Ingxaki yempilo yengqondo kwimimandla ephantsi

Ingxaki yengqondo ichaza ukuba kukho inxaxheba enkulu kumsebenzi wezifo emhlabeni wonke, kodwa uninzi lwabantu abahlala kwimimandla efumana imali ephantsi abafumani nyango konke konke. IWorld Health Organization (WHO) iqikelela ukuba phakathi kwe-76% ne-85% yabantu abanokuphazamiseka okunzima kwengqondo kumazwe aphantsi naphakathi afumana imali eninzi (LMSC) abangenankathalo. Lo msantsa wonyango uqhutywa ngumxube onzima ngaphantsi kwemiqobo, ukunqongophala kweingcali zezakhono, nokungaphindiswa kwentsebenzi yoluntu. Kwimimandla emininzi kula mazwe, uqingqo-mali lwengqondo olupheleleyo lulingana nomlinganiselo ongaphantsi kwemali encinane e-20.

Imimandla efunyenwe phantsi idla ngokungabikho nakwezona zibonelelo zisisiseko zengqondo. Umzekelo, ngaphaya kwe-Saharan esezantsi eAfrika, kukho iingcali zengqondo ezingaphantsi kwababini kubantu abali-100 000 ngokomlinganiselo, “‘ ezithelekisa ngaphezu kwe 10 kwi-100 000 eYurophu. Oonongogo, oogqirha jikelele, nabasebenzi bempilo-ntle basekuhlaleni basoloko bebizwa ukuba bazalise lo msantsalo, kodwa bafumana okuncinane kokungaqeqeshwa okusemthethweni kwimpilo yengqondo. Oku kubangelwa kukuba iinkonzo zempilo zengqondo zisoloko zidityaniswe kwimimandla yasedolophini, zishiya abantu basemakhaya bengafumani nkathalo.

Ngaphandle kokunqongophala kobuncwane, ukuhlazeka kwabantu kungumqobo omkhulu. Kwizithethe ezininzi, ukugula ngengqondo kuqondwa njengophawu lobuthathaka bobuqu okanye isiqalekiso, nto leyo ekhokelela ekucalucalulweni nasekuhlazisweni. Iintsapho zisenokufihla amalungu achaphazelekayo, kwaye abantu abafuni uncedo ngenxa yokoyika ukucinezelwa ngabantu. Oku kuhlazisa akuthiyi kuthinteli nje kuphela abantu ukuba bafumane unyango olufumanekayo kodwa kukwadima oorhulumente nabanikeli bengqondo ngaphambi kokuba bafumane impilo entle njengengxaki yempilo kawonke-wonke.

Iziphumo zezoqoqosho zokugula ngengqondo okunganyangwayo zinzima. Udandatheko kunye nokuxhalaba kukodwa kubiza uqoqosho lwehlabathi lonke i-US $1 ezigidi zezigidi zezigidi ngonyaka ekulahlekelweni yimveliso. Kwimiqathango ephantsi yemali, apho iintsapho zisoloko zixhomekeke kwimivuzo yemihla ngemihla, ukungakwazi ukusebenza ngenxa yesifo sengqondo kubangela ukuba iintsapho zibe nobuhlwempu obugqithisileyo. Oku kubangela umjikelo otshabalalisayo: ukuxinezeleka kwengqondo, ngoxa ukugula ngengqondo kubangela ubuhlwempu. Ukuthetha ngalo mjikelo ngoncedo olusebenzayo, akuyomfuneko nje kuphela yemilinganiselo yokuziphatha kodwa kwanemfuneko yezoqoqosho.

Indima Yoncedo Lwezizwe Ngezizwe Ekupheliseni Umsantsa

Uncedo lwehlabathi luye lwaba ngumqhubi ogxekayo ekulinganiseleni kweenkonzo zempilo yengqondo kwimimandla ehlwempuzekileyo yehlabathi. Ngeli xesha umthamo wonke wophuhliso lwempilo yengqondo uhlala liyinxalenye encinane yoncedo lobomi olupheleleyo."Phakathi kowe-1%/inkqubo ezifakelweyo zibonise ukuba kwanotyalo-mali olubekelwe phambili lungavelisa inkqubela ephawulekayo. Uncedo lunegalelo kumlinganiselo omninzi, ukusuka kulwakhiwo lwesiseko somzimba ukutshintsha isimo sengqondo soluntu.

