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印度尼西亚私营医疗机构儿童免疫服务评估:人口稠密城市的案例研究。

Assessment of childhood immunization services at private healthcare facilities in Indonesia: a case study in a highly-populated city.

机构信息

Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia.

Center of Excellence for Pharmaceutical Care Innovation (PHARCI), Universitas Padjadjaran, Bandung, Indonesia.

出版信息

Front Public Health. 2023 Jul 27;11:1093387. doi: 10.3389/fpubh.2023.1093387. eCollection 2023.

Abstract

INTRODUCTION

The need to enhance the utilization of the private sector for immunization programs in Indonesia while maintaining the high quality of services provided is evident. This study aimed to rapidly assess immunization services at private healthcare facilities in Indonesia by using Bandung, the most densely populated city, as the reference case.

METHODS

Initially, a situation analysis was conducted by collecting data from selected healthcare facilities ( = 9). Furthermore, a qualitative study was taken into account by developing framework approaches and conducting interviews with different layers, such as mid-level managers at healthcare facilities ( = 9), professional organizations ( = 4), and public stakeholders ( = 7).

RESULTS

The situation analysis showed that private healthcare facilities had provided sufficient time for essential childhood immunization services with adequate staff. Nevertheless, the number of limited staff the Ministry of Health (MoH) has trained remains a programmatic problem. Furthermore, private healthcare facilities have used the MoH guidelines and additional internal guidelines for immunization services as the primary reference, including in the efforts to provide complete and reliable equipment. Vaccine availability at private healthcare facilities is manageable with an acceptable out-of-stock level. The results of our interviews highlighted three key findings: the lack of coordination across public and private sectors, the need for immunization service delivery improvement at private healthcare facilities, and the urgency to strengthen institutional capacity for advocacy and immunization systems support.

CONCLUSION

Even though private healthcare facilities have been shown to make a modest contribution to childhood immunization services in Indonesia, efforts should be made to expand the role of private healthcare facilities in improving the performance of routine immunization programs.

摘要

简介

印度尼西亚显然需要提高私营部门在免疫规划中的利用,同时保持所提供服务的高质量。本研究旨在通过以人口最密集的城市万隆作为参考案例,快速评估印度尼西亚私营医疗保健机构的免疫服务。

方法

最初,通过收集选定医疗保健机构的数据( = 9)进行情况分析。此外,通过制定框架方法并对医疗保健机构中层管理人员( = 9)、专业组织( = 4)和公共利益相关者( = 7)等不同层面进行访谈,考虑了定性研究。

结果

情况分析表明,私营医疗保健机构已经为基本儿童免疫服务提供了充足的时间和足够的工作人员。然而,卫生部培训的有限数量的工作人员仍然是一个计划问题。此外,私营医疗保健机构已经使用卫生部的指南和额外的内部指南作为免疫服务的主要参考,包括在提供完整和可靠设备方面。私营医疗保健机构的疫苗供应是可以管理的,并且缺货水平可以接受。我们的访谈结果突出了三个关键发现:公共和私营部门之间缺乏协调,需要改善私营医疗保健机构的免疫服务提供,以及迫切需要加强机构能力以进行宣传和免疫系统支持。

结论

尽管私营医疗保健机构已经为印度尼西亚的儿童免疫服务做出了适度的贡献,但应努力扩大私营医疗保健机构在改善常规免疫规划绩效方面的作用。

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