Kanchense Jane Handina Murigwa
Department of Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, 68124, USA.
Health Care Women Int. 2006 Aug;27(7):627-45. doi: 10.1080/07399330600803774.
The primary health care model of public health has been implemented in many countries around the globe since the Declaration of Alma Ata in 1978, without pilot testing the primary health care model. Therefore, many public health researchers have sought methods of improving primary health care by creating evidence-based models. Many of these researchers recognize the role of behavioral models in public health. These offshoots of primary health care include the ecological, care, central human capabilities, and the SPECIES models. Holistic self-management education and support is a capacity-building philosophy that ensures active involvement of consumers of health care in the planning and implementation and evaluation of health care services. It helps consumers of health care to achieve the desired improved quality of health and life in managing and sustaining their health at the grassroots level. The care model addresses disease management ideals of the in the original primary health care model. The SPECIES model addresses those aspects of the primary health care model that include the cultural and social factors, as well as individual health education and support in the original primary health care model. The ecological model offers an improvement of the socioeconomic ideal in the original primary health care model. Improving the health of individuals will prevent illness, thereby reducing health care costs and lessening the current strain on an overburdened health care system in Zimbabwe. Holistic self-management education and support links health care delivery systems with social processes. It is a best practices model that could better serve Zimbabwean girls and women by contributing positively to the national challenges in health care, thereby meeting the Zimbabwean primary health care and safe motherhood goals. It is here recommended that holistic self-management education and support must be pilot tested before being adopted as the most appropriate model for ensuring population health.
自1978年《阿拉木图宣言》发布以来，全球许多国家都实施了初级卫生保健模式，但并未对该模式进行试点测试。因此，许多公共卫生研究人员一直在寻求通过创建循证模式来改进初级卫生保健的方法。这些研究人员中的许多人认识到行为模式在公共卫生中的作用。初级卫生保健的这些分支包括生态模式、关爱模式、核心人类能力模式和物种模式。整体自我管理教育与支持是一种能力建设理念，可确保卫生保健消费者积极参与卫生保健服务的规划、实施和评估。它有助于卫生保健消费者在基层管理和维持自身健康，从而实现预期的更高健康和生活质量。关爱模式解决了最初初级卫生保健模式中的疾病管理理念。物种模式解决了初级卫生保健模式中包括文化和社会因素以及最初初级卫生保健模式中的个人健康教育与支持等方面。生态模式改进了最初初级卫生保健模式中的社会经济理念。改善个人健康将预防疾病，从而降低医疗成本，减轻津巴布韦负担过重的医疗系统目前的压力。整体自我管理教育与支持将卫生保健提供系统与社会进程联系起来。它是一种最佳实践模式，通过积极应对卫生保健方面的国家挑战，能够更好地服务于津巴布韦的女孩和妇女，从而实现津巴布韦的初级卫生保健和安全孕产目标。在此建议，在将整体自我管理教育与支持作为确保人群健康的最合适模式采用之前，必须先进行试点测试。
