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评估针对乡村卫生工作者的结构化培训项目对资源有限环境下医疗服务提供的影响:来自冈比亚的证据。

Evaluating the impact of structured training programs for village health workers on healthcare delivery in resource-limited settings: Evidence from The Gambia.

作者信息

Bah Ebrima, Adhikari Saroj

机构信息

Ministry of Health, Banjul, The Gambia.

Ministry of Health and Population, Kathmandu, Nepal.

出版信息

PLOS Glob Public Health. 2025 Aug 22;5(8):e0005079. doi: 10.1371/journal.pgph.0005079. eCollection 2025.

Abstract

Community health workers (CHWs) are critical in bridging healthcare gaps in underserved areas, particularly in resource-limited settings. In The Gambia, Village Health Workers (VHWs) play a pivotal role in primary healthcare delivery. Despite their significance, evidence on the effectiveness of structured training programs for VHWs remains sparse. This study evaluates the impact of a training program designed to enhance the knowledge and skills of VHWs in The Gambia, focusing on their capacity to address key community health needs. A retrospective quantitative design was employed, analyzing pre- and post-test scores from VHWs across three health regions in The Gambia. The training included 60 sessions on topics such as child health, nutrition, sanitation, and disease prevention. Data were analyzed using descriptive statistics, paired t-tests, and one-way ANOVA to assess improvements in knowledge and identify influencing factors like age, sex, and education level. The results revealed significant improvements in knowledge and practical skills, with mean post-test scores increasing by 26.32 points (p < 0.001) compared to pre-test scores. Age and education were significant predictors of performance, with older participants and those with secondary or tertiary education achieving higher post-test scores. No significant differences were observed based on sex, indicating the program's inclusivity. These findings underscore the effectiveness of structured training programs in equipping VHWs with essential competencies to improve healthcare delivery. The study highlights the need for tailored approaches to address disparities in educational backgrounds and recommends ongoing capacity-building initiatives to sustain the impact. By strengthening VHW capacities, this intervention contributes to improving healthcare access and outcomes in The Gambia, offering valuable insights for similar programs in resource-limited settings.

摘要

社区卫生工作者在弥合服务不足地区的医疗差距方面至关重要,尤其是在资源有限的环境中。在冈比亚,乡村卫生工作者在初级卫生保健服务中发挥着关键作用。尽管他们很重要,但关于针对乡村卫生工作者的结构化培训项目有效性的证据仍然很少。本研究评估了一个旨在提高冈比亚乡村卫生工作者知识和技能的培训项目的影响,重点关注他们满足关键社区卫生需求的能力。采用回顾性定量设计,分析了冈比亚三个卫生区域乡村卫生工作者的测试前和测试后分数。培训包括60节关于儿童健康、营养、卫生和疾病预防等主题的课程。使用描述性统计、配对t检验和单因素方差分析对数据进行分析,以评估知识的提高情况并确定年龄、性别和教育水平等影响因素。结果显示,知识和实践技能有显著提高,测试后平均分数比测试前分数提高了26.32分(p < 0.001)。年龄和教育是表现的重要预测因素,年龄较大的参与者以及具有中等或高等教育程度的参与者测试后分数更高。未观察到基于性别的显著差异,表明该项目具有包容性。这些发现强调了结构化培训项目在使乡村卫生工作者具备改善医疗服务的基本能力方面的有效性。该研究强调需要采取量身定制的方法来解决教育背景方面的差异,并建议持续开展能力建设举措以维持影响。通过加强乡村卫生工作者的能力,这一干预措施有助于改善冈比亚的医疗服务可及性和成果,为资源有限环境中的类似项目提供了宝贵的见解。

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