卫生工作者罢工时的公私参与和卫生系统复原力:加纳案例研究。

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Bettina Buabeng-Baidoo, Jill Olivier
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引用次数: 0

摘要

在加纳这样的中低收入国家,私营医疗服务提供者,特别是由加纳基督教健康协会(CHAG)联网的非营利性信仰医疗服务提供者集团,在医疗工作者罢工期间保持服务连续性方面发挥着至关重要的作用。在罢工期间,如果私营部门参与不力,可能会影响医疗质量,并给民众,尤其是贫困人口带来经济困难。本研究采用定性描述和探索性案例研究方法,深入探讨了 2010-2016 年卫生工作者罢工期间 CHAG 与加纳政府(GoG)的合作情况。通过分析同行评议文献、媒体档案、灰色文献中的证据,以及采用定性主题分析方法进行的相关研究中的访谈记录,本研究将卫生工作者罢工确定为加纳持续存在的慢性压力源。研究结果强调了 CHAG 与加纳政府之间一些系统层面的互动,促进了适应性和吸收性复原策略,这受到了 CHAG 的非罢工精神、双方之间独特的借调政策以及国家健康保险制度的影响。然而,政府在罢工期间对 CHAG 成员机构的支持有限,以及国家医疗保险体系面临的系统性挑战,都对 CHAG 提供优质、可负担医疗服务的能力构成了威胁。本研究强调了私营医疗机构在提高加纳医疗系统在罢工期间的应变能力方面的关键作用,倡导政府与私营医疗机构建立积极的合作伙伴关系,共同努力在罢工前解决与人力资源相关的挑战。报告还建议开展进一步研究,为各国制定和评估应对罢工的有效战略,确保在此类危机期间做好准备并持续提供高质量的医疗服务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Public-Private engagement and health systems resilience in times of health worker strikes: a Ghanaian case study.

In low and middle-income countries like Ghana, private providers, particularly the grouping of faith-based non-profit health providers networked by the Christian Health Association of Ghana (CHAG), play a crucial role in maintaining service continuity during health worker strikes. Poor engagement with the private sector during such strikes could compromise care quality and impose financial hardships on populations, especially the impoverished. This study delves into the engagement between CHAG and the Government of Ghana (GoG) during health worker strikes from 2010 to 2016, employing a qualitative descriptive and exploratory case study approach. By analysing evidence from peer-reviewed literature, media archives, grey literature and interview transcripts from a related study using a qualitative thematic analysis approach, this study identifies health worker strikes as a persistent chronic stressor in Ghana. Findings highlight some system-level interactions between CHAG and GoG, fostering adaptive and absorptive resilience strategies, influenced by CHAG's non-striking ethos, unique secondment policy between the two actors and the presence of a National Health Insurance System. However, limited support from the government to CHAG member facilities during strikes and systemic challenges with the National Health Insurance System pose threats to CHAG's ability to provide quality, affordable care. This study underscores private providers' pivotal role in enhancing health system resilience during strikes in Ghana, advocating for proactive governmental partnerships with private providers and joint efforts to address human-resource-related challenges ahead of strikes. It also recommends further research to devise and evaluate effective strategies for nations to respond to strikes, ensuring preparedness and sustained quality healthcare delivery during such crises.

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来源期刊
Health policy and planning
Health policy and planning 医学-卫生保健
CiteScore
6.00
自引率
3.10%
发文量
98
审稿时长
6 months
期刊介绍: Health Policy and Planning publishes health policy and systems research focusing on low- and middle-income countries. Our journal provides an international forum for publishing original and high-quality research that addresses questions pertinent to policy-makers, public health researchers and practitioners. Health Policy and Planning is published 10 times a year.
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