Report on the pilot study of multi-purpose health workers (male) in Athoor Block, Madurai District
Sethu, S.; Ramasamy, T.P.; Paul, M.P.
Bulletin 10(2): 1-26
1975
PMID: 12259431 Document Number: 424086
This study in the Institute's intensive field practice demonstration area in India attempted to determine if male health workers at the rate of 1/5000 population can carry out the various activities now being carried out by unipurpose health workers employed by the national malaria, smallpox, family planning, leprosy, and tuberculosis programs. 2 patterns were tried: 1) the workers to carry out all the activities of the various programs simultaneously through house visits at the rate of 40 a day for 6 working days a week, and 2) to do all activities except smallpox vaccination and family planning for 4 days a week with 1 day reserved for smallpox vaccination and 1 day for family planning activities. 23 workers were employed and trained. 9 were assigned to Plan 1, covering 40% of the population of 120,000; 14 under Plan 2 covered the remaining 60%. Survey design is detailed along with job descriptions. In the 1st round the multipurpose workers discovered as many fever cases as the single-purpose malaria workers and in the 2nd round, their performance improved. Performance was slightly better under Plan 2. Smallpox vaccination coverage was slightly better under Plan 1 but the time spent per worker was about double that of Plan 2 and wastage of lymph was nearly 3 times as great as when a separate day was set aside for vaccination. Family planning performance was much better under Plan 1 with 44.5% of high priority couples contacted on round 1 and 33.3% on round 2 compared with 28.2% and 36.4% under Plan 2. It was found that the worker gained effectiveness after he had developed rapport through other health services. There was demand for treatment of side effects and complications resulting from contraceptive use and for treatment of minor ailments among other household members. Quantities of Nirodh condoms distributed was higher under Plan 2. The multipurpose workers were not as effective as single-purpose workers in detecting tuberculosis or leprosy but they can refer suspected cases. It was pointed out that under Plan 2 group meetings could be held and more couples reached but that people were shy about attending group discussions and treatment of minor ailments helped in talking about family planning.