谁缺席,为什么缺席? 影响孟加拉国医生缺勤的因素
Mir Raihanul Islam1, Blake Angell2, Nahitun Naher3
1Poverty, Gender and Inclusion Division, International Food Policy Research Institute, Dhaka, Bangladesh.
PLOS global public health
|April 4, 2024
概括
孟加拉国农村公共卫生保健设施的医生缺勤率与社会政治网络有关,而不仅仅是工作量. 间断的调度与更少的难以管理的工作负载有关,而强大的社区联系改善了农村留守.
科学领域:
- 公共卫生 公共卫生
- 医疗保健管理的管理
- 卫生社会学 卫生社会学
背景情况:
- 孟加拉国农村公共卫生保健设施的医生缺勤是政府的一个重大问题.
- 从医生的角度了解潜在因素对于有效的政策制定至关重要.
研究的目的:
- 探索影响孟加拉国农村公共卫生保健设施医生缺勤的因素.
- 确定农村保留在初级医生中的决定因素.
主要方法:
- 在孟加拉国达卡的四家政府医院进行了基于设施的横截面调查.
- 有农村派遣经验的初级医生接受了关于社会人口统计学,工作/生活条件和社交网络的采访.
- 采用多重物流回归分析来确定与农村保留相关的因素.
主要成果:
- 在308名受访者中,有74%的受访者不间断地完成了他们的农村派遣;缺勤的主要原因是培训 (65%) 和家庭 (41%).
- 近一半的受访者表示工作量难以管理,96%的人面临挑战,包括不安全的环境和患者/护理人员的虐待.
- 有影响力的当地联系的医生更有可能完成农村派遣 (AOR 2.40);那些没有完成派遣的人不太可能报告无法管理的工作负载 (AOR 0.39).
结论:
- 孟加拉农村的医生缺勤率受到社会政治网络和具有挑战性的工作环境的影响,而不仅仅是工作量.
- 政策干预应解决不支持社区行为的问题,并加强对医生的支持,特别是那些网络较弱的医生.
- 提高农村保留率需要解决超出个人医生问责制的系统性问题.
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