从去中心化到再中心化:从越南迅速扭转疫苗接种扩大计划融资的情况吸取经验教训
Khanh Phuong Nguyen1, The Due Ong1, Xinyu Zhang2
1Health Strategy and Policy Institute, Ministry of Health, Hanoi, Vietnam.
The Lancet regional health. Western Pacific
|August 13, 2025
概括
中等收入国家在疫苗采购融资方面面临挑战. 越南 越南 越南 越南
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 疫苗采购 疫苗采购
背景情况:
- 疫苗接种2030年议程强调,需要为有效的疫苗采购提供足够的资金.
- 中等收入国家 (MICs) 面临着独特的挑战,因为他们无法获得Gavi,疫苗联盟的支持.
- 越南将2023年扩大疫苗接种计划 (EPI) 资金分散到省级政府.
研究的目的:
- 分析越南EPI融资去中心化的后果.
- 确定去中心化的负面结果的根本原因.
- 为其他中等收入国家提取关于EPI融资和管理的教训.
主要方法:
- 分析越南扩大疫苗接种计划中去中心化的后果.
- 检查了快速扭转去中心化政策的根本原因.
- 确定其他MIC在疫苗融资方面面临类似挑战的经验教训.
主要成果:
- 分权化导致严重的疫苗缺货,越南儿童免疫覆盖率大幅下降.
- 政策的逆转强调了中央政府参与EPI融资和管理的必要性.
- 资源分配中的国内差异因分散式方法而加剧.
结论:
- 中央政府必须在扩大疫苗接种计划中保持主要作用,为MICs提供资金和管理.
- 提高当地管理能力对于成功的分散卫生计划至关重要.
- 向较不发达地区分配有针对性的资源对于减少国家内部差异和确保公平的免疫覆盖率至关重要.
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