Kiwanuka Suzanne N, Rutebemberwa Elizeus, Nalwadda Christine, Okui Olico, Ssengooba Freddie, Kinengyere Alison A, Pariyo George W
Health Policy Planning and Management, Makerere University School of Public Health, New Mulago Complex, School of Public Health Building, Kampala, Uganda, P.O.Box 7072.
Cochrane Database Syst Rev. 2011 Jul 6;2011(7):CD008405. doi: 10.1002/14651858.CD008405.pub2.
Dual practice, whereby health workers hold two or more jobs, is a common phenomenon globally. In resource constrained low- and middle-income countries dual practice poses an ongoing threat to the efficiency, quality and equity of health services, especially in the public sector. Identifying effective interventions to manage dual practice is important.
To assess the effects of regulations implemented to manage dual practice.
Databases searched included: The Cochrane Central Register of Controlled Trials (CENTRAL) 2011, Issue 4, part of The Cochrane Library. www.thecochranelibrary.com, including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register (searched 26 May 2011); MEDLINE In-Process & Other Non-Indexed Citations May 24, 2011 (searched 26 May 2011); MEDLINE, Ovid (1948 to May week 2 2011) (searched 26 May 2011); EMBASE, Ovid (1980 to 2011 week 20) (searched 26 May 2011); Science Citation Index and Social Sciences Citation Index, ISI Web of Science (1975 to present) (searched 04 December 2009); LILACS (searched January 2010); and AIM (December 2009) (searched 18 December 2009).
Randomized controlled trials, non-randomized controlled trials, controlled before-and-after studies and interrupted-time-series studies. Dual practice was defined as holding more than one job. Studies for inclusion were those focusing on interventions to manage dual practice among health professionals employed in the public health sector.
Two review authors independently applied the criteria for inclusion and exclusion of studies when scanning the identified titles and abstracts. The same two review authors independently screened full reports of selected citations. At each stage, results were compared and discrepancies settled through discussion.
No studies were found which were eligible for inclusion in this review.
AUTHORS' CONCLUSIONS: There is a need to rigorously evaluate the effects of interventions implemented to manage dual practice among health workers. However, there is still much that is unknown about dual practice itself. The designing of studies to evaluate the effects of interventions to manage dual practice could benefit from prior studies to assess the various manifestations of dual practice, their prevalence and their likely impacts on health services delivery. These findings would then inform the design of studies to evaluate interventions to manage dual practice.
卫生工作者从事两份或更多工作的双重执业现象在全球普遍存在。在资源有限的低收入和中等收入国家，双重执业对卫生服务的效率、质量和公平性持续构成威胁，尤其是在公共部门。确定管理双重执业的有效干预措施非常重要。
评估为管理双重执业而实施的法规的效果。
检索的数据库包括：《 Cochr ane系统评价数据库》2011年第4期，Cochrane图书馆的一部分。www.thecochranelibrary.com，包括Cochrane有效实践与护理组织（EPOC）小组专业注册库（2011年5月26日检索）；MEDLINE在研及其他未索引引文，2011年5月24日（2011年5月26日检索）；MEDLINE，Ovid（1948年至2011年第2周）（2011年5月26日检索）；EMBASE，Ovid（1980年至2011年第20周）（2011年5月26日检索）；科学引文索引和社会科学引文索引，ISI Web of Science（1975年至今）（2009年12月4日检索）；LILACS（2010年1月检索）；以及AIM（2009年12月）（2009年12月18日检索）。
随机对照试验、非随机对照试验、前后对照研究和中断时间序列研究。双重执业定义为从事一份以上工作。纳入的研究是那些关注公共卫生部门聘用的卫生专业人员双重执业管理干预措施的研究。
两位综述作者在浏览已识别的标题和摘要时，独立应用研究纳入和排除标准。同样的两位综述作者独立筛选所选引文的全文报告。在每个阶段，比较结果并通过讨论解决分歧。
未发现符合本综述纳入标准的研究。
有必要严格评估为管理卫生工作者双重执业而实施的干预措施的效果。然而，关于双重执业本身仍有许多未知之处。设计评估管理双重执业干预措施效果的研究，可受益于先前评估双重执业各种表现形式、其普遍性及其对卫生服务提供可能影响的研究。这些研究结果将为评估管理双重执业干预措施的研究设计提供参考。
