了解马拉维,马里和卢旺达国家卫生系统中的综合社区病例管理制度化过程:质量研究
Alyssa L Davis1, Erica Felker-Kantor2, Jehan Ahmed3
1Consultant, U.S. President's Malaria Initiative Impact Malaria, Washington, DC, USA. alyssa.l.davis@gmail.com.
综合社区案例管理 (iCCM) 的制度化通过代阶段进行,由核心价值观,领导力,资源和政策驱动. 维持iCCM需要在国家卫生系统内不断加强.
科学领域:
- 全球健康 全球健康
- 加强卫生系统 加强卫生系统
- 公共卫生干预措施 公共卫生干预措施
背景情况:
- 世界卫生组织和联合国儿童基金会建议综合社区病例管理 (iCCM) 用于在资源有限的环境中治疗儿童疾病.
- 越来越多的人认为,在国家系统中,iCCM和社区健康的制度化至关重要.
- 医疗保健医院为五岁以下的儿童提供疟疾,肺炎和腹的iCCM.
研究的目的:
- 识别和描述iCCM制度化的过程.
- 从卫生系统参与者的角度了解这些过程.
- 使用新开发的iCCM制度化框架来分析制度化.
主要方法:
- 使用51个半结构面试对马拉维,马里和卢旺达的关键信息提供者的定性研究.
- 对面试数据进行主题分析.
- 审查国家文档,以将调查结果置于背景.
- 应用iCCM制度化框架 (阶段和驱动因素).
主要成果:
- iCCM制度化通过代的,非线性成熟阶段进行.
- 这四个驱动因素 (核心价值观,领导力,资源,政策) 都有助于制度化.
- 持续的iCCM需要在卫生系统内不断加强.
结论:
- 政府的所有权和国家系统集成是iCCM制度化状态的关键指标.
- 进一步开发iCCM制度化框架可以帮助卫生系统的参与者.
- 实际的感知模型可以促进iCCM和其他健康干预措施的制度化.
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