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探索来自选定国家的年轻医疗保健专业人员对农村证明的看法。

Exploring the ideas of young healthcare professionals from selected countries regarding rural proofing.

机构信息

Ukwanda Centre for Rural Health, Department of Global Health, Stellenbosch University, Cape Town, South Africa

Ukwanda Centre for Rural Health, Department of Global Health, Stellenbosch University, Cape Town, South Africa; and Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa

出版信息

Rural Remote Health. 2023 Nov;23(4):8294. doi: 10.22605/RRH8294. Epub 2023 Nov 18.

Abstract

INTRODUCTION

Globally, most countries struggle to meet the health needs of rural communities. This has resulted in rural areas performing poorly when compared to urban areas in terms of a range of health indicators. There have been few coherent or systematic strategies that target rural communities and address their needs within the rural context. Rural proofing, defined as the systematic application of a rural lens across policies and guidelines to ensure that they speak to these health needs, seeks to address this gap. The healthcare professionals (HCPs) who will be called upon to advocate for and lead the implementation of rural proofing efforts are those currently in training or early career stages. We thus sought to understand the perspectives of young HCPs regarding the concept of rural proofing.

METHODS

The study adopted an interpretivist paradigm. Data were collected using semi-structured individual interviews and focus group discussions (FGDs). Selected HCPs who are in leadership in Rural Seeds, a movement for young HCPs, participated in the study. FGDs in the form of Rural Cafés were led by some Rural Seeds leaders who participated in the interviews and who showed interest in organising the discussions. Eleven exploratory interviews and six FGDs were conducted using Zoom. HCPs were from Australia, Europe, Africa, North America, South America, and Asia. Interviews and FGDs were conducted in English, recorded, and transcribed verbatim. Thematic analysis was then undertaken.

RESULTS

Participants perceived the state of rural healthcare globally to be problematic. Access to care was seen as the most significant issue in rural health care, associated with the challenges of lack of equity in access, and limited funding and support for healthcare professionals and their career pathways. Despite varying understanding of the concept, rural proofing was seen to be of great value in improving rural health care. A number of ideas for applying rural proofing, with examples, were proposed from their perspectives as frontline healthcare providers. They particularly recognised the importance of addressing the local needs of rural communities and the needs of present and future HCPs. Implementation of rural proofing was seen to require the involvement of key stakeholders from a range of sectors at multiple levels.

CONCLUSION

Given the state of rural health, young rural HCPs suggest that rural proofing strategies are needed as they have the potential to bring about equity in the delivery of health care in rural and remote communities. These strategies will assist in creating a more positive future for rural health care worldwide and motivate young HCPs to become involved in rural health care, as well as to increase their motivation to take an interest in health policy development. These strategies need to be applied at multiple levels, from national government to local contexts. It is also seen to be critically important to involve multiple levels of stakeholders, from politicians to healthcare providers and community members, in the process of rural proofing.

摘要

引言

在全球范围内,大多数国家都难以满足农村社区的卫生需求。这导致农村地区在一系列健康指标方面的表现不如城市地区。几乎没有连贯或系统的策略能够针对农村社区,并在农村背景下满足他们的需求。农村证明(rural proofing)的定义是在政策和准则中系统地应用农村视角,以确保这些政策和准则能够满足这些健康需求,旨在解决这一差距。那些将被呼吁倡导和领导农村证明工作的医疗保健专业人员(HCPs)是那些正在接受培训或处于职业生涯早期的人。因此,我们试图了解年轻 HCPs 对农村证明概念的看法。

方法

该研究采用解释主义范式。使用半结构化的个人访谈和焦点小组讨论(FGD)收集数据。参与农村种子(Rural Seeds)的年轻 HCPs 领导者参加了研究。农村种子是一个为年轻 HCPs 发起的运动。以农村咖啡馆形式举行的 FGD 由一些参与访谈并对组织讨论表现出兴趣的农村种子领导人领导。使用 Zoom 进行了 11 次探索性访谈和 6 次 FGD。HCPs 来自澳大利亚、欧洲、非洲、北美、南美和亚洲。访谈和 FGD 以英语进行,记录并逐字转录。然后进行了主题分析。

结果

参与者认为全球农村医疗保健状况存在问题。他们认为农村医疗保健中最严重的问题是获得医疗保健的机会,这与农村地区缺乏公平获取医疗保健的机会、医疗保健专业人员资金和支持有限有关。尽管对该概念的理解各不相同,但农村证明在改善农村医疗保健方面被认为具有巨大价值。他们从一线医疗保健提供者的角度提出了一些应用农村证明的想法,并举例说明。他们特别认识到解决农村社区的当地需求以及当前和未来 HCPs 的需求的重要性。农村证明的实施被认为需要来自多个部门的关键利益相关者在多个层面上参与。

结论

鉴于农村地区的卫生状况,年轻的农村 HCPs 认为需要采取农村证明策略,因为这些策略有可能在农村和偏远社区提供医疗保健方面实现公平。这些策略将有助于为全球农村医疗保健创造更美好的未来,并激励年轻的 HCPs 参与农村医疗保健,同时提高他们对健康政策制定的兴趣。这些策略需要在多个层面上实施,从国家政府到地方情况。还必须让来自政治家到医疗保健提供者和社区成员等多个层面的利益相关者参与农村证明过程。

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