社区卫生工作者双框架计划中的劳动条件:系统审查
Madeleine Ballard1, Abimbola Olaniran2, M Matías Iberico3
1Community Health Impact Coalition, London, UK; Department of Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
The Lancet. Global health
|September 21, 2023
概括
双人计划中的无薪社区卫生工作者经常面临劳动剥削,原因是工资低和工作量过大. 这种利用可能会破坏基本的医疗保健服务,并迫切需要政策改革.
科学领域:
- 全球健康 全球健康
- 公共卫生政策 公共卫生政策
- 健康劳动力研究 卫生劳动力研究
背景情况:
- 社区卫生工作者 (CHW) 对于降低发病率和死亡率至关重要,为投资提供了显著的回报.
- 双干部计划,雇佣有薪和无薪的CHW,尽管关于公平补偿的共识,但很常见.
- 这项研究调查了国家双框架CHW计划中的劳动剥削情况.
研究的目的:
- 确定双干部计划中无薪社区卫生工作者中劳动剥削的存在,流行和规模.
- 分析导致剥削的因素,包括薪酬,工作量和任务复杂性.
主要方法:
- 在2021年8月2日之前,对同行评审数据库和灰色文献进行了系统审查.
- 纳入了双层系统中无薪CHW干部的研究;单层或仅有薪酬的计划被排除在外.
- 通过使用定义的利用模型,提取和分析了有关报酬,工作量,任务复杂性和CHW经验的数据.
主要成果:
- 分析了来自19个国家的112项研究的117份报告,主要包括女性医疗保健工作者.
- 劳动剥削在59%的无薪CHW干部中被发现,而在有薪干部中只有10%.
- 无薪的CHW经常报告没有薪酬,激励不足和过度的工作负载,有些人需要每周工作40个小时以上.
结论:
- 双人干部系统中的无薪医疗保健工作者经常经历劳动剥削,危及医疗保健提供.
- 维护劳工法,优先考虑公平合同和透明资金至关重要.
- 建议评估工作负载,CHW政策投入,并避免志愿者提供基本服务.
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