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印度的初级卫生保健与儿童生存

Primary health care and child survival in India.

机构信息

Department of Community Medicine, G. R. Medical College, Gwalior, India.

出版信息

Indian J Pediatr. 2010 Mar;77(3):283-90. doi: 10.1007/s12098-010-0036-y. Epub 2010 Mar 9.

Abstract

The Primary Health Care (PHC) has been globally promoted as a comprehensive approach to achieve optimal health status and 'Health for all'. The PHC approach, although, initially received the attention but failed to meet the expectations of the people in India. The child health programs in India had been started for long as verticals programs, which later on integrated and had been planned in a way to deliver the services through the PHC systems. Nevertheless, the last decade has witnessed many new initiatives for improving child health, specially; a number of strategies under National Rural Health Mission have been implemented to improve child survival--Skilled Birth Attendant and Emergency Obstetric Care, Home Based Newborn Care, Sick newborn care units, Integrated Management of Neonatal and Childhood Illnesses, strengthening Immunization services, setting up Nutritional rehabilitation centers etc. However, for a large proportion of rural population, an effective and efficient PHC system is the only way for service delivery, which still needs more attention. The authors note that although there have been improvements in infrastructure, community level health workers, and availability of the funding etc., the areas like community participation, district level health planning, data for action, inter-sectoral coordination, political commitment, public private partnership, accountability, and the improving health work force and need immediate attention, to strengthen the PHC system in the country, making it more child friendly and contributory in child survival, in India.

摘要

初级卫生保健(PHC)已在全球范围内得到推广,作为实现最佳健康状态和“人人享有健康”的综合方法。尽管 PHC 方法最初受到关注,但未能满足印度人民的期望。印度的儿童健康计划长期以来一直作为垂直计划开展,后来进行了整合,并计划通过 PHC 系统提供服务。然而,过去十年见证了许多改善儿童健康的新举措,特别是在国家农村卫生使命下实施了多项战略,以提高儿童生存率——熟练的接生员和紧急产科护理、家庭新生儿护理、新生儿疾病护理单位、新生儿和儿童疾病综合管理、加强免疫服务、建立营养康复中心等。然而,对于很大一部分农村人口来说,有效的 PHC 系统是提供服务的唯一途径,这仍然需要更多的关注。作者指出,尽管基础设施、社区卫生工作者和资金可用性等方面有所改善,但社区参与、地区卫生规划、行动数据、部门间协调、政治承诺、公私伙伴关系、问责制和改善卫生工作队伍等领域仍需要立即关注,以加强该国的 PHC 系统,使其更有利于儿童,并有助于提高印度的儿童生存率。

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