Inkxaso-mali yeZibonelelo

Enye yezona minikelo zibonakalayo yoncedo lukwakhiwa nokuxhobisa izibonelelo zempilo yengqondo. Kumazwe anjengeLiberia, iSierra Leone, kunye neNepal, izimali zomnikeli zincedile ekwakheni amaqela empilo yengqondo asekelwe kwizibhedlele jikelele, endaweni yokuthembela kumaqumrhu agcina iingqondo. La maqela anikela inkathalo, ixesha elifutshane lokuhlala, nokulandela iinkonzo ezithe phithi-phithi-phithi-phithi-phithi-phicotha. Uncedo lukwaxhasa ukufunyanwa kwamayeza abalulekileyo engqondo, asoloko ethintelwa ukubiza imali eninzi okanye angafumaneki ngemixokelelwa ngoongezo zonikezelo. I-Mental Healthgate Act Programme (mGA) iye yaba luncedo ekulathiseni abanikezeyo kunye noorhulumente ekumiseleni iindleko, unyango olunexabiso eliphantsi oluphezulu.

Uqeqesho Nobuchule Bokwakha Abasebenzi Abanezonyango

Iinkqubo zoncedo zijolise kwingqeqesho yabasebenzi bezempilo abangengobathandi bonyango, `a sicwangciso sokuncedisa umsebenzi. Kwimimiselo emininzi efunyenweyo ephantsi, akukho ingcali zengqondo ezaneleyo ukuhlangabezana neemfuno. Iintlangano zezizwe ngezizwe ezifana ezisisiseko se-NTP kunye [[FLT:] nenkqubo ye-Menter Health Innova Commation Inethwele iinkqubo zokuqeqesha abongikazi, abasebenzi bezempilo, kwanabafundisi-zolwazi lokuqonda iziphakamiso eziqhelekileyo, ukucebisa, nokuphatha amayeza phantsi kolawulo. Ezi nkqubo zenkcubeko zicezelelwe ukuba zilungelene kwaye zilungelene, ukuchana kwempilo ezikhoyo kunokuba zixhomekeke kwiingcalo olukhoyo kuncedo lwempilo oluphambili lwe-extriate.

Iphulo lokuLumkisa uLuntu kunye nokuTyhiliselwa

Uncedo lwamaphulo olwazi ngezimali kawonke-wonke ajongene nehlazo elikhethekileyo. Ngokomzekelo, e-Ethiopia, iphulo elithi "Bona M, Hayi Isifo Sam" lisebenzisa unomathotholo, iingxoxo zoluntu, kunye nezinto ezishicilelweyo ukucel' umngeni weentsomi ngesifo sengqondo. Lixhaswe yi-comium yabaniksi behlabathi lonke, eli phulo lifikelele izigidi kwaye linxulunyaniswa nolwando olunokufumaneka kwisimilo sonyango. Amanyathelo afanayo eUganda neKenya aye asebenzisa abantu abadumile kunye neinkokeli zonqulo njengothetha abantu, enza ukuba umyalezo ubaluleke ngakumbi ngokwenkcubeko. La matyala abalulekile; ngaphandle kokunciphisa isihombo, kwanokwanda kolwazi oluphezulu lweziko lwezamayeza ahlala phantsi kwenkonzo.

Ukufumana Amayeza Ezifo Zengqondo Abalulekileyo

Kwanaxa iikliniki kunye nabasebenzi abaqeqeshiweyo bekhona, izigulana azinakufumana amayeza. Amazwe amaninzi afumana imali ephantsi agula ngezamayeza alwa noxinzelelo lwengqondo, amayeza okulwa noxinzelelo lwengqondo, kunye nezinzisi. Uncedo lwezizwe ngezizwe lunceda ekuqiniseni ukunikezelwa kweminxeba ngokudibanisa izambulo, ukuxhasa iivenkile zezamayeza ezisembindini, nokuxhasa imveliso apho kunokwenzeka khona. Iintlangano ezifana [[FLT:] [Managementss zenzululwazi yezempilo ziye zasebenzisana nesebe lezempilo ukuqinisekisa nokunyusa iinkqubo zokusasa nokuhambisa, ukuqinisekisa ukuba amayeza abalulekileyo afikelela kwizibonelelo zempilo ezikude. Uncedo loncedo lwempilo lwesizwe, inkqubo efunekayo efunekayo ekufumaneni imali.

