Huff-Rousselle M, Pickering H
Social Sectors Development Strategies, Inc., Boston, MA, USA.
Int J Health Plann Manage. 2001 Jan-Mar;16(1):33-46. doi: 10.1002/hpm.609.
Set within the context of recent literature on the private-public divide in the health sector of developing countries generally and Asia specifically, this study considers the major government and the major indigenous non-government clinics offering out-patient reproductive health services in Phnom Penh, Cambodia. Reproductive health is of critical importance in Cambodia, which has one of the highest levels of unmet need for family planning in the developing world and suffers from what is arguably the most severe STD and HIV/AIDS problem in Asia. The study is unusual in that it examines and compares aspects of service delivery and pricing along with the socio-economic profile and health-seeking behaviour of clients self-selecting services in the two settings. The socio-economic status of clients was much higher than the norm in Cambodia but did not differ significantly between the two clinics. A few service indicators suggested that the quality of care was better in the NGO clinic. Underlying variables--such as the broader mandate of the public sector institution and the significant discrepancy between public and private sector salaries--offer an obvious explanation for these differences. The Ministry of Health in Cambodia has been developing policies related to the NGO sector, which has expanded rapidly in Cambodia during the 1990s, and it is struggling to increase staff remuneration within the public sector.
本研究以近期关于发展中国家尤其是亚洲卫生部门公私划分的文献为背景，考察了柬埔寨金边提供门诊生殖健康服务的主要政府诊所和主要本土非政府诊所。生殖健康在柬埔寨至关重要，该国是发展中国家计划生育需求未得到满足程度最高的国家之一，且面临着亚洲最严重的性传播疾病和艾滋病毒/艾滋病问题。该研究的独特之处在于，它考察并比较了两种环境下的服务提供、定价方面，以及自行选择服务的客户的社会经济概况和就医行为。客户的社会经济地位远高于柬埔寨的平均水平，但两家诊所之间没有显著差异。一些服务指标表明，非政府诊所的护理质量更好。诸如公共部门机构的更广泛职责以及公共部门与私营部门薪资的显著差异等潜在变量，为这些差异提供了明显的解释。柬埔寨卫生部一直在制定与非政府部门相关的政策，该部门在20世纪90年代的柬埔寨迅速扩张，卫生部还在努力提高公共部门的员工薪酬。
