Desai P, Paul T J, McCaw-Binns A M
Department of Social and Preventive Medicine, U.W.I., Jamaica.
West Indian Med J. 1993 Jun;42(2):57-61.
Jamaica's primary health-care services have been in a process of development since the 1970s. In 1984, a large management study collected data on levels of material resources (basic facilities, utilities, furniture, equipment and supplies items). Since 1984, serious staff shortages have affected the services, and there have been economic constraints, as well as a major hurricane. In order to measure changes over subsequent years, data on material resources were again collected in 1991/1992, using the same sample of 65 types 2 and 3 health centres as in 1984. Data were collected by interview with health centre staff. Results, whilst showing various changes item-by-item, showed constancy or minor improvements overall in levels of resources. Type 2 health centres continued to have lower resource levels than type 3s, even though the methodology allowed for their different needs where appropriate. Staff members' opinions of condition and adequacy of resources had become more positive than before. It was concluded that, in terms of material resources, activities within the primary health-care sector have offset the adverse effects of the macro-environmental conditions affecting the health centres. This method of material resource monitoring has implications for quality assessment of health facilities in primary health-care.
自20世纪70年代以来，牙买加的初级卫生保健服务一直在发展。1984年，一项大型管理研究收集了有关物质资源水平（基本设施、公用事业、家具、设备和供应品）的数据。自1984年以来，严重的人员短缺影响了这些服务，还存在经济限制以及一场重大飓风。为了衡量随后几年的变化，1991/1992年再次收集了物质资源数据，采用了与1984年相同的65个2类和3类健康中心样本。数据通过与健康中心工作人员面谈收集。结果虽然逐项显示出各种变化，但总体资源水平保持不变或略有改善。2类健康中心的资源水平继续低于3类健康中心，尽管该方法在适当情况下考虑到了它们的不同需求。工作人员对资源状况和充足程度的看法比以前更加积极。得出的结论是，在物质资源方面，初级卫生保健部门的活动抵消了影响健康中心的宏观环境条件的不利影响。这种物质资源监测方法对初级卫生保健中卫生设施的质量评估具有启示意义。
