Mfaki Bahati M, Anasel Mackfallen, Swai Idda Lyatonga, Kacholi Godfrey
Ministry of Health, Private Health Laboratory Board Dodoma Tanzania.
Department of Health Systems Management Mzumbe University Morogoro Tanzania.
Public Health Chall. 2025 Aug 18;4(3):e70084. doi: 10.1002/puh2.70084. eCollection 2025 Sep.
Project Extension for Community Health Care Outcomes (Project ECHO) is recognized as an effective and affordable way to improve healthcare professionals' knowledge. Project ECHO rapidly expanded in Tanzania from 1 hub to 4 hubs and 12 to nearly 200 spokes in just 3 years. Despite its success, participation among healthcare workers remains low. The study aimed to determine the institutional factors influencing nurses' participation in Project ECHO sessions.
This cross-sectional study was conducted among 450 nurses from 42 selected primary health facilities in Dar es Salaam, Tanzania. A standardized questionnaire was used to collect data from the study participants. We evaluated the association between sociodemographic variables and institutional factors with Project ECHO participation through descriptive analyses and multivariable logistic regression.
Overall, 64% of the study participants had not attended a single ECHO clinic in the past year. The availability of information and communications technology experts to provide technical backstopping to staff (AOR: 0.45, 95% CI: 0.27-0.76, value = 0.003) and the availability of designated rooms equipped with appropriate equipment (AOR: 20.95, 95% CI: 4.44-98.82, value < 0.001) were associated with participation.
The study identifies several factors influencing nurse participation in Project ECHO. These include internet access, incentives, and well-equipped computer labs, all highly valued. Additionally, the availability of information, communication, and technologies (ICT) experts and effective training significantly contribute to positive experiences. To improve participation, addressing the challenges posed by inflexible scheduling and resource limitations is essential.
社区卫生保健成果项目拓展计划（Project ECHO）被认为是提高医疗保健专业人员知识水平的一种有效且经济实惠的方式。Project ECHO在坦桑尼亚迅速扩张，仅3年时间就从1个中心扩展到4个中心，分支从12个增加到近200个。尽管取得了成功，但医护人员的参与率仍然很低。该研究旨在确定影响护士参与Project ECHO课程的机构因素。
这项横断面研究在坦桑尼亚达累斯萨拉姆42家选定的初级卫生设施中的450名护士中进行。使用标准化问卷从研究参与者那里收集数据。我们通过描述性分析和多变量逻辑回归评估社会人口统计学变量和机构因素与参与Project ECHO之间的关联。
总体而言，64%的研究参与者在过去一年中没有参加过一次ECHO诊所。有信息通信技术专家为工作人员提供技术支持（调整后比值比：0.45，95%置信区间：0.27 - 0.76，P值 = 0.003）以及设有配备适当设备的指定房间（调整后比值比：20.95，95%置信区间：4.44 - 98.82，P值 < 0.001）与参与情况相关。
该研究确定了影响护士参与Project ECHO的几个因素。这些因素包括互联网接入、激励措施和设备完善的计算机实验室，所有这些都备受重视。此外，信息、通信和技术（ICT）专家的可用性以及有效的培训对积极体验有显著贡献。为了提高参与率，应对由不灵活的日程安排和资源限制带来的挑战至关重要。
