肯尼亚尼耶里县社区卫生志愿者筛查和联系非传染性疾病的干预能力

Kenneth Langakuo, J. Nyaberi, Elizabeth Echoka
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摘要

目的:非传染性疾病 (NCD) 是一项重大的全球健康挑战,占全球发病率的 50%,死亡率的 63%。在中低收入国家(LMICs),这一负担尤为沉重,80% 的非传染性疾病相关死亡发生在这些国家。本研究评估了尼耶里县非传染性疾病有效筛查和联系所面临的障碍和挑战。研究方法:2022 年 5 月至 2023 年 3 月期间进行了一项准实验性非等效前后测试设计。研究采用多阶段群组和随机抽样的方法选取了 10 个社区单位,结果对照组和干预组分别有 150 名和 150 名社区卫生志愿者(CHVs)。数据收集通过 KOBO 应用程序进行。定量数据使用 SPSS 28.0 版进行分析,定性数据通过 N-Vivo 12 进行录音、转录和分析,研究结果以文字描述和主题分析的形式呈现,其中包括参与者的直接引语、观察到的行为描述以及对模式和主题的解释。研究结果研究表明,59.3% 的受访者对 NCDs 的了解甚少,92.7%(n = 139)的受访者对 NCDs 没有清晰的认识,干预前的认知能力为 48.8%。独立样本 t 检验显示,受访者的认知能力从干预前的平均 48.75 (SD±5.7) % 上升到 68.28 (SD±7.6) %,差异显著,p<0.001。对理论、实践和政策的独特贡献:有必要开展以现代医疗保健实践为重点的全面且具有文化敏感性的培训,实施更多结构化的、以社区为中心的方法,包括有效的沟通、动员和宣传,这将提高社区卫生志愿者在抗击非传染性疾病方面的能力和接受度。持续的研究和评估应确保实际的变化,包括创新和使用移动应用程序,如 NCDs 应用程序和轮子。一个易于使用的卫生保健志愿者移动应用程序、持续的能力建设以及提高认识和培训将极大地改善卫生保健志愿者的筛查和联系。因此,在这个技术和使用手机的时代,有必要开发一款可与卫生保健志愿者手机、医疗机构和客户集成的应用程序,以便密切监测非传染性疾病并进行转诊。
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The Interventional Capacity of Community Health Volunteers for Screening and Linkages of Non-Communicable Diseases in Nyeri County, Kenya
Purpose: Non-communicable diseases (NCDs) are a significant global health challenge, contributing to 50% of worldwide morbidity and 63% of mortality. The burden is particularly substantial in low—and middle-income countries (LMICs), where 80% of NCD-related deaths occur. This study evaluated barriers and challenges to effective screening and linkages of NCDs in Nyeri County. Methodology: A quasi-experimental non-equivalent pre-and post-test design was conducted from May 2022 to March 2023. The study employed multistage cluster and random sampling to select ten community units, resulting in 150 community health volunteers (CHVs) in the control unit and 150 in the intervention group. Data collection was facilitated through the KOBO app. Quantitative data was analyzed using SPSS version 28.0, and qualitative data was audio-recorded, transcribed, and analyzed via N-Vivo 12 and findings were presented in textual descriptions and thematic analysis that included direct quotes from participants, descriptions of observed behaviors, and interpretations of patterns and themes. Findings: The study shows that 59.3% of respondents have minimal information, and 92.7 % (n =139) have no clear understanding of NCDs, with a pre-intervention capacity of 48.8%. Independent sample t-test showed a significant difference in capacity from a pre-intervention average of 48.75 (SD±5.7) %, which increased to 68.28 (SD±7.6) %, p<0.001. Unique Contribution to Theory, Practice and Policy: There is a need for a comprehensive, and culturally sensitive training for that will focus on modern healthcare practices, implementing more structured, community-centric approaches involving effective communication, mobilization, and sensitization will enhance the capacity and acceptance of CHVs' roles in combating NCDs. Continuous research and evaluation should ensure practical changes including innovations and use of mobile apps like NCDs app and wheel. An easy-to-use CHV mobile app, continuous capacity building and increased awareness and training will greatly improve on CHVs screening and linkages. Therefore, in this era of technology and use of mobile phones, there is need to develop an app that can be integrated with CHVs mobile phones, Healthcare facility and clients for close NCD monitoring and referral.
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