Can a community health worker and a trained traditional birth attendant work as a team to deliver child health interventions in rural Zambia?

BMC Health Services Research

David R Marsh¹  Bias Sichamba⁴  Stephen Filumba⁴  Amon Sakala⁴  Chilobe Kambikambi⁴  Gail Snetro-Plewman²  Karen Z Waltensperger²  Katherine Semrau³  Davidson H Hamer⁵  Kojo Yeboah-Antwi³ 

[1] Save the Children, Westport, CT, USA;Save the Children, Department of Health and Nutrition, Africa Region, South Africa;Department of Global Health, Boston University School of Public Health, Boston, MA, USA;Save the Children Zambia, Lusaka, Zambia;Zambia Center for Applied Health Research and Development, Lusaka, Zambia

关键词: Zambia;    Child health care;    Newborn health;    Traditional birth attendants;    Community health workers;    Continuum of care;    Taskwork;    Teamwork;    Teaming;    Teams;   

Others  :  1118193
DOI  :  10.1186/s12913-014-0516-2

 received in 2014-08-05, accepted in 2014-10-14,  发布年份 2014

【 摘 要 】

Background

Teaming is an accepted approach in health care settings but rarely practiced at the community level in developing countries. Save the Children trained and deployed teams of volunteer community health workers (CHWs) and trained traditional birth attendants (TBAs) to provide essential newborn and curative care for children aged 0–59 months in rural Zambia. This paper assessed whether CHWs and trained TBAs can work as teams to deliver interventions and ensure a continuum of care for all children under-five, including newborns.

Methods

We trained CHW-TBA teams in teaming concepts and assessed their level of teaming prospectively every six months for two years. The overall score was a function of both teamwork and taskwork. We also assessed personal, community and service factors likely to influence the level of teaming.

Results

We created forty-seven teams of predominantly younger, male CHWs and older, female trained TBAs. After two years of deployment, twenty-one teams scored “high”, twelve scored “low,” and fourteen were inactive. Teamwork was high for mutual trust, team cohesion, comprehension of team goals and objectives, and communication, but not for decision making/planning. Taskwork was high for joint behavior change communication and outreach services with local health workers, but not for intra-team referral. Teams with members residing within one hour’s walking distance were more likely to score high.

Conclusion

It is feasible for a CHW and a trained TBA to work as a team. This may be an approach to provide a continuum of care for children under-five including newborns.

【 授权许可】

   
2014 Yeboah-Antwi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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