European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
Health Policy Plan. 2012 Jul;27(4):281-7. doi: 10.1093/heapol/czr040. Epub 2011 May 24.
Since becoming independent at the break-up of the Soviet Union in 1991, the countries of Central Asia have made profound changes to their health systems, affecting organization and governance, financing and delivery of care. The changes took place in a context of adversity, with major political transition, economic recession, and, in the case of Tajikistan, civil war, and with varying degrees of success. In this paper we review these experiences in this rarely studied part of the world to identify what has worked. This includes effective governance, the co-ordination of donor activities, linkage of health care restructuring to new economic instruments, and the importance of pilot projects as precursors to national implementation, as well as gathering support among both health workers and the public.
自 1991 年苏联解体独立以来，中亚国家的卫生系统发生了深刻的变化，影响了组织和治理、融资和医疗服务的提供。这些变化发生在一个逆境的背景下，包括重大的政治转型、经济衰退，在塔吉克斯坦的情况下，还有内战，并且在不同程度上取得了成功。在本文中，我们回顾了这个在世界上很少被研究的地区的这些经验，以确定哪些是有效的。这包括有效的治理、协调捐助者的活动、将医疗保健结构调整与新的经济手段联系起来，以及试点项目作为国家实施的前兆的重要性，以及在卫生工作者和公众中获得支持。
