Shuey Dean A, Qosaj Fatime Arenliu, Schouten Erik J, Zwi Anthony B
World Health Organization, P.O. Box 343, Vientiane, Lao People's Democratic Republic.
Health Policy. 2003 Mar;63(3):299-310. doi: 10.1016/s0168-8510(02)00121-5.
The restoration and development of health care systems in post-conflict situations and complex emergencies are attracting attention. Kosovo is unique in being a post-conflict situation, in a former socialist country, with an unclear political future, under temporary UN administration. The World Health Organization (WHO) led a process of developing a health policy framework for the emergency period that included elements of health sector reform, a somewhat controversial initiative. Reform elements of the policy were consistent with normative health policies in much of eastern and central Europe. There was tension between the need to have a policy in place rapidly and the desire to be participatory. Policy to deal with emergency situations that is not available at the time required is of limited value. Although there was some tension between relief and development agendas, the policy process did direct significant resources and effort in directions that contributed to longer-term reform and development. A policy framework does not ensure compliance with policy unless issues of authority, mandate, and leadership are clear. A rapidly developed health policy framework at the onset of an emergency is desirable. Policy developers should be experienced, seen as being neutral and be relatively independent of any specific donor or interest group. WHO is well situated to play this role if it meets certain conditions.
冲突后局势和复杂紧急情况下医疗保健系统的恢复与发展正受到关注。科索沃具有独特性，它处于冲突后局势，位于一个前社会主义国家，政治前途不明朗，处于联合国临时管理之下。世界卫生组织（WHO）牵头制定了一个紧急时期的卫生政策框架，其中包括卫生部门改革的内容，这是一项颇具争议的举措。该政策的改革内容与东欧和中欧大部分地区的规范性卫生政策相一致。迅速出台一项政策的需求与参与性的愿望之间存在矛盾。在需要时却没有可用的应对紧急情况的政策，其价值有限。尽管救济议程和发展议程之间存在一些矛盾，但政策制定过程确实将大量资源和精力导向了有助于长期改革和发展的方向。除非权力、授权和领导等问题明确，否则政策框架并不能确保政策得到遵守。在紧急情况一开始就迅速制定卫生政策框架是可取的。政策制定者应经验丰富，被视为中立，且相对独立于任何特定捐助方或利益集团。如果满足某些条件，世卫组织很适合发挥这一作用。
