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Exploración de la implementación del programa de trabajadores de la salud comunitarios en Fiji: Un estudio

Azeb Gebresilassie Tesema^1,2, Bindu Patel², Unise Vakaloloma³

¹School of Population Health, University of New South Wales, Sydney, Australia.

PLOS global public health

|December 23, 2025

Resumen

Los trabajadores de la salud comunitarios (TSC) en Fiji mejoran la atención primaria, pero la implementación enfrenta desafíos. Abordar la gobernanza, la capacitación y los problemas de suministro es crucial para el éxito del programa y el fortalecimiento de la prestación de servicios de salud.

Área de la Ciencia:

Salud Pública
Políticas de Salud
Fortalecimiento de los Sistemas de Salud

Sus antecedentes:

Los trabajadores de la salud comunitarios (TSC) son vitales para la prestación de atención primaria de salud en Fiji, especialmente en áreas remotas.
Existe una política de TSC, que demuestra el compromiso político para fortalecer el programa.

Objetivo del estudio:

Explorar la implementación del programa de TSC de Fiji.
Identificar las brechas entre políticas y su implementación para mejorar la atención primaria de salud.

Principales métodos:

Estudio cualitativo exploratorio realizado en las seis subdivisiones de Fiji.
Se recopilaron datos a través de discusiones de grupos focales (41 TSC) y entrevistas a informantes clave (supervisores, gerentes de enfermería).
Se utilizó el análisis temático para analizar los datos cualitativos.

Principales resultados:

Los TSC desempeñan diversas funciones que mejoran la atención primaria de salud.
Los aspectos positivos incluyen el compromiso político, la supervisión funcional, la fuerza laboral motivada y la confianza de la comunidad.
Se identificaron desafíos importantes: gobernanza inconsistente, desempeño variado, capacitación inadecuada, incentivos irregulares, escasez de enfermeras y limitaciones de suministro.

Conclusiones:

Fortalecer la gobernanza local, refinar los roles de los TSC y mejorar la capacitación son esenciales.
Los incentivos consistentes, los suministros adecuados y la mejora de la gestión de datos son fundamentales para el éxito del programa.
Abordar las brechas identificadas reforzará el sistema de atención primaria de salud de Fiji a través de su programa de TSC.

Palabras clave:

trabajadores de la salud comunitarios Fiji atención primaria implementación gobernanza capacitación suministro fortalecimiento del sistema de salud

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