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津巴布韦初级卫生保健中的乡村卫生工作:卫生工作者的观点。

Village health work in the primary healthcare of Zimbabwe: Health workers' perspectives.

作者信息

Munyai Ofhani, Mudau Azwinndini G, Mashau Ntsieni S

机构信息

Department of Public Health, University of Venda, Thohoyandou, South Africa.

出版信息

PLoS One. 2025 Aug 25;20(8):e0326956. doi: 10.1371/journal.pone.0326956. eCollection 2025.

Abstract

Migration and poor performance of healthcare workers in Zimbabwe hinder primary healthcare delivery. This has compelled the country to exploit the potential of village health workers in primary healthcare. The Village Health Worker Strengthening Plan was never operationalised owing to unclear roles and limited coordination. The study aimed to explore the roles, challenges, and strategies as informed by setting and context to improve the effectiveness and efficiency of Village Health Workers in service delivery. The study was conducted in the Beitbridge district, Matabeleland South Province, Zimbabwe. A qualitative exploratory survey with semi-structured interview guides was administered to 36 participants, comprising Village Health Workers, nurses, environmental health practitioners, and medical doctors. Three main themes were analysed, and 15 subthemes were found. The role of Village Health Workers was to promote health, prevent and control disease, diagnose and treat minor ailments, and conduct community-based disease surveillance and referrals for complicated cases to primary healthcare facilities. Challenges were inadequate logistical supplies, allowances, knowledge and skills, mobility, and personal protective equipment. Optimal stocking of the medical and equipment supplies, improving allowances, community health integration into the healthcare system, embracing mobile health technology, capacity building, and supportive supervision were sub-themes on suggested strategies to improve service delivery. The study helped clarify the roles and challenges and suggested strategies by health service providers, as informed by empirical findings, to improve the effectiveness and efficiency of Village Health Workers in service delivery. It is recommended that needs assessments be conducted on village health work to enhance their capacity and support.

摘要

津巴布韦医护人员的流动和低效工作阻碍了初级医疗服务的提供。这迫使该国挖掘乡村卫生工作者在初级医疗保健方面的潜力。由于角色不明确和协调有限,《乡村卫生工作者强化计划》从未实施。该研究旨在根据环境和背景探索乡村卫生工作者的角色、挑战及策略,以提高其服务提供的有效性和效率。研究在津巴布韦南马塔贝莱兰省的贝特布里奇区开展。采用半结构化访谈指南对36名参与者进行了定性探索性调查,参与者包括乡村卫生工作者、护士、环境卫生从业者和医生。分析得出三个主要主题,发现了15个子主题。乡村卫生工作者的职责是促进健康、预防和控制疾病、诊断和治疗小病,并开展社区疾病监测以及将复杂病例转诊至初级医疗保健机构。挑战包括后勤供应不足、津贴不足、知识和技能欠缺、流动性问题以及个人防护装备问题。医疗和设备供应的优化储备、提高津贴、将社区卫生纳入医疗体系、采用移动健康技术、能力建设以及支持性监督是关于改善服务提供建议策略的子主题。该研究有助于明确角色和挑战,并根据实证结果为卫生服务提供者提出改善乡村卫生工作者服务提供有效性和效率建议策略。建议对乡村卫生工作进行需求评估,以增强他们的能力并提供支持。

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