National Institute for Medical Research, Mwanza Centre, Tanzania.
Institute for Health Care Management and Research, University of Duisburg-Essen, Essen, Germany.
PLoS One. 2018 Sep 7;13(9):e0203588. doi: 10.1371/journal.pone.0203588. eCollection 2018.
To explore the operational feasibility of using mobile health clinics to reach the chronically underserved population with maternal and child health (MCH) services in Tanzania.
We conducted fifteen key informant interviews (KIIs) with policy makers and district health officials to explore issues related to mobile health clinic implementation and their perceived impact.
Policy makers' perspective indicates that mobile health clinics have improved coverage of essential maternal and child health interventions; however, they face financial, human resource-related and logistic constraints. Reported are the increased engagement of the community and awareness of the importance of MCH services, which is believed to have a positive effect on uptake of services. Key informants (KIs)' perceptions and opinions were generally in favour of the mobile clinics, with few cautioning on their potential to provide care in a manner that promotes a continuum of care. Immunization, antenatal care, postnatal care and growth monitoring all seem to be successfully implemented in this mode of service delivery. Nevertheless, all informants perceive mobile clinics as a resource intensive yet unavoidable mode of service delivery given the current situation of having women and children residing in remote settings.
While the government shows the clear motive, the need and the willingness to continue providing services in this mode, the plan to sustain them is still a puzzle. We argue that the continuing need for these services should go hand in hand with proper planning and resource mobilization to ensure that they are being implemented holistically and to promote the provision of quality services and continuity of care. Plans to evaluate their costs and effectiveness are crucial, and that will require the collection of relevant health information including outcome data to allow sound evaluations to take place.
探索在坦桑尼亚使用移动医疗诊所为母婴健康(MCH)服务中长期服务不足的人群提供服务的运营可行性。
我们对政策制定者和地区卫生官员进行了 15 次关键知情人访谈(KII),以探讨与移动医疗诊所实施相关的问题及其预期影响。
政策制定者的观点表明,移动医疗诊所提高了基本母婴健康干预措施的覆盖率;然而,它们面临着财务、人力资源相关和后勤方面的限制。报告显示,社区参与度提高,对 MCH 服务的重要性的认识提高,这被认为对服务的接受度有积极影响。知情人(KIs)的看法和意见普遍赞成移动诊所,少数人对其提供促进连续护理的服务的潜力持谨慎态度。免疫、产前护理、产后护理和生长监测似乎都以这种服务提供模式成功实施。尽管如此,所有知情人都认为,鉴于妇女和儿童居住在偏远地区的现状,移动诊所是一种资源密集型但不可避免的服务提供模式。
虽然政府表现出明确的动机、需求和继续以这种模式提供服务的意愿,但维持这些服务的计划仍然是一个谜。我们认为,继续需要这些服务应与适当的规划和资源调动齐头并进,以确保全面实施,并促进提供优质服务和护理的连续性。评估其成本和效果的计划至关重要,这将需要收集相关的健康信息,包括结果数据,以便进行合理的评估。