DEVELOPMENT OF STROKE INTERMEDIATE CARE GUIDELINE FOR VILLAGE HEALTH VOLUNTEER

Abstract

This participatory action research aimed to develop intermediate care guidelines for stroke patients managed by village health volunteers through the application of intermediate care concepts and the Participatory Action-Oriented Research (PAOR) framework proposed by Kemmis and McTaggart. The study comprised two phases: situational analysis and guideline development. Purposive sampling recruited 95 participants, including stroke patients, family caregivers, village health volunteers, multidisciplinary healthcare professionals, community leaders, and local government representatives. Data were collected through in-depth interviews and focus group discussions. Quantitative data were analyzed using descriptive statistics, while qualitative data underwent content analysis.

The findings revealed that intermediate care guidelines for village health volunteers should encompass: (1) a clearly defined policy framework aligned with local healthcare service levels and contextual factors; (2) a structured working committee with explicit roles and responsibilities across all levels; (3) a comprehensive service system featuring step-by-step protocols and operational procedures; (4) systematic information management for collaborative care planning; and (5) competency development for village health volunteers in health assessment and counseling, with clear operational protocols for healthcare sector collaboration.

The developed guidelines should be implemented within provincial healthcare networks to optimize intermediate care for stroke patients. Continuous monitoring and evaluation are essential to enhance service outcomes and system efficiency. This framework provides a structured approach for integrating village health volunteers into the stroke care continuum, potentially improving accessibility and quality of intermediate care services in community settings.