Strengthening the health system for a people-centred community orientation in South Africa. A formative study.

加强南非的卫生系统，以实现以人为本的社区导向。

• 批准号: MR/V015044/1
• 负责人: Inge Petersen
• 金额: $ 25.79万
• 依托单位: University of KwaZulu-Natal
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FV015044%2F1
• 关键词: Strengthening; health; system; people; centred

Health systems in sub-Saharan Africa are typically fragile, reactive and organized around responding to specific diseases. This makes them ill-equipped to deal with multiple co-existing conditions such as tuberculosis, HIV and non-communicable diseases as well as emerging health shocks, such as COVID-19. The need to build resilient and responsive quality health systems is paramount. To this end, people-centred oriented systems which focus on health promotion and prevention interventions and empowering people to take responsibility for their health and that of their communities have been identified as the way forward for sub-Saharan Africa. This need is amplified in the context of COVID-19 which requires people to change their behavior to prevent the spread of the virus. This requires strengthening of the community sub-system (historically a neglected component of the health system) including households, civic groups, community structures and other sectors to play an active rather than passive role in the health care system. While the SA Dept of Health has engaged in policy reforms to strengthen the system to have a more people-centred community orientation, there are gaps in knowledge about how best to practically achieve these reforms. To narrow this gap, the applicants have partnered with the KwaZulu-Natal (KZN) provincial Department of Health (DoH), to investigate how best to implement these reforms. To this end, we will conduct a formative investigation of the barriers, needs and opportunities for strengthening of the pillars of the health system to be enabling of a people-centred community orientation. This information will be used to inform the co-development (with the KZN DoH and other sectors) of conceptual models of how the pillars of the health system could be strengthened to be more enabling of a people-centred community orientation. Testing and refining of these conceptual models will form the basis of a full stage proposal.

撒哈拉以南非洲的卫生系统通常很脆弱，被动反应，围绕应对具体疾病而组织。这使得他们没有能力应对结核病、艾滋病毒和非传染性疾病等多种并存的疾病以及新出现的健康冲击，如COVID-19。必须建立有复原力和反应迅速的高质量卫生系统，这一点至关重要。为此目的，撒哈拉以南非洲的前进方向是建立以人为本的系统，重点是促进健康和预防干预措施，使人们能够对自己及其社区的健康负责。在COVID-19的背景下，这种需求被放大，这要求人们改变他们的行为以防止病毒的传播。这就需要加强社区次级系统（历来是保健系统中被忽视的组成部分），包括家庭、民间团体、社区结构和其他部门，使其在保健系统中发挥积极而不是消极的作用。虽然南澳大利亚州卫生部进行了政策改革，以加强该系统，使其更具以人为本的社区导向，但在如何最好地切实实现这些改革方面存在知识差距。为了缩小这一差距，申请人与夸祖鲁-纳塔尔省卫生厅合作，调查如何最好地实施这些改革。为此，我们将对加强卫生系统支柱的障碍、需求和机会进行初步调查，以实现以人为本的社区方向。这些信息将用于（与KZN DoH和其他部门）共同制定概念模型，说明如何加强卫生系统的支柱，使其更有利于以人为本的社区方向。对这些概念模型的测试和改进将构成整个阶段提案的基础。

项目成果

Special series on the District Health System

地区卫生系统特别系列

• DOI: 10.7196/samj.2023.v113i11.1653
• 发表时间: 2023
• 期刊: South African Medical Journal
• 作者: Schneider H