Factors influencing the National School Health Policy implementation in Lao PDR: a multi-level case study
Factors influencing the National School Health Policy implementation in Lao PDR: a multi-level case study
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DOI：
10.1093/heapro/dau016
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发表时间：
2015-12-01
影响因子：
2.7
通讯作者：
Jimba, Masamine
中科院分区：
文献类型：
--
作者：
Saito, Junko;Ngouay Keosada;Jimba, Masamine
在过去的十年中，根据全球学校健康倡议的建议，一些发展中国家制定了一项国家学校健康政策。然而，全国各地的NSHP实施还没有完全共享。这项研究旨在找出影响老挝人民民主共和国(老挝人民民主共和国)执行国家卫生规划的因素。我们对20名NSHP实施者进行了关键线人访谈和文件审查。数据是在国家一级和三个地区(北部、中部和南部)的三个较低行政级别(省、区和学校)收集的。根据NSHP干预的历史选择研究地区。我们应用了内容分析，使用了成功实施政策的12个关键组成部分和政策三角框架。我们发现，扩大到全国范围内的实施是有限的。结果表明，老挝国家卫生计划的实施受到九个相互关联的因素的影响，包括广泛的规划、资源管理、监测周期、国家和下级行政官员之间的认知差距、国家工作队的所有权、地区教育官员的持续培训、学校校长的管理技能、学校卫生的优先事项和权力下放。此外，这九个因素可以整合到现有的教育制度中。最后，为了在老挝人民民主共和国可持续地在全国范围内实施国家小岛屿发展中国家方案，需要在教育系统中纳入以下三个因素：国家一级具有明确长期远景的广泛规划；人力资源管理，包括在每个行政级别组织良好的培训；以及了解学校一级真实情况的监测周期。
In the last decade, a National School Health Policy (NSHP) has been formulated in several developing countries following the recommendations of the Global School Health Initiative. However, NSHP implementations across the country have not been fully shared. This study aimed to identify factors that have influenced implementation of the NSHP in Lao People's Democratic Republic (Lao PDR). We conducted key informant interviews with 20 NSHP implementers and document reviews. Data were collected at the national level and at three lower administrative levels (provincial, district and school) in three areas (north, central and south). Study areas were selected according to the history of NSHP interventions. We applied content analysis using 12 key components of successful policy implementation and a policy triangle framework. We found that scaling up to nationwide implementation was limited. Results showed the NSHP implementation in Lao PDR was influenced by nine interlinked factors, including extensive planning, resource management, monitoring cycle, the perception gap between national and lower administrative officers, national task-force ownership, ongoing coaching of district educational officers, management skills of school principals, priority of school health and decentralization. Furthermore, these nine factors could be integrated into the existing educational system. In conclusion, for sustainable and nationwide implementation of the NSHP in Lao PDR, the following three factors need to be embedded in the educational system: extensive planning with a clear long-term vision at national level, human resource management including well-organized training at each administrative level and a monitoring cycle to understand the real situation at school level.