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社会问责制监测对医疗机构绩效的影响:来自坦桑尼亚的证据。

Impact of social accountability monitoring on health facility performance: Evidence from Tanzania.

机构信息

Health Organization, Policy and Economics (HOPE) Group, Centre for Primary Care and Health Services Research, School of Health Sciences, University of Manchester, Manchester, UK.

Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.

出版信息

Health Econ. 2021 Apr;30(4):766-785. doi: 10.1002/hec.4219. Epub 2021 Jan 17.

Abstract

Social accountability programs are increasingly used to improve the performance of public service providers in low-income settings. Despite their growing popularity, evidence on the effectiveness of social accountability programs remains mixed. In this manuscript, we assess the impact of a social accountability intervention on health facility management exploring quasiexperimental variation in program exposure in Tanzania. We find that the social accountability intervention resulted in a 1.8 SD reduction in drug stockouts relative to the control group, but did not improve facility infrastructure maintenance. The results of this study suggest that social accountability programs may be effective in areas of health service provision that are responsive to changes in provider behavior but may not work in settings where improvements in outcomes are conditional on larger health systems features.

摘要

社会问责制项目越来越多地被用于提高低收入环境中公共服务提供者的绩效。尽管它们越来越受欢迎,但关于社会问责制项目有效性的证据仍然存在分歧。在本文中,我们评估了坦桑尼亚一项社会问责制干预措施对卫生机构管理的影响,探讨了该项目暴露的准实验性变化。我们发现,与对照组相比,社会问责制干预使药品缺货减少了 1.8 个标准差,但并没有改善设施基础设施的维护。这项研究的结果表明,社会问责制项目在对提供者行为变化做出反应的卫生服务提供领域可能是有效的,但在需要改善卫生系统特征才能取得成果的环境中可能无效。

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