Freeman Toby, Baum Fran, Lawless Angela, Labonté Ronald, Sanders David, Boffa John, Edwards Tahnia, Javanparast Sara
Senior Research Fellow at the Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide, Australia.
Director of the Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide, Australia.
Health Hum Rights. 2016 Dec;18(2):93-108.
Universal health coverage provides a framework to achieve health services coverage but does not articulate the model of care desired. Comprehensive primary health care includes promotive, preventive, curative, and rehabilitative interventions and health equity and health as a human right as central goals. In Australia, Aboriginal community-controlled health services have pioneered comprehensive primary health care since their inception in the early 1970s. Our five-year project on comprehensive primary health care in Australia partnered with six services, including one Aboriginal community-controlled health service, the Central Australian Aboriginal Congress. Our findings revealed more impressive outcomes in several areas-multidisciplinary work, community participation, cultural respect and accessibility strategies, preventive and promotive work, and advocacy and intersectoral collaboration on social determinants of health-at the Aboriginal community-controlled health service compared to the other participating South Australian services (state-managed and nongovernmental ones). Because of these strengths, the Central Australian Aboriginal Congress's community-controlled model of comprehensive primary health care deserves attention as a promising form of implementation of universal health coverage by articulating a model of care based on health as a human right that pursues the goal of health equity.
全民健康覆盖提供了一个实现卫生服务覆盖的框架，但并未阐明所期望的照护模式。全面初级卫生保健包括促进、预防、治疗和康复干预措施，并将健康公平和健康作为一项人权作为核心目标。在澳大利亚，自20世纪70年代初成立以来，原住民社区控制的卫生服务机构一直是全面初级卫生保健的先驱。我们在澳大利亚开展的为期五年的全面初级卫生保健项目与六个服务机构合作，其中包括一个原住民社区控制的卫生服务机构——澳大利亚中部原住民大会。我们的研究结果显示，与其他参与项目的南澳大利亚服务机构（州管理和非政府服务机构）相比，原住民社区控制的卫生服务机构在几个领域取得了更显著的成果，包括多学科工作、社区参与、文化尊重和可及性策略、预防和促进工作，以及在健康的社会决定因素方面的宣传和部门间合作。由于这些优势，澳大利亚中部原住民大会的全面初级卫生保健社区控制模式值得关注，因为它通过阐明一种基于将健康作为人权的照护模式，追求健康公平目标，有望成为全民健康覆盖的一种实施形式。
