Beja André, Moreira Van Hanegem Menezes, Biai Augusta, N'Dumbá Agostinho, Neves Clotilde, Ferrinho Paulo
Global Health and Tropical Medicine/Instituto de Higiene e Medicina Tropical. Universidade NOVA de Lisboa. Lisboa. Portugal.
Direção-Geral de Administração do Sistema de Saúde. Ministério da Saúde Pública. Bissau. Guiné-Bissau.
Acta Med Port. 2020 Feb 3;33(2):101-108. doi: 10.20344/amp.11178.
The weaknesses of Guinea-Bissau's health system have long been highlighted. The purpose of this study is to contribute with evidence for decision-making on the reform of the country's healthcare map, by analyzing the availability and readiness of services at the facilities that may become part of a Hospital Complex in Bissau, proposed in the National Health Development Plan.
We analyzed 13 public and private facilities with inpatient capacity, located in Bissau and Biombo. Service Availability and Readiness Assessment (SARA) tools were used for data collection, treatment and analysis.
A comprehensive overview of these facilities has been provided, describing their general capacity to provide care and their readiness to implement it, along with the availability and readiness of specific services: diagnosis, family planning, mother and child health, obstetrics, communicable and non communicable diseases, blood transfusion and surgery. We observed a greater concentration of beds and professionals in the facilities of public sector, the only that provides all the specific services analyzed. Private sector services with agreements to supply the public sector have higher readiness levels and the private sector has the lowest operating capacity.
Findings reflect the lack of equipment, infrastructure and resources, the predominance of the public sector and the growth of the private for-profit and non-profit sectors, as well as inadequacies in planning and regulation. Similarities and differences between our findings and those described in the literature for other African countries are identified.
This study reinforces the relevance of developing integrated and rational responses of health services and provides evidence for this.
几内亚比绍卫生系统的弱点长期以来一直受到关注。本研究的目的是通过分析可能成为比绍综合医院一部分的设施的服务可用性和准备情况,为该国医疗地图改革的决策提供证据,这一综合医院是《国家卫生发展计划》中提议的。
我们分析了位于比绍和比翁博的13家具备住院能力的公立和私立医疗机构。使用服务可用性和准备情况评估(SARA)工具进行数据收集、处理和分析。
对这些设施进行了全面概述,描述了它们提供护理的总体能力及其实施护理的准备情况,以及特定服务的可用性和准备情况:诊断、计划生育、母婴健康、产科、传染病和非传染病、输血和手术。我们观察到公共部门设施中床位和专业人员更为集中,只有公共部门设施提供了所有分析的特定服务。与公共部门签订供应协议的私营部门服务准备水平较高,而私营部门的运营能力最低。
研究结果反映出设备、基础设施和资源的匮乏、公共部门的主导地位以及私营营利性和非营利性部门的增长,以及规划和监管方面的不足。我们还确定了本研究结果与其他非洲国家文献中描述的结果之间的异同。
本研究强化了制定综合合理的卫生服务应对措施的相关性,并为此提供了证据。