Private money-making indulgence and inefficiency of primary healthcare in Nigeria: a qualitative study of health workers' absenteeism
Private money-making indulgence and inefficiency of primary healthcare in Nigeria: a qualitative study of health workers' absenteeism
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DOI：
10.1007/s00038-020-01405-3
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发表时间：
2020-08-25
影响因子：
4.6
通讯作者：
Onwujekwe, Obinna
中科院分区：
文献类型：
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作者：
Agwu, Prince;Ogbozor, Pamela;Onwujekwe, Obinna
目标在尼日利亚的初级卫生保健(PHC)劳动力中，创造额外的个人收入是常见的，这可能是因为他们的月薪不一致。因此，这项研究调查了公共部门公共卫生服务提供者的私营经济活动的驱动因素，以及与旷工和尼日利亚公共卫生服务设施效率低下的联系。方法采用定性研究设计，采用深度访谈的方法，收集30名关键知情人的资料。他们是从尼日利亚东南部埃努古州三个地方政府地区的5个PHC设施中挑选出来的。对数据进行了主题分析，并以现象学为指导。结果调查结果显示，大多数医务人员参与了不同的私人赚钱活动。一个主要的驱动因素是工资的不一致，这使得他们很难经常满足他们的个人和家庭需求。结果，发现PHC设施的功能较差。结论：如果努力弥合导致卫生工作者非正式斗争的合理差距，PHC提供者的缺勤问题可以得到解决。这种经验教训可对低收入和中等收入国家加强其卫生系统具有指导意义。
Objectives Generating additional personal income is common with primary healthcare (PHC) workforce in Nigeria, which could be because of the inconsistencies marring their monthly salaries. Therefore, this study investigates the drivers of private economic activities of PHC providers in the public sector, and the links to absenteeism, as well as inefficiency of PHC facilities in Nigeria. Methods A qualitative study design was used to collect data from 30 key-informants using in-depth interviews. They were selected from 5 PHC facilities across three local government areas in Enugu state, south-eastern Nigeria. Data were analysed thematically, and guided by phenomenology. Results Findings showed that majority of the health workers were involved in different private money-making activities. A main driver was inconsistencies in salaries, which makes it difficult for them to routinely meet their personal and household needs. As a result, PHC facilities were found less functional. Conclusions Absenteeism of PHC providers can be addressed if efforts are made to close justifiable gaps that cause health workers to struggle informally. Such lesson can be instructive to low- and middle-income countries in strengthening their health systems.