Abstract
Introduction: In rural areas
of Namibia where health facilities are far apart, health outcomes are poor
among high utilization groups such as pregnant women and children. Among
children, orphans and vulnerable children (OVC) are generally more affected
than non-OVC. This study assessed the health changes of orphans and
other vulnerable and non-vulnerable children visiting a mobile clinic in rural
Namibia.
Methods: Over
a 6 month period, information on immunization status, diagnosis of anemia,
skin and intestinal disorders, nutrition, dental disorders and referrals was
collected from the records of a mobile clinic serving farms and surrounding
areas in parts of rural Namibia. Data were compared for all children with
visits in months 1 or 2 (baseline) and a visit in months 5 or 6
(follow up). Data for a cohort of children seen at both time points (the
longitudinal group) were also analyzed.Results: For
all children, there was significant reduction in outstanding immunizations (5%
to 1% p<0.0001),
skin and intestinal parasites (15.5% to 0.2% p<0.0001), and stunting (26.9% to 14.2% p<0.0001) between baseline and
follow up. Within the longitudinal group, reductions were observed in the
prevalence of anemia (1.9% to 0.5% p<0.0001),
incomplete immunizations (6.5% to <1% p<0.0001), and parasitic infections (16.9% to
0.2% p<0.0001)
between the two time points. At baseline, orphans were more likely to have
incomplete immunizations and parasitic infections. Among orphans, incomplete
immunizations declined from 25% to 0 (p<0.001)
while parasitic infections decreased from 22.7% to 0 (p<0.001). Among other
vulnerable children incomplete immunizations declined from 5% to 1% (p=0.002), as did skin and
parasitic infestations (17.2% to 0.3% p<0.001).Conclusion: Regular
mobile clinic visits improved the health indices of child attendees. The
greatest change was among OVC whose disease burden was greater at
baseline. Mobile clinics may be an effective intervention in
hard-to-reach, resource-limited settings.
Opini:
Jurnal ini menilai outcome dari program mobile clinic yang
dijalankan di Nigeria, khususnya daerah terpencil. Daerah terpencil di Nigeria
memiliki fasilitas kesehatan yang terbatas dan sangat sulit dicapai dengan
outcome kesehatan masyarakatnya yang buruk. Jarak rerata desa dengan fasiliast
kesehatan di daerah terpencil di Nigeria mencapai 63,5 km. Penelitian ini
ditujukan kepada anak-anak yatim piatu dan vulnerable children.
Mister sister clinic merupakan mobile clinic yang digunakan di
Nigeria. Mobile clinic ini dilengkapi dengan peralatan medis dan dijalankan
oleh perawat yang memiliki kemanpuan dalam mendiagnosis dan merawat.
Outcome dari program yang dinilai pada jurnal ini adalah (i) immunization
status assessed by examining children’s health records; (ii) number and
frequency of referrals; (iii) clinical and laboratory presence of anemia
(all children had blood tests for anemia at base line and at follow up only
those anemic at baseline or who had clinical features of anemia in the follow-up months
were reassessed with blood tests); (iv) clinical diagnosis of skin and/or
intestinal parasitic infections; (v) presence of dental disorders; and
(vi) nutritional status. Penelitian dilakukan selama 7 bulan dan outcome
dinilai pada bulan ke 2-3 dan bulan ke 5-6 kemudian dibandingkan.
Dari total anak 1210 yang mengunjungi mobile clinic, dengan
rentang usia 0-18 tahun, terdapat penurunan yang signifikan mengenai
ketidakpedulian akan imunisasi (5% to 1% p<0.0001), infeksi parasites pada kulit dan
intestinal (15.5% to 0.2% p<0.0001), and anak kurang gizi (26.9% to 14.2% p<0.0001). Jika dibandingkan dari 2 kali penilain
outcome yaitu terdapat penurunan prevalensi anemia (1.9% to 0.5% p<0.0001), incomplete immunizations (6.5% to
<1% p<0.0001), and parasitic
infections (16.9% to 0.2% p<0.0001).
Jika dilihat dari hasil yang
diperoleh dari penelitian tersebut dapat dikatakan bahwa program mobile clinic
di Nigeria ini efektif dalam meningkatkan taraf kesehatan masyarakat daerah
terpencil di Nigeria, khususnya pada anak-anak.
Kekurangan dari penelitian ini
yaitu waktu penelitian yang sangat singkat serta sample penelitian yang hanya
mencakup pada anak-anak sehingga kita tidak bisa menilai apakah program ini
memberikan dampak yang positif juga bagi masyarakat dewasa.
Referensi:
http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=2380
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