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首页> 外文期刊>Canadian journal of public health: Revue canadienne de sante publique >Challenges and opportunities in addressing social determinants of child health in Cambodia: perspectives and experience of frontline providers in two health districts
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Challenges and opportunities in addressing social determinants of child health in Cambodia: perspectives and experience of frontline providers in two health districts

机译：解决柬埔寨儿童健康社会决定因素的挑战和机遇：两个健康区前线提供者的观点和经验

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Objectives Other forces related to socio-economic and cultural factors, besides biomedical and behavioural fields, also influence health but receive little attention in health research. This study aims to illuminate social determinants of health and to identify challenges and opportunities in addressing social determinants of child health (SDCH) in rural Cambodia. Methods This is a qualitative study based on interviews of frontline primary health care providers, health officials, local authorities and community volunteers in two health districts in Cambodia. The data were supplemented by secondary data on different aspects of the districts and Cambodia.Results Poverty, lack of basic commodities and adverse social conditions remained problems for population health. While access to health services was considered adequate, households and communities had several major risk exposures. Challenges in addressing SDCH were the high prevalence of social and household adverse conditions, and the lack of training of providers, of information about social services, of effective coordination and of trust in public services. Opportunities were present, including social services being existent albeit poor functioning, the traditional practice of social inquiry, existing frontline providers being open to further information and training, existing subnational coordination bodies at district and provincial levels, and use of evidence in planning and resource allocation.Conclusion Addressing SDCH requires broad and coordinated efforts of stakeholders from multiple sectors. Among the prerequisites are to leverage the existing structures and mechanisms, training primary health care providers and providing them with adequate information about local resources and available supports. Improving social care services and infrastructures requires strong coordination, planning and adequate resource allocation.
机译：目的除生物医学和行为领域外，与社会经济和文化因素相关的其他力量也影响健康，但在健康研究中很少受到关注。本研究旨在阐明健康的社会决定因素，并确定柬埔寨农村地区解决儿童健康社会决定因素（SDCH）的挑战和机遇。方法这是一项基于对柬埔寨两个卫生区的一线初级卫生保健提供者、卫生官员、地方当局和社区志愿者进行访谈的定性研究。这些数据得到了地区和柬埔寨不同方面的二次数据的补充。结果贫困、基本商品匮乏、社会条件恶劣仍是影响人口健康的主要问题。虽然人们认为获得医疗服务是足够的，但家庭和社区有几个主要的风险暴露。解决SDCH的挑战是社会和家庭不利条件的高流行率，以及缺乏对提供者的培训、关于社会服务的信息、有效的协调和对公共服务的信任。机会是存在的，包括社会服务虽然运作不佳，但仍然存在，社会调查的传统做法，现有的一线提供者对进一步的信息和培训持开放态度，现有的地区和省级国家以下协调机构，以及在规划和资源分配中使用证据。结论应对SDCH需要来自多个部门的利益相关者广泛而协调的努力。先决条件包括利用现有的结构和机制，培训初级保健提供者，并向他们提供有关当地资源和可用支持的充分信息。改善社会护理服务和基础设施需要强有力的协调、规划和充分的资源分配。

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