在中国资助非国家免疫计划疫苗的公平道路:从定性研究的挑战和机遇
Mingzhu Jiang1, Weixi Jiang1, Xuanxuan Yan1
1School of Public Health, Fudan University, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.
International journal for equity in health
|September 28, 2024
概括
在中国,为非国家免疫计划 (NIP) 疫苗提供资金是不公平的,高昂的自费成本阻碍了接种. 可持续,协同的融资策略对于公平的疫苗接种和公共卫生改善至关重要.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 卫生政策 卫生政策
背景情况:
- 在中国,国家免疫计划 (NIP) 疫苗的覆盖率很高,这是由于强有力的财政支持.
- 非NIP疫苗面临着低于最佳和不公平的覆盖率,原因是资金分散,主要是自付费用.
- 可持续融资对于公平的非NIP疫苗接种至关重要,但对这一问题的理解有限.
研究的目的:
- 分析目前中国非NIP疫苗的融资情况.
- 确定非NIP疫苗融资方面的挑战和机遇.
- 提出提高疫苗接种率和公共卫生结果的战略.
主要方法:
- 半结构化,面对面采访了来自中国五个省份卫生和金融局的55名利益相关者.
- 为参与者选择进行分层抽样.
- 对融资参与,挑战和改进策略的采访数据进行主题分析.
主要成果:
- 非NIP疫苗融资涉及自付款,政府财政支持,医疗保险和外部资金,每个都有不同的挑战.
- 高昂的自费成本是公平接种疫苗的主要障碍,尽管市场竞争提高了可负担性.
- 政府的承诺正在增长,集中采购降低了成本;然而,地方财政支持的可持续性和区域差异仍然存在.
- 基本医疗保险和商业选择的使用有限,但私人储蓄账户和互助机制提供了新的途径.
- 外部支持虽然范围有限,但提高了疫苗接种意识.
结论:
- 对于非NIP疫苗,单独依赖个人支付是不可持续的,并阻碍了普遍获得.
- 协调和协同的方法对于确保足够的可持续资源至关重要.
- 加强公共财务管理是必要的,以提高非NIP疫苗交付中的公平性.
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