「住民参加」による保健福祉計画策定における住民の力を活かすための要因
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概要
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本研究の目的は,成果のあった住民参加による保健福祉計画策定における行政職員の行為の意図・理由および行政側の策定体制の特徴を明らかにし,住民の力を計画策定に活かすための要因を検討することである。調査対象はA県内5市町村の計画策定担当者である。半構造化面接によって「住民参加の影響」,「住民の参加状況」,「担当者の住民参加に関する行為の意図・理由」および「行政側の策定体制」を調査し,それらの関連を分析した。成果のあった住民参加の行為の意図・理由の特徴は,(1)計画を策定するのみでなく実行できるようにすることを住民参加のねらいとしている,(2)日常業務において地域の健康課題を捉えているため,住民に期待する役割や住民参加の効果を明確に認識している,(3)日常業務の経験から住民が役割を発揮できるような参加状況を作り出すための支援の必要性を予測している,であった。成果のあった行政側の策定体制の特徴は,一部の担当者だけではなくスタッフ職員の多くが計画策定に参加し,住民の参加は必要と考えている,であった。住民の力が保健福祉計画策定に活かされるための要因として,(1)日常業務で住民個々への支援や住民との協働をしている実践者であることを活かして,住民への期待を明確化し,支援の必要性を判断する,(2)日常業務による地域の健康課題の把握を基に,課題解決のための具体策の検討および実行に住民の力を活かす,(3)スタッフ職員が計画策定に参加する体制と住民参加の必要性を共有できるような職員間の対話の場をつくる,が見出された。The purpose of this study was two-fold: 1) to describe the intentions/reasons for actions of health planning managers in promoting community participation within administrative organizations creating municipal health plans, and to describe those administrative organization, and 2) to examine factors involved in utilizing community participation when creating municipal health plans. Data were collected through semi-structured interviews of individuals of health planning managers at 5 municipalities in one prefecture. Intentions/reasons for the action of health planning managers were as follows: (1) the aim of community participation was not only to plan but also to implement these plans; (2) as health planning managers were tackling local health problems in their daily activities, their expectations of the community members' role and the effect of community participation were clear; (3) their day-to-day experiences led them to predict the need for support to create a participation situation in which community members could undertake specified roles. In the administrative organizations surveyed, community participation was considered necessary not only by the health planning managers but also by most of the staff participating in creating municipal health plans. Factors influencing the use of community participation were as follows: (1) health planning managers clarified expectations of the community members' roles and predicted the need for support, as they supported community members individually and collaborated with them on a daily basis; (2) as they were tackling local health problems in their daily activities, health planning managers recruited community members to devise and to practice concrete measures for solutions to local health problems; (3) they created a system in which staff participated in planning, and promoted dialogue between staff so as to collaboratively consider the necessity of community participation.
- 2006-06-30