公平和赋权效应:社区卫生项目中的多种"志愿主义"风格
1Department of Geographical and Sustainability Sciences, University of Iowa, 312 Jessup Hall, Iowa City, IA 52242, USA.
概括
对社区卫生工作者 (CHWs) 的激励措施对计划的公平性和赋权产生影响. 支付可能使边缘化的妇女能够获得支付.
科学领域:
- 公共卫生 公共卫生
- 健康 公平 卫生 公平
- 社区参与 社区参与
背景情况:
- 社区卫生工作者 (CHWs) 解决健康差异,但面临着关于激励结构的辩论.
- 对于影响社区健康知识和规范的"变革代理人"CHWs的证据很少.
- 医疗保健项目通常依赖于志愿者或最低报酬的妇女,这使激励讨论变得复杂.
研究的目的:
- 分析背景因素如何塑造印度营养教育计划中变化剂CHWs的管理.
- 检查不同管理方法对CHW有效性,赋权和公平性的影响.
- 推进志愿者的类型学,并分析其对选择,管理和支付的影响.
主要方法:
- 68次采访和10个重点小组的定性分析.
- 在印度东部三个地点对CHW计划进行比较分析.
- 开发一个志愿者的类型学:自由放任,积极培养,和费用问责制.
主要成果:
- 社区选择的志愿者倾向于处于有利的社会经济地位的女性,不一定是最有动机的女性.
- 培训和责任的增加导致了心理社会赋权,但也导致了更高的参与成本和经济不平等.
- 仅供志愿者使用的网站将付款视为解决方案,而荣誉网站则将其视为吸引不那么内在动机的个人.
结论:
- 支付可能不会本质上激励没有动力的人,但可以使更多边缘化的妇女参与.
- 这种参与对于实现更公平,更有效的社区健康影响至关重要.
- 背景因素显著影响CHW管理,影响计划成果.
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