健康に関する国際的集団行動:目標,機能,論理的根拠
D T Jamison1, J Frenk, F Knaul
1Center for Pacific Rim Studies, UCLA, Los Angeles, CA 90095-1487, USA.
Lancet (London, England)
|March 3, 1998
まとめ
国際保健機関は,パフォーマンスの向上のために,定義されたコア機能とサポート機能を必要としています. この枠組みは,グローバルな公共財と外部性を,国家保健システム支援と区別し,組織的な役割を指針にしています.
科学分野:
- グローバル・ヘルス グローバル・ヘルス
- 保健政策 保健政策 保健政策
- 国際関係 国際関係
背景:
- 国際保健機関 (IHOs) は,効果的なパフォーマンスのために明確な委任事項を必要とします.
- 既存の枠組みでは,IHO機能の明確な分類が欠けている.
- 基本的な機能の定義は,世界の保健活動を最適化するために不可欠です.
研究 の 目的:
- 国際保健機関の基本的機能を分類するための枠組みを開発する.
- 核心機能と補助機能を,その範囲と受益者によって区別する.
- 組織の任務を特定の機能タイプに合わせるためのガイドラインを提供すること.
主な方法:
- 文献レビューと分析に基づく概念的枠組みの開発.
- 主権と必要性に基づいて,機能を"コア"と"サポート"に分類する.
- 国際的な公共財,外部性,国内システムの欠陥の例を分析する.
主要な成果:
- 基本的な機能の2つの主要なカテゴリを特定しました:コアとサポーター.
- 核心機能は,国際的公共財 (例えば,R&D) とグローバルな外部性 (例えば,病原体監視) を扱います.
- 支援機能は,国家保健システムの欠陥を補う (例えば,脆弱な集団への援助,技術的協力など).
結論:
- コア機能はすべての国にとって有益であり,サポート機能はより大きなニーズを持つ国を対象としています.
- WHOのような組織をコア機能に,世界銀行をサポート機能に合わせると,効果が向上します.
- 明確な機能的枠組みは,国際保健機関の役割を定義し,パフォーマンスを改善するために不可欠です.
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