全国妇幼卫生岗位培训拉开帷幕

<正> 全国区域性妇幼卫生专家培训班于1990年10月14～19日在杭州举办,拉开了全国妇幼卫生项目培训工作的帷幕。以这次培训班为先导的培训工作将覆盖全国300个项目县、1亿多人口,通过逐级培训强化各级妇幼卫生人员面向农村、面向群体、面向实际需求的观念,提高妇幼卫生队伍的整体素质,将急需的妇幼卫生知识传递给乡村医生。培训班学员来自5所医科大学组成的5个区域专家组,北京和上海医科大学作为项目的外部审评单位派人参加了培训的全过程。卫生部妇幼卫生司司长王凤兰参加了培训班,并讲了话。这次培训班的培训内容分三个部分:培训方法学、人际交流技巧和妇幼卫生专业技术。     

立足社区卫生服务 满足妇幼健康需求

福建省１４个社区在实施《社区妇幼卫生服务国际合作项目》１年半后,对其社区工作概况、资金投入与使用,培训与开展健康教育活动以及开展妇幼保健项目等方面进行评估,肯定了提高纯母乳喂养率,改善爱婴医院服务状况的成绩,总结了社区完成项目指标成果,并提出存在问题与对策。     

云南省怒江州妇幼卫生人员培训实践与效果*

目的对云南省怒江州妇幼卫生人员培训实施情况及培训效果进行分析,为进一步提升妇幼卫生人员能力提供科学依据。方法通过问卷调查、访谈和实地考察等多途径收集相关资料,对怒江州妇幼卫生人员培训实施情况及其效果进行分析。结果小规模、指导性的参与式培训充分调动了学员的积极性,让其能够快速有效掌握相关知识和技能。国家级和省级专家亲自指导示教也让学员感受到了重视和动力,培训结束后多数学员在工作中都积极运用了培训所学的知识和技能。结论本土化培训教材有助于提高培训的适宜性;参与式培训方法有效提升学员参与程度;逐级培训机制有助于提升培训效果的可持续性。     

云南省怒江州妇幼卫生人员培训实践与效果

目的对云南省怒江州妇幼卫生人员培训实施情况及培训效果进行分析,为进一步提升妇幼卫生人员能力提供科学依据。方法通过问卷调查、访谈和实地考察等多途径收集相关资料,对怒江洲妇幼卫生人员培训实施情况及效果进行分析。结果小规模、指导性的参与式培训充分调动了学员的积极性,让其能够快速有效掌握相关知识和技能。国家级和省级专家亲自指导示教也让学员感受到了重视和动力,培训结束后多数学员在工作中都积极运用了培训所学的知识和技能。结论本土化培训教材有助于提高培训的适宜性;参与式培训方法有效提升学员参与程度;逐级培训机制有助于提升培训效果的可持续性。     

精河县卫Ⅸ项目妇幼卫生子项目运行效益及问题与对策

精河县实施卫Ⅸ项目妇幼卫生子项目,以改善基本妇幼卫生服务的公平性和可及性,提高妇女、儿童利用基本妇幼保健的能力,加强对妇女、儿童健康管理,预防和减少疾病危险的发生,满足基层农牧区贫困及弱势人群的基本卫生需求.该项目主要有五个活动领域:提高基础妇幼卫生服务质量;促进家庭、社区的参与和健康教育;加强妇幼卫生管理;加强卫生医务人员的培训;提高妇幼卫生服务的可及性,对贫困人群实施医疗救助.     

