth interviews (IDIs) with FCHVs and key informant interviews (KIIs) with local stakeholders. All the interviews were conducted through telephone.
Six municipalities in Kavre district, Nepal.
16 FCHVs participated in IDIs and 12 local stakeholders involving members of mother's group, health workers and local ward representatives of the selected municipalities were involved in KIIs from May to August 2021.
The FCHVs perceived a sense of workload because of their wide scope of work. The major challenges faced by FCHVs were limited allowances and incentives for their contribution, negative and judgemental attitudes, geographical challenges, multitasking, inadequate supply of health commodities and limited infrastructures for service delivery. Both the FCHVs and the stakeholders perceived the FCHV programme as one of the most effective programmes supporting the health system. However, they seem concerned about the sustainability of FCHVs programme. In addition, they indicated that the FCHVs could possibly alleviate the shortage of health workforce by providing preventive and promotive healthcare services at the grassroot level.
Our study showed a need for systematic and integrated health programme delivery packages thereby reducing additional workload and burden among FCHVs.
确定女性社区卫生志愿者(FCHV)对其工作范围、工作对其专业经历的影响、应对策略的看法,以及利益相关者对FCHV项目的看法、她们对卫生部门的贡献及其可持续性。
一项定性研究,包括对FCHV进行深入访谈(IDI)以及对当地利益相关者进行关键 informant 访谈(KII)。所有访谈均通过电话进行。
尼泊尔卡夫雷区的六个市。
2021年5月至8月,16名FCHV参与了IDI,12名当地利益相关者参与了KII,其中包括母亲团体成员、卫生工作者以及所选市的当地选区代表。
由于工作范围广泛,FCHV有工作量之感。FCHV面临的主要挑战包括因贡献而获得的津贴和激励有限、负面和评判性态度、地理挑战、多任务处理、卫生用品供应不足以及服务提供的基础设施有限。FCHV和利益相关者都认为FCHV项目是支持卫生系统的最有效项目之一。然而,他们似乎担心FCHV项目的可持续性。此外,他们指出,FCHV有可能通过在基层提供预防和促进性医疗服务来缓解卫生人力短缺的问题。
我们的研究表明,需要有系统和综合的卫生项目实施包,从而减少FCHV的额外工作量和负担。