改变权力叙述:利比里亚社区卫生工作者专业化的示例案例研究
Anne Neumann1,2,3, Marion Subah4, Helene-Mari van der Westhuizen5,6,7
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK anne.neumann@globaldigital.health.
社区卫生工作者 (CHW) 对健康公平至关重要,但往往缺乏正式认可和报酬. 分析像利比里亚这样的CHW计划中的权力动态,揭示了专业化和可持续角色的战略.
科学领域:
- 全球健康 全球健康
- 卫生政策 卫生政策
- 健康劳动力研究 卫生劳动力研究
背景情况:
- 社区卫生工作者 (CHW) 对健康公平和全民健康覆盖至关重要,但往往缺乏正式认可和薪水.
- 医疗保健政策是由全球卫生力量动态所塑造的,需要进行批判性审查,以加强医疗保健的角色.
研究的目的:
- 调查影响CHW计划设计和实施的动力动态.
- 将利比里亚的社区卫生助理计划作为成功的CHW专业化的案例研究.
- 为在其他全球卫生环境中加强CHW角色提供见解.
主要方法:
- 对利比里亚国家社区卫生助理计划的案例研究分析.
- 应用斯蒂文·卢克斯的权力理论来分析政策谈判.
- 检查政治承诺,政府权威,共识建设和证据利用.
主要成果:
- 利比里亚成功实现了医疗保健工作的专业化,通过强有力的政治承诺和政府权威,克服了外部资助者对支付的抵制.
- 在政府部门之间建立共识增强了决策权.
- 对CHW权利的证据的战略性使用促进了与资助者的接触.
结论:
- 加强CHW角色需要理解和导航政策谈判中的权力动态.
- 专注于专业化和政府权威,超越功能有效性,可以重新构建CHW计划方法.
- 利比里亚的经验为全球推进CHW认可和可持续性提供了宝贵的教训.
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