精河县卫Ⅸ项目妇幼卫生子项目运行效益及问题与对策

精河县实施卫 项目妇幼卫生子项目 ,以改善基本妇幼卫生服务的公平性和可及性 ,提高妇女、儿童利用基本妇幼保健的能力 ,加强对妇女、儿童健康管理 ,预防和减少疾病危险的发生 ,满足基层农牧区贫困及弱势人群的基本卫生需求。该项目主要有五个活动领域 :提高基础妇幼卫生服务质量 ;促进家庭、社区的参与和健康教育 ;加强妇幼卫生管理 ;加强卫生医务人员的培训 ;提高妇幼卫生服务的可及性 ,对贫困人群实施医疗救助。     

济南城区社区妇幼保健现状及展望

目的 :为了更好地推动我市妇女保健工作的开展 ,探讨妇女保健工作与社区卫生工作的切点 ,开创济南市妇幼社区工作的新局面。方法 :设计济南市社区妇幼卫生现状调查表 ,统一调查时间、调查内容、培训调查员 ,对济南市妇幼卫生工作在全市开展的情况进行调查。结果 :济南城区妇幼卫生社区覆盖面达 95 % ,从事社区妇女保健工作的人员由内、外、妇、儿各科医师组成 ,其中 ,大专以上学历占 2 3%。结论 :济南市妇幼社区工作内容局限 ,工作潜力很大。完善制度 ,队伍培训 ,是发展济南市社区妇女保健工作的有效措施。     

妇幼卫生人员艾滋病相关知识培训效果分析

目的 了解云南省部分县(市)妇幼卫生人员接受艾滋病母婴传播阻断专业知识及技能培训的效果.方法 在云南省47个县(市)的414名妇幼卫生人员中进行培训前评估,并于培训1年半后抽取107名卫生人员进行问卷调查.结果 培训后,妇幼卫生人员对艾滋病基本知识及防护知识知晓率明显提高,比如对"窗口期"、蚊虫叮咬能否传播、传播机率最高的传播途径和常用消毒药品可以杀灭人类免疫缺陷病毒(HIV)回答的正确率分别从68.1%,83.6%,69.1%和61.6%提高到95.3%,100%,90.7%和94.4%.对有关艾滋病自愿咨询检测(VCT)和母婴传播阻断知识回答正确率显著提高,对孕产妇VCT免费与否、谁是阳性结果告知对象和母婴传播能否阻断回答的正确率分别从77.4%,39.7%和78.4%提高到99.1%,81.3%和98.2%.对HIV感染者的恐惧和歧视态度明显改善;害怕与HIV感染者接触的人群比率从36.4%下降至11.2%.结论 以理论结合实践为目标的系统专业培训模式明显提高了妇幼卫生人员艾滋病防治知识,并缓解了对HIV感染者的恐惧和改善了对HIV感染者的歧视.     

安徽省社区妇幼卫生健康服务项目实施定性评价

对安徽省社区妇幼卫生健康服务项目实施进行定性评价。结果显示:3 个试点区均成立了项目组织,加强了领导,确定了优先关注领域,对各类人员进行了培训,添置了设备,配备了人员,提供了服务;服务对象对社区妇幼卫生健康服务试点工作给予了充分肯定,7 项指标都有不同程度的提高。针对存在的问题,提出了3 点建议     

培训效果的评价

<正> 多年来的经验表明,重视妇幼卫生基层队伍的岗位培训,切实提高各级妇幼卫生人员的思想和业务水平,是使各项妇幼卫生技术策略能得到贯彻落实,进而能园满地实现妇幼卫生各项工作目标的重要保证,培训工作已成为建立和发展有效的保健服务所不可少的基础.然而为了提高培训工作的价值和效率,在精心组织各层次各种类型的培训工     

Ethical issues in health workforce development

Increasing the numbers of health workers and improving their skills requires that countries confront a number of ethical dilemmas. The ethical considerations in answering five important questions on enabling health workers to deal appropriately with the circumstances in which they must work are described. These include the problems of the standards of training and practice required in countries with differing levels of socioeconomic development and different priority diseases; how a society can be assured that health practitioners are properly trained; how a health system can support its workers; diversion of health workers and training institutions; and the teaching of ethical principles to student health workers. The ethics of setting standards for the skills and care provided by traditional health-care practitioners are also discussed.     

