Dussault Gilles, Franceschini Maria Cristina
Human Development Department, World Bank Institute, Washington, DC, USA.
Hum Resour Health. 2006 May 27;4:12. doi: 10.1186/1478-4491-4-12.
Access to good-quality health services is crucial for the improvement of many health outcomes, such as those targeted by the Millennium Development Goals (MDGs) adopted by the international community in 2000. The health-related MDGs cannot be achieved if vulnerable populations do not have access to skilled personnel and to other necessary inputs. This paper focuses on the geographical dimension of access and on one of its critical determinants: the availability of qualified personnel. The objective of this paper is to offer a better understanding of the determinants of geographical imbalances in the distribution of health personnel, and to identify and assess the strategies developed to correct them. It reviews the recent literature on determinants, barriers and the effects of strategies that attempted to correct geographical imbalances, with a focus on empirical studies from developing and developed countries. An analysis of determinants of success and failures of strategies implemented, and a summary of lessons learnt, is included.
获得高质量的卫生服务对于改善许多健康成果至关重要，例如2000年国际社会通过的千年发展目标（MDGs）所针对的那些成果。如果弱势群体无法获得专业人员和其他必要投入，与健康相关的千年发展目标就无法实现。本文重点关注可及性的地理维度及其一个关键决定因素：合格人员的可获得性。本文的目的是更好地理解卫生人员分布中地理不平衡的决定因素，并识别和评估为纠正这些不平衡而制定的策略。它回顾了近期关于试图纠正地理不平衡的决定因素、障碍和策略效果的文献，重点是来自发展中国家和发达国家的实证研究。其中包括对已实施策略成败的决定因素分析以及经验教训总结。
