了解利益相关者关于将垂直艾滋病预防计划整合和维持在津巴布韦的常规卫生服务中的观点:一项定性研究
Amanda Marr Chung1,2, Joseph Murungu3, Peter Case4,5,6
1Center for Innovation in Global Health, Stanford University, Stanford, California, USA amarr@stanford.edu.
BMJ global health
|August 11, 2025
概括
在津巴布韦,过渡到自愿医疗男性割礼 (VMMC) 需要解决成功政府所有权的心理和结构障碍. 克服财务限制和减少捐助者控制是当地一体化和可持续性的关键.
科学领域:
- 公共卫生 公共卫生
- 预防艾滋病毒 预防艾滋病毒
- 加强卫生系统 加强卫生系统
背景情况:
- 自愿医疗男性割礼 (VMMC) 是一种关键的艾滋病毒预防策略.
- 津巴布韦正在将其VMMC计划从捐助者资助转变为政府所有权.
- 这一转型涉及多个利益相关者,包括政府官员,医疗保健提供者和社区成员.
研究的目的:
- 了解VMMC计划过渡期间有关障碍和促进者的利益相关者的观点.
- 收集关于成功整合和当地对VMMC计划拥有权的建议.
- 分析从垂直的,由捐助者资助的模式转向综合的,由政府领导的方法所面临的挑战.
主要方法:
- 进行了54次半结构化采访,与国家和地方层面的利益相关者进行了采访.
- 采访被录音,转录,并进行主题分析.
- 定性数据分析以确定与计划过渡相关的关键主题.
主要成果:
- 确定了心理和结构性障碍,包括融资和人员问题,员工 attrition,以及对运营变革的抵抗.
- 缺乏国内资源和持续的捐助者对资金的控制是重要的金融障碍.
- 心理障碍包括对员工失去权力和工作安全的担忧.
- 治理的分散化为增加地方责任和所有权提供了机会.
结论:
- 解决心理和结构障碍对于成功的VMMC项目整合和当地所有权至关重要.
- 减少捐助者参与和赋予地方政府利益相关者权力对于财政自主至关重要.
- 确保适当的补偿和解决供应商的担忧对于可持续性至关重要.
- 为了顺利过渡到政府主导的VMMC计划,需要调整利益相关者的观点.
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