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  • Title: Community health worker competency in managing acute respiratory infections of childhood in Bolivia.
    Author: Zeitz PS, Harrison LH, López M, Cornale G.
    Journal: Bull Pan Am Health Organ; 1993; 27(2):109-19. PubMed ID: 8339109.
    Abstract:
    A competency-based training and evaluation method was developed to improve and assess the management of acute respiratory infections (ARI) in young children by community health workers (CHWs) in Bolivia. This method was used to evaluate three groups of Bolivian CHWs, provide them with a one-day refresher course in ARI management, and assess the effects of the course. The results showed the CHWs capable of acquiring the skills needed to effectively manage ARI cases in accordance with the World Health Organization's ARI case management strategy. It was found important, however, that their training emphasize how to count the respirations of children with tachypnea and how to identify chest indrawing. In general, the competency-based methods appeared to be effective in training and evaluating CHWs in the area of ARI case management; it is expected that these methods will prove useful in other community-based health interventions. Acute respiratory infections (ARI) are a leading cause of child mortality in developing countries. With under-5 mortality due to ARI in Bolivia estimated at 172/1000 live births, these infections are the second largest cause of child mortality in the country. The World Health Organization (WHO) has developed a strategy for managing cases of child ARI with respect to treatment and community health worker (CHW) tasks. Bolivia adheres to these guidelines with some exceptions regarding the tasks of CHWs. This paper reports on the development and implementation and assess the management of ARI in young children by CHWs in Bolivia. 3 groups of Bolivian CHWs were evaluated, given a 1-day refresher course in ARI management, then reevaluated to assess the effects of the course. The short duration of the program and its focus on essential tasks had a significant impact on its participants. The CHWs were found to be capable of acquiring the skills needed to effectively manage ARI cases in accordance with the WHO ARI case management strategy. It was also found important that training emphasize how to count the respirations of children with tachypnea and how to identify chest indrawing. These competency-based methods should prove useful in other community-based health interventions.
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