非政府组织与公共卫生服务机构之间的合作——来自厄瓜多尔农村地区的一项定性案例研究
Collaboration between non-governmental organizations and public services in health - a qualitative case study from rural Ecuador.
作者信息
Biermann Olivia, Eckhardt Martin, Carlfjord Siw, Falk Magnus, Forsberg Birger C
机构信息
Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden;
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
出版信息
Glob Health Action. 2016 Nov 15;9:32237. doi: 10.3402/gha.v9.32237. eCollection 2016.
BACKGROUND
Non-governmental organizations (NGOs) have a key role in improving health in low- and middle-income countries. Their work needs to be synergistic, complementary to public services, and rooted in community mobilization and collective action. The study explores how an NGO and its health services are perceived by the population that it serves, and how it can contribute to reducing barriers to care.
DESIGN
A qualitative exploratory study was conducted in remote Ecuador, characterized by its widespread poverty and lack of official governance. An international NGO collaborated closely with the public services to deliver preventative and curative health services. Data were collected using focus group discussions and semistructured interviews with purposively sampled community members, healthcare personnel, and community health workers based on their links to the health services. Conventional qualitative content analysis was used, focusing on manifest content.
RESULTS
Emerging themes relate to the public private partnership (PPP), the NGO and its services, and community participation. The population perceives the NGO positively, linking it to healthcare improvements. Their priority is to get services, irrespective of the provider's structure. The presence of an NGO in the operation may contribute to unrealistic expectations of health services, affecting perceptions of the latter negatively.
CONCLUSIONS
To avoid unrealistic expectations and dissatisfaction, and to increase and sustain the population's trust in the organization, an NGO should operate in a manner that is as integrated as possible within the existing structure. The NGO should work close to the population it serves, with services anchored in the community. PPP parties should develop a common platform with joint messages to the target population on the provider's structure, and regarding partners' roles and responsibilities. Interaction between the population and the providers on service content and their expectations is key to positive outcomes of PPP operations.
背景
非政府组织（NGO）在改善低收入和中等收入国家的健康状况方面发挥着关键作用。它们的工作需要具有协同性，与公共服务相辅相成，并扎根于社区动员和集体行动。本研究探讨了一个非政府组织及其卫生服务在其服务人群中的形象，以及它如何有助于减少就医障碍。
设计
在厄瓜多尔偏远地区进行了一项定性探索性研究，该地区普遍贫困且缺乏官方治理。一个国际非政府组织与公共服务部门密切合作，提供预防和治疗性卫生服务。通过焦点小组讨论和对有目的地抽样的社区成员、医护人员和社区卫生工作者进行半结构化访谈来收集数据，这些人员基于他们与卫生服务的联系进行抽样。采用传统的定性内容分析，重点关注显性内容。
结果
新出现的主题涉及公私伙伴关系（PPP）、非政府组织及其服务以及社区参与。人群对该非政府组织持积极看法，将其与医疗改善联系起来。他们的首要任务是获得服务，而不考虑提供者的结构。非政府组织参与运营可能会导致对卫生服务产生不切实际的期望，对后者的看法产生负面影响。
结论
为避免不切实际的期望和不满，并增强和维持人群对该组织的信任，非政府组织应以尽可能融入现有结构的方式运作。该非政府组织应贴近其服务的人群开展工作，服务扎根于社区。公私伙伴关系各方应建立一个共同平台，就提供者的结构以及合作伙伴的角色和责任向目标人群传达联合信息。人群与提供者就服务内容及其期望进行互动是公私伙伴关系运营取得积极成果的关键。
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