Abimbola Seye, Olanipekun Titilope, Schaaf Marta, Negin Joel, Jan Stephen, Martiniuk Alexandra L C
School of Public Health, University of Sydney, New South Wales, Australia.
National Primary Health Care Development Agency, Abuja, Federal Capital Territory, Nigeria.
Int J Health Plann Manage. 2017 Oct;32(4):492-508. doi: 10.1002/hpm.2356. Epub 2016 May 4.
The posting and transfer of health workers and managers receives little policy and research attention in global health. In Nigeria, there is no national policy on posting and transfer in the health sector. We sought to examine how the posting and transfer of frontline primary health care (PHC) workers is conducted in four states (Lagos, Benue, Nasarawa and Kaduna) across Nigeria, where public sector PHC facilities are usually the only form of formal health care service providers available in many communities. We conducted in-depth interviews with PHC workers and managers, and group discussions with community health committee members. The results revealed three mechanisms by which PHC managers conduct posting and transfer: (1) periodically moving PHC workers around as a routine exercise aimed at enhancing their professional experience and preventing them from being corrupted; (2) as a tool for improving health service delivery by assigning high-performing PHC workers to PHC facilities perceived to be in need, or posting PHC workers nearer their place of residence; and (3) as a response to requests for punishment or favour from PHC workers, political office holders, global health agencies and community health committees. Given that posting and transfer is conducted by discretion, with multiple influences and sometimes competing interests, we identified practices that may lead to unfair treatment and inequities in the distribution of PHC workers. The posting and transfer of PHC workers therefore requires policy measures to codify what is right about existing informal practices and to avert their negative potential. © 2016 The Authors The International Journal of Health Planning and Management Published by John Wiley & Sons Ltd.
卫生工作者和管理人员的调配在全球卫生领域很少受到政策和研究关注。在尼日利亚，卫生部门没有关于调配的国家政策。我们试图研究尼日利亚四个州（拉各斯、贝努埃、纳萨拉瓦和卡杜纳）一线初级卫生保健（PHC）工作者的调配是如何进行的，在这些州，公共部门的初级卫生保健设施通常是许多社区唯一可用的正规卫生保健服务提供者形式。我们对初级卫生保健工作者和管理人员进行了深入访谈，并与社区卫生委员会成员进行了小组讨论。结果揭示了初级卫生保健管理人员进行调配的三种机制：（1）定期调动初级卫生保健工作者，作为一项常规工作，旨在增强他们的专业经验并防止他们腐败；（2）作为改善卫生服务提供的一种工具，将表现出色的初级卫生保健工作者分配到被认为有需求的初级卫生保健设施，或者将初级卫生保健工作者调配到离他们居住地更近的地方；（3）作为对初级卫生保健工作者、政治官员、全球卫生机构和社区卫生委员会提出的惩罚或偏袒请求的回应。鉴于调配是由人酌情决定的，受到多种影响且有时存在相互竞争的利益，我们确定了可能导致初级卫生保健工作者分配中不公平待遇和不平等的做法。因此，初级卫生保健工作者的调配需要政策措施来规范现有非正式做法中的合理之处，并避免其负面潜力。© 2016作者 国际卫生规划与管理杂志 由约翰·威利父子有限公司出版
