低收入和中等收入国家社区卫生工作者的财务动机模型:范围审查
Oumar Mallé Samb1, Mariétou Niang2, Emilie Gelinas1
1Health Research and Training Unit, Rouyn-Noranda Campus, Université du Québec en Abitibi-Témiscamingue, Abitibi-Témiscamingue, QC, Canada.
社区卫生工作者 (CHW) 对低收入国家的初级医疗保健至关重要. 本次审查审查了CHW补偿模式,发现虽然大多数改善了动机,但不规则支付仍然是一个重大挑战.
科学领域:
- 全球健康 全球健康
- 加强卫生系统 加强卫生系统
- 提供初级医疗保健服务
背景情况:
- 社区卫生工作者 (CHWs) 是低收入和中等收入国家 (LMICs) 初级医疗保健的组成部分.
- 医疗保健人员往往没有融入正式的卫生系统,这使得可持续的报酬变得复杂.
- 有效的补偿对于CHW的动机,保留和表现至关重要.
研究的目的:
- 系统地审查和记录LMIC中CHW的报酬策略.
- 分析不同薪酬模式对CHW工作和绩效的影响.
- 确定各种CHW支付机制的优点和弱点.
主要方法:
- 采用了一种全面的范围审查方法.
- 包括50篇详细介绍CHW计划和LMIC薪酬的文章.
- 确定并分类了四种主要的薪酬模式.
主要成果:
- 确定了四种补偿类型:固定,基于绩效,创造收入的活动 (IGAs) 和组合模式.
- 跨模型的共同优势包括增强CHW动机和提高绩效.
- 一个普遍的弱点是支付的不规则性,影响了CHW的生计.
- 没有一个单一的模型是普遍优越的;需要适应特定的环境.
结论:
- 医疗保健员的补偿模式必须根据特定的经济,社会和文化背景进行调整.
- 让CHW参与薪酬策略的选择和设计对于成功至关重要.
- 解决不规则支付问题对于可持续的CHW计划至关重要.
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