Seasonal malaria chemoprevention (SMC) relies on community health workers to distribute drugs. This study assessed: (1) the capacity of community-based distributors (CBDs) at the start and end of a campaign and from one campaign to another after training or refresher courses before each round; (2) to what extent CBDs’ experience over several campaigns contributed to measurable increase in their capacities; and (3) to what extent the training and experience of committed CBDs helped the less productive to catch up. A longitudinal analysis was conducted in one Burkina Faso health district during the 2017 and 2018 campaigns. A panel including all CBDs was created. Their capacities were observed after: (1) initial training for the 2017 season; (2) refresher training for that year’s fourth round; and (3) initial training for the 2018 season. All were invited to complete a questionnaire at the end of training with 27 multiple-choice questions on their main tasks. Observers noted content coverage and conditions under which training sessions were conducted. The 612 CBDs showed, on average, high understanding of their tasks from the start of the annual campaigns. Tasks related to communicating with parents and reporting were best mastered. Their capacities grew from round to round and campaign to campaign, after most had undergone training and been supervised by head nurses. The greatest progress was in the technical components, considered more complex, which involved selecting eligible children, choosing the correct drug packet, and referring children to health professionals. Retaining CBDs from one round to the next benefited everyone, whatever their starting level. Groups that initially obtained the lowest scores (women, illiterates, youngest/oldest) progressed the most. These results confirm the potential of using CBDs under routine programme implementation. Mandating CBDs with targeted tasks is a functional model, as they achieve mastery in this context where investments are made in training and supervision. Losing this specificity by extending CBDs’ mandates beyond SMC could have undesirable consequences. The added value of retaining committed CBDs is high. It is suggested that motivation and commitment be considered in recruitment, and that a supportive climate be created to foster retention.

中文翻译：

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对布基纳法索动员社区卫生工作者进行季节性疟疾化学预防的能力的纵向分析

季节性疟疾化学预防（SMC）依靠社区卫生工作者来分发药物。这项研究评估：（1）在每个活动之前的培训或进修课程之后，在活动的开始和结束以及从一个活动到另一个活动的社区分销商（CBD）的能力；（2）《生物多样性公约》在几次运动中的经验在多大程度上有助于其能力的显着提高；（3）承诺的CBD的培训和经验在多大程度上帮助了生产力较低的人追赶。在2017年和2018年的运动期间，在一个布基纳法索卫生区进行了纵向分析。创建了包括所有CBD的面板。在以下情况下观察他们的能力：（1）2017赛季的初始训练；（2）当年第四轮的进修培训；（3）2018赛季的初始训练。在培训结束时，邀请所有学生填写问卷，回答27项关于其主要任务的多项选择题。观察员注意到内容的覆盖范围和进行培训的条件。从年度竞选活动开始，平均而言，612个CBD表现出对任务的高度理解。与父母沟通和报告相关的任务最好掌握。在大多数人都经过培训并得到护士长的监督之后，他们的能力从一个接一个的轮到另一个轮又从一个运动到另一个运动。最大的进步是在技术组件上，这些组件被认为更加复杂，其中包括选择合格的儿童，选择正确的药物包装以及将儿童推荐给卫生专业人员。将CBD从一轮移到下一轮，无论起点如何，都对所有人都有好处。最初得分最低的群体（妇女，文盲，年龄最小/年龄最大）进步最大。这些结果证实了在常规计划实施下使用生物多样性公约的潜力。强制具有目标性任务的CBD是一种功能模型，因为在这种情况下，它们可以在培训和监督上进行投资，从而掌握了相关知识。通过将CBD的职责范围扩展到SMC之外而失去这种特殊性可能会带来不良后果。保留承诺的CBD的附加值很高。建议在招聘时考虑动力和承诺，并创造一种支持性气氛以促进留任。强制具有目标任务的CBD是一种功能模型，因为在这种情况下，他们可以在培训和监督上进行投资，从而掌握了这些知识。通过将CBD的职责范围扩展到SMC之外而失去这种特殊性可能会带来不良后果。保留承诺的CBD的附加值很高。建议在招聘时考虑动力和承诺，并创造一种支持性气氛以促进留任。强制具有目标任务的CBD是一种功能模型，因为在这种情况下，他们可以在培训和监督上进行投资，从而掌握了这些知识。通过将CBD的职责范围扩展到SMC之外而失去这种特殊性可能会带来不良后果。保留承诺的CBD的附加值很高。建议在招聘时考虑动力和承诺，并创造一种支持性气氛以促进留任。