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首页> 外文期刊>International journal for equity in health >Supporting and retaining Village Health Teams: an assessment of a community health worker program in two Ugandan districts
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Supporting and retaining Village Health Teams: an assessment of a community health worker program in two Ugandan districts

机译：支持和保留乡村卫生小组：对乌干达两个地区的社区卫生工作者计划的评估

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BackgroundUganda’s national community health worker program involves volunteer Village Health Teams (VHTs) delivering basic health services and education. Evidence demonstrates their positive impact on health outcomes, particularly for Ugandans who would otherwise lack access to health services. Despite their impact, VHTs are not optimally supported and attrition is a growing problem. In this study, we examined the support needs and existing challenges of VHTs in two Ugandan districts and evaluated specific factors associated with long-term retention. We report on findings from a standardized survey of VHTs and exploratory interviews with key stakeholders and draw conclusions that inform efforts to strengthen and sustain community health care delivery in Uganda. MethodsA mixed-methods approach was employed through a survey of 134 individual VHT members and semi-structured interviews with six key stakeholders. Descriptive and bivariate regression analysis of quantitative survey data was performed along with thematic analysis of qualitative data from surveys and interviews. In the regression analysis, the dependent variable is 10-year anticipated longevity among VHTs, which asked respondents if they anticipate continuing to volunteer as VHTs for at least 10 more years if their current situation remains unchanged. ResultsVHTs desire additional support primarily in the forms of money (e.g. transportation allowance) and material supplies (e.g. rubber boots). VHTs commonly report difficult working conditions and describe a lack of respect from their communities and other health workers. If their current situation remains unchanged, 57% of VHTs anticipate remaining in their posts for at least 10?years. Anticipated 10-year longevity was positively associated with stronger partnerships with local health center staff and greater ease in home visiting. ConclusionsSupporting and retaining Uganda’s VHTs would be enhanced by building stronger partnerships between VHTs and other health workers and regularly providing supplies and transportation allowances. Pursuing such measures would likely improve equity in access to healthcare for all Ugandans.
机译：背景乌干达的全国社区卫生工作者计划包括自愿提供的乡村卫生小组（VHT），他们提供基本的卫生服务和教育。证据表明，它们对健康结果具有积极影响，特别是对否则无法获得卫生服务的乌干达人而言。尽管有其影响，VHT仍未得到最佳支持，损耗已成为一个日益严重的问题。在这项研究中，我们检查了两个乌干达地区VHT的支持需求和现有挑战，并评估了与长期保留相关的特定因素。我们报告了来自VHT的标准化调查和与主要利益相关者进行的探索性访谈的结果，并得出结论，为加强和维持乌干达社区卫生保健的开展提供了信息。方法通过对134个VHT成员的调查以及对六个主要利益相关者的半结构化访谈，采用了混合方法。对定量调查数据进行描述性和双变量回归分析，并对来自调查和访谈的定性数据进行主题分析。在回归分析中，因变量是VHT的10年预期寿命，这询问受访者，如果他们的当前状况保持不变，他们是否期望继续自愿至少10年作为VHT。结果VHT希望主要以金钱（例如运输津贴）和材料供应（例如橡胶靴）的形式提供额外的支持。 VHT通常报告困难的工作条件，并表示缺乏社区和其他卫生工作者的尊重。如果目前的状况保持不变，则有57％的VHT预计将保留其职位至少10年。预期的10年寿命与当地医疗中心工作人员之间更牢固的合作伙伴关系以及家庭访问的便利性密切相关。结论通过在VHT与其他卫生工作者之间建立更牢固的伙伴关系，并定期提供物资和运输补贴，可以加强对乌干达VHT的支持和保留。采取此类措施可能会改善所有乌干达人获得医疗保健的公平性。

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