虽然它持续了好吗? 估计马拉维基于结果的融资对母婴护理使用的长期和撤回影响,使用常规数据
Tisha Dasgupta1,2, Manuela De Allegri3, Stephan Brenner3
1Department of Women & Children's Health, King's College London, London, UK tisha.dasgupta@kcl.ac.uk.
BMJ open
|March 8, 2024
概括
马拉维的基于结果的母婴健康融资计划 (RBF4MNH) 对服务利用趋势的影响很小. 取消RBF4MNH计划导致医院分娩和产前护理服务大幅下降.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
- 产妇和新生儿健康 产妇和新生儿健康
背景情况:
- 基于结果的融资 (RBF) 倡议越来越多地用于改善医疗保健服务提供.
- 在马拉维实施了RBF for Maternal and Newborn Health Initiative (RBF4MNH) 计划,以提高母亲和婴儿的健康状况.
- 了解RBF引入和撤销对服务利用的影响对于可持续的卫生系统加强至关重要.
研究的目的:
- 评估马拉维引入并随后撤销RBF4MNH倡议的影响.
- 评估对使用机构分娩,产前护理 (ANC) 和产后护理 (PNC) 的影响.
主要方法:
- 采用了受控中断时间序列设计.
- 分析了来自马拉维卫生管理信息系统 (HMIS) 的二次数据.
- 在90个月的时间里,干预区和非干预区之间比较了基于设施的分娩,ANC和PNC服务的使用趋势.
主要成果:
- 在RBF4MNH干预的最初2.5年中,没有观察到对服务利用趋势的重大影响.
- 在实施5年后,在设施分娩的微小积极趋势和PNC趋势的下降被注意到.
- 取消RBF4MNH计划导致设施分娩和ANC的立即下降,以及这两项服务的负面利用趋势.
结论:
- 像RBF4MNH这样复杂的医疗融资干预措施可能需要更长的时间来证明效果.
- 除了实施之外,RBF倡议的持续影响取决于更广泛的卫生融资改革.
- 撤销RBF4MNH导致马拉维关键孕产妇和新生儿卫生服务利用率显著下降.
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