Community Case Management of Childhood Illness in Nicaragua: Transforming Health Systems in Underserved Rural Areas
| Autor: | David R. Marsh, Elaine P Menotti, Dixmer Rivera, Irma Montes, Carmen Maria Reyes, Asha George |
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| Rok vydání: | 2009 |
| Předmět: |
Male
Program evaluation Child Health Services Population Medically Underserved Area Nicaragua Health Services Accessibility Interviews as Topic Nursing Health care Humans Medicine Community Health Services education Qualitative Research education.field_of_study business.industry Public Health Environmental and Occupational Health Infant Focus Groups Focus group Community mobilization Child Preschool Workforce Patient Compliance Female Rural Health Services Rural area business Attitude to Health Case Management Qualitative research |
| Zdroj: | Journal of Health Care for the Poor and Underserved. 20:99-115 |
| ISSN: | 1548-6869 |
| Popis: | While social factors broadly determine health outcomes, strategic health workforce innovations such as community case management (CCM) can redress social inequalities in access to health care. Community case management enables trained health workers to assess children, diagnose common childhood infections, administer medicines, and monitor life-saving treatment in the poor, remote communities where they reside. This article reports on research that combined focus group discussions and key informant interviews to examine the perceptions of multiple stakeholders, with monitoring data, in order to assess programmatic results, limitations, and lessons learned in implementing CCM in Nicaragua. We found that CCM increases the use of curative services by poor children with pneumonia, diarrhea, or dysentery by five to six-fold over facility-based services. Apart from dramatically increasing geographic access to treatment for underserved groups, our qualitative research suggests that Nicaragua's CCM model also addresses the managerial challenges and social relations that underpin good quality of care, care-giver knowledge and awareness, and community mobilization, all health system-strengthening factors that are central to equitably and effectively improving child health. While our findings are promising, we suggest areas for further operational research to strengthen CCM program learning and functioning. |
| Databáze: | OpenAIRE |
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