扩大巴西儿童发展家庭访问计划:一个比较的案例研究分析
Gabriela Buccini1, Muriel Bauermann Gubert1,2, Poliana de Araújo Palmeira3
1Department of Social and Behavioral Health, University of Nevada Las Vegas, School of Public Health, Las Vegas, NV, United States.
Lancet regional health. Americas
|January 18, 2024
概括
巴西Criança Feliz计划 (PCF) 实施中的障碍,包括信任和资金不足,阻碍了儿童早期发展 (ECD) 的影响. 解决这些系统层面的问题对于计划的成功至关重要.
科学领域:
- 公共卫生 公共卫生
- 儿童早期发展 儿童早期发展
- 计划实施科学 计划实施科学
背景情况:
- 巴西的Criança Feliz计划 (PCF) 是一个大规模的儿童早期发展 (ECD) 计划.
- 尽管规模庞大,但PCF在实现其预期影响方面面临着挑战.
- 该研究检查了COVID-19大流行期间使用RE-AIM框架实现PCF实施结果的障碍和促进因素.
研究的目的:
- 确定影响"儿童快乐计划" (PCF) 实施的障碍和促进因素.
- 分析整个RE-AIM维度的PCF结果:覆盖范围,有效性,采用,实施和维护.
- 为了在COVID-19大流行背景下了解这些因素.
主要方法:
- 采用了比较案例研究设计,选择了巴西的五个不同市镇.
- 数据是通过244次采访与项目工作人员,家庭和跨部门专业人士收集的.
- 使用快速定性分析来确定与RE-AIM维度相关的主题.
主要成果:
- 实现障碍包括有限的家庭知识和对PCF目标的信任.
- 由于缺乏针对社会需求的转介协议,有效性受到损害.
- 关于部门责任的问题对采用提出了挑战;实施面临着诸如低薪水,高周转率和监测不足等问题,这些问题因流行病而加剧. 缺乏制度化资金阻碍了可持续发展.
结论:
- 复杂的,相互交织的系统级障碍严重阻碍了PCF的成功实施.
- 解决这些多方面的障碍对于利用该计划的覆盖范围及其基于证据的培养护理原则至关重要.
- 建议侧重于加强计划基础设施,跨部门合作和可持续融资模式.
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