中层管理人员对在乌干达卫生区为艾滋病毒感染者实施异化预防治疗的看法:一项定性研究
Canice Christian1, Elijah Kakande2, Violah Nahurira2
1University of California San Francisco, San Francisco, CA, USA. canice.christian@ucsf.edu.
BMC health services research
|March 8, 2024
概括
通过向管理人员提供领导力培训并促进协作,克服资源和动机有限等障碍,SEARCH-IPT干预改善了艾滋病毒感染者对结核病预防的普及.
科学领域:
- 公共卫生 公共卫生
- 传染病管理 传染病管理
- 加强卫生系统 加强卫生系统
背景情况:
- 伊索尼亚预防疗法 (IPT) 对于预防艾滋病毒感染者 (PLHIV) 结核病 (TB) 至关重要,但其在撒哈拉以南非洲的吸收率很低.
- 识别中层管理人员在扩展IPT时面临的障碍对于改善结核病/艾滋病协作服务至关重要.
- 搜索-IPT试验的目的是通过乌干达地区卫生管理人员的新型干预来加强IPT的吸收.
研究的目的:
- 确定中层管理人员在乌干达扩大伊索尼亚预防治疗 (IPT) 时遇到的障碍.
- 探索通过SEARCH-IPT试验干预影响管理人员增加IPT采用能力的机制.
- 了解领导力,管理培训和区间合作在改善结核病预防治疗的作用.
主要方法:
- 一项定性研究分析了集群随机搜索-IPT试验 (2017-2021) 中的焦点小组讨论和关键信息人采访的成绩单.
- 使用了归纳和演编码,并采用了数据合成的框架方法.
- 包括来自地区卫生管理人员干预和控制小组的参与者观察现场笔记.
主要成果:
- 干预经理报告说,由于领导力培训,干预经理报告说,由于领导力培训,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说,干预经理报告说.
- 两组都发现的障碍包括外部资助者议程,自上而下的会议方法,资源不足 (供应,人员) 和前线提供者的动机低.
- 干预经理通过区间的库存再分配来加强合作,与只在区内再分配的控制经理不同.
结论:
- 乌干达的中层管理人员面临着扩大IPT的重大障碍,包括对议程/资金的有限控制,资源限制,提供者的动机问题以及缺乏政治优先级.
- 搜索-IPT干预有效地支持管理人员制定和实施战略,以促进IPT的采用和促进区间合作.
- 与标准护理相比,干预措施在提高管理人员能力方面的成功可能有助于增加PLHIV中IPT的采用率.
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