印度尼西亚西爪哇省艾滋病病毒/艾滋病防控中的优先事项设定：基于合理性问责框架的评估
Priority setting in HIV/AIDS control in West Java Indonesia: an evaluation based on the accountability for reasonableness framework.
作者信息
Tromp Noor, Prawiranegara Rozar, Subhan Riparev Harris, Siregar Adiatma, Sunjaya Deni, Baltussen Rob
机构信息
Department of Primary and Community Care, Radboud University Medical Center, Geert Grooteplein Noord No. 21, 6525 EZ Nijmegen, The Netherlands, Medical Research Unit, Faculty of Medicine, Padjadjaran University, Jalan Eijkman No. 28, 40161 Bandung, Indonesia, Department of Economics, Faculty of Economics, Padjadjaran University, Jalan Dipatiukur No. 35, 40132 Bandung, Indonesia and Department of Public Health, Faculty of Medicine, Padjadjaran University, Jalan Eyckman No. 38, 40161 Bandung, Indonesia Department of Primary and Community Care, Radboud University Medical Center, Geert Grooteplein Noord No. 21, 6525 EZ Nijmegen, The Netherlands, Medical Research Unit, Faculty of Medicine, Padjadjaran University, Jalan Eijkman No. 28, 40161 Bandung, Indonesia, Department of Economics, Faculty of Economics, Padjadjaran University, Jalan Dipatiukur No. 35, 40132 Bandung, Indonesia and Department of Public Health, Faculty of Medicine, Padjadjaran University, Jalan Eyckman No. 38, 40161 Bandung, Indonesia
Department of Primary and Community Care, Radboud University Medical Center, Geert Grooteplein Noord No. 21, 6525 EZ Nijmegen, The Netherlands, Medical Research Unit, Faculty of Medicine, Padjadjaran University, Jalan Eijkman No. 28, 40161 Bandung, Indonesia, Department of Economics, Faculty of Economics, Padjadjaran University, Jalan Dipatiukur No. 35, 40132 Bandung, Indonesia and Department of Public Health, Faculty of Medicine, Padjadjaran University, Jalan Eyckman No. 38, 40161 Bandung, Indonesia.
出版信息
Health Policy Plan. 2015 Apr;30(3):345-55. doi: 10.1093/heapol/czu020. Epub 2014 Apr 15.
BACKGROUND
Indonesia has insufficient resources to adequately respond to the HIV/AIDS epidemic, and thus faces a great challenge in prioritizing interventions. In many countries, such priority setting processes are typically ad hoc and not transparent leading to unfair decisions. Here, we evaluated the priority setting process in HIV/AIDS control in West Java province against the four conditions of the accountability for reasonableness (A4R) framework: relevance, publicity, appeals and revision, and enforcement.
METHODS
We reviewed government documents and conducted semi-structured qualitative interviews based on the A4R framework with 22 participants of the 5-year HIV/AIDS strategy development for 2008-13 (West Java province) and 2007-11 (Bandung).
RESULTS
We found that criteria for priority setting were used implicitly and that the strategies included a wide range of programmes. Many stakeholders were involved in the process but their contribution could be improved and particularly the public and people living with HIV/AIDS could be better engaged. The use of appeal and publicity mechanisms could be more transparent and formally stated. Public regulations are not yet installed to ensure fair priority setting.
CONCLUSIONS
To increase fairness in HIV/AIDS priority setting, West Java should make improvements on all four conditions of the A4R framework.
背景
印度尼西亚资源不足，难以充分应对艾滋病毒/艾滋病疫情，因此在确定干预措施的优先次序上面临巨大挑战。在许多国家，此类优先事项确定过程通常是临时的且不透明，导致决策不公平。在此，我们对照合理问责制（A4R）框架的四个条件，即相关性、公开性、申诉与修订以及执行情况，评估了西爪哇省艾滋病毒/艾滋病控制中的优先事项确定过程。
方法
我们查阅了政府文件，并根据A4R框架对参与2008 - 2013年（西爪哇省）和2007 - 2011年（万隆）为期5年的艾滋病毒/艾滋病战略制定的22名参与者进行了半结构化定性访谈。
结果
我们发现，优先事项确定标准是隐性使用的，而且战略涵盖了广泛的项目。许多利益相关者参与了该过程，但他们的贡献可以得到改进，特别是公众以及艾滋病毒/艾滋病感染者可以更好地参与进来。申诉和公开机制的使用可以更加透明并正式说明。尚未制定公共法规以确保公平的优先事项确定。
结论
为提高艾滋病毒/艾滋病优先事项确定的公平性，西爪哇应在A4R框架的所有四个条件方面做出改进。
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