School of Business & Law, Central Queensland University, Brisbane, Australia.
School of Business & Law, Central Queensland University, Emerald, Australia.
Health Soc Care Community. 2022 Sep;30(5):e3184-e3192. doi: 10.1111/hsc.13763. Epub 2022 Feb 22.
This study examines health regulation under conditions of geographical constraint in two strikingly different settings, one on a remote island in Bangladesh and the other in an impoverished rural region in Australia. Both suffer from an absence of medically qualified professionals, which means that in the resultant vacuum, patients access alternative healthcare. The concept of regulation (or lack of regulation) is explored in terms of unconventional new responses to rural health deficits. The two cases show unexpected commonality, with policymakers facing shared challenges beyond physical remoteness. The difference in the degree of enforcement of regulation offers the greatest point of difference. This comparative study revealed a weak health regulatory system in the remote Bangladesh area of Bhola Island where 'alternatives' to formal clinical approaches have become the default choice. Brazen stop-gap servicing is commonplace on Bhola Island, but in The Gemfields such practices only occur in the shadows or as a last resort. Each isolated location, one in a developing country and the other in a developed setting, exemplifies how geographical remoteness can present an opportunity for innovations in supply to emerge. Surprisingly, it is the developing world case that better leverages a regulatory void to respond to local healthcare needs.
本研究考察了在地理限制条件下的卫生监管情况，研究对象是孟加拉国一个偏远岛屿和澳大利亚一个贫困农村地区这两个截然不同的地方。这两个地方都缺乏合格的医疗专业人员，这意味着在这种情况下，患者只能寻求其他医疗服务。本研究从非传统的新方法应对农村卫生缺陷的角度，探讨了监管（或缺乏监管）的概念。这两个案例显示出意想不到的共同性，政策制定者面临着超越物理偏远的共同挑战。监管执行程度的差异是最大的不同点。这项比较研究揭示了孟加拉国布罗拉岛偏远地区卫生监管系统薄弱，这里的“替代”正规临床方法已经成为默认选择。在布罗拉岛，公然的权宜之计很常见，但在宝石矿区，这种做法只在暗处或作为最后手段出现。每个孤立的地方，一个在发展中国家，另一个在发达国家，都说明了地理上的偏远如何为供应创新提供了机会。令人惊讶的是，正是发展中国家更好地利用了监管空白来满足当地的医疗保健需求。
