"すべての新生児:保健システムのボトルネックと,各国で拡大を加速するための戦略"
Kim E Dickson1, Aline Simen-Kapeu1, Mary V Kinney2
1UNICEF, Programmes Division, New York, NY, USA.
Lancet (London, England)
|May 24, 2014
まとめ
基本的医療の普及を図れば,新生児死亡率を71%削減できる. 重要な戦略は,医療従事者の技能の向上,財政的保護,母親と新生児のケアを拡大するための強力なリーダーシップを含む.
科学分野:
- グローバル・ヘルス グローバル・ヘルス
- 母親と新生児の健康について
- 医療システム研究 医療システム研究
背景:
- 重要な介入は,新生児死亡,死産を大幅に削減し,母親と子供のアウトカムを改善することができます.
- 死亡率の低減に不可欠な,出産前期および小さな/病気の新生児の介護は,現在,低かつ不公平なカバーに苦しんでいます.
- これらの重症医療パッケージは,全体的な保健システム機能の敏感な指標です.
研究 の 目的:
- 妊産婦と新生児の医療を阻害する瓶頸を体系的に評価する. 妊産婦と新生児の医療を阻害する瓶頸を体系的に評価する.
- 新生児死亡率を減らすために急速に進歩している国によって採用された成功した戦略を特定する.
- 医療の質とカバーを改善するために,国家保健計画のためのデータ主導のプロセスを提案する.
主な方法:
- 新生児死亡率が高い8カ国の600人以上の専門家を対象に,保健医療のボトルネックを体系的に評価した.
- 医療従事者,資金調達,サービス提供における共通の制約の分析.
- 新生児死亡率削減の野心的な目標を達成するために,急速に進歩している国の戦略の検討.
主要な成果:
- 2465のボトルネックが特定され,医療従事者,資金調達,および高負担国におけるサービス提供に関する共通の問題がある.
- 介入特有のボトルネックにおける観察された変動,例えば,アジアにおけるカンガルーマザーケアにおける課題とアフリカにおける実現可能性.
- 地域のベストプラクティスの新生児死亡率を達成することは,2035年の目標を超えることができるとわかった.
結論:
- 新生児死亡率を減らすための重要な要因には,戦略的労働力計画,金融保護措置,ダイナミックなリーダーシップが含まれます.
- 国家主導のデータベースのアプローチが提案され,国家保健計画を強化し,基本的ケアを拡大する.
- 出産時のケアや,小さな/病気の新生児のケアにおける質のギャップを解決することは,すべての母親と赤ちゃん,特に最も脆弱な赤ちゃんに到達するために不可欠です.
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