Muula Adamson S
Department of Community Health, University of Malawi College of Medicine, Malawi.
Afr J Health Sci. 2006 Jan-Jun;13(1-2):124-30. doi: 10.4314/ajhs.v13i1.30826.
The quality and quantity of health care services delivered by the Malawi public health system is severely limited, due to, among other things the shortage of adequate numbers of trained health care workers. In order to suggest policy changes and implement corrective measures, there may be need to describe the perceptions of the legislature on how they perceive as the cause of the problem, which could be the solutions and an evaluation of those solution. In this paper, I present the finding from a qualitative study of Hansards (official verbatim record of parliamentary speeches) analysed by discourse analysis. Parliamentarians identified the shortage of health workers as resulting from death, retirement and brain drain to other countries mostly the UK, Saudi Arabia and South Africa. Training more health workers, training new but lower cadres of health workers not marketable to the outside world, improving the working conditions and remuneration of health workers are suggested as some of the solutions. Even without the brain drain of health workers to other countries, Malawi's health sector personnel numbers are not adequate to serve the needs of the country. Relying on training more health workers in the numbers normally produced from the prevailing training institutions is unlikely to remove the shortages.
由于训练有素的医护人员数量不足等原因,马拉维公共卫生系统提供的医疗服务质量和数量受到严重限制。为了提出政策变革并实施纠正措施,可能需要描述立法机构对他们所认为的问题根源的看法,这些看法可能成为解决方案以及对这些解决方案的评估。在本文中,我展示了一项对议会议事录(议会演讲的官方逐字记录)进行话语分析的定性研究结果。议员们认为卫生工作者短缺是由死亡、退休以及流向其他国家(主要是英国、沙特阿拉伯和南非)的人才外流造成的。建议的一些解决方案包括培训更多卫生工作者、培训新的但对外界缺乏吸引力的低级别卫生工作者、改善卫生工作者的工作条件和薪酬。即使没有卫生工作者流向其他国家,马拉维卫生部门的人员数量也不足以满足该国的需求。依靠现有的培训机构按常规数量培养更多卫生工作者不太可能消除短缺。