Uphando lweemeko zeenkqubo zoncedo eziphumeleleyo

Impembelelo yeenkqubo zoncedo ezicwangcisiweyo zinokubonwa kuphuculo lwekonkrithi kunye neziphumo zonyango zomguli kwimimandla emininzi. Ngezantsi yimizekelo emibini enenkcukacha ebonisa indlela iindlela ezahlukeneyo eziye zaphumelela ngayo kumongo owahlukeneyo.

I-Sub-Saharan Afrika: IiNkonzo zempilo yengqondo ezisekelwe kuluntu eZimbabwe

EZimbabwe, iprojekthi yoBungane inika umzekelo onyanzelisayo wendlela uncedo olunokusetyenziswa ngayo ukucombulula umsantsa wonyango kwisikali. Ekuqaleni luveliswe ngenkxaso evela kwiZiko loMgaqo-siseko wezeMpilo nezorhulumente waseZimbabwe, olu cwangciso luqeqesha oomakhulu .ukunikela unyango olugocagocileyo kubantu abaneengxaki ezifanayo zengqondo. Aba "oomama" bangamaxhoba athembekileyo kuluntu lwabo, ancedayo ukuphelisa ukuhlazeka. Inkqubo iye yakhutshwa kwiikliniki ezingaphezulu kwama-70 kulo lonke ilizwe, kwaye uphando olupapashwe [[FLT:] i-Globalth Health lubonise ukuba abaququzeli bevene noxinezeleko oluphawulekayo kwiempawu zoxinezeleko. Ukuxhasa nokuxhasa ulawulo, kunye noqeqesho loncedo loonomakhulu, kunye noqeqesho lwezibonelelo lwezentlalo lwezenteko.

Omnye umzekelo ophawulekayo yiMental Health and Polity Project eGhana, exhaswa liSebe lezeNkcubeko leZizwe Ezihlukeneyo (ngoku i-Commonwealth, Common & Development Office). Le projekthi idityaniswe nempilo yengqondo kwiphondo elithathu, iqeqesha abongikazi kunye nabaphathi-mpilo boluntu abangaphezu kwama-2000. Ekupheleni kweprojekthi, umlinganiselo wabantu abagula kakhulu ngengqondo abafumana unyango wanyuka ukusuka ngaphantsi kwe-10% ukuya ku-50%. Iprojektha edingsko yengqondo ekhoyo kumama-nasenovel-asenovel-aselkliniki eluncedo nenovel-ooooktance, imodeli exhaka, imodelwayo ukususela oko ifunyenwe kwamanye amazwe aseNtshona Afrika.

UMzantsi - mpuma Asia: Ukufudusela impilo yengqondo Kwindawo Eqhelekileyo Yokunyamekela Abantu ENepal

I-Nepal, elinye lamazwe ahlwempuzekileyo e-Asia, iye yajamelana nocelomngeni olukhulu ekunikezeni iinkonzo zempilo yengqondo, ingakumbi emva kwenyikima yonyaka wama-2015. Uncedo lwezizwe ngezizwe, kuquka iminikelo evela kwi-World Health Organization, uRhulumente wase-Australia, kunye neentlangano ezingezoburhulumente ezifana SANGAth[, iye yasetyenziselwa ukuvuselela nokuguqula unyango lwengqondo. Icebo eliphambili belikuqeqesha abasebenzi abaphambili bezempilo kwi-m-mGAP, kunye nokusungula iindlela zokuqhuba icandelo lenzululwazi yengqondo kwicandelo lesithili. Uhlolisiso lwama-2019 lufumanisethi inani labantu abafumana izikhathale zempilo zengqondo kwimimandla enenxaxheba kwimimandla yezonyango lwengqondo liye landa ngeminyaka engaphezu kwama-400% kwiminyaka emithathu.

