Feasibility of health systems strengthening in South Sudan: a qualitative study of international practitioner perspectives
Feasibility of health systems strengthening in South Sudan: a qualitative study of international practitioner perspectives
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DOI：
10.1136/bmjopen-2015-009296
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发表时间：
2015-01-01
期刊：
影响因子：
2.9
通讯作者：
Legido-Quigley, Helena
中科院分区：
文献类型：
--
作者：
Jones, Abigail;Howard, Natasha;Legido-Quigley, Helena
目的探讨从国际卫生保健实施者和捐助者的角度加强南苏丹卫生系统的可行性。设计一项定性访谈研究，使用世界卫生组织卫生系统构建模块框架进行主题分析。设置南苏丹。参与者17名卫生系统从业人员，在南苏丹为国际机构工作，有目的地抽样调查他们在加强卫生系统、提供服务、结果参与者普遍报告卫生人力不足，能力和服务提供水平低由于政府在采购和供应方面缺乏承诺，获得药品的机会受到限制。然而，在改善县卫生部门的治理，健康管理信息系统的功能，增加卫生工作者的工资协调和加强财务管理，取得了明显的进展。结论冲突和政治紧张局势的复苏产生了负面影响的所有卫生系统的组成部分，保持或继续加强卫生系统已成为极具挑战性的。需要采取协调一致的办法，平衡人道主义需求，特别是受冲突影响地区的人道主义需求和长期发展，以免失去已取得的进展。
Objective To explore the feasibility of health systems strengthening from the perspective of international healthcare implementers and donors in South Sudan.Design A qualitative interview study, with thematic analysis using the WHO health system building blocks framework.Setting South Sudan.Participants 17 health system practitioners, working for international agencies in South Sudan, were purposively sampled for their knowledge and experiences of health systems strengthening, services delivery, health policy and politics in South Sudan.Results Participants universally reported the health workforce as insufficient and of low capacity and service delivery as poor, while access to medicines was restricted by governmental lack of commitment in undertaking procurement and supply. However, progress was clear in improved county health department governance, health management information system functionality, increased health worker salary harmonisation and strengthened financial management.Conclusions Resurgent conflict and political tensions have negatively impacted all health system components and maintaining or continuing health system strengthening has become extremely challenging. A coordinated approach to balancing humanitarian need particularly in conflict-affected areas, with longer term development is required so as not to lose improvements gained.