南非农村初级卫生保健机构精神科医生的情况分析。
A situation analysis of psychiatrists in South Africa's rural primary healthcare settings.
作者信息
De Kock Johannes H, Pillay Basil J
机构信息
Department of Behavioural Medicine, University of KwaZulu-Natal.
出版信息
Afr J Prim Health Care Fam Med. 2017 May 29;9(1):e1-e6. doi: 10.4102/phcfm.v9i1.1335.
BACKGROUND
South Africa (SA) has been facing serious challenges in providing human resources for the delivery of essential mental health (MH) services. The majority of its prescribing MH specialists, psychiatrists, practise in private, urban and peri-urban areas. The findings of a situation analysis audit of psychiatrist human resources in the public rural primary healthcare (PRPHC) sector are presented in this paper.
METHOD
This audit was based on both primary and secondary data. The primary data were obtained from key informant interviews with the clinical heads of 160 PRPHC facilities, while the secondary data comprised a literature review.
RESULTS
The results indicate that psychiatrists are severely underrepresented, employed at a rate of 0.03 per 100 000 population in SA's PRPHC settings.
CONCLUSIONS
Because of a lack of MH nurses and medical officers dedicated to MH in PRPHC facilities, recommendations are made that the current task shifting strategy be revisited to include more cadres of MH professionals with specialised psychopharmacological training, as non-medical prescribers at PRPHC level. It is advised that visiting psychiatrists and family physicians be involved in the construction of training and supervision programmes for non-medical prescribers at the primary healthcare level.
背景
南非在提供基本心理健康服务的人力资源方面一直面临严峻挑战。其大多数开具处方的心理健康专家，即精神科医生，在城市和城郊的私立机构执业。本文介绍了对公共农村初级医疗保健部门精神科医生人力资源的现状分析审计结果。
方法
本次审计基于一手和二手数据。一手数据来自对160个农村初级医疗保健机构临床负责人的关键信息人访谈，二手数据包括文献综述。
结果
结果表明，在南非农村初级医疗保健机构中，精神科医生的比例严重不足，每10万人口中的聘用率为0.03。
结论
由于农村初级医疗保健机构缺乏专门从事心理健康工作的护士和医务人员，建议重新审视当前的任务转移策略，将更多经过专门精神药理学培训的心理健康专业人员纳入其中，作为农村初级医疗保健层面的非医学处方者。建议邀请来访的精神科医生和家庭医生参与为初级医疗保健层面的非医学处方者制定培训和监督计划。
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