南アフリカにおける健康: 2009年以降の変化と課題
Bongani M Mayosi1, Joy E Lawn, Ashley van Niekerk
1Department of Medicine, Groote Schuur Hospital, Cape Town, South Africa.
Lancet (London, England)
|December 4, 2012
まとめ
南アフリカ 南アフリカ
科学分野:
- 公衆衛生は公衆衛生である.
- 健康政策 保健政策 保健政策
- エピデミオロジー エピデミオロジー
背景:
- 南アフリカは2009年以来,健康政策に重大な変化を遂げ,平均寿命が伸びました.
- HIV/結核,慢性疾患,傷害/暴力,母子保健の"衝突する疫病"に対処することは依然として重要である.
- 歴史的な不公正と過去の行政政策は,現在の健康環境に影響を及ぼし続けています.
研究 の 目的:
- 南アフリカの保健部門の変革を振り返り,分析する.
- 主要な保健疫病と社会的決定要因の管理における進展と課題を評価する.
- 全国民医療のための国民健康保険のような新しい政策の可能性を評価する.
主な方法:
- 主要な保健分野における政策・プログラム変更の分析.
- HIV/結核の治療と予防における進歩のレビュー.
- 非伝染病と怪我の予防のための政府のイニシアティブの評価.
- 健康と医療制度改革の社会的決定要因における進展の検討.
主要な成果:
- 平均寿命が60歳まで増加し,HIV/結核の予防と幼児死亡率の改善が進みました.
- 政府政策にもかかわらず,非伝染性疾患の負担が増加しています.
- 暴力と傷害の持続的な高いレベル,統合された予防の枠組みのための継続的な努力.
- 14年にわたって計画された国民健康保険の導入と初等医療の再設計.
- 健康研究の優先事項に関する全国的なコンセンサスと,研究費の増額へのコミットメント.
結論:
- 進展はあったが,保健システム統合,監視,公正なサービス提供などに課題が残っている.
- 公平で,功績に基づいた保健システムへの変革は,保健目標の達成に不可欠です.
- 健康の社会的決定因子,特に人種的およびジェンダーの不平等に対処することは,市民の生活を改善するために不可欠です.
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