Tayler-Smith Katie, Kociejowski Alice, de Lamotte Nadine, Gerard Seco, Ponsar Frederique, Philips Mit, Zachariah Rony
Médecins Sans Frontières, Operational Research Unit, Medical Department, Brussels Operational Centre, Brussels, Belgium.
Médecins Sans Frontières, London UK.
J Public Health Afr. 2011 Feb 11;2(1):e12. doi: 10.4081/jphia.2011.e12. eCollection 2011 Mar 1.
Halving the burden of malaria by 2015 and ensuring that 80% of people with malaria receive treatment is among the health related targets of the Millennium Development Goals (MDGs). Despite political momentum toward achieving this target, progress is slow and many with malaria (particularly in poor and rural communities in Africa) are still without access to effective treatment. Finding ways to improve access to anti-malarial treatment in Africa is essential to achieve the malaria related and other MDG targets. During its work in Chad, Sierra Leone and Mali in the period 2004 to 2008, Médecins Sans Frontières showed that it was possible to significantly improve access to effective malaria treatment through: i) the removal of health centre level user fees for essential healthcare for vulnerable population groups, ii) the introduction of free community based treatment for children using malaria village workers to diagnose and treat simple malaria in communities where geographical and financial barriers limited access to effective malaria care, iii) the improved diagnosis and treatment of malaria using rapid diagnosis tests and artemisinin based combination therapy, at both health facilities and in the community. This paper describes and discusses these strategies and their related impact.
到2015年将疟疾负担减半并确保80%的疟疾患者得到治疗，是千年发展目标（MDGs）中与健康相关的目标之一。尽管在实现这一目标方面有政治动力，但进展缓慢，许多疟疾患者（特别是非洲贫困和农村社区的患者）仍然无法获得有效治疗。找到改善非洲抗疟治疗可及性的方法对于实现与疟疾相关的及其他千年发展目标至关重要。无国界医生组织在2004年至2008年期间在乍得、塞拉利昂和马里开展工作时表明，通过以下方式可以显著改善有效疟疾治疗的可及性：一、取消卫生中心对弱势群体基本医疗保健的用户收费；二、在地理和经济障碍限制有效疟疾治疗可及性的社区，利用疟疾村工为儿童提供免费的社区治疗，以诊断和治疗单纯性疟疾；三、在卫生设施和社区使用快速诊断检测和基于青蒿素的联合疗法改善疟疾的诊断和治疗。本文描述并讨论了这些策略及其相关影响。