EKhambodiya, i-Transcultural Psychoconial Psychocial Organization (TPO) iye yasungula iinkqubo zonyango lwengqondo ezisekelwe kuluntu ezixhaswa ngabantu abanikela ngenkxaso yehlabathi. I-TPO iqeqesha amatsha - ntliziyo asekuhlaleni ukuqhuba amatyelelo asekhaya, ukunikela uncedo lokuqala ngengqondo, kunye nokunceda amaqela abantu abanoxinzelelo lwengqondo kunye nodandatheko oluqhelekileyo (---------actalss) oluqhelekileyo ekulandeleni ukutshatyalaliswa kohlanga lwe-Khmer Rougey kunye nokungalungelelaniseki kwamashumi eminyaka. Le nkqubo iye yaphumelela ngokukhethekile ekufikeleleni iincube-luntlukwano nabantu abakumazwe asemaphandleni. Ukuxhasa inkxaso kwemibutho enjenge-Europe Union ne-USAID kuye kwabangela ukuba inkqubo yokwandisa ingakumbi kwisiqingatha samaphondo elizwe, kwaye ngoku imodeli yenzelwe ukusetyenziswa kwezinye izicwangciso zemfazwe ezisentlalo.

Iingxaki Zokujamelana Nenkqubo Yempilo Yengqondo Yoncedo

Ngaphandle kwezi mpumelelo, indlela ekhokelela kwimpilo yengqondo eqinileyo kwimimandla efunyenweyo encinci izele yimiqobo. Ukubona le mingeni kubalulekile ekuyileni iinkqubo zoncedo ezisebenzayo kwixesha elide.

Izithintelo Zenkcubeko Nokufaneleka

Impilo yengqondo asiyonto isebenza jikelele. Oko kusisifo sengqondo, nendlela esimele siphathwe ngayo, kuyahluka-hluka kwizithethe. Iinkqubo zoncedo ezingenisa nje iindidi zokuxilonga kwezee-Ntshona kunye neendlela zonyango zingadityaniswa ngokuxhathisa okanye ngokungenamdla. Umzekelo, kwimimandla emininzi yaseAfrika, uxinezeleko lwengqondo ludla ukubonakaliswa ngeempawu ze-somatic (izigulo, ukudinwa) kwaye zibotshelelwa ukuba zibangelwa zizinto zokomoya. Iinkqubo ezizityeshela ezi nkolelo zasekuhlaleni zinokuba ziyingozi ekusebenziseni ixesha eliphantsi kwanobubi.

Ukubonelela ngenkxaso-mali

Uncedo lusoloko lufutshane emva kwexesha, ludityaniswe kwimisebenzi ethile eneengcali ezilinganiselweyo. Xa iimali ziphela, abasebenzi abaqeqeshiweyo bangashiya, iinkqubo zivalwe, banikezele amatyathanga. Iindlela ezininzi zempilo yengqondo kwimimandla efumana imali ephantsi ziye zazama ukukhusela inkxaso karhulumente eqhubekayo emva kokuphelisa inkxaso yomnikezeli. Ukulwa koku, uncedo lwezizwe ngezizwe kufuneka longezelelwe ukuphucula inkqubo yempilo yasekuhlaleni kunye nokwakha inkqubo yemali yasekhaya yezemali. Oku kuquka ukukhuthaza impilo yengqondo ukuze iqukwe kwiiplani ze-inshorensilensilensi zempilo yesizwe, njengoko kwenziwe ngoncedo lwamaqabane. Izibophelelo zexesha elide ezivela kubantu abanikela ngeminye nangemali, ezinje ngenkcingo yehlabathi yempilo yengqondo (okokuba kuhlala kusenziwa i-stelencelksssss sych, kuselkt synding)

