アルマ・アタ事件から30年: 各国で初等保健医療が機能したか?
Jon Rohde1, Simon Cousens, Mickey Chopra
1Management Sciences for Health, Boston, MA, USA; James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
Lancet (London, England)
|September 16, 2008
まとめ
国は,限られた資源さえも,主要な保健医療の重要な進歩を達成することができます. 重要な教訓は,段階的な実施,強力な地区管理,そして普遍的な健康保険のための医療従事者への投資です.
科学分野:
- グローバル・ヘルス グローバル・ヘルス
- 医療サービス 研究 医療サービス
- 公共衛生政策 公共衛生政策
背景:
- アルマ・アタ宣言は",すべての人のための健康"を達成するために,初等保健医療 (PHC) が不可欠であることを強調した.
- PHCの進歩を評価するには,社会経済的な要因と特定の介入に関連した健康結果の分析が必要です.
研究 の 目的:
- アルマ・アタ会議以来,様々な国の初等保健医療 (PHC) の進展を評価する.
- 低所得国および中所得国におけるPHCの成功的な実施と子供の死亡率の低下に貢献する要因を特定する.
主な方法:
- 平均余命と国民所得とHIV感染率を比較して分析し,国を過度または過度と分類しました.
- 5歳未満の死亡率の減少に関して,高パフォーマンスを発揮している30の低,中所得国に焦点を当てた.
- これらの国のPHCのカバー,公平性,および健康以外のセクターのアクションを調査した.
主要な成果:
- 30カ国が子供の死亡率を大幅に低下させ,多くの国が選択的PHC (例えば免疫) を拡大しました.
- これらの国のうち14カ国が包括的なPHCに進歩し,高技能出産率を特徴としています.
- タイは,普遍的な予防接種と熟練した出産者,低い不平等,高い幼児死亡率の削減で例外的な進歩を示しました.
結論:
- 成功したPHCには,ステークホルダーのコミットメントを伴う,全国的に合意された段階的な戦略が必要です.
- 効果的な地区管理システムと,プライマリーヘルスケア・エクステンション・ワーカーへの一貫した投資が不可欠です.
- 投資を誘導し,ミレニアム開発目標と普遍的な健康保険への進展を加速するために,さらなる分析が不可欠です.
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