HIV/aids related home based care practices among primary health care workers in Ogun state, Nigeria

ABSTRACT: BACKGROUND: HIV/AIDS is fast becoming a chronic disease with the advent of antiretroviral drugs, therefore making home based care key in the management of chronically ill HIV/AIDS patient. The objective of this study was to determine the perception and practice of health care workers on HIV/AIDS related home based care in the health facilities in Ogun state, Nigeria. METHODS: This study is an analytical cross-sectional study. A multistage cluster sampling technique was used to obtain a representative sample of the primary health care workers in Ogun state. An interviewer administered structured questionnaire was administered by trained health workers to elicit the required information. Result A total of 350 health care workers were interviewed, 70% of the respondents could adequately describe the components of home based care. Only 38.7% were aware of the National guideline on home based care practices and 17.1% believe that home based care will not significantly improve the prognosis of PLWAs. Few 19.1% had ever been trained or ever involved 16.6% in home based care practices. Only 20 [5.7%] are involved on a weekly basis, 16 [4.6%] monthly and 22 [6.3%] quarterly. Reasons given for non implementation of home based care are inadequate number of healthcare workers 45%, lack of political will 24.4%, lack of implementation by facility managers 14% and inadequate funds 16.6%. Factors that were significantly associated with the practice of home based care were perception of its relevance in improving prognosis [OR = 54.21, C.I = 23.22-129.52] and presence of a support group in the facility [OR = 4.80, C.I = 2.40-9.57]. There was however no statistically significant relationship between adequate knowledge of home based care [OR = 0.78, C.I = 0.39-1.54] and previous training on home based care (OR = 1.43, C.I = 0.66- 3.06]. CONCLUSION: The practice of home based care for HIV/AIDS among the study population is low and it is greatly influenced by perception of its effectiveness and relevance. The study recommends that the health care workers should be adequately educated on the importance of home based care in the management of chronic illnesses in order to enhance its practice.     

The impact of supervision on stock management and adherence to treatment guidelines: a randomized controlled trial

Ensuring the availability of essential drugs and using them appropriately are crucial if limited resources for health care are to be used optimally. While training of health workers throughout Zimbabwe in drug management (including stock management and rational drug use) resulted in significant improvements in a variety of drug use indicators, these achievements could not be sustained, and a new strategy was introduced based on the supervision of primary health care providers. This was launched in 1995 with a training course in supervisory skills for district pharmacy staff. In order to evaluate the impact of the supervision and the effectiveness of the training programme, adherence to standard treatment guidelines (STG) and stock management protocols was evaluated in a randomized controlled trial. The study compared three different groups of health facilities: those that received supervision for either use of STG (n = 23) or stock management (n = 21) - each facility acting as control for the other area of supervision - and a comparison group of facilities which received no supervision (n = 18). On-the-spot supervision by a specially trained pharmacy staff, based around identified deficiencies, took place at the start of the study and 3 months later. The evaluation compared performance on a variety of drug management indicators at baseline and 6-8 months after the second supervisory visit. The results of the study showed that, following supervision, overall stock management improved significantly when compared with the control and comparison groups. Similar improvements were demonstrated for adherence to STG, although the effect was confounded by other interventions. The study also showed that supervision has a positive effect on improving performance in areas other than those supervised, and demonstrated that pharmacy technicians with limited clinical skills can be trained to influence primary health care workers to positively improve prescribing practices. Allocating resources to supervision is likely to result in improved performance of health workers with regard to the rational use of essential drugs, resulting in improved efficiency and effectiveness.     

Village-Based Primary Health Care in the Central Highlands of Vietnam

This paper describes the first year of an ongoing village health care and economic development project in the Krong Buk district of Dak Lak province in Vietnam's Central Highlands. The project serves 21 villages with a total population of just over 15,000. Most belong to ethnic minority groups. Physicians from the province capital of Boun Me Thuot were trained by a multi-disciplinary team of American health care workers to be trainers and supervisors of 21 village health care workers (VHWs). Two months later, a VHW from each village was trained in primary and preventive health care by the physician-supervisors. Since this initial training, each VHW has been provided with materials, medicines and monthly supervision by the physician-supervisors. The health care component has been complemented by an economic development project based on a system of small loans. Data from the first year of monthly reports and from a baseline survey are presented in this paper.     

