Management of acute respiratory infections by community health volunteers:
experience of Bangladesh Rural Advancement Committee (BRAC).
Hadi A.
Research and Evaluation Division, Bangladesh Rural Advancement Committee, Dhaka,
Bangladesh. shirsha@bangla.net
OBJECTIVE: To assess the role of management practices for acute respiratory
infections (ARIs) in improving the competency of community health volunteers in
diagnosing and treating acute respiratory infections among children. METHODS:
Data were collected by a group of research physicians who observed the
performance of a sample of 120 health volunteers in 10 sub-districts in
Bangladesh in which Bangladesh Rural Advancement Committee (BRAC) had run a
community-based ARI control programme since mid-1992. Standardized tests were
conducted until the 95% interphysician reliability on the observation of
clinical examination was achieved. FINDINGS:The sensitivity, specificity, and
overall agreement rates in diagnosing and treating ARIs were significantly
higher among the health volunteers who had basic training and were supervised
routinely than among those who had not. CONCLUSION: Diagnosis and treatment of
ARIs at the household level in developing countries are possible if intensive
basic training and the close supervision of service providers are ensured.
PMID: 12764514