Scammell Katy, Noble Douglas J, Rasanathan Kumanan, O'Connell Thomas, Ahmed Aishath Shahula, Begkoyian Genevieve, Goldner Tania, Jayatissa Renuka, Kuppens Lianne, Raaijmakers Hendrikus, Simbeye Isabel Vashti, Varkey Sherin, Chopra Mickey
UNICEF Regional Office for South Asia, Kathmandu, Nepal.
UNICEF Headquarters, New York, New York, USA.
BMJ Glob Health. 2016 Jun 22;1(1):e000017. doi: 10.1136/bmjgh-2015-000017. eCollection 2016.
The United Nations made universal health coverage (UHC) a key health goal in 2012 and it is one of the Sustainable Development Goals' targets. This analysis focuses on UHC for mothers and children in the 8 countries of South Asia. A high level overview of coverage of selected maternal, newborn and child health services, equity, quality of care and financial risk protection is presented. Common barriers countries face in achieving UHC are discussed and solutions explored. In countries of South Asia, except Bhutan and Maldives, between 42% and 67% of spending on health comes from out-of-pocket expenditure (OOPE) and government expenditure does not align with political aspirations. Even where reported coverage of services is good, quality of care is often low and the poorest fare worst. There are strong examples of ongoing successes in countries such as Bhutan, the Maldives and Sri Lanka. Related to this success are factors such as lower OOPE and higher spending on health. To make progress in achieving UHC, financial and non-financial barriers to accessing and receiving high-quality healthcare need to be reduced, the amount of investment in essential health services needs to be increased and allocation of resources must disproportionately benefit the poorest.
2012年，联合国将全民健康覆盖（UHC）确立为一项关键卫生目标，它也是可持续发展目标的指标之一。本分析聚焦于南亚8国的孕产妇和儿童的全民健康覆盖情况。文中对选定的孕产妇、新生儿和儿童卫生服务的覆盖情况、公平性、医疗服务质量以及经济风险保护进行了高层次概述。讨论了各国在实现全民健康覆盖方面面临的常见障碍，并探索了解决方案。在南亚各国，除不丹和马尔代夫外，42%至67%的卫生支出来自自费支出（OOPE），且政府支出与政治抱负不一致。即使在报告的服务覆盖率良好的地方，医疗服务质量往往也很低，最贫困人群的情况最差。不丹、马尔代夫和斯里兰卡等国存在持续取得成功的有力例证。与这一成功相关的因素包括较低的自费支出和较高的卫生支出。为在实现全民健康覆盖方面取得进展，需要减少获得和接受高质量医疗保健的经济和非经济障碍，增加对基本卫生服务的投资金额，并且资源分配必须使最贫困人群受益更多。
