Berggren W L
Am J Trop Med Hyg. 1974 Sep;23(5):936-49. doi: 10.4269/ajtmh.1974.23.936.
Tetanus has been a public health problem of major importance in rural Haiti. Energetic preventive measures by a rural Haitian hospital were successful in controlling the problem only after immunization services were made easily available to the entire population served by the hospital. This was accomplished by a program which carried the services to the market places and villages of the region. The program developed several new categories of auxiliary personnel who were recruited locally and trained on the job. These personnel were utilized in a program which incorporated preparatory publicity, timing, handling of large crowds in open surroundings, education, record keeping, follow-up and evulation as well as the technical matters concerning the giving of injections. The program sharply reduced the number of admissions to the hospital for the treatment of tetanus. Evaluated on the basis of hospitalizations avverted the program cost only 1/9 the value of the 50,000 hospital days of care for the tetanus cases it prevented.
破伤风一直是海地农村地区一个极为重要的公共卫生问题。海地一家农村医院采取了积极的预防措施，只有在为该医院服务的全体民众都能轻松获得免疫服务之后，才成功控制住了这一问题。这是通过一个将服务带到该地区的市场和村庄的项目实现的。该项目培养了几类新的辅助人员，他们在当地招募并接受在职培训。这些人员被用于一个综合了前期宣传、时间安排、在露天环境中处理大量人群、教育、记录保存、随访与评估以及注射相关技术问题的项目。该项目大幅减少了因破伤风治疗而入院的人数。以避免的住院天数来评估，该项目的成本仅为其预防的破伤风病例所节省的50000个住院日护理价值的九分之一。
