为非洲提供发展援助:从依赖援助的疾病控制到新的公共卫生秩序
Justice Nonvignon1,2, Agnès Soucat3,4, Paulina Ofori-Adu5
1Africa Centre for Disease Control and Prevention, Addis Ababa, Ethiopia.
Health policy and planning
|January 22, 2024
概括
非洲的卫生发展援助 (DAH) 增加了一倍,但没有有效地改善卫生系统. 这种援助可能取代了国内资金,阻碍了可持续的全民健康覆盖 (UHC) 模式. 需要紧急改革官方发展援助 (ODA).
科学领域:
- 全球健康 全球健康
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
背景情况:
- 由于数十年来投资不足,COVID-19大流行暴露了非洲卫生系统的弱点.
- 卫生发展援助 (DAH) 在2000-2020年间翻了一番,这促使对其对加强卫生系统的影响进行了评估.
研究的目的:
- 分析非洲DAH的区域间变化和趋势.
- 检查DAH与卫生系统融资/绩效指标之间的关系.
- 评估援助替代国内融资及其对问责制和政策制定的影响.
主要方法:
- 自2000年以来,对非洲五个区域经济共同体的DAH趋势的分析.
- 对DAH支出与卫生系统绩效指标之间的相关性分析.
- 对援助对国内医疗保健融资和治理的影响的定量和定性评估.
主要成果:
- 在过去的二十年里,DAH对南非的利益不成比例;到2020年,它占非洲总卫生支出的10%.
- 实现全民健康覆盖 (UHC) 的进展仅与DAH水平略有关联.
- DAH可能已经取代了国内的公共资金,可能会破坏可持续的UHC融资模式. 在COVID-19危机期间,DAH没有增加.
结论:
- 目前的官方发展援助 (ODA) 结构不足,需要转型以优先考虑国家主导的倡议.
- 国内融资必须成为非洲公共卫生社会契约的核心.
- 重新利用DAH和建立透明的监测框架对于可持续的卫生系统发展至关重要.
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