Ansari Mohammed Farhan, Boopalan Deenadayalan, Inbaraj Ganagarajan, Govindaraj Sarath, Parthasarathy Rajani, Rao Girish N, Shahed Rehan, Arshad Faheem, Alladi Suvarna
Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, 560029, India.
Department of Health and Family Welfare, Government of Karnataka, Bengaluru, India.
BMC Health Serv Res. 2025 Jul 3;25(1):924. doi: 10.1186/s12913-025-12549-4.
Neurological disorders pose a substantial burden on India's healthcare system, contributing significantly to disability and mortality. In rural areas, where access to specialists availability is limited, Community Health Officers (CHOs) play a crucial role in bridging the gap in care. However, the lack of structured training programs for CHO's in neurological disorder management highlights an urgent need for targeted capacity-building interventions. This study evaluates the impact of a structured training program on the knowledge and skills of CHOs in managing common neurological disorders under the Karnataka Brain Health Initiative (KaBHI).
The quasi-experimental study was conducted across three districts in Karnataka-Chikkaballapura, Kolar, and Bengaluru South. A total of 295 CHOs participated in a two-hour training program delivered by expert neurologists, covering headache, epilepsy, stroke, and dementia through lectures, discussions, and case-based scenarios. Pre- and post-training knowledge assessments using a standardized multiple-choice questionnaire evaluated the program's impact. Feedback from participants was collected to assess training quality.
Of the 295 participants, 280 completed both pre- and post-training assessments. Significant improvements were observed in knowledge scores across all disorders, with a mean score increase from 57.46 ± 16.4 to 75.79 ± 12.9 (mean difference: 18.3, p<0.001). The program was effective regardless of prior clinical experience, indicating its adaptability. Feedback highlighted high satisfaction with the training's structure, content, and delivery.
This study provides strong evidence that structured training programs can significantly enhance CHOs' ability to diagnose and manage neurological disorders, particularly in resource-limited settings. Beyond immediate knowledge gains, these findings highlight the broader potential for integrating similar capacity-building initiatives for neurological care into national healthcare programs, such as the Ayushman Bharat Mission and Health and Wellness Centers (HWCs). By equipping frontline healthcare providers with specialized skills, such programs can improve early diagnosis, facilitate timely intervention, and enhance patient outcomes, ultimately reducing the burden of neurological disorders at the primary care level. Future phases of KaBHI, implemented state-wide, will focus on ensuring long-term sustainability by refining and expanding this training model to address a wider range of neurological conditions and strengthening its integration into primary healthcare frameworks.
神经系统疾病给印度的医疗体系带来了沉重负担，在残疾和死亡率方面占比显著。在农村地区，专科医生资源有限，社区卫生官员（CHOs）在弥合医疗差距方面发挥着关键作用。然而，针对社区卫生官员在神经系统疾病管理方面缺乏结构化培训项目，凸显了开展有针对性的能力建设干预措施的迫切需求。本研究评估了在卡纳塔克邦脑健康倡议（KaBHI）下，一个结构化培训项目对社区卫生官员管理常见神经系统疾病的知识和技能的影响。
这项准实验研究在卡纳塔克邦的三个地区——奇卡巴拉普拉、科拉尔和班加罗尔南部开展。共有295名社区卫生官员参加了由神经科专家提供的为期两小时的培训项目，通过讲座、讨论和基于案例的情景模拟，内容涵盖头痛、癫痫、中风和痴呆。使用标准化的多项选择题问卷进行培训前和培训后的知识评估，以评估该项目的影响。收集参与者的反馈以评估培训质量。
295名参与者中，280人完成了培训前和培训后的评估。所有疾病的知识得分均有显著提高，平均得分从57.46±16.4提高到75.79±12.9（平均差异：18.3，p<0.001）。无论之前有无临床经验，该项目都有效，表明其适应性强。反馈显示对培训的结构、内容和授课方式高度满意。
本研究提供了有力证据，表明结构化培训项目可显著提高社区卫生官员诊断和管理神经系统疾病的能力，尤其是在资源有限的环境中。除了能立即获得知识外，这些发现还凸显了将类似的神经系统护理能力建设举措纳入国家医疗保健项目（如阿育吠陀 Bharat使命和健康与 wellness 中心（HWCs））的更广泛潜力。通过使一线医疗服务提供者具备专业技能，此类项目可改善早期诊断、促进及时干预并提高患者治疗效果，最终减轻基层医疗层面的神经系统疾病负担。KaBHI 在全州实施的未来阶段，将专注于通过完善和扩展此培训模式以应对更广泛的神经系统疾病，并加强其与基层医疗框架的整合，来确保长期可持续性。