Ukungaxilongwa Kwindlela Ephambili Yokunyamekela Impilo

Ngaphandle kwesivumelwano esasazekileyo sokuba impilo yengqondo ifanele idityaniswe kwinkathalo yokuqala, inyaniso yeyokuba imigudu emininzi yokudibanisa ihlala ingekho ngqiqweni. Abasebenzi abaphambili abanezicwangciso zonyango ezincinane sele bethwale izifo ezasulelayo, ubumama kunye nabantwana, nezifo ezingasasazekiyo. Ukongeza impilo yengqondo ngaphandle kwenkxaso eyaneleyo, ulawulo, kunye nezixhobo zikhokelele ekusetyenzisweni kwemiqathango eqinileyo. Iinkqubo zoncedo kufuneka zicombulule inkqubo yempilo yonke, dibanisa ukunikezela ngeminxeba, ukukhomba, ukukhokela, kunye nokuqokelelwa kolwazi (* kunokuqeqesha nje abasebenzi abambalwa. "rea" ukuncedisana kwendlela yokuqala yokunyamekela iinkathalo, ulawulo lwengqondo, kunye nokuxhasa imo yemali, apho kunokuthi kudlalwe indima efunekayo.

Iinkqubo zoLawulo

Iingingqi ezifunyenweyo eziphantsi zisoloko zingenalwazi oluthembekileyo oluphathelele ukwanda kwempilo yengqondo, usetyenziso lwenkonzo, kunye neziphumo. Ngaphandle kogcino-lwazi oluqinileyo, kunzima ukuvavanya impembelelo yeenkqubo zoncedo, ukwabelana ngobuchule boovimba bemali ngokunempumelelo, okanye ukuxhasa ukuqhubekeka kwemali. Iinkqubo ezininzi zoncedo ziquka inxalenye yophando, kodwa iziphumo aziqheleki ziphinde zabelwe kunye nabantu okanye zisetyenziswe ukulungisa ukwenziwa kolwazi lokwenene. Ukwenza uphando kunye nobuchule bokuhlola basekuhlaleni kufuneka kube yinxalenye esezantsi yakho nayiphi na inyathelo lonyango lwengqondo elilungeleleneyo. I-Atlas yempilo yengqondo ye-WHOP. ibonelela isicwangciso selizwe lomgangatho wogcino-lwazi lwemali, kodwa inkxaso-mali ekufuneka ukusebenza kwicandelo lengingqini.

Iindlela zexesha elizayo: Kwinkqubo eqinileyo nenokunyibilika

Ukuqinisa kwimpumelelo yangaphambili, imigudu yoncedo yexesha elizayo kufuneka isebenzise indlela eninzi esetyenziswayo kunye nekhokelwa kwindawo ekufuphi. Izinto ezilandelayo eziphambili zinokuba luncedo ekuqinisekiseni ukuba iinkonzo zempilo yengqondo ziba yinto esisigxina kumaziko empilo afunyenweyo aphantsi kunokuba ibe yiprojekthi yexeshana.

Ukujoliswa ekucombululeni impilo njengelungu le-oyile

Kunokuba kunyangwe impilo yengqondo njengenkqubo emileyo, emileyo, yoncedo kufuneka luxhase ukudibana kwayo ngokupheleleyo kwizibonelelo ezikhoyo zonyango lwempilo. Oku kuthetha ukuba baqeqeshe bonke abasebenzi abaphambili abanyamekela abasebenzi abanolwazi oluphambili .*iingcali nje zempilo yengqondo (kwizihlolo kunye nolawulo, inkxaso yengqondo echaphazela ingqondo phakathi kweenkqubo zezempilo zabantwana, kunye nokudibanisa impilo yengqondo kulawulo lwesifo esinganyangekiyo (umz., isifo seswekile nodandatheko ngokufuthi olukhoyo). Amazwe afana ne-Indonesia ne-Sri Lanka abonise ukuba ngenkxaso eqhubekayo yenkxaso eqhubekayo yempilo, unganiselwano-mdla wabemi. Uncedo kufuneka lusetyenziswe ukubonisa ukufaneleka kolwando olunjalo, ukwenza imeko yokusetyenziswa kwemali yasekhaya.

