过渡和变化:利比里亚社区卫生系统和垂直疾病计划的CHW计划改革的机遇和挑战
Georgina Zawolo1, Gertrude Nsorma Nyaaba2, Gartee Nallo1
1University of Liberia Pacific Institute for Research and Evaluation, University of Liberia, Capitol Hill, Monrovia, Liberia.
Health research policy and systems
|October 7, 2024
概括
利比里亚的社区卫生工作者 (CHW) 计划改革为CHW的表现提供了机会和挑战. 加强CHW计划和卫生干预措施可以共同提高整体卫生系统的运作和CHW的绩效.
科学领域:
- 加强卫生系统 加强卫生系统
- 公共卫生干预 公共卫生干预
- 社区卫生工作者计划
背景情况:
- 社区卫生工作者 (CHW) 计划对于解决卫生工作者短缺和实现全民健康覆盖 (UHC) 至关重要.
- 利比里亚2016年国家社区卫生服务政策旨在改革CHW计划,以解决劳动力差距.
- 这些改革对现有的卫生干预措施的影响,特别是对被忽视的热带疾病 (NTDs) 的干预措施的影响,没有得到充分考虑.
研究的目的:
- 探讨利比里亚的CHW计划改革如何影响提供NTD计划的CHW的表现.
- 了解卫生系统改革如何影响日常卫生干预措施,反之亦然.
主要方法:
- 定性案例研究方法 (2017年3月 - 2018年8月).
- 政策文件的文档审查,25个关键告密者采访,以及42个CHW生活和工作史.
- 以CHW绩效框架为指导的专题框架分析,使用QRS NVIVO 11 Pro.
主要成果:
- 医疗保健计划改革为医疗保健业绩带来了机遇和挑战.
- 机会包括正式承认CHW,改善培训,结构化监督和每月激励金 (70美元).
- 加强硬件组件可以减轻效率差距,而干预措施可以支持监管赤字. 社区参与和性别变革的方法对于系统软件至关重要.
结论:
- 医疗卫生保健计划改革对卫生系统的加强产生了影响,对日常卫生干预措施产生了积极和消极的影响.
- 医疗保健计划与日常卫生干预之间的协作努力可以创造互惠互利的支持.
- 通过综合性支持提高CHW的性能可以改善整体卫生系统的运作.
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