参与式培训在珠宝加工企业健康教育中应用效果分析

目的 探讨适合珠宝加工企业的健康教育方式。 方法 实验组采用多媒体授课、小组讨论、个人防护用品使用练习等参与式培训方式对100名工人进行培训;传统组采用传统的授课方式对另100名工人进行相同内容的培训。在培训前后对两组进行测验,对得分进行汇总、分析。 结果 两组员工培训后绝大部分得分有所提高。实验组工人培训前得分总分为(41.29 ±8.59)分,培训后得分总分为(81.06 ±11.78)分,两者比较,差异有统计学意义(t=10.11,P < 0.05)。传统组培训前得分为(53.68 ±10.58)分,培训后得分为(61.37 ±15.39)分,两者比较,差异无统计学意义(t=1.39,P > 0.05)。实验组不同学历、工龄、技术职称的员工得分在培训前后比较,差异均有统计学意义(P < 0.05)。传统组小学及以下人员、工龄小于15个月人员和初级工在培训后得分有提高,但与培训前相比,差异无统计学意义(P > 0.05)。 结论 参与式培训在珠宝加工企业健康教育中效果明显,可以很好地提高工人的职业健康安全知识水平。     

The effects of a training program on knowledge, attitude and practice of the staff of primary health care centers towards growth monitoring: an intervention study

This study was carried out aiming at assessing the effects of a training program on the knowledge, attitude and practices (KAP) of health care workers (HCWs) in primary health care centers (PHCCs) regarding growth monitoring (GM). It included 148 health care workers (30 General Practitioners (GPs) and 118 nurses), from 17 PHCCs in Jeddah city, Kingdom of Saudi Arabia (KSA). Tests on KAP were held before and six months following a training program on GM conducted by the investigators. Results showed significant improvements in the KAP of the trained health care workers after training, the 44 trained HCWs obtained higher mean comprehension score (7.9 +/- 1.2), higher mean practice score (11.6 +/- 3.0), and higher mean general scores (32.3 +/- 4.6) compared to the mean scores they obtained in the pre-test (5.7 +/- 1.5; 7.4 +/- 2.2 and 25.7 +/- 4.4, respectively). These differences were statistically significant (P < 0.001). However; the difference in the mean knowledge scores, before and after the GM training program was not significant. The training has also led to the disappearance of the significant knowledge gap between GPs and nurses. And also, the 44 trained HCWs had higher mean comprehension score (7.9 +/- 1.2), mean practice score (11.6 +/- 3.0), and mean general scores (32.3 +/- 4.6) compared to those among untrained group (controls) (6.3 +/- 2.1; 8.5 +/- 3.7, and 27 +/- 6.1, respectively). These differences were statistically significant (P < 0.0005). Nevertheless, the difference in the mean knowledge scores, between the two groups, was not statistically significant. It also has led to some changes in the attitude of the trained HCWs towards GM compared to the untrained group. In conclusion, We credit the significant improvements in KAP of HCWs to the training program and recommend its adoption by the national MCH program in KSA. We also recommend new methods of teaching and training based on sound educational concept of active participation and practical work as well as supportive supervision and evaluation.     

Effects of web-based supervisor training on supervisor support and psychological distress among workers: a randomized controlled trial

BACKGROUND: A randomized controlled trial was conducted to determine the effects of web-based supervisor training on worksite mental health on supervisor support and psychological distress among subordinate workers. METHODS: Section chiefs in a computer engineering company were randomly assigned to either a training group (n = 9) or a non-training group (n = 7). The section chiefs in the training group participated in web-based self-learning training on worksite mental health. A total of 92 subordinate workers under the trained section chiefs (the intervention group) and 84 subordinate workers under the untrained section chiefs (the control group) completed a questionnaire at baseline and a 3-month follow-up. RESULTS: The score of supervisor support greatly decreased in the control group during the follow-up period, and the score changed very little in the intervention group, with a significant intervention effect (P = 0.032). This pattern was more pronounced for one particular item dealing with the extent to which a supervisor listens to personal problems of subordinate workers (the intervention effect, P = 0.012). No intervention effect was observed for the score measuring co-worker support, psychological distress, or other job stressors among subordinate workers (P > 0.05). CONCLUSIONS: It is suggested that the web-based training of supervisors on worksite mental health is useful in improving, or at least maintaining, supervisor support among subordinate workers.     

