Gurung Gagan, Derrett Sarah, Hill Philip C, Gauld Robin
Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Int J Health Plann Manage. 2016 Apr;31(2):167-74. doi: 10.1002/hpm.2290. Epub 2015 Mar 30.
Nepal has seen impressive recent health gains through a successful community-based health program. However, governance challenges remain within the Nepalese primary health care system that include under-staffing and absenteeism, limited health facility opening hours, poor supervision and monitoring, and insufficient financial management. We propose that these be addressed through expanded community engagement and a power shift towards local communities, enhancing skills of community representatives in co-managing health facilities and of service providers to effectively engage the community, increased quality of community participation, and improved documentation of the process and impact of engagement on health outcomes. Copyright © 2015 John Wiley & Sons, Ltd.
通过一项成功的社区卫生项目，尼泊尔近期在健康方面取得了令人瞩目的进展。然而，尼泊尔初级卫生保健系统仍面临治理挑战，包括人员配备不足和旷工、卫生设施开放时间有限、监督和监测不力以及财务管理不善。我们建议通过扩大社区参与和权力向当地社区转移来解决这些问题，提高社区代表共同管理卫生设施的技能以及服务提供者有效与社区互动的技能，提高社区参与的质量，并改进对参与过程及其对健康结果影响的记录。版权所有© 2015约翰·威利父子有限公司。
