De Costa Ayesha, Johansson Eva, Diwan Vinod K
Division of International Health, Karolinska Institutet, Stockholm, Sweden.
Qual Health Res. 2008 Jun;18(6):756-66. doi: 10.1177/1049732308318504.
India has one of the most highly privatized health care systems in the world. The dominant private health sector functions alongside a traditional tiered public health sector. There has been an overall lack of collaboration between the two sectors despite international policy recommendations and local initiatives. It has been postulated that "conflicting perceptions" might contribute to the uncooperative attitude between the two sectors. But there has been little empirical exploration of the existing perceptions that the private and public health sectors have of each other. We explored these perceptions among key stakeholders (who influence the direction of health policy) in the public and private health sectors in the province of Madhya Pradesh, India. The barriers of mistrust, which hinder true dialogue, are complex, and have social, moral, and economic bases. They can be best addressed by necessary structural change before any significant long-term partnership between the two sectors is possible.
印度拥有世界上私有化程度最高的医疗保健系统之一。占主导地位的私营医疗部门与传统的分级公共卫生部门并行运作。尽管有国际政策建议和地方举措，但这两个部门之间总体上缺乏合作。据推测，“相互冲突的认知”可能导致两个部门之间的不合作态度。但是，对于私营和公共卫生部门对彼此的现有认知，几乎没有实证研究。我们在印度中央邦的公共和私营卫生部门的关键利益相关者（他们影响卫生政策的方向）中探讨了这些认知。阻碍真正对话的不信任障碍很复杂，并且有社会、道德和经济基础。在两个部门之间建立任何重要的长期伙伴关系之前，通过必要的结构变革才能最好地解决这些障碍。
