Reddaiah V P, Kapoor S K
Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi.
Indian J Pediatr. 1993 Mar-Apr;60(2):283-8. doi: 10.1007/BF02822192.
WHO advocated a standard case management for control of ARI related mortality. India has started an ARI control programme in 15 districts. Conflicting reports appeared regarding the effectiveness of case management strategy. Authors reported earlier that it was not effective. The coverage was only about 57% in pneumonias, and 23% in severe pneumonias. Health agencies & health workers have a low utilization (13.7%), and RMPs were used in large numbers (36.9%). Most of the deaths were in those treated by RMPs (75%). The efficacy of standard case management (88%) is highlighted. The problem of coverage and assumptions behind the strategy were discussed and recommendations for improvement were suggested.
世界卫生组织倡导采用标准病例管理方法来控制与急性呼吸道感染相关的死亡率。印度已在15个地区启动了急性呼吸道感染控制项目。关于病例管理策略的有效性出现了相互矛盾的报告。作者此前报告称该策略无效。肺炎的覆盖率仅约为57%,重症肺炎的覆盖率为23%。卫生机构和卫生工作者的利用率较低(13.7%),大量使用了注册西医(36.9%)。大多数死亡发生在由注册西医治疗的患者中(75%)。强调了标准病例管理的有效性(88%)。讨论了覆盖率问题及该策略背后的假设,并提出了改进建议。