Nguyen Ha, Snider Jeremy, Ravishankar Nirmala, Magvanjav Oyunbileg
International Health Division, Abt Associates Inc, Bethesda, MD, USA.
Reprod Health Matters. 2011 May;19(37):62-74. doi: 10.1016/S0968-8080(11)37561-1.
The present study provides evidence to support enhanced attention to reproductive health and comprehensive measures to increase access to quality reproductive health services. We compare and contrast the financing and utilization of reproductive health services in six sub-Saharan African countries using data from National Health Accounts and Demographic and Health Surveys. Spending on reproductive health in 2006 ranged from US$4 per woman of reproductive age in Ethiopia to US$17 in Uganda. These are below the necessary level for assuring adequate services given that an internationally recommended spending level for family planning alone was US$16 for 2006. Moreover, reproductive health spending shows signs of decline in tandem with insufficient improvement in service utilization. Public providers played a predominant role in antenatal and delivery care for institutional births, but home deliveries with unqualified attendants dominated. The private sector was a major supplier of condoms, oral pills and IUDs. Private clinics, pharmacies and drug vendors were important sources of STI treatment. The findings highlight the need to commit greatly increased funding for reproductive health services as well as more policy attention to the contribution of public, private and informal providers and the role of collaboration among them to expand access to services for under-served populations.
本研究提供了证据，以支持加强对生殖健康的关注以及采取综合措施来增加获得优质生殖健康服务的机会。我们利用国家卫生账户和人口与健康调查的数据，对撒哈拉以南非洲六个国家的生殖健康服务融资和利用情况进行了比较和对比。2006年，埃塞俄比亚每位育龄妇女的生殖健康支出为4美元，乌干达为17美元。鉴于2006年国际上仅计划生育的建议支出水平为16美元，这些支出低于确保提供充足服务的必要水平。此外，生殖健康支出显示出下降迹象，同时服务利用率的改善不足。公共提供者在机构分娩的产前和分娩护理中发挥了主要作用，但由不合格人员接生的家庭分娩占主导地位。私营部门是避孕套、口服避孕药和宫内节育器的主要供应商。私人诊所、药店和药品供应商是性传播感染治疗的重要来源。研究结果强调，需要大幅增加对生殖健康服务的资金投入，并在政策上更多地关注公共、私营和非正规提供者的贡献以及它们之间的合作在为服务不足人群扩大服务获取方面的作用。
