Prospects for the development of community-based care in remote rural areas: a stakeholder analysis in Laos
説明
<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Community-based health programmes have been a cornerstone of primary care in Laos for decades. The study presented here aimed to document prospects for the development of current programmes, considering perceptions about health and health care priorities in the communities, implementation challenges, the policy landscape and opportunities associated with the availability of new technologies.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>The research design primarily involved qualitative in-depth interviews with stakeholders (n = 35) responsible for the planning, management, or implementation of community-based care in Laos at different levels of the health system. These included health managers at central departments or institutes of the Ministry of Health, provincial health departments, district health offices, heads of health centres, village health volunteers, community representatives, and international stakeholders.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>There was consensus that service delivery is still a challenge in many areas, due to geographic inaccessibility of health facilities, communication barriers, health-seeking behaviour, trust, and gender discrimination, particularly among ethnic minorities. In these settings, community health workers have the potential to extend the reach of the formal health system, acting as cultural brokers across sectors of society, ethnicities, and worldviews. To maximise impact, planners need to carefully consider the implementation model, financing arrangements, health system integration, and changing health priorities in the communities.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>This study examined challenges to, and opportunities for, the expansion and health system integration of community-based care in Laos. Further development and horizontal integration of community-based care remains a complex financing and governance challenge, although the renewed emphasis on primary care and the ongoing process of decentralisation provide a favourable policy environment in the country to sustain and potentially expand existing programmes.</jats:p> </jats:sec>
収録刊行物
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- BMC Health Services Research
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BMC Health Services Research 24 2024-01-11
Springer Science and Business Media LLC
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キーワード
- Health informatics
- Public relations
- Economics
- FOS: Political science
- Health administration
- Nursing research
- Nursing
- FOS: Health sciences
- Applied Microbiology and Biotechnology
- Global Burden of Antimicrobial Resistance
- Health Sciences
- Stakeholder
- Health services research
- Business
- Global Impact of Arboviral Diseases
- Political science
- Economic growth
- Global Maternal and Child Health Outcomes
- Immunology and Microbiology
- Public health
- Community health workers
- Corporate governance
- Research
- Ethnic minorities
- Public Health, Environmental and Occupational Health
- Health care
- Life Sciences
- Health Service Utilization
- Primary care
- International health
- Health policy
- Laos
- HRHIS
- Pediatrics, Perinatology and Child Health
- Medicine
- Public aspects of medicine
- RA1-1270
- Community health
- Finance
詳細情報 詳細情報について
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- CRID
- 1870303265811327360
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- ISSN
- 14726963
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- データソース種別
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- OpenAIRE