分析与卢旺达实施社区医疗保险相关的挑战

Felix Rubogora
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引用次数: 4

摘要

为了实现第四、第五和第六个千年发展目标,自2000年以来,卢旺达一直在努力加强基于社区的健康保险计划。据悉,该计划覆盖了最大比例的贫困人口。它的实施每年都取得了成功,覆盖率从2000年的1%上升到2010年的91%。然而,卢旺达的迅速恢复和在实现人人享有卫生保健的全球目标方面的成功,有卫生系统管理方面的未记录需要记录(卫生保健标准和卫生保健计划政策下向人们提供的不良服务以及卫生保健计划资金管理不善)。通过各种文献(当地报纸,研究),本研究解决了上述医疗伦理问题的根源和策略,以减轻问题的程度。首先,卢旺达教育系统应培训更多的护士和医生,以增加卢旺达卫生系统的劳动力数量。第二,建立激励机制,以留住现有的卫生专业人员并吸引在农村地区工作的新卫生专业人员。第三,为护士和其他与病人打交道的卫生机构工作人员提供更多与道德相关的培训项目。最后,卢旺达政府和其他主要利益相关者应该重新考虑建商集团的结构,将建商集团地方部门与国家主管委员会(RSSB)之间的关系正规化,使其成为一个结构良好的机构,以避免建商集团资金出现奇怪和反复出现的管理不善。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analyzing Challenges Associated with the Implementation of CommunityBased Health Insurance (CBHI) in Rwanda
With the aim of achieving the fourth, fifth and sixth Millennium Development goals, since 2000 Rwanda has been striving to put much effort in reinforcing the Community Based Health Insurance scheme (CBHI). The scheme is known to be covering the largest percentage of the poorer population. Its implementation had recorded success from year to year, whereby the trend went from 1% of coverage in 2000 to 91% in 2010. However, the quick recovery of Rwanda and the success in achieving global goal of healthcare for all, there are undocumented facets of health system management that need to be documented (health care standards and poor services offered to people under CBHI policy and the mismanagement of CBHI funds). Through various documentations (local newspapers, researches), this study has addressed the roots of the above healthcare ethical issues and strategies to mitigate the extent of the problem. Firstly, Rwandan education system should train more nurses and doctors in order to increase the number of workforce in Rwandan health system. Secondly, put in place incentive mechanism to retain the existing health professionals and attract the new ones working in rural areas. Thirdly, offering more ethics related training programs to nurses and other health facilities’ staff who deal with patients. Finally, Rwandan government with other key stakeholders should rethink CBHI structure by formalizing relationship between CBHI sections at local level and the national board in charge (RSSB) as a well-structured institution in order to avoid a bizarre and recurring mismanagement of CBHI funds.
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