School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown, 2193, South Africa.
J Public Health Policy. 2011;32 Suppl 1:S44-51. doi: 10.1057/jphp.2011.37.
In sub-Saharan Africa previous health gains have been reversed and many countries are not on track to achieving the Millennium Development Goals. The reasons are multifaceted but relate fundamentally to poorly functioning health systems and the HIV, AIDS, and tuberculosis epidemics. Although population health can be improved through specific health interventions that target high burden diseases, these interventions must be offered within a functional health system for optimal effectiveness. Schools of Public Health in Africa should respond to the many systemic issues that confound improvements in population level health through reviewing approaches to health professional training that incorporates a public health approach, focusing on health systems research; collaboration, advocacy and networking; and strengthening health systems management. Institutional mechanisms to define joint research agendas and two-way exchanges between universities and national health systems are required.
在撒哈拉以南非洲,先前取得的卫生成果已经出现逆转,许多国家也无法实现千年发展目标。造成这种局面的原因有很多,但根本上与运转不良的卫生系统以及艾滋病毒、艾滋病和结核病的流行有关。虽然可以通过针对高负担疾病的具体卫生干预措施来改善人群健康,但这些干预措施必须在功能健全的卫生系统内提供,才能发挥最大效果。非洲的公共卫生学院应该应对许多影响人群健康水平改善的系统性问题,办法是审查将公共卫生方法纳入其中的卫生专业人员培训方法,重点是卫生系统研究、合作、宣传和联网,以及加强卫生系统管理。需要建立机构机制,确定联合研究议程,并促进大学与国家卫生系统之间的双向交流。