Department of Management, Canberra Business School, University of Canberra, Canberra, Australia.
Department of Gynaecology and Obstetrics, Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh.
Int J Health Plann Manage. 2021 May;36(S1):174-181. doi: 10.1002/hpm.3154. Epub 2021 Apr 5.
Healthcare workers, who are in low-resource settings, are critically vulnerable during the COVID-19 pandemic. The increasing rate of coronavirus infection in a developing country such as Bangladesh caused the highest death rate of doctors among frontline service providers and resulted in fear and anxiety among healthcare workers. Even with the preliminary measures of hospitals and clinics to protect healthcare workers, the growing casualties are alarming. This research uses case study approach to explore the issues doctors and nurses face in 'priority intervention areas' (PIA) in order to improve the health system quality. Qualitative in-depth semi-structured interviews were conducted from 12 May to 4 June 2020 among doctors and nurses from two different private hospitals in Dhaka city. Data were analysed using thematic content analysis. The two significant areas that required immediate attention were identified from the PIA framework as 'patient and staff safety, infection control' and 'cultural aspects and community engagement'. Each area of the PIA framework showed previously ignored issues in the current health system. The adaptation of the PIA framework helped identify critical health system issues. Possible corrective actions including proper planning and management of isolating the infected patients and provision of adequate personal protective equipment are recommended to management and policymakers to save the lives of healthcare workers and to minimise the spread of infection.
在 COVID-19 大流行期间，医疗工作者在资源匮乏的环境中处于极为脆弱的境地。在孟加拉国等发展中国家，冠状病毒感染率不断上升，导致一线服务提供者中医生的死亡率最高，这使得医疗工作者感到恐惧和焦虑。即使医院和诊所采取了初步措施来保护医疗工作者，不断增加的伤亡人数仍令人震惊。本研究采用案例研究方法，探讨了医生和护士在“优先干预区”（PIA）中面临的问题，以提高卫生系统的质量。2020 年 5 月 12 日至 6 月 4 日，在达卡市的两家私立医院中，对来自 12 名医生和护士进行了定性深入的半结构式访谈。使用主题内容分析法对数据进行分析。从 PIA 框架中确定了两个需要立即关注的重要领域，即“患者和员工安全、感染控制”和“文化方面和社区参与”。PIA 框架的每个领域都显示了当前卫生系统中以前被忽视的问题。PIA 框架的适应性有助于确定关键的卫生系统问题。建议管理层和决策者采取适当的规划和管理措施，隔离感染患者，并提供足够的个人防护设备，以挽救医疗工作者的生命，并最大程度地减少感染的传播。
