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Abstract：
BACKGROUND: In Yemen, morbidity and malnutrition are major public health problems. The Community Health and Nutrition Volunteers (CHNVs) program was launched to tackle these problems through providing services to mothers and their children residing in remote villages. Since establishment of the CHNVs program in Yemen, its outcome has never been evaluated. Therefore, the aim of this study was to assess the role of CHNVs in improving the immunization, morbidity and nutritional status of infant and young children (IYC).
METHODS: A comparative cross-sectional study design was conducted in Al-Maghrabah and Bani-Qais districts, Hajjah governorate. It was carried out between January and April 2023. A three-stage cluster sampling method was used. A total of 926 IYC with their mothers were interviewed using a pre-tested questionnaire. SPSS 26 was used for data analysis. The multinomial logistic regression and chi-square or fisher exact tests were used to compare the vaccination, morbidity and nutritional status of IYC between the volunteer and non-volunteer villages. Odds Ratio (OR) with 95% Confidence Interval (CI) were calculated. A p value < 0.05 was considered statistically significant.
RESULTS: The IYC in volunteer villages were more likely to be fully or partially vaccinated compared to those in non-volunteer villages [OR = 2.3, 95% CI: 1.5-3.7, p < 0.0001, and OR = 1.9, 95% CI: 1.3-2.8, p = 0.001, respectively]. The specific coverage rates for BCG, and the 1st and 2nd doses of OPV/Pentavalent/Pneumo/Rota vaccines were significantly higher in the volunteer compared to non-volunteer villages [(OR = 1.8, 95% CI: 1.3-2.5, p < 0.0001), (OR = 1.5, 95% CI: 1.2-2.1, p = 0.003), and (OR = 1.5, 95% CI: 1.2-2.0, p = 0.002), respectively]. Moreover, the prevalence of diarrhea and fever among IYC was significantly lower in the volunteer compared to non-volunteer villages [(OR = 0.7, 95% CI: 0.5-0.9, p = 0.004) and (OR = 0.7 95% CI: 0.5-0.9, p = 0.045), respectively].
CONCLUSIONS: The study found that CHNVs play a significant role in improving vaccination status and the coverage rate for BCG, and 1st and 2nd doses of OPV/Pentavalent/Pneumo/Rota vaccines, and reducing the prevalence of diarrhea and fever among IYC in their villages compared to non-volunteer villages, in Hajjah governorate. Future follow-up study and expansion to other settings in different governorates is recommended.
METHODS: A comparative cross-sectional study design was conducted in Al-Maghrabah and Bani-Qais districts, Hajjah governorate. It was carried out between January and April 2023. A three-stage cluster sampling method was used. A total of 926 IYC with their mothers were interviewed using a pre-tested questionnaire. SPSS 26 was used for data analysis. The multinomial logistic regression and chi-square or fisher exact tests were used to compare the vaccination, morbidity and nutritional status of IYC between the volunteer and non-volunteer villages. Odds Ratio (OR) with 95% Confidence Interval (CI) were calculated. A p value < 0.05 was considered statistically significant.
RESULTS: The IYC in volunteer villages were more likely to be fully or partially vaccinated compared to those in non-volunteer villages [OR = 2.3, 95% CI: 1.5-3.7, p < 0.0001, and OR = 1.9, 95% CI: 1.3-2.8, p = 0.001, respectively]. The specific coverage rates for BCG, and the 1st and 2nd doses of OPV/Pentavalent/Pneumo/Rota vaccines were significantly higher in the volunteer compared to non-volunteer villages [(OR = 1.8, 95% CI: 1.3-2.5, p < 0.0001), (OR = 1.5, 95% CI: 1.2-2.1, p = 0.003), and (OR = 1.5, 95% CI: 1.2-2.0, p = 0.002), respectively]. Moreover, the prevalence of diarrhea and fever among IYC was significantly lower in the volunteer compared to non-volunteer villages [(OR = 0.7, 95% CI: 0.5-0.9, p = 0.004) and (OR = 0.7 95% CI: 0.5-0.9, p = 0.045), respectively].
