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什么可行,谁知道呢?社区和卫生工作者的观点对于确定应对医疗保健受袭问题的解决方案的重要性。

What works and who knows? The importance of community and health worker perspectives in defining solutions to attacks on healthcare.

作者信息

Makali Samuel Lwamushi, Ogueji Okechi, Tax Leonie, Fast Larissa

机构信息

Ecole Régionale de Santé Publique, Université Catholique de Bukavu (ERSP-UCB), Bukavu, Democratic Republic of the Congo.

International Rescue Committee, New York, USA.

出版信息

Confl Health. 2025 Jul 24;19(1):46. doi: 10.1186/s13031-025-00692-y.

Abstract

Attacks against healthcare are increasingly a strategy of modern warfare, with devastating short and long-term impacts on health staff, patients, and the health system as a whole. What is the solution? Communities play a significant role in protecting healthcare in war zones, as do health workers and civil society networks. We argue existing methods can help identify operationally-relevant solutions in a timely way, facilitating response strategies co-designed with those most affected and in support of existing capacities. This commentary draws on three studies in Nigeria, South Sudan, and Democratic Republic of Congo (2022-2024) that examined health worker and community perspectives on attacks on healthcare and about response priorities in order to inform strategies to prevent attacks and reduce their impact. Here we identify two additional contributions of this research approach. First, these studies document contextually-relevant responses of community- and health worker-defined actions and priorities. Second, they provide new insights on how health worker and community perspectives can be gathered in a timely way, considering the many competing priorities of health workers and people exposed to conflict. They elicited what affected people prioritise, when asked. As such, the approaches are relevant for operational actors working in all areas where people face systematic violence against healthcare.

摘要

对医疗保健的攻击日益成为现代战争的一种策略,对医护人员、患者以及整个卫生系统都产生了毁灭性的短期和长期影响。解决方案是什么?社区在保护战区的医疗保健方面发挥着重要作用,医护人员和民间社会网络也是如此。我们认为,现有方法有助于及时确定与行动相关的解决方案,促进与受影响最大的群体共同设计应对策略,并支持现有能力。本评论借鉴了在尼日利亚、南苏丹和刚果民主共和国开展的三项研究(2022 - 2024年),这些研究考察了医护人员和社区对医疗保健攻击以及应对优先事项的看法,以便为预防攻击和减少其影响的策略提供信息。在此,我们确定了这种研究方法的另外两个贡献。第一,这些研究记录了社区和医护人员界定的行动及优先事项在具体背景下的应对情况。第二,考虑到医护人员和受冲突影响人群的众多相互竞争的优先事项,它们就如何及时收集医护人员和社区的观点提供了新的见解。当被问及的时候,这些研究引出了受影响人群的优先事项。因此,这些方法对于在人们面临针对医疗保健的系统性暴力的所有地区开展工作的行动者而言具有相关性。

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