PDF(Pubmed)
Abstract：
OBJECTIVE: With the phase-out of the polio campaigns, Burkina Faso has developed a new strategy for routine community-based vitamin A supplementation (VAS) by institutionalising community-based health workers (CBHW) to sustain the gain of two decades of successful programming. Formative research was conducted soon after the strategy was introduced to solicit feedback on the acceptability of the new approach by the implementing actors while identifying the main implementation challenges for improving its effectiveness and sustainability.
METHODS: This qualitative study was conducted in 2018 through (i) document review, (ii) individual interviews with key informants at the central, regional and district levels, and (iii) focus groups with CBHW and caregivers.
METHODS: Data collection was carried out at six levels of sites covering the entire country and selected based on VAS coverage rates with the community routine. A total of six health districts were selected.
METHODS: We conducted 46 individual interviews with health workers and 20 focus groups with 59 CBHW and 108 caregivers.
RESULTS: The study showed good acceptability of the strategy by all stakeholders. In the first 2 years of implementation, the national coverage of VAS was maintained at a high level (above 90 %) and there was a reduction in operational costs. The main challenges included delayed CBHW remuneration and weak communication and supervision.
CONCLUSIONS: The acceptability of the community-based routine VAS was good and was perceived to have a high potential for sustainability. Addressing identified challenges will allow us to better manage the expectations of community stakeholders and maintain the initial results.
METHODS: This qualitative study was conducted in 2018 through (i) document review, (ii) individual interviews with key informants at the central, regional and district levels, and (iii) focus groups with CBHW and caregivers.
METHODS: Data collection was carried out at six levels of sites covering the entire country and selected based on VAS coverage rates with the community routine. A total of six health districts were selected.
METHODS: We conducted 46 individual interviews with health workers and 20 focus groups with 59 CBHW and 108 caregivers.
RESULTS: The study showed good acceptability of the strategy by all stakeholders. In the first 2 years of implementation, the national coverage of VAS was maintained at a high level (above 90 %) and there was a reduction in operational costs. The main challenges included delayed CBHW remuneration and weak communication and supervision.
CONCLUSIONS: The acceptability of the community-based routine VAS was good and was perceived to have a high potential for sustainability. Addressing identified challenges will allow us to better manage the expectations of community stakeholders and maintain the initial results.
摘要：
目标：随着脊髓灰质炎运动的逐步淘汰，布基纳法索通过将社区卫生工作者（CBHW）制度化，制定了一项常规社区维生素A补充（VAS）的新战略，以维持二十年成功计划的收益。该战略出台后不久就进行了形成性研究，以征求执行行为者对新方法的可接受性的反馈，同时确定提高其有效性和可持续性的主要执行挑战。
方法：这项定性研究于2018年通过（i）文件审查进行，(二)个别约谈中央主要线人,区域和地区层面，（iii）与CBHW和护理人员的焦点小组。
方法：在覆盖整个国家的六个级别的站点上进行数据收集，并根据社区常规的VAS覆盖率进行选择。总共选择了六个卫生区。
方法：我们对卫生工作者进行了46次单独访谈，对59名CBHW和108名护理人员进行了20个焦点小组访谈。
结果：该研究表明，所有利益相关者都对该策略具有良好的可接受性。在实施的头两年，VAS的全国覆盖率保持在较高水平(90%以上)，运营成本有所下降。主要挑战包括CBHW薪酬延迟以及沟通和监督薄弱。
结论：基于社区的常规VAS的可接受性很好，并且被认为具有很高的可持续性潜力。解决已确定的挑战将使我们能够更好地管理社区利益相关者的期望并保持初步结果。
方法：这项定性研究于2018年通过（i）文件审查进行，(二)个别约谈中央主要线人,区域和地区层面，（iii）与CBHW和护理人员的焦点小组。
方法：在覆盖整个国家的六个级别的站点上进行数据收集，并根据社区常规的VAS覆盖率进行选择。总共选择了六个卫生区。
方法：我们对卫生工作者进行了46次单独访谈，对59名CBHW和108名护理人员进行了20个焦点小组访谈。
结果：该研究表明，所有利益相关者都对该策略具有良好的可接受性。在实施的头两年，VAS的全国覆盖率保持在较高水平(90%以上)，运营成本有所下降。主要挑战包括CBHW薪酬延迟以及沟通和监督薄弱。
结论：基于社区的常规VAS的可接受性很好，并且被认为具有很高的可持续性潜力。解决已确定的挑战将使我们能够更好地管理社区利益相关者的期望并保持初步结果。