CONCLUSIONS: The study found that CHNVs play a significant role in improving vaccination status and the coverage rate for BCG, and 1st and 2nd doses of OPV/Pentavalent/Pneumo/Rota vaccines, and reducing the prevalence of diarrhea and fever among IYC in their villages compared to non-volunteer villages, in Hajjah governorate. Future follow-up study and expansion to other settings in different governorates is recommended.
摘要：
背景：在也门，发病率和营养不良是主要的公共卫生问题。启动了社区卫生和营养志愿者（CHNVs）计划，通过向居住在偏远村庄的母亲及其子女提供服务来解决这些问题。自从也门建立CHNVs计划以来，它的结果从未被评估过。因此,这项研究的目的是评估CHNVs在改善免疫接种中的作用，婴幼儿（IYC）的发病率和营养状况。
方法：在Al-Maghrabah和Bani-Qais地区进行了比较横断面研究设计，Hajjah省。它是在2023年1月至4月之间进行的。采用三阶段整群抽样方法。使用预先测试的问卷对926名IYC与母亲进行了访谈。采用SPSS26进行数据分析。使用多项逻辑回归和卡方或费希尔精确检验来比较疫苗接种，志愿者和非志愿者村庄之间IYC的发病率和营养状况。计算95%置信区间(CI)的赔率比(OR)。P值<0.05被认为是统计学上显著的。
结果：与非志愿者村庄相比，志愿者村庄的IYC更有可能完全或部分接种疫苗[OR=2.3，95％CI：1.5-3.7，p<0.0001和OR=1.9，95％CI：1.3-2.8，p=0.001，分别]。BCG的具体覆盖率，和第一和第二剂量的OPV/五价/肺炎/Rota疫苗在志愿者中明显高于非志愿者村庄[（OR=1.8，95％CI：1.3-2.5，p<0.0001），（OR=1.5，95%CI：1.2-2.1，p=0.003），和(OR=1.5，95%CI：1.2-2.0，p=0.002)，分别]。此外，与非志愿者村庄相比，IYC的腹泻和发烧患病率显着降低[（OR=0.7，95％CI：0.5-0.9，p=0.004）和（OR=0.795％CI：0.5-0.9，p=0.045），分别]。
结论：该研究发现，CHNVs在改善疫苗接种状况和卡介苗覆盖率方面发挥着重要作用，以及第一剂和第二剂OPV/五价/肺炎/Rota疫苗，与非志愿者村庄相比，IYC村庄的腹泻和发烧患病率降低，在Hajjah省。建议将来进行后续研究，并将其扩展到不同省份的其他环境。
方法：在Al-Maghrabah和Bani-Qais地区进行了比较横断面研究设计，Hajjah省。它是在2023年1月至4月之间进行的。采用三阶段整群抽样方法。使用预先测试的问卷对926名IYC与母亲进行了访谈。采用SPSS26进行数据分析。使用多项逻辑回归和卡方或费希尔精确检验来比较疫苗接种，志愿者和非志愿者村庄之间IYC的发病率和营养状况。计算95%置信区间(CI)的赔率比(OR)。P值<0.05被认为是统计学上显著的。
结果：与非志愿者村庄相比，志愿者村庄的IYC更有可能完全或部分接种疫苗[OR=2.3，95％CI：1.5-3.7，p<0.0001和OR=1.9，95％CI：1.3-2.8，p=0.001，分别]。BCG的具体覆盖率，和第一和第二剂量的OPV/五价/肺炎/Rota疫苗在志愿者中明显高于非志愿者村庄[（OR=1.8，95％CI：1.3-2.5，p<0.0001），（OR=1.5，95%CI：1.2-2.1，p=0.003），和(OR=1.5，95%CI：1.2-2.0，p=0.002)，分别]。此外，与非志愿者村庄相比，IYC的腹泻和发烧患病率显着降低[（OR=0.7，95％CI：0.5-0.9，p=0.004）和（OR=0.795％CI：0.5-0.9，p=0.045），分别]。
结论：该研究发现，CHNVs在改善疫苗接种状况和卡介苗覆盖率方面发挥着重要作用，以及第一剂和第二剂OPV/五价/肺炎/Rota疫苗，与非志愿者村庄相比，IYC村庄的腹泻和发烧患病率降低，在Hajjah省。建议将来进行后续研究，并将其扩展到不同省份的其他环境。
