乌干达卫生服务去中心化后卫生人力绩效的描述性研究。
A descriptive study on health workforce performance after decentralisation of health services in Uganda.
机构信息
Department of Health Studies, PO Box 392, Pretoria, Unisa 0003, South Africa.
出版信息
Hum Resour Health. 2012 Nov 7;10:41. doi: 10.1186/1478-4491-10-41.
BACKGROUND
Uganda, like many developing countries, is committed to achieving the Millennium Development Goals (MDGs) by 2015. However, serious challenges prove to hamper the attainment of these goals, particularly the health related MDGs. A major challenge relates to the human resources for health. The health system in Uganda was decentralised in the 1990s. Despite the health sector reforms, the services have remained significantly deficient and performance of health workers is thought to be one of the contributing factors. The purpose of this study was, therefore, to investigate the performance of health workers after decentralisation of the health services in Uganda in order to identify and suggest possible areas for improvement.
METHODS
A cross-sectional descriptive survey, using quantitative research methods was utilised. A structured self-administered questionnaire was used to collect quantitative data from 276 health workers in the districts of Kumi, Mbale, Sironko and Tororo in Eastern Uganda. The health workers included doctors, clinical officers, professional nurses and midwives. The sample was selected using stratified random sampling. The data was analysed using SPSS version 18.0 and included both univariate and bivariate analysis. The results were presented in tabular and text forms.
RESULTS
The study revealed that even though the health workers are generally responsive to the needs of their clients, the services they provide are often not timely. The health workers take initiatives to ensure that they are available for work, although low staffing levels undermine these efforts. While the study shows that the health workers are productive, over half (50.4%) of them reported that their organisations do not have indicators to measure their individual performance. The findings indicate that the health workers are skilled and competent to perform their duties. In general, the results show that health workers are proficient, adaptive, proactive and client-oriented.
CONCLUSION
Although Uganda is faced with a number of challenges as regards human resources for health, the findings show that the health workers that are currently working in the health facilities are enthusiastic to perform. This may serve as a motivator for the health workers to improve their performance and that of the health sector.
背景
乌干达与许多发展中国家一样，致力于在 2015 年之前实现千年发展目标（MDGs）。然而，严峻的挑战证明阻碍了这些目标的实现，尤其是与卫生相关的千年发展目标。一个主要的挑战与卫生人力资源有关。乌干达的卫生系统在 1990 年代实现了权力下放。尽管进行了卫生部门改革，但服务仍然存在严重不足，卫生工作者的绩效被认为是促成因素之一。因此，本研究旨在调查乌干达卫生服务权力下放后卫生工作者的绩效，以确定并提出可能的改进领域。
方法
本研究采用横断面描述性调查，使用定量研究方法。采用结构化的自我管理问卷，从乌干达东部的库米、姆巴莱、锡龙科和托罗罗地区收集了 276 名卫生工作者的定量数据。卫生工作者包括医生、临床医生、专业护士和助产士。采用分层随机抽样选择样本。使用 SPSS 版本 18.0 对数据进行分析，包括单变量和双变量分析。结果以表格和文字形式呈现。
结果
研究表明，尽管卫生工作者普遍对客户的需求做出反应，但他们提供的服务往往不够及时。卫生工作者主动确保自己能够工作，尽管人员配备水平低会破坏这些努力。尽管研究表明卫生工作者具有生产力，但超过一半（50.4%）的人报告说他们的组织没有指标来衡量他们的个人绩效。调查结果表明，卫生工作者具备履行职责的技能和能力。总的来说，结果表明卫生工作者熟练、适应能力强、积极主动且以客户为中心。
结论
尽管乌干达在卫生人力资源方面面临着许多挑战，但调查结果表明，目前在卫生设施工作的卫生工作者热情很高，愿意履行职责。这可能会激励卫生工作者提高绩效和卫生部门的绩效。
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