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探索健康管理流程对境内流离失所者健康结果的影响。

Exploring the influence of health management processes on health outcomes among internally displaced persons (IDPs).

作者信息

Ekezie Winifred, Siebert Penelope, Timmons Stephen, Murray Rachael L, Bains Manpreet

机构信息

Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, United Kingdom.

Health and Internal Displacement Network (HIDN).

出版信息

J Migr Health. 2022 Jun 22;6:100124. doi: 10.1016/j.jmh.2022.100124. eCollection 2022.

Abstract

BACKGROUND

Despite global action and policy initiatives, internally displaced persons (IDPs) experience poor living conditions and lack healthcare access compared to refugees. This study sought to understand the relationship between health management processes and health outcomes among camp-dwelling IDPs in northern Nigeria.

METHOD

73 individuals participated in either a focus group ( = 49) or one-to-one interview ( = 24), comprising IDPs ( = 49), camp managers ( = 9), health workers ( = 7) and government administrative authorities ( = 8). Interviews explored IDP health management processes, partners and perceptions around camp management. Data were analysed using an inductive thematic approach.

RESULTS

Four main themes were identified: opinions about healthcare organisation and management, service availability, interventions and information management, and IDP health outcomes. Though many stakeholders, partnerships, and national and international government agencies were involved in the provision of healthcare services, respondents described efforts as disjointed. Reports suggested that the coordination and management of health services and resources were not tailored to the needs of those living in all camps. And because so many national and international agencies were involved, but under weak coordination, access to services was less than optimal and adequate management of critical public health interventions was lacking. Varied allocation of resources such as funding, medication and medically trained staff were viewed as key factors in the availability and the ability to access what was considered as essential healthcare services.

CONCLUSION

The health of IDPs in camp-like settings was compromised by uncoordinated management, treatment, and control of communicable and non-communicable diseases. Government authorities need to be aware and consider the complexity of the multiagency involvement in the management and provision of IDP healthcare services. Introducing systems to streamline, monitor and support IDP healthcare management could be cost-effective strategies for achieving optimal health care.

摘要

背景

尽管有全球行动和政策倡议,但与难民相比,境内流离失所者(IDP)的生活条件较差且缺乏医疗保健服务。本研究旨在了解尼日利亚北部营地居住的境内流离失所者的健康管理过程与健康结果之间的关系。

方法

73人参与了焦点小组(n = 49)或一对一访谈(n = 24),包括境内流离失所者(n = 49)、营地管理人员(n = 9)、卫生工作者(n = 7)和政府行政当局(n = 8)。访谈探讨了境内流离失所者的健康管理过程、合作伙伴以及对营地管理的看法。数据采用归纳主题分析法进行分析。

结果

确定了四个主要主题:对医疗保健组织和管理的看法、服务可用性、干预措施和信息管理以及境内流离失所者的健康结果。尽管许多利益相关者、合作伙伴以及国家和国际政府机构都参与了医疗保健服务的提供,但受访者称这些努力是脱节的。报告表明,卫生服务和资源的协调与管理并非针对所有营地居民的需求进行调整。而且由于涉及众多国家和国际机构,但协调不力,服务获取不太理想,且缺乏对关键公共卫生干预措施的充分管理。资金、药品和受过医学培训的人员等资源分配不均被视为影响基本医疗保健服务可用性和获取能力的关键因素。

结论

在类似营地的环境中,境内流离失所者的健康因传染病和非传染病的管理、治疗和控制不协调而受到损害。政府当局需要意识到并考虑多机构参与境内流离失所者医疗保健服务管理和提供的复杂性。引入简化、监测和支持境内流离失所者医疗保健管理的系统可能是实现最佳医疗保健的具有成本效益的策略。

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