Global Health Equities Residency Track, University of Pennsylvania, Philadelphia, PA, USA.
Glob Public Health. 2011;6(7):687-702. doi: 10.1080/17441692.2010.521165. Epub 2011 May 24.
Research into the effects of global health initiatives (GHIs) on health systems has largely left out the viewpoints and contributions of civil society. This study details civil society's perspective regarding the effects of two GHIs, the US President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), on country health systems and the added value of civil society interacting with GHIs to strengthen health systems. The study employed qualitative data collection methods using semi-structured interviews administered during focus groups and key informant interviews. A range of health system stakeholders were interviewed in Kenya, Malawi, Uganda and Zambia. Data were coded and analysed for themes and sub-themes. In total, 2910 civil society participants provided information individually or in focus groups. Respondents reported that GHIs have contributed to dramatic health benefits within and outside of a disease-specific focus, including health systems strengthening efforts. However, opportunities for synergy between GHIs and health systems have been missed, and GHIs have not worked sufficiently to close capacity gaps of grassroots civil society organisations. Despite some governance innovations, civil society's opportunities to participate meaningfully in GHI priority setting efforts are limited. Recommendations are included on how to best use GHIs to strengthen health systems by partnering with civil society.
全球卫生倡议（GHIs）对卫生系统的影响研究在很大程度上忽略了民间社会的观点和贡献。本研究详细介绍了民间社会对两项 GHIs，即美国总统艾滋病救援计划（PEPFAR）和全球抗击艾滋病、结核病和疟疾基金（GFATM）对国家卫生系统的影响以及民间社会与 GHIs 互动以加强卫生系统的附加价值的看法。该研究采用定性数据收集方法，在焦点小组和关键知情人访谈中使用半结构化访谈。在肯尼亚、马拉维、乌干达和赞比亚采访了一系列卫生系统利益攸关方。对主题和子主题进行了编码和分析。共有 2910 名民间社会参与者单独或在焦点小组中提供了信息。受访者报告称，GHIs 在特定疾病重点内外都带来了巨大的健康益处，包括加强卫生系统的努力。然而，GHIs 与卫生系统之间协同增效的机会被错失，GHIs 并没有努力充分弥补基层民间社会组织的能力差距。尽管有一些治理创新，但民间社会有意义地参与 GHI 优先事项制定工作的机会有限。报告中包括了如何通过与民间社会合作，利用 GHIs 来加强卫生系统的建议。
