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孟加拉国乡卫生综合机构和地区医院医务人员在提供医疗服务时面临的挑战——一项定性研究

Challenges faced by medical officers in providing healthcare services at upazila health complexes and district hospitals in Bangladesh - a qualitative study.

作者信息

Rahman Khan Mohammad Thouhidur, Rayna Shahrin Emdad, Khan Fahmida Afroz, Khan Md Maruf Haque, Rahman Fariya, Ether Saraban Tahura, Islam Md Zahidul, Sarkar Supriya, Islam Syed Shariful, Khalequzzaman Md

机构信息

Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, 1000, Bangladesh.

icddrb, Dhaka, 1212, Bangladesh.

出版信息

Lancet Reg Health Southeast Asia. 2024 Apr 16;24:100398. doi: 10.1016/j.lansea.2024.100398. eCollection 2024 May.

Abstract

BACKGROUND

Upazila Health Complexes (UHCs) and District Hospitals (DHs) play a crucial role in the healthcare delivery system of Bangladesh. But very few research has been conducted to find out the prevailing challenges of the medical officers working in these tiers. The objective of the study was to identify the challenges faced by medical officers in providing healthcare services at UHCs and DHs.

METHODS

In-depth interviews of 51 medical officers from 17 UHCs and nine DHs were done between March and April 2021. All participants were purposively sampled. Data were transcribed verbatim and analysed using thematic analysis.

FINDINGS

Inadequate service rooms, unavailability of proper medical equipment, poor housing conditions, lack of public amenities, shortage of health workforce, lack of laboratory services, and excessive workload were the common challenges mentioned by the medical officers in providing healthcare services in UHCs and DHs. Lack of workplace safety, security, and undue pressure from local political leaders and journalists made the work environment fearful. The absence of proper implementation of policy related to higher education, posting, transfer, and promotion was also stated as challenge for the medical officers.

INTERPRETATION

Infrastructural improvements along with increased safety and security of the doctors at their workplace and transparent implementation of reformed policies are essential to reduce the workplace challenges of medical officers in UHCs and DHs of Bangladesh.

FUNDING

The study was funded by Hospital Services Management, Directorate General Of Health Services (DGHS), Mohakhali, Dhaka, and Bangabandhu Sheikh Mujib Medical University.

摘要

背景

乡级卫生综合机构(UHCs)和区级医院(DHs)在孟加拉国的医疗服务体系中发挥着关键作用。但很少有研究去探究在这些层级工作的医务人员面临的普遍挑战。本研究的目的是确定医务人员在乡级卫生综合机构和区级医院提供医疗服务时所面临的挑战。

方法

2021年3月至4月期间,对来自17个乡级卫生综合机构和9个区级医院的51名医务人员进行了深入访谈。所有参与者均为目的抽样。数据逐字转录并采用主题分析法进行分析。

结果

服务用房不足、缺乏合适的医疗设备、住房条件差、公共设施匮乏、卫生人力短缺、缺乏实验室服务以及工作量过大,是医务人员在乡级卫生综合机构和区级医院提供医疗服务时提到的常见挑战。工作场所缺乏安全保障,以及来自当地政治领袖和记者的不当压力,使得工作环境令人恐惧。与高等教育、岗位分配、调动和晋升相关的政策缺乏有效实施,也被认为是医务人员面临的挑战。

解读

改善基础设施,同时提高医生工作场所的安全性和保障,并透明地实施改革后的政策,对于减少孟加拉国乡级卫生综合机构和区级医院医务人员的工作场所挑战至关重要。

资金来源

该研究由达卡莫哈卡利卫生服务总局(DGHS)医院服务管理部门以及孟加拉国谢赫穆吉布医科大学资助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/595a/11043881/303f6899980e/gr1.jpg

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