不断变化的派驻和随派驻而调动的情况:来自印度的一线视角。

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Bhaskar Purohit, Peter S Hill
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引用次数: 0

摘要

通过初始和后续的派驻和调动(PT)来部署医疗卫生队伍,是医疗卫生队伍管理的一个关键要素。然而,目前现有的派岗与调任文献主要关注的是后续派岗与调任,而初始派岗与后续派岗之间的区别很少受到研究关注。针对这一空白,我们在本文中研究了印度两个邦的医生在随后的工作经历中如何与最初的工作经历进行比较。在缺乏政策文件的情况下,我们通过六种规范作为隐含政策的证据,对两者进行了区分。这项混合方法研究对医生和主要信息提供者进行了深入访谈,并通过他们讲述的工作经历提供了定量数据。根据对这些一线医生和其他主要政策参与者的访谈,本文揭示了医生们所认为的最初岗位和后续岗位之间的主要差异:与最初岗位相比,在最初岗位上,满足服务需求的国家要求占主导地位,而在后续岗位上,医生们在决定结果方面有更大的自主权,他们的选择以本地为中心。我们的分析通过医生对其自身在系统中的地位和权力的认识的转变,提供了对公共卫生服务环境的细微理解,与最初的派驻相比,医生在随后的公共卫生服务中的行为发生了显著变化。本文揭示了医生在其后的公共交通服务中的行为变化,提供了对公共交通服务环境的更深入理解,将公共交通服务的概念扩展到服务需求与医生要求之间的简单二分法之外。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Changes from initial Posting to subsequent Posting and Transfer: a frontline perspective from India.

The deployment of the health workforce, carried out through initial and subsequent posting and transfer (PT), is a key element of health workforce management. However, the focus of the currently available PT literature is mostly on subsequent PT, and the distinction between initial and subsequent PT has received little research attention. Drawing on this gap, in this paper, we examine how doctors experience their subsequent PT compared with their initial postings in two states in India. The distinctions have been drawn using the prism of six norms that we developed as evidence for implied policy in the absence of documented policy. This mixed-methods study used in-depth interviews of doctors and key informants, with job histories providing quantitative data from their accounts of their PT experience. Based on the interviews of these frontline doctors and other key policy actors, this paper brings to light key differences between initial and subsequent postings as perceived by the doctors: compared with initial postings, where the State demands to meet service needs dominated, in subsequent postings, doctors exercised greater agency in determining outcomes, with native place a central preoccupation in their choices. Our analysis provides a nuanced understanding of PT environment through this shift in doctors' perceptions of their own position and power within the system, with a significant change in the behaviour of doctors in subsequent PT compared with their initial postings. The paper brings to light the changing behaviour of doctors with subsequent PT, providing a deeper understanding of PT environment, expanding the notion of PT beyond the simple dichotomy between service needs and doctors' requests.

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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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