全球卫生经济学:公平影响敏感工具 (EQUIST) - 开发,验证,实施和评估影响 (2011年至2022年)
Mickey Chopra1, Lakshmi N Balaji2, Harry Campbell3
1The World Bank, Washington, District of Columbia, USA.
Journal of global health
|December 14, 2023
概括
公平影响敏感工具 (EQUIST) 通过将公平整合到成本效益分析中来增强全球卫生政策. 该工具有助于建立更有效的卫生系统,特别是在低收入和中等收入国家,通过优先考虑弱势群体.
科学领域:
- 全球卫生经济学 全球卫生经济学
- 卫生政策分析 卫生政策分析
- 健康 公平 研究 健康 公平 研究
背景情况:
- 传统的全球卫生成本效益分析 (CEA) 往往忽视了公平考虑,导致在解决健康不平等方面取得的进展不足,特别是在低收入和中等收入国家 (LMICs).
- 公平影响敏感工具 (EQUIST) 是为了解决这些局限性而开发的,它将公平作为卫生政策决策的核心因素.
- 尽管在儿童疫苗接种等领域取得了成功,但CEA在解决日益严重的健康差距方面的缺陷得到了承认,这促使需要采取更细微的方法.
研究的目的:
- 开发和验证一个工具 (EQUIST),该工具明确将公平性纳入全球卫生干预的成本效益分析.
- 通过优先考虑公平的资源分配,实现更有效和高效的卫生系统的建立.
- 通过提供一个平衡成本效益与弱势群体需求的框架,为LMICs的健康政策决策提供信息.
主要方法:
- 从2011年开始,EQUIST的开发涉及一个多阶段的过程,重点是2012年3月至5月期间开发的概念框架.
- 该框架评估了跨股权层的干预效率,有效性,影响和成本效益.
- 与数据科学平台的整合,如"拯救生命工具"和"瓶边缘预算"工具,允许对跨社会经济群体的干预影响进行详细分析.
主要成果:
- 2012年在五个国家进行的验证表明,EQUIST能够识别出更公平,更具成本效益的干预措施,从而在脆弱人群中挽救更多生命.
- EQUIST被用来开发全球融资工具的投资案例,为母亲和儿童健康计划提供了大量资金.
- 该工具直接影响了非洲26多个国家的国家卫生政策和资源分配.
结论:
- EQUIST是制定具有成本效益和公平的健康政策的宝贵工具,代表了全球健康经济学的范式转变.
- 该工具已经显示出对健康结果的切实影响,特别是在减少母婴死亡率和解决LMICs的健康不平等方面.
- 未来将与其他工具进行整合,并计划扩展以涵盖更广泛的健康问题,如青少年健康和艾滋病毒/艾滋病规划.
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