Zou, G, King, R, Walley, J et al. (3 more authors) (2015) Barriers to hospital and tuberculosis programme collaboration in China: context matters. Global Health Action, 8. 27067. ISSN 1654-9716
Abstract
Background: In many developing countries, programmes for ‘diseases of social importance’, such as tuberculosis (TB), have traditionally been organised as vertical services. In most of China, general hospitals are required to report and refer suspected TB cases to the TB programme for standardised diagnosis and treatment. General hospitals are the major contacts of health services for the TB patients. Despite the implementation of public–public/private mix, directly observed treatment, short-course, TB reporting and referral still remain a challenge. Objective: This study aims to identify barriers to the collaboration between the TB programme and general hospitals in China. Design: This is a qualitative study conducted in two purposefully selected counties in China: one in Zhejiang, a more affluent eastern province, and another in Guangxi, a poorer southwest province. Sixteen in-depth interviews were conducted and triangulated with document review and field notes. An open systems perspective, which views organisations as social systems, was adopted. Results: The most perceived problem appeared to be untimely reporting and referral associated with non-standardised prescriptions and hospitalisation by the general hospitals. These problems could be due to the financial incentives of the general hospitals, poor supervision from the TB programme to general hospitals, and lack of technical support from the TB programme to the general hospitals. However, contextual factors, such as different funding natures of different organisations, the prevalent medical and relationship cultures, and limited TB funding, could constrain the processes of collaboration between the TB programme and the general hospitals. Conclusions: The challenges in the TB programme and general hospital collaboration are rooted in the context. Improving collaboration should reduce the potential mistrust of the two organisations by aligning their interests, improving training, and improving supervision of TB control in the hospitals. In particular, effective regulatory mechanisms are crucial to alleviate the negative impact of the contextual factors and ensure smooth collaboration.
Metadata
Item Type: | Article |
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Copyright, Publisher and Additional Information: | © 2015 Guanyang Zou et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license. |
Keywords: | tuberculosis programme; general hospitals; collaboration; open systems |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Nuffield Centre for International Health and Development (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 03 May 2016 14:03 |
Last Modified: | 03 May 2016 14:03 |
Published Version: | http://dx.doi.org/10.3402/gha.v8.27067 |
Status: | Published |
Publisher: | Co-Action Publishing |
Identification Number: | 10.3402/gha.v8.27067 |
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Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:97608 |