'It puts life in us and we feel big': shifts in the local health care system during the introduction of rapid diagnostic tests for malaria into drug shops in Uganda.
'It puts life in us and we feel big': shifts in the local health care system during the introduction of rapid diagnostic tests for malaria into drug shops in Uganda.
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DOI：
10.1080/09581596.2014.886762
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发表时间：
2015-01-01
影响因子：
2.8
通讯作者：
Mbonye A
中科院分区：
文献类型：
--
作者：
Hutchinson E;Chandler C;Clarke S;Lal S;Magnussen P;Kayendeke M;Nabirye C;Kizito J;Mbonye A
本文分析了在乌干达穆科诺地区私营药店引入疟疾快速诊断测试的医学试验中，毒贩、他们的客户和当地卫生保健工作者之间的社会互动。它针对当地对治疗选择和评估的关切以及地方卫生保健系统内社会合法化的地位、作用和等级，确定了采用一种新的血液检测技术和转诊制度。基于对21个焦点小组讨论的多层次解释，我们描述了这项试验的三个关键方面：公开验血、对药店的监督访问和新的转诊形式。每一家都有可能将药店供应商从正规医疗服务的局外人转变为局内人。不同参与者群体的答复反映了他们在保健系统内的情况。客户和患者欢迎当地提供新的诊断技术，以及政府明显参与确保他们从资质往往不确定的提供者那里获得高质量的医疗服务。药店商贩对公开验血的授权表示欢迎，这使得作为一名卫生工作者而不是简单的药贩，一种新的技能和新发现的合法性得以展示。正规部门的卫生工作者对这项试验的热情较低，这引发了人们对专业等级制度以及在正规卫生服务机构周围保持界限以确保将他们认为未经培训、不专业和不值得信任的人员排除在外的担忧。
This paper is an analysis of the social interaction between drug sellers, their clients and local health care workers within a medical trial that introduced rapid diagnostic tests for malaria into private sector drug shops in Mukono District, Uganda. It locates the introduction of a new technology to test blood and a system of referral within the context of local concerns about the choice and evaluation of treatment; and the socially legitimated statuses, roles and hierarchies within the local health care system. Based on the multi-layered interpretation of 21 focus group discussions, we describe three key aspects of the trial central to local interpretation: openly testing blood, supervisory visits to drug shops and a new referral form. Each had the potential to shift drug shop vendors from outsider to insider of the formal health service. The responses of the different groups of participants reflect their situation within the health care system. The clients and patients welcomed the local availability of new diagnostic technology and the apparent involvement of the government in securing good quality health services for them from providers with often uncertain credentials. The drug shop vendors welcomed the authorization to openly test blood, enabling the demonstration of a new skill and newfound legitimacy as a health worker rather than simple drug seller. Formal sector health workers were less enthusiastic about the trial, raising concerns about professional hierarchies and the maintenance of a boundary around the formal health service to ensure the exclusion of those they considered untrained, unprofessional and untrustworthy personnel.
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影响因子：
2.3
作者：
Mogensen, Hanne O
通讯作者：
Mogensen, Hanne O
影响因子：
3.7
作者：
Cohen J;Fink G;Berg K;Aber F;Jordan M;Maloney K;Dickens W
通讯作者：
Dickens W
影响因子：
5.4
作者：
Bloom, Gerald;Standing, Hilary;Lloyd, Robert
通讯作者：
Lloyd, Robert
影响因子：
5.4
作者：
Chandler, Clare I. R.;Hall-Clifford, Rachel;Asaph, Turinde;Pascal, Magnussen;Clarke, Sian;Mbonye, Anthony K.
通讯作者：
Mbonye, Anthony K.
影响因子：
1.7
作者：
WHYTE, SR
通讯作者：
WHYTE, SR