印度结核病 (TB) 消除工作的前线工作者:街头层面的官僚主义视角
Vanita Singh1, Rajesh Chandwani2, Viswanath Pingali2
1Management Development Institute, C-19 Scholars Block, MDI Campus, Sector-17C, Sukhrali, Gurugram, Haryana, 122007, India. vanita.singh@mdi.ac.in.
BMC public health
|November 22, 2025
概括
印度的前线工作者.
科学领域:
- 公共卫生 公共卫生
- 卫生政策和管理卫生政策和管理
- 卫生社会学 卫生社会学
背景情况:
- 印度国家结核病消除计划 (NTEP) 面临着尽管有战略计划,但在减少高结核病发病率方面面临挑战.
- 人力资源的限制,特别是前线工作者 (FWs),严重阻碍了有效的结核病控制政策的实施.
- 街头级官僚主义 (SLB) 理论为了解FW在NTEP中的经验和挑战提供了一个框架.
研究的目的:
- 利用Lipsky的街头级官僚制度 (SLB) 理论,探索印度国家结核消除计划 (NTEP) 下前线工作者 (FW) 面临的挑战.
- 确定FW如何在日常工作中应对系统性约束和资源限制.
- 通过了解FW和领导的作用,提供加强结核病消除努力的见解.
主要方法:
- 对孟买大都会地区的前线工作者进行了23次深入采访,这是结核病发病率较高的地区.
- 使用主题编码,使用由街道级官僚主义 (SLB) 理论为基础的演方法.
- 采访被录音并逐字转录以进行分析.
主要成果:
- 前线工人 (FWs) 在管理繁重的工作负载,恶劣的工作条件和稀缺资源方面表现出实际的谨慎,符合SLB理论.
- 确定的主要主题包括项目特定的挑战,人力资源缺口和领导力支持的影响.
- 变革式领导力激励了工人,而交易式领导力导致了不满和疏远.
结论:
- 艰难的工作条件和资源短缺阻碍了有效的结核病计划实施,但监督领导对于FW的参与至关重要.
- 建议包括改善工作条件,解决人员短缺问题,提供基于风险的激励措施 (带薪假期,保险,营养),并确保更安全的工作场所.
- 有效的领导力培训和能力建设对于FWs是推动结核病消除目标的必要条件.
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