Gorsky Martin, Sirrs Christopher
Centre for History in Public Health, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH E-mail:
J Glob Hist. 2017 Nov;12(3):361-385. doi: 10.1017/S1740022817000134.
This article examines the development of health system metrics by international organizations, exploring their relationship to the politics of world health. Current historiography treats measurement either as progressive illumination or adopts a critical stance, viewing indicators as instruments of global governance by powerful nations. We draw on diverse statistical publications to provide an empirical overview of change and continuity, beginning with the League of Nations Health Organization, which initiated health system statistics, and concluding with the , with its controversial comparative rankings. We then develop analysis and explanation of these trends. Population indicators appeared consistently owing to their protective function and compatibility with development thinking. Others, related to provision, financing, and coverage, appeared more sporadically, owing to changing trends and assumptions in international health. While partly affirming the critical literature, metrics were also used by peripheral or resistant actors to challenge or influence policy at the centre.
本文考察了国际组织卫生系统指标的发展情况,探讨其与全球卫生政治的关系。当前的史学研究要么将衡量视为渐进式的阐明,要么采取批判立场,将指标视为强国全球治理的工具。我们利用各种统计出版物,从发起卫生系统统计的国际联盟卫生组织开始,到具有争议性比较排名的[具体组织名称缺失]结束,提供了变化与延续性的实证概述。然后,我们对这些趋势进行分析和解释。人口指标因其保护功能以及与发展思维的兼容性而始终存在。其他与服务提供、筹资和覆盖范围相关的指标则因国际卫生领域不断变化的趋势和假设而出现得更为零散。虽然部分认可批判性文献的观点,但这些指标也被边缘或抵制行为体用来挑战或影响核心政策。