Ukwabelana Ngomsebenzi, Ubunikazi Boluntu, kunye nezixhobo zamanani

Kwiminyaka elishumi ezayo iza kubona ulwando lwemiboniso yempilo esetyenziswayo exhomekeke kwimibutho yezempilo yoluntu, abaxhasi boontanga, kunye nabacebisi abaqeqeshiweyo. Ezi zinto azikhange zifikelele nje kuphela kumgangatho wobuxhakaxhaka boovimba babantu kodwa zikwakhuthaza ubunikazi boluntu (ukungamandla angundoqo okuzigcina zizimele. Amacebo amanani ezixhobo (umz., iselula yezonyango, itelepsychiatry) ingaxhasa kwaye inikezele ugcino-zigqibo ezingeyo ezingeyo, kodwa kufuneka zenzelwe ngenyameko ukulungiselela abemi abaphantsi kwabemi kunye nokusingqongileyo okusezantsi. Uncedo lungaxhasa ukuphuhliswa nokuvavanywa kwezixhobo ezinjalo kwimiqobo yeli yenene, ngemigangatho evulekileyo engenisa izicwangciso-enokusetyenziswa ngaphandle kokulungisa iivili.

Ukukhuthaza ukhokelo lwasekuhlaleni kunye nokukhuthaza

Ukhuseleko luxhomekeke ekukhokeleleni okunamandla kwesizwe nakwizindululo zezobupolitika. Iintlangano zoncedo kufuneka zimisele ukuqinisa amandla abo baxhasa impilo yengqondo yasekuhlaleni, amaqumrhu obugcisa, nemibutho yasekuhlaleni yokukhuthaza oorhulumente babo. Oku kuquka ukuqeqesha abaphandi basekuhlaleni ukuba bavelise ubungqina obuthetha izinto eziza kuqala kwilizwe, ukuxhasa ukuphuhliswa kweenkqubo zempilo yesizwe, nokuxhasa ukuthathiswa kwee-LMIC kwimicimbi yempilo yengqondo yehlabathi lonke. Xa iinkokeli zasekuhlaleni zinocwangciso, zisengozini ngakumbi yokwandisa ubuncwane kunye nemigaqo engqongqo enjenge-inshorensislavery ethintela ukucalula ukuhla kwempilo yengqondo yabantu.

Ukusetyenziswa kweNkcubeko

Uluntu lwehlabathi kufuneka lushenxise ukusuka kwimijikelo yeprojekthi yexeshana elifutshane kwaye luye kwizixhobo zenkxaso-mali ezinika inkxaso ethe ngqo, ethatha iminyaka emininzi. Izakhelo zeNgxowa-mali yehlabathi Lonke Yempilo Yengqondo, ezifuziselwe kwiNgxowa yehlabathi Ephumelelayo Ukulwa noGawulayo, Isifo Sephepha ne-Malariya, zifumene igalelo kodwa zihlala zingakhange zivuleke. Kwinkqubo yenkcitho yemali enika uncedo lwempilo yengqondo eninzi zingenza ingxwelerheke kwinkqubo yokomeleza impilo entle kunye nenkxaso-yo yempilo yezenzululwazi. Kwangamanye amaxesha, amazwe aphantsi kwemali kufuneka andise uqingqo-mali yempilo yasekhaya ngokucothanga ulwano-mali kunye noncedo lwempilo yezempilo.

Isiphelo: Isicelo Sokuzibophelela

Uncedo lwezizwe ngezizwe sele lubonise ukuba lunako ukuphuculwa kokwenene kwimisebenzi yempilo yengqondo kwimimandla efunyenweyo ephantsi. Ukusuka koomakhulu abanikela unyango eZimbabwe ukuya kubasebenzi bezempilo baseluntwini abanikela inkathalo kwimizana ekude ye-Nepal, ubungqina bubonisa ukuba impumelelo, ukungenelwa okucwangcisiweyo kokubhekiselelelweyo kusenokuvala umsantsa wonyango. Noko ke, ezi nkqubela zihlala zibuthathaka kwaye zixhomekeke kwinkcitho eqhubekayo yonikezelo kunye neenkqubo ezichuliweyo. Ngaphandle kokutshintshela kunyango olude, inkqubo yokuzinzisa inkqenkqenkqeza efuna ukufikelela kwiidolo ezikwindawo ezikude ezikude kunye nomanyano, kodwa ubuchule obuninzi bokuphumelela kweminyaka emibini edluleyo bungadibani nangakumbi.