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Coping and compromise: a qualitative study of how primary health care providers respond to health reform in China
- Source :
- Human Resources for Health, Human Resources for Health, Vol 15, Iss 1, Pp 1-12 (2017)
- Publication Year :
- 2016
-
Abstract
- Background Health reform in China since 2009 has emphasized basic public health services to enhance the function of Community Health Services as a primary health care facility. A variety of studies have documented these efforts, and the challenges these have faced, yet up to now the experience of primary health care (PHC) providers in terms of how they have coped with these changes remains underdeveloped. Despite the abundant literature on psychological coping processes and mechanisms, the application of coping research within the context of human resources for health remains yet to be explored. This research aims to understand how PHC providers coped with the new primary health care model and the job characteristics brought about by these changes. Methods Semi-structured interviews with primary health care workers were conducted in Jinan city of Shandong province in China. A maximum variation sampling method selected 30 PHC providers from different specialties. Thematic analysis was used drawing on a synthesis of theories related to the Job Demands-Resources model, work adjustment, and the model of exit, voice, loyalty and neglect to understand PHC providers’ coping strategies. Results Our interviews identified that the new model of primary health care significantly affected the nature of primary health work and triggered a range of PHC providers’ coping processes. The results found that health workers perceived their job as less intensive than hospital medical work but often more trivial, characterized by heavy workload, blurred job description, unsatisfactory income, and a lack of professional development. However, close relationship with community and low work pressure were satisfactory. PHC providers’ processing of job demands and resources displayed two ways of interaction: aggravation and alleviation. Processing of job demands and resources led to three coping strategies: exit, passive loyalty, and compromise with new roles and functions. Conclusions Primary health care providers employed coping strategies of exit, passive loyalty, and compromise to deal with changes in primary health work. In light of these findings, our paper concludes that it is necessary for the policymakers to provide further job resources for CHS, and involve health workers in policy-making. The introduction of particular professional training opportunities to support job role orientation for PHC providers is advocated.
- Subjects :
- Male
China
Capacity Building
Public Administration
Attitude of Health Personnel
Health Personnel
education
Coping strategy
03 medical and health sciences
0302 clinical medicine
Nursing
Health care
Medicine
Humans
030212 general & internal medicine
Health policy
Qualitative Research
HRHIS
lcsh:R5-920
Primary Health Care
business.industry
030503 health policy & services
lcsh:Public aspects of medicine
Research
Public Health, Environmental and Occupational Health
Health services research
International health
lcsh:RA1-1270
Community health services
Work attitude
Health reform
Health Care Reform
Community health
Health law
Female
Health care reform
Health Services Research
0305 other medical science
business
lcsh:Medicine (General)
Subjects
Details
- ISSN :
- 14784491
- Volume :
- 15
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Human resources for health
- Accession number :
- edsair.doi.dedup.....6514cc7322fc354c6a833e7a9fea096f