Tumwine J K
J R Soc Health. 1992 Dec;112(6):286-90. doi: 10.1177/146642409211200616.
The beginning of the 1980s saw the birth of Zimbabwe as a result of a protracted liberation war. It coincided with global interest in primary health care, the concept of universal primary school education and, unfortunately, moves towards economic stabilization and structural adjustment programmes. Economic structural adjustment was adopted by several sub Saharan African countries with dire consequences for the poor and vulnerable. Zimbabwe's commitment to social justice and to equitable distribution of resources demonstrated a practical move away from the culture of rhetoric so characteristic of many governments and non-governmental organisations and agencies. This commitment has been translated into impressive improvements in health and education. Current evidence shows that education has had a positive impact on health and related areas like contraceptive use, child mortality and the nutrition status of children. Conversely nutrition and health conditions among school children are important determinants of educational outcomes. Hitherto Zimbabwe's economy has been sufficiently strong to avoid excessive dependence on the International Monetary Fund, the World Bank and other foreign financial institutions. Unfortunately, however, the current economic recession together with economic structural adjustment programmes are beginning to have a negative impact on health and education. Will true synergism between health and education weather these structural problems? It seems that the people and government of Zimbabwe have the capacity and resolve to weather such a storm.
20世纪80年代初,经过长期的解放战争,津巴布韦诞生了。这一时期恰逢全球对初级卫生保健、普及小学教育概念的关注,不幸的是,也出现了经济稳定和结构调整计划的动向。撒哈拉以南的几个非洲国家采用了经济结构调整政策,给穷人和弱势群体带来了可怕的后果。津巴布韦对社会正义和资源公平分配的承诺表明,它切实摆脱了许多政府及非政府组织和机构惯有的夸夸其谈的文化。这一承诺已转化为卫生和教育领域令人瞩目的改善。目前的证据表明,教育对健康及避孕措施使用、儿童死亡率和儿童营养状况等相关领域产生了积极影响。反之,学童的营养和健康状况是教育成果的重要决定因素。迄今为止,津巴布韦的经济一直足够强劲,避免了对国际货币基金组织、世界银行和其他外国金融机构的过度依赖。然而,不幸的是,当前的经济衰退以及经济结构调整计划正开始对卫生和教育产生负面影响。卫生与教育之间真正的协同作用能否经受住这些结构性问题的考验?津巴布韦人民和政府似乎有能力和决心经受住这样的风暴。