Where there is no policy: governing the posting and transfer of primary health care workers in Nigeria
Where there is no policy: governing the posting and transfer of primary health care workers in Nigeria
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DOI：
10.1002/hpm.2356
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发表时间：
2017-10-01
影响因子：
2.7
通讯作者：
Martiniuk, Alexandra L. C.
中科院分区：
文献类型：
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作者：
Abimbola, Seye;Olanipekun, Titilope;Martiniuk, Alexandra L. C.
保健工作人员和管理人员的调派和调动在全球卫生方面很少得到政策和研究的关注。在尼日利亚，没有关于卫生部门职位分配和调动的国家政策。我们试图研究如何在尼日利亚的四个州（拉各斯、贝努埃、纳萨拉瓦和卡杜纳）部署和调动一线初级保健工作人员，在这些州，公共部门初级保健设施通常是许多社区唯一形式的正规保健服务提供者。我们对初级保健工作者和管理人员进行了深入访谈，并与社区卫生委员会成员进行了小组讨论。调查结果揭示了初级保健管理人员进行调派和调动的三种机制：（1）定期调动初级保健工作人员，作为一项例行工作，旨在提高他们的专业经验，防止他们被腐败;（2）作为一种改善保健服务提供的工具，将高绩效的初级保健工作人员分派到被认为有需要的初级保健设施，或将初级保健工作人员调派到离他们居住地较近的地方;（3）作为对初级保健工作者、政治官员、全球卫生机构和社区卫生委员会提出的惩罚或优待请求的回应。鉴于职位的调派和调动是由多方面的影响力和有时相互竞争的利益决定的，我们确定了可能导致初级保健工作人员分配方面的不公平待遇和不公平的做法。因此，初级保健工作人员的安置和调动需要采取政策措施，将现有非正式做法的正确之处编纂成法律，并避免其负面潜力。(c)2016年作者国际卫生规划与管理杂志由约翰威利父子有限公司出版
The posting and transfer of health workers and managers receives little policy and research attention in global health. In Nigeria, there is no national policy on posting and transfer in the health sector. We sought to examine how the posting and transfer of frontline primary health care (PHC) workers is conducted in four states (Lagos, Benue, Nasarawa and Kaduna) across Nigeria, where public sector PHC facilities are usually the only form of formal health care service providers available in many communities. We conducted in-depth interviews with PHC workers and managers, and group discussions with community health committee members. The results revealed three mechanisms by which PHC managers conduct posting and transfer: (1) periodically moving PHC workers around as a routine exercise aimed at enhancing their professional experience and preventing them from being corrupted; (2) as a tool for improving health service delivery by assigning high-performing PHC workers to PHC facilities perceived to be in need, or posting PHC workers nearer their place of residence; and (3) as a response to requests for punishment or favour from PHC workers, political office holders, global health agencies and community health committees. Given that posting and transfer is conducted by discretion, with multiple influences and sometimes competing interests, we identified practices that may lead to unfair treatment and inequities in the distribution of PHC workers. The posting and transfer of PHC workers therefore requires policy measures to codify what is right about existing informal practices and to avert their negative potential. (c) 2016 The Authors The International Journal of Health Planning and Management Published by John Wiley & Sons Ltd