Amare Ashenafi Tazebew, Toni Alemayehu Teklu, Mekonnen Zeleke Abebaw, Endehabtu Berhanu Fikadie, Tilahun Binyam Chakilu
Department of Pediatrics and Child Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
J Multidiscip Healthc. 2021 Jan 6;14:9-19. doi: 10.2147/JMDH.S285280. eCollection 2021.
Supportive supervision is one of the five essential components of the WHO's Reaching Every District (RED) strategy. However, it is generally not practiced based on the standard schedule because of capacity and low number of staff in the health system. Thus, this study aimed to test the feasibility and effectiveness of a capacity building and mentorship program in immunization by health science colleges to supplement the existing approach.
This study applied a pre-post quasi-experimental research design. The study included health workers of 30 health facilities (15 intervention and 15 control) followed for six months. A total of 90 health workers were included. To assess the effectiveness of the intervention package on immunization coverage and a change in RED strategy implementation over time, difference in difference (DID) analysis was used. Finally, a RE-AIM framework was used to evaluate the implementation process.
The study indicated that the intervention package has a significant effect (P = 0.0001) on the overall implementation of RED outcomes. The DID analysis also indicated that health facilities in the intervention district have shown a higher Penta III coverage (17.4%) and complete vaccination coverage (16.6%) that are attributable to the intervention package. Similarly, knowledge and skills of health workers improved significantly (P < 0.05) after the intervention. The key informants also mentioned that the new approach was effective and acceptable.
The newly introduced capacity building and mentorship program by well-trained personnel of medical universities had positive effects on the immunization program. Thus, it is recommended to facilitate policy adoption and readiness for routine use at large scale.
支持性监督是世界卫生组织“覆盖每个地区”(RED)战略的五个基本组成部分之一。然而,由于卫生系统的能力和工作人员数量较少,通常无法按照标准时间表实施。因此,本研究旨在测试健康科学学院开展的免疫能力建设和指导计划补充现有方法的可行性和有效性。
本研究采用前后准实验研究设计。该研究包括30个卫生设施的卫生工作者(15个干预组和15个对照组),随访6个月。共纳入90名卫生工作者。为了评估干预措施对免疫覆盖率和RED战略实施随时间变化的有效性,采用了差分差分(DID)分析。最后,使用RE-AIM框架评估实施过程。
研究表明,干预措施对RED成果的总体实施有显著影响(P = 0.0001)。DID分析还表明,干预地区的卫生设施显示出更高的三联疫苗第三剂覆盖率(17.4%)和全程疫苗接种覆盖率(16.6%),这可归因于干预措施。同样,干预后卫生工作者的知识和技能有显著提高(P < 0.05)。关键信息提供者也提到新方法是有效且可接受的。
医科大学训练有素的人员新引入的能力建设和指导计划对免疫计划产生了积极影响。因此,建议推动政策采纳并为大规模常规使用做好准备。