× خانه ژورنال ها پست ها ثبت نام ورود

Quality of Sick Child-Care Delivered by Community Health Workers in Tanzania

نویسندگان

  • Colin Baynes Mailman School of Public Health, Columbia University, New York City, NY, USA
  • Helen Semu Ministry of Health and Social Welfare, Dar es Salaam, Tanzania
  • Kate Ramsey Mailman School of Public Health, Columbia University, New York City, NY, USA
  • Senga Pemba Tanzania Training Center for International Health, Ifakara, Tanzania

چکیده

Background Community health worker (CHW) interventions to manage childhood illness is a strategy promoted by the global health community which involves training and supporting CHW to assess, classify and treat sick children at home, using an algorithm adapted from the Integrated Management of Childhood Illness (IMCI). To inform CHW policy, the Government of Tanzania launched a program in 2011 to determine if community case management (CCM) of malaria, pneumonia and diarrhea could be implemented by CHW in that country.   Methods This paper reports the results of an observational study on the CCM service delivery quality of a trial cohort of CHW in Tanzania, called WAJA. In 2014, teams of data collectors, employees of the Ministry of Health and Social Welfare trained in IMCI, assessed the IMCI skills rendered by a sample of WAJA on sick children who presented to WAJA with illness signs and symptoms in their communities. The assessment included direct observations of WAJA IMCI episodes and expert re-assessment of the same children seen by WAJA to assess the congruence between the assessment, classification and treatment outcomes of WAJA cases and those from cases conducted by expert re-assessors.   Results In the majority of cases, WAJA correctly assess sick children for CCM-treatable illnesses (malaria, pneumonia, and diarrhea) and general danger signs (90% and 89%, respectively), but too few correctly assess for physical danger signs (39%); on classification in the majority of cases (73%) WAJA correctly classified illness, though more for CCM-treatable illnesses (83%). In majority of cases (78%) WAJA treated children correctly (84% of malaria, 74% pneumonia, and 71% diarrhea cases). Errors were often associated with lapses in health systems support, mainly supervision and logistics.   Conclusion CCM is a feasible strategy for CHW in Tanzania, who, in the majority of cases, implemented the approach as well as IMCI expert re-assessors. Nevertheless, for CCM to be effective, in Tanzania, a strategy to implement it must be coordinated with efforts to strengthen local health systems.

برای دسترسی به متن کامل این مقاله و 10 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

ورود

منابع مشابه

BACKGROUND As community case management of childhood illness expands in low-income countries, there is a need to assess the quality of care provided by community health workers. This study had the following objectives: 1) examine methods of recruitment of sick children for assessment of quality of care, 2) assess the validity of register review (RR) and direct observation only (DO) compared to ...

OBJECTIVE To assess the quality of care provided by Health Surveillance Assistants (HSAs)-a cadre of community-based health workers-as part of a national scale-up of community case management of childhood illness (CCM) in Malawi. METHODS Trained research teams visited a random sample of HSAs (n = 131) trained in CCM and provided with initial essential drug stocks in six districts, and observe...

This study assessed the quality of care provided by community health workers (CHWs) in managing cases of severe acute malnutrition (SAM) according to a treatment algorithm. A mixed methods approach was employed to provide perspectives on different aspects of quality of care, including technical competence and acceptability to caretakers. CHWs screened children at community level using a mid-upp...

BACKGROUND Ethiopia has scaled up integrated community case management of childhood illness (iCCM), including several interventions to improve the performance of Health Extension Workers (HEWs). We assessed associations between interventions to improve iCCM quality of care and the observed quality of care among HEWs. METHODS We assessed iCCM implementation strength and quality of care provide...

Background and Objectives: Social Security Organization (SSO) is the second largest organization to the Ministry of Health and Medical Education (MOHME) in providing health care services in Iran. In recent years the gap between the SSO’s resources and expenditures has shown an unprecedented growing trend due to the rapidly increasing demand. Continuation of this trend may lead ...

BACKGROUND There is a higher neonatal mortality rate while the adherence to the existing guidelines is rarely studied in Tanzania. AIM The aim of this study is to assess the performance of health workers for neonatal health-care. MATERIALS AND METHODS Settings - Peripheral health facilities (regional referral, district hospitals and health centers) and a tertiary referral hospital of Kilima...