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首页> 美国卫生研究院文献>Global Health: Science and Practice >Taking knowledge for health the extra mile: participatory evaluation of a mobile phone intervention for community health workers in Malawi
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Taking knowledge for health the extra mile: participatory evaluation of a mobile phone intervention for community health workers in Malawi

机译：更加了解健康：对马拉维社区卫生工作者的手机干预的参与式评估

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In Malawi, where the majority of the population resides in rural areas, community health workers (CHWs) are the first, and often only, providers of health services. An assessment of health information needs, however, found that these frontline workers often lacked essential health information. A pilot project, implemented in 2 rural districts of Malawi between 2010 and 2011, introduced a mobile phone system to strengthen knowledge exchange within networks of CHWs and district staff. To evaluate the mobile phone intervention, a participatory evaluation method called Net-Map was used, an approach built on traditional social network analysis. Together, CHWs and district personnel discussed information needs and gaps and the roles of different actors in their information networks. They then used drawings and 3-dimensional objects to create baseline and endline maps showing the linkages and levels of influence among members of the information network. Net-Map provided them with powerful evidence of differences before and after the mobile phone initiative. At baseline, CHWs were not mentioned as actors in the information network, while at endline they were seen to have significant connections with colleagues, beneficiaries, supervisors, and district health facilities, as both recipients and providers of information. Focus groups with CHWs complemented the Net-Map findings with reports of increased self-confidence and greater trust by their communities. These qualitative results were bolstered by surveys that showed decreases in stockouts of essential medicines, lower communication costs, wider service coverage, and more efficient referrals. As an innovative, participatory form of social network analysis, Net-Map yielded important visual, quantitative, and qualitative information at reasonable cost.
机译：在大多数人口居住在农村地区的马拉维，社区卫生工作者（CHW）是第一批，而且通常是唯一的卫生服务提供者。然而，对健康信息需求的评估发现，这些一线工人通常缺乏基本的健康信息。 2010年至2011年在马拉维的两个农村地区实施的一个试点项目引入了移动电话系统，以加强社区卫生工作者和地区工作人员网络之间的知识交流。为了评估手机干预，使用了一种称为Net-Map的参与式评估方法，该方法基于传统的社交网络分析。社区工作者和地区人员一起讨论了信息需求和差距以及不同参与者在其信息网络中的作用。然后，他们使用图纸和3维对象创建基线和终点图，以显示信息网络成员之间的联系和影响程度。 Net-Map为他们提供了强有力的证据，证明了手机计划前后的差异。在基线时，没有将CHW视为信息网络中的参与者，而在最后阶段，他们被视为与作为信息接收者和提供者的同事，受益者，主管和地区卫生机构有着重要联系。带有CHW的焦点小组对Net-Map的发现进行了补充，报告称其社区增加了自信心并增加了信任。这些定性结果得到了调查的支持，这些调查显示基本药物的库存减少，通信成本降低，服务范围更广，转诊效率更高。作为社交网络分析的一种创新性，参与性形式，Net-Map以合理的成本生成了重要的视觉，定量和定性信息。

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