"我们的手被捆绑":肯尼亚社区卫生工作的途径
Kathy Dodworth1, Brenda N Mukungu2
1Centre of African Studies, School of Social and Political Science, University of Edinburgh, 15a George Square, Edinburgh, EH8 9LD, United Kingdom; Institute of Anthropology, Gender and African Studies, University of Nairobi, Kenya.
Social science & medicine (1982)
|August 7, 2023
概括
社区卫生工作者 (CHW) 的选择很少遵循理想的自愿模式. 相反,路径就像路径一样.
科学领域:
- 全球健康 全球健康
- 健康和疾病的社会学
- 公共卫生政策 公共卫生政策
背景情况:
- 传统的社区卫生工作者 (CHW) 选择模式强调自愿,社区选举参与,植根于历史叙述.
- 这种理想化的模式与CHW招聘的复杂现实形成鲜明对比,受各种结构性和个人因素的影响.
- 西方推广的社区卫生自愿主义观念往往无法解释这种劳动在资源不足的环境中持续存在的原因.
研究的目的:
- 探索在肯尼亚北部Isiolo成为社区卫生工作者 (CHW) 的主要途径.
- 分析这些途径如何挑战志愿者和社区卫生劳动的理想化观念.
- 了解导致贫困地区依赖CHW劳动力的基础结构因素.
主要方法:
- 在肯尼亚北部的Isiolo,与68名CHW (简称CHV) 进行了生命史采访,持续了十二个月 (2022-2023年).
- 采用定性分析来识别和阐明社区卫生工作的不同途径.
- 介绍了五个"理想类型"的路径:模型,精选,影子,局外人和剥夺,突出了它们的复杂相互关系.
主要成果:
- 确定了五种不同的,经常重叠的CHW选择途径:模型,精选,影子,局外人和剥夺.
- "处置"路径,个人生命机会有限,显得尤为重要.
- 这些发现挑战了纯粹志愿者的概念,揭示了CHW角色是如何被社会经济约束和有限的机会所塑造的.
结论:
- 自愿性CHW选择的理想化模型在实践中基本上不存在,取而代之的是复杂的,通常是非自愿的途径.
- 由于结构性贫困和缺乏对卫生人力资源的投资,CHW劳动仍然存在,作为一种"结构性暴力"形式运作.
- 了解这些途径对于解决在贫困地区对低估的医疗保健工作的历史依赖和促进公平的卫生系统至关重要.
更多相关视频
11:21Methodology for Establishing a Community-Wide Life Laboratory for Capturing Unobtrusive and Continuous Remote Activity and Health Data
Published on: July 27, 2018
8.3K
07:20Dried Blood Spot Collection of Health Biomarkers to Maximize Participation in Population Studies
Published on: January 28, 2014
36.6K
相关概念视频
01:30Community Based Intervention
65
Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
65
01:30Primary Healthcare Services
1.4K
Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
1.4K
01:26Methods Of Healthcare Delivery System
3.3K
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
3.3K
01:30Specialized Care Centers and Settings-II
756
Rural Health Centers
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
756
01:28International Nursing Organizations II
1.0K
The World Health Organization (WHO) is a specialized agency of the United Nations based in Geneva. The WHO has many initiatives that center around health. Primarily, they lead global efforts to expand universal health coverage using science-based policies and programs. They are also responsible for shaping health research agendas and developing norms and standards.
The WHO provides expert team support, including funding, vaccines, testing, and treatment tools at the country level to fight...
The WHO provides expert team support, including funding, vaccines, testing, and treatment tools at the country level to fight...
1.0K
01:25Models of Health Promotion and Illness Prevention I
2.1K
A model is a theoretical way to understand a concept or an idea. Models can overcome barriers to health regardless of diverse economic and cultural backgrounds. In addition, models make the task easier by providing different ways to approach complex issues. There are two major health promotion models: the health belief model and the health promotion model.
The health belief model (HBM) attempts to predict health-related behavior in specific belief patterns. According to the HBM, a person's...
The health belief model (HBM) attempts to predict health-related behavior in specific belief patterns. According to the HBM, a person's...
2.1K