阿尔玛-阿塔30年后:革命性的,相关的,是时候重新振兴
Joy E Lawn1, Jon Rohde, Susan Rifkin
1Saving Newborn Lives/Save the Children-US, Cape Town, South Africa.
Lancet (London, England)
|September 16, 2008
概括
1978年阿尔马塔宣言的原则对于全球卫生公平和实现"全民健康"目标至关重要. 从30年的初级医疗保健政策中吸取的经验教训为整合服务和可持续卫生系统的当前战略提供了信息.
科学领域:
- 全球卫生政策 全球卫生政策
- 主要医疗保健系统主要是医疗保健系统.
- 健康 公平 卫生 公平
背景情况:
- 1978年"阿尔玛-阿塔宣言"确立了初级医疗保健的基本原则,包括公平,社会正义和社区参与.
- 持续和新出现的健康挑战,如艾滋病毒/艾滋病,慢性疾病和心理健康,强调了这些原则的持久相关性.
- 三十年的全球政策转变凸显了对健康投资和服务提供的不断变化的方法.
研究的目的:
- 重新审视"阿尔马塔宣言"的核心原则,并评估它们的当代相关性.
- 检查30年来全球卫生政策的变化,并确定对初级卫生保健的经验教训.
- 为扩大初级卫生保健服务的战略提供信息,以实现全球卫生目标.
主要方法:
- 三十年来全球卫生政策变化的回顾.
- 分析初级医疗保健提供模式的转变 (选择性与综合性,社区与设施为基础).
- 对实现公平的初级医疗保健覆盖率至关重要的因素的评估.
主要成果:
- 初级医疗保健已经从投资不足和单一疾病的重点发展到更多的资金和多重举措.
- 辩论已经从选择性 versus 综合性护理转向将两种方法整合到卫生系统中.
- 一致的政治和财务承诺,数据驱动的实施以及强大的社区/跨部门联系对于成功至关重要.
- 社区参与和跨部门参与仍然是初级医疗保健的弱点.
- 人力资源规划,培训和支持性监督对于初级卫生保健工作者来说是必要的.
结论:
- 振兴阿尔马塔原则和运用30年来所学到的经验,对于实现全球"全民健康"至关重要.
- 综合的初级卫生保健系统需要持续的承诺,基于证据的实施和强有力的伙伴关系.
- 解决人力资源需求和加强社区/跨部门行动是提高初级医疗保健效率的关键.
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