Strengthening health system promotion of maternal and child health through medical travel

这笔12个月的赠款重点是加强卫生系统，通过医疗旅行促进妇幼健康。它集中在南非以及从邻国前往南非接受治疗的患者对常住人口的影响。这是开普敦大学和伦敦卫生与热带医学院的合作项目。主要目标是确定如何评估和影响医疗旅行对南非保健系统和妇幼保健的影响。有三个相互关联的具体目标：1)了解入境医疗旅行如何影响南非居民的孕产妇和儿童健康；2)确定和分析南非与邻国之间管理和影响病人旅行的现行协定；3)建立和审查国家和国家以下各级可用于监测医疗旅行对妇幼保健系统影响的指标和数据。研究采用了定量和定性相结合的方法。为了评估对南非居民妇幼保健的影响，它检查了卫生机构有大量医疗旅行者进入的地区的卫生工作者、患者和其他行为者的指标和经验，并将这些指标和没有进入的地区和设施进行比较。这些人将通过最初的关键线人面谈来确定。面谈将在接待大量医疗旅行者的五个社区/设施和没有接待的五个社区/设施进行。量化工作将评估可公开获取的妇幼保健和保健系统准入核心指标的有用性。研究将包括分析南非与邻国之间关于医疗旅行的协定，以确定关于这种治理安排如何能够最好地支持卫生系统促进妇幼保健的政策建议。这些发现，包括对方法的反思，将为与印度和泰国的研究人员进行更大规模的比较研究提供参考。

This 12 month grant focuses on strengthening health system promotion of maternal and child health through medical travel. It concentrates on South Africa and the effect on resident population of patients traveling to South Africa for treatment from neighbouring countries. It is a collaboration between the University of Cape Town and the London School of Hygiene and Tropical Medicine. The main objective is to identify how to assess and influence the effect of medical travel on the health system and maternal and child health in South Africa. There are three linked specific objectives.1) To understand how inbound medical travel affects the maternal and child health of the resident South African population.2) To identify and analyse current agreements between South Africa and neighbouring countries which govern and affect patients traveling.3) To establish and review what kind of indicators and data are available at national and sub-national level to monitor health systems impact of medical travel on MCH. Research employs quantitative and qualitative methods. To assess effects on resident South African MCH, it examines indicators and experiences of health workers, patients and other actors in areas where health facilities are seeing a large number of medical travellers coming in and compare these with areas and facilities who do not. These will be identified through initial key informant interviews. Interviews will be in five communities/facilities where large numbers of medical travellers are received and five where there are not. Quantitative work will evaluate usefulness of core indicators for MCH and health systems access which are publicly accessible. Research will include the analysis of agreements governing medical travel between South Africa and neighbouring countries to identify policy recommendations on how such governance arrangements can best support health systems' promotion of maternal and child health. Findings, including reflection on methods, will inform a larger comparative research proposal with researchers in India and Thailand.