How can humanitarian services provision during mass displacement better support health systems? An exploratory qualitative study of humanitarian service provider perspectives in Cox's Bazar, Bangladesh.
How can humanitarian services provision during mass displacement better support health systems? An exploratory qualitative study of humanitarian service provider perspectives in Cox's Bazar, Bangladesh.
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DOI：
10.1016/j.jmh.2022.100132
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发表时间：
2022
影响因子：
4.6
通讯作者：
Howard, Natasha
中科院分区：
文献类型：
--
作者：
Krishnan, Sneha;Zaman, Samia;Ferdaus, Muhammad;Kabir, Md Humayun;Khatun, Hafiza;Rahman, S. M. Safiqur;Marzouk, Manar;Durrance-Bagale, Anna;Howard, Natasha
我们研究了孟加拉国考克斯巴扎尔的人道主义和政府卫生服务提供之间的联系，采访了25个人道主义服务提供者。政府卫生系统面临的挑战是药品、设备和训练有素的工作人员的可获得性、可负担性和可用性。人道主义卫生服务提供者通过与社区团体合作、招募和培训罗兴亚志愿者以及让宗教领袖参与进来，加强了政府的应对措施。我们敦促所有提供服务的组织从FDMN社区招聘工作人员，并确保罗兴亚社区能够参与医疗服务提供的决策。在大规模流离失所情况下提供卫生服务是一项人道主义要务，对促进国际和区域安全至关重要。国际流离失所人口在流离失所前、流离失所中、流离失所后以及在东道国居住期间会遇到一系列影响其健康和福祉的问题。本研究探讨了为考克斯巴扎尔地区被迫流离失所的缅甸国民（FDMN）提供人道主义和政府卫生服务之间的联系，以考虑如何改善知识共享和合作，在大规模流离失所期间更好地支持卫生系统。我们进行了一项定性描述性研究，于2021年初在孟加拉国亲自采访了25名人道主义服务提供者，并按主题分析数据。我们发现，政府限制了人道主义卫生行动者可以提供的基本服务，FDMN必须经过严格的筛选和转诊才能接受三级医疗保健。与此同时，政府卫生系统在药品、设备和训练有素的工作人员的可获得性、可负担性和可用性方面面临挑战。人道主义卫生服务提供者通过与社区团体合作、招募和培训罗兴亚志愿者以及让宗教领袖参与进来，加强了政府的应对措施。调查结果表明，缓解障碍，以更全面的卫生服务，允许访问数字设备，并雇用FDMN，以支持他们的社区将提高卫生系统的响应FDMN流离失所的合法需求周围考克斯的巴扎尔。必须扩大和倾听少数民族的声音，并合作解决限制他们获得有效保健服务的结构性和社会障碍，以增加对保健系统的信任和响应能力。
We examined links between humanitarian and government health services provision in Cox's Bazar, Bangladesh, interviewing 25 humanitarian service providers. The government health system is challenged by accessibility, affordability and availability of medicines, equipment, and trained staff. Humanitarian health service providers augmented government responses by working with community groups, recruiting and training Rohingya volunteers, and involving religious leaders. We urge all service provision organisations to recruit staff from FDMN communities and ensure Rohingya communities can engage in decision-making on health services provision. Health services provision in mass displacement settings is a humanitarian imperative and essential to promoting international and regional security. Internationally displaced populations experience a range of issues pre-, peri-, post-displacement and residing in host countries that affect their health and well-being. This study examined links between humanitarian and government health services provision for forcibly displaced Myanmar nationals (FDMN) in Cox's Bazar to consider how improved knowledge sharing and collaboration might better support health systems during mass displacement. We conducted a qualitative descriptive study, interviewing 25 humanitarian service providers in-person in Bangladesh in early 2021 and analysing data thematically. We found that government restricted what essential services humanitarian health actors could provide and FDMN had to undergo stringent screening and referral to receive tertiary healthcare. Concurrently, the government health system was challenged by accessibility, affordability and availability of medicines, equipment, and trained staff. Humanitarian health service providers augmented government responses by working with community groups, recruiting and training Rohingya volunteers, and involving religious leaders. Findings suggest that easing barriers to a fuller range of health services, allowing access to digital devices, and hiring FDMN to support their communities would improve health system responsiveness to the legitimate needs of FDMN displaced around Cox's Bazar. It is imperative to amplify and listen to the voices of FDMN and collaborate in addressing structural and social barriers constraining their access to effective health services, both to increase trust in and responsiveness of the health system.
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DOI：
10.1186/s12905-021-01506-y
发表时间：
2021-10-16
期刊：
BMC women's health
影响因子：
--
作者：
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影响因子：
3.6
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DOI：
10.3390/ijerph19042239
发表时间：
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影响因子：
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作者：
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通讯作者：
Howard N