Barriers Faced by the Health Workers to Deliver Maternal Care Services and Their Perceptions of the Factors Preventing Their Clients from Receiving the Services: A Qualitative Study in South Sudan

Objective The study objective was to explore challenges and barriers confronted by maternal and child healthcare providers to deliver adequate quality health services to women during antenatal care visits, facility delivery and post-delivery care. Methods We conducted 18 in-depth-interviews with maternal and child health professionals including midwives/nurses, trained traditional birth attendants (TBAs), gynecologists, and pediatricians in three public health facilities in Juba, South Sudan. We purposively selected these health professionals to obtain insights into service delivery processes. We analyzed the data using thematic analysis. Results Limited support from the heath system, such as poor management and coordination of staff, lack of medical equipment and supplies and lack of utilities such as electricity and water supply were major barriers to provision of health services. In addition, lack of supervision and training opportunity, low salary and absence of other forms of non-financial incentives were major elements of health workers’ de-motivation and low performance. Furthermore, security instability as a result of political and armed conflicts further impact services delivery. Conclusions for Practice This study highlighted the urgent need for improving maternal and child healthcare services such as availability of medical supplies, equipment and utilities. The necessity of equal training opportunities for maternal and child healthcare workers at different levels were also stressed. Assurance of safety of health workers, especially at night, is essential for providing of delivery services.     

Improving performance with clinical standards: the impact of feedback on compliance with the integrated management of childhood illness algorithm in Niger, West Africa

The joint BASICS/Quality Assurance Project tested several research-based interventions in three districts in Niger, West Africa to improve case management of sick children. The research design was a non-concurrent, prospective case control design. Quality of care was determined as the degree of compliance of health care workers with the Integrated Management of Childhood Illness (IMCI) standards of assessment, treatment and counselling of sick children and their caretakers. The interventions tested were (1) structured feedback of health worker performance data and (2) formal IMCI training and (3) team-based quality improvement. Performance feedback had a significant effect on compliance. Performance feedback alone created a significant short-term impact on health care worker compliance, which improved between 34% and 85% in areas of assessment of sick children (p < 0.05). In addition, performance feedback was significantly cheaper than formal training ($108 per health worker versus $430 per worker for IMCI training). However, this impact was not universal over all areas of compliance following each feedback. Instead, performance feedback had the greatest effect in areas in which health care workers performed poorly, while areas in which compliance was high eventually saw declines. In settings such as Niger, which has the highest child mortality in the world according to UNICEF figures, low-cost techniques for supporting health workers once they have been trained in clinical standards are sorely needed. Performance feedback shows promise as a technique for improving quality of care with clinical algorithms such as IMCI.     

Incorporating what Promotoras Learn: Becoming Role Models to Effect Positive Change

Promotoras (community health workers) play an important health promotion role and must be continuously trained, but little is known about how much of their learning they actually put into practice. This non-randomized, longitudinal study examined knowledge and home environmental outcomes of an asthma and healthy homes training offered to promotoras using a train-the-trainer model. Eighty-five promotoras received the training and pre- and post-test surveys were used to measure training outcomes. Results showed a statistically significant increase in asthma and healthy home-related knowledge (P < .001). At 12-months post-intervention, a majority of the promotoras (69%) reported they made household changes to improve their indoor environment as a result of the training. This study suggests that effective trainings can improve promotoras knowledge and behaviors for the promotion of healthy homes in the community. Further evaluation is needed to investigate whether these trainings allow promotoras to serve as role models within their communities "by educating through example" and thereby enhance their credibility as health educators.