Each Home as a Health Post Program and the Role of the Health Messengers and Health Volunteers in the COVID-19 Epidemic Management and Control

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Extended Abstract
Background COVID-19, caused by a new beta-coronavirus called SARS-CoV-2, started in China in late December 2019. Its outbreak was officially announced in Iran on February 19, 2020. In mid-March 2020, the Ministry of Health reported that the virus had spread throughout the country. The "Each Home as a Health Post" (HAHP) program was strictly adhered to in an effort to control and manage COVID-19. In this regard, additional activities were done to draft and train community volunteers, including family health messengers and neighborhood health volunteers. Universities were also required to expand the program coverage, prioritizing the training of all family health messengers and health volunteers with the “A Guide to Live with COVID-19” training content.The Ministry of Health has added a new class of service delivery to the country’s primary healthcare delivery system, which lies before the health houses and health posts. This program was implemented to expand community participation in providing, maintaining, and promoting health as a comprehensive solution to facilitate health communication in the country and was able to achieve valuable results. According to this program, one family member with sufficient knowledge, intelligence, skills, and acceptance was appointed as the health messenger for each household. The training course included three fields: health promotion and prevention, primary treatment, and rehabilitation. The instructional content of “A Guide to Live with COVID-19” was compiled and made available to medical universities as part of the HAHP training program. The majority of health messengers and volunteers were trained using the training package.This study aimed to assess the influence of the HAHP program and the roles of health messengers and health volunteers in the Management and Control of the COVID-19 Epidemic.
Methods
This descriptive cross-sectional study examines the roles of health messengers and health volunteers in the management and control of the COVID-19 Epidemic from February 2018 to September 2021. The data were collected using the Integrated Health Information System data and the Ministry of Health and Medical Education’s Network Management Center portal. The statistical population of this study included all health messengers and health volunteers involved in the implementation of the National Mobilization Plan against COVID-19. These individuals were selected from 63 universities and medical schools that function as executive units of the primary health network. In addition, the sampling method was the census method. The data were assessed using descriptive statistical methods and displayed in comparative tables and graphs. Excel, Access, and SPSS were utilized in the preparation of the report.
Results
There were 11,134,290 household health messengers and 280,619 health volunteers. Shahid Beheshti University had the most health volunteers and health messengers, with 824,803 individuals, while Gerash medical school had the fewest, with 7,088 individuals. A total of 11,656,389 (50.1%) Iranian households were monitored by health messengers. The national average score of trained messengers in the COVID-19 training course was 79.2%. In 22 universities/colleges, 100% of the health messengers passed the COVID-19 training course. The University of Mashhad had the lowest coverage, with 4.6% of household health messengers. The highest number of messengers and health volunteers in interception teams were at Zanjan University (41,349) and Ardabil University (40,470), while Torbat Jam, Isfahan, and Khoy universities had the lowest number. The highest number of messengers and health volunteers were in support teams in Ardabil, with 32308 people. The medical universities of Zahedan, Abadan, Dezful, Jahrom, Babol, Sirjan, Kerman, Shushtar, Khomein, Sabzevar, Khoy, and Isfahan had the fewest messengers and health volunteers (per population).
Conclusion
The HAHP program significantly helped control COVID-19 by increasing community awareness and promoting self-care. Health messengers and health volunteers were the essential elements of the HAHP program. They identified and referred patients to selected COVID-19 centers, improving care and services such as interceptions and support. Increasing the number of health messengers and health volunteers and strengthening and educating them in tracking and patient support had a significant effect on preventing the spread of the disease. Strengthening health messengers and health volunteers will increase awareness, responsibility, capability, and structured and active participation of individuals, families, and communities in delivering, maintaining, and promoting health and comprehensive healthcare.
Practical Implications of Research
In general, according to the present study results, social participation and community cooperation in self-care and family healthcare had a significant impact on disease management and control and will cause maximum use of health system forces to provide more specialized services. Dealing with such diseases is impossible without the close cooperation of society. Social participation is the conscious, voluntary, and purposeful participation in social affairs to facilitate social development. Therefore, it is suggested that health system policymakers consider using health messengers and health volunteers.
Ethical Considerations
In this study, secondary data and aggregate reports were used, and no intervention was performed.
Conflict of Interest
The authors declare that there is no conflict of interest in the present study, and this study is the result of an independent study.
Acknowledgment
This research summarizes the measures taken in line with the plan of HAHP and the role of health messengers and health volunteers in the management and control of the COVID-19 epidemic. The authors consider it necessary to express their gratitude and appreciation to all the participants and contributors in this project and the compilation of related documents. We would like to thank all the healthcare providers in the fight against coronavirus.