在坦桑尼亚的初级医疗保健系统中获得紧急护理:在资源有限的环境中进行混合方法社区研究
Gimbo Hyuha1,2, Manase Kilonzi3, Nathanael Sirili4
1Emergency Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of.
BMJ public health
|November 24, 2025
概括
在坦桑尼亚的初级医疗保健 (PHC) 中,获得紧急护理服务 (ECS) 受到系统,基础设施和社会文化障碍的限制. 改善接入需要涉及政策制定者,提供者和社区的多部门干预.
科学领域:
- 全球健康 全球健康
- 医疗保健服务研究 医疗服务研究
- 初级医疗保健是一项主要的医疗保健.
背景情况:
- 及时获得紧急护理服务 (ECS) 对于减少急性疾病死亡率至关重要.
- 在全球范围内,ECS的障碍已得到充分记录,但在低收入和中等收入国家,人们对初级医疗保健 (PHC) 的获取情况知之甚少.
- 本研究调查了坦桑尼亚的PHC级别的ECS接入.
研究的目的:
- 评估在坦桑尼亚的初级卫生保健 (PHC) 层面获得紧急护理服务 (ECS).
- 识别在坦桑尼亚的PHC系统中阻碍及时访问ECS的障碍.
- 提供相关的见解,以改善在类似的低收入和中等收入国家环境中ECS访问.
主要方法:
- 一项基于社区的混合方法研究在坦桑尼亚农村进行.
- 通过问卷从673个社区成员采用WHO-ECS指标收集定量数据.
- 通过深入采访和与社区领导人和医疗保健提供者的焦点小组讨论,收集了定性数据.
主要成果:
- 只有27%的参与者寻求ECS,而73%的人获得了它.
- 虽然感知到的可用性 (79%) 和负担能力 (64%) 相对较高,但主要障碍包括长途旅行 (48%),长时间等待 (74%) 和药物短缺 (64%).
- 定性发现突出了系统性问题,如基础设施差,对设施的信任低,以及对传统治疗师的偏好.
结论:
- 在坦桑尼亚,显著的系统,基础设施和社会文化障碍阻碍了在PHC层面获得ECS的机会.
- 解决这些障碍需要协调,多部门干预.
- 政策制定者,医疗保健提供者,当地决策者和社区之间的合作对于加强ECS访问至关重要.
相关概念视频
01:30Primary Healthcare Services
1.9K
Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
1.9K
01:26Methods Of Healthcare Delivery System
3.9K
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
3.9K
01:11Secondary Healthcare System
1.9K
Secondary healthcare is offered by a specialist, generally in hospitals or clinics for patients referred by primary healthcare providers. It occurs when a person has an illness or injury that requires specific medical care. Secondary care is often referred to as acute care. Secondary care can range from uncomplicated care to repair a minor laceration or treat a strep throat infection to more complicated emergent care, such as treating a head injury sustained in an automobile accident. Whatever...
1.9K
01:26Traditional Level Of Health Care System
3.3K
The levels of care describe the services provided in the healthcare system. Accordingly, there are six levels of the traditional healthcare system in the US: preventive, primary, secondary, tertiary, restorative, and continuing healthcare. A nurse must understand how the healthcare industry organizes and provides services within these levels of care.
The preventive healthcare service includes tests for screening. Preventive health care services include identifying and reducing disease risk...
The preventive healthcare service includes tests for screening. Preventive health care services include identifying and reducing disease risk...
3.3K
01:21Tertiary Healthcare System
2.1K
Specialized care provided over an extended period is called tertiary care. Usually, a primary or secondary care physician will refer a patient to tertiary care. A patient's maximum physical and mental function is restored in tertiary care, which is caused due to the impact of a chronic illness or condition. Tertiary care aims to achieve the highest level of functioning possible while managing chronic illness. For example, a patient who falls and fractures their hip will need secondary care...
2.1K
01:30Specialized Care Centers and Settings-II
1.2K
Rural Health Centers
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
1.2K