根据结果支付可以确保公平获得避孕服务吗? 一个定性案例研究
Victoria Boydell1, Joseph Holden2, Ginny Robins3
1University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK. vb21763@essex.ac.uk.
International journal for equity in health
|May 27, 2023
概括
根据结果支付 (PbR) 鼓励在性和生殖健康计划中接触青少年和贫困人口. 然而,全球指标提出了方法上的挑战,影响了公平获取.
科学领域:
- 公共卫生 公共卫生
- 卫生系统研究 卫生系统研究
- 发展研究 发展研究 研究
背景情况:
- "不让任何人落后" (Leave No One Behind,LNOB) 议程要求解决性和生殖健康和权利 (SRHR) 中交叉不平等的问题.
- 根据结果支付 (PbR) 是一项旨在在SRHR编程中实现公平覆盖和影响的战略.
- 妇女综合性健康 (WISH) 计划作为一个案例研究来评估PbR的有效性.
研究的目的:
- 检查是否以及如何根据结果支付 (PbR) 可以确保SRHR编程的公平覆盖和影响.
- 分析PbR机制中基于股权的指标的影响.
- 确定使用PbR用于公平的SRHR服务交付的挑战和权衡.
主要方法:
- 基于理论的方法被用于评估设计和分析.
- 在WISH计划中进行了四个案例研究.
- 数据收集包括审查全球和国家计划数据,并在国家,区域和全球层面采访50名WISH员工.
主要成果:
- 在PbR中包含基于股权的指标影响了激励措施,系统操作和工作实践.
- 愿望计划成功实现了其所需的计划指标.
- 关键绩效指标 (KPIs) 激励创新以达到青少年和贫困人口,但在覆盖率和公平获取指标之间存在权衡,系统性挑战限制了激励效应.
结论:
- 通过关键关键指标,PbR激发了接触青少年和贫困群体的战略.
- 在PbR中使用全球指标过于简单,并导致了方法问题.
- 系统性挑战和指标设计需要仔细考虑,以平衡PbR机制中的覆盖范围和公平性.
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