Wolfson College, University of Oxford, United Kingdom.
Int J Health Plann Manage. 2013 Jul-Sep;28(3):290-302. doi: 10.1002/hpm.2193. Epub 2013 Jun 25.
The past year witnessed considerable turbulence in the Arab world-in this case, Syria, a lower middle-income country with a record of a strong public health infrastructure. This paper explores the current challenges facing its health system from reforms, civil strife and international sanctions all of which we argue have serious implications for population health. The health sector in Syria was little known, and until recently, it was well integrated to provide preventive and specialized care when needed. Regionally, it was one of the few countries ready and capable of addressing the challenges of demographic and epidemiologic transition with a long-standing emphasis on primary care and prevention, unlike most countries of the region. This context has changed dramatically through the recent implementation of reforms and the current civil war. Changes to financing, management and the delivery of health service placed access to services in jeopardy, but now, these are compounded by the destruction from an intractable and violent conflict and international sanctions. This paper explores some of the combined effects of reforms, conflict and sanctions on population health.
过去一年，阿拉伯世界经历了相当大的动荡——在这种情况下，叙利亚是一个中低收入国家，拥有强大的公共卫生基础设施。本文探讨了其卫生系统目前面临的改革、内乱和国际制裁等挑战，我们认为这些都对人口健康产生了严重影响。叙利亚的卫生部门鲜为人知，直到最近，它的整合程度还很高，能够在需要时提供预防和专业护理。在该地区，它是少数几个有能力和准备应对人口和流行病学转变挑战的国家之一，与该地区大多数国家不同，它长期以来一直重视初级保健和预防。这种情况因最近的改革实施和当前的内战而发生了巨大变化。卫生服务筹资、管理和提供方式的改变使获得服务的机会受到威胁，但现在，这种情况因难以解决的暴力冲突和国际制裁而更加恶化。本文探讨了改革、冲突和制裁对人口健康的综合影响。
