Mayhew Susannah H, Walt Gill, Lush Louisiana, Cleland John
Center for Population Studies, London School of Hygiene and Tropical Medicine, London, England.
Int J Health Serv. 2005;35(3):579-601. doi: 10.2190/K46B-RRXJ-95M4-JDQU.
The debates about what services constitute reproductive health, how these services should be organized, managed, and delivered, and what the role of donor agencies' support should be mirror the long-standing debates on how best to implement primary health care. After briefly reviewing the development of the discourse on primary health care and reproductive health, the authors present results of qualitative research in Ghana, Kenya, and Zambia that indicate a range of factors influencing and explaining the way donors operate in these countries and consider the implications of these results for the delivery of comprehensive reproductive health services. These findings are compared with South Africa, a country with limited donor activity. In the light of the complex interplay of factors, the authors suggest that donors' words and actions frequently do not correlate. Conclusions are drawn as to the potential for donor support for integrated reproductive health service delivery in sub-Saharan Africa, drawing on the research to provide lessons and a reappraisal of the role of donors in health sector aid.
关于哪些服务构成生殖健康、这些服务应如何组织、管理和提供，以及捐助机构的支持应发挥何种作用的辩论，反映了关于如何最好地实施初级卫生保健的长期辩论。在简要回顾了初级卫生保健和生殖健康话语的发展之后，作者展示了在加纳、肯尼亚和赞比亚的定性研究结果，这些结果表明了一系列影响和解释捐助者在这些国家运作方式的因素，并考虑了这些结果对提供全面生殖健康服务的影响。这些发现与捐助活动有限的南非进行了比较。鉴于各种因素的复杂相互作用，作者认为捐助者的言行往往不一致。借鉴该研究提供的经验教训以及对捐助者在卫生部门援助中作用的重新评估，得出了关于捐助者支持撒哈拉以南非洲综合生殖健康服务提供的潜力的结论。
