Helitzer-Allen D L, Macheso A, Wirima J, Kendall C
Department of International Health, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD 21205.
Acta Trop. 1994 Dec;58(3-4):255-66. doi: 10.1016/0001-706x(94)90019-1.
The widespread problem of low and non-compliance to antimalarial chemoprophylaxis during pregnancy demands that attention be focused on alternative approaches to programming, product acceptability and demand for preventive services. This study describes the testing of three interventions to determine their effect on use of chloroquine (currently the most widely used drug for chemoprophylaxis) during pregnancy. The strategies evolved from community-based formative research undertaken to learn about the local concept of malaria and issues surrounding malaria prevention and treatment during pregnancy. The resulting interventions were tested in four clinics, and included a change in the health education message given during antenatal sessions, distribution of a sugar-coated chloroquine tablet, and an intervention combining the two strategies. The results showed a 45% increase in chloroquine use when the health education message was changed, and a 64% increase when the product was changed. High use levels were maintained with the combined intervention; an additive effect was seen. The study shows that improving the product was the most important factor in increasing the use of the program, and that changing the health education message can also make an impact on use.
孕期抗疟化学预防措施依从性低及不依从这一普遍问题，要求将注意力集中在规划的替代方法、产品可接受性及对预防服务的需求上。本研究描述了对三种干预措施的测试，以确定它们对孕期氯喹（目前最广泛用于化学预防的药物）使用情况的影响。这些策略源自基于社区的形成性研究，该研究旨在了解当地对疟疾的认识以及孕期疟疾预防和治疗相关问题。由此产生的干预措施在四家诊所进行了测试，包括改变产前检查时给出的健康教育信息、分发糖衣氯喹片，以及将这两种策略结合的一种干预措施。结果显示，改变健康教育信息时氯喹的使用增加了45%，更换产品时增加了64%。联合干预措施使高使用水平得以维持，呈现出相加效应。该研究表明，改进产品是增加项目使用的最重要因素，并且改变健康教育信息也会对使用产生影响。
