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通过全球融资机制突破极限:在50个高负担国家筹集额外支持以扩大针对妇女、儿童和青少年的救生干预措施的潜在影响。

Pushing the envelope through the Global Financing Facility: potential impact of mobilising additional support to scale-up life-saving interventions for women, children and adolescents in 50 high-burden countries.

作者信息

Chou Victoria B, Bubb-Humfryes Oliver, Sanders Rachel, Walker Neff, Stover John, Cochrane Tom, Stegmuller Angela, Magalona Sophia, Von Drehle Christian, Walker Damian G, Bonilla-Chacin Maria Eugenia, Boer Kimberly Rachel

机构信息

Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Cambridge Economic Policy Associates, London, UK.

出版信息

BMJ Glob Health. 2018 Oct 2;3(5):e001126. doi: 10.1136/bmjgh-2018-001126. eCollection 2018.

Abstract

INTRODUCTION

The Global Financing Facility (GFF) was launched to accelerate progress towards the Sustainable Development Goals (SDGs) through scaled and sustainable financing for Reproductive, Maternal, Newborn, Child and Adolescent Health and Nutrition (RMNCAH-N) outcomes. Our objective was to estimate the potential impact of increased resources available to improve RMNCAH-N outcomes, from expanding and scaling up GFF support in 50 high-burden countries.

METHODS

The potential impact of GFF was estimated for the period 2017-2030. First, two scenarios were constructed to reflect conservative and ambitious assumptions around resources that could be mobilised by the GFF model, based on GFF Trust Fund resources of US$2.6  billion. Next, GFF impact was estimated by scaling up coverage of prioritised RMNCAH-N interventions under these resource scenarios. Resource availability was projected using an Excel-based model and health impacts and costs were estimated using the Lives Saved Tool (V.5.69 b9).

RESULTS

We estimate that the GFF partnership could collectively mobilise US$50-75  billion of additional funds for expanding delivery of life-saving health and nutrition interventions to reach coverage of at least 70% for most interventions by 2030. This could avert 34.7  million deaths-including preventable deaths of mothers, newborns, children and stillbirths-compared with flatlined coverage, or 12.4  million deaths compared with continuation of historic trends. Under-five and neonatal mortality rates are estimated to decrease by 35% and 34%, respectively, and stillbirths by 33%.

CONCLUSION

The GFF partnership through country- contextualised prioritisation and innovative financing could go a long way in increasing spending on RMNCAH-N and closing the existing resource gap. Although not all countries will reach the SDGs by relying on gains from the GFF platform alone, the GFF provides countries with an opportunity to significantly improve RMNCAH-N outcomes through achievable, well-directed changes in resource allocation.

摘要

引言

全球融资机制(GFF)的设立旨在通过为生殖、孕产妇、新生儿、儿童及青少年健康与营养(RMNCAH-N)成果提供规模化且可持续的融资,加速实现可持续发展目标(SDGs)。我们的目标是评估在50个高负担国家扩大和增加全球融资机制的支持后,可用于改善RMNCAH-N成果的更多资源的潜在影响。

方法

对2017年至2030年期间全球融资机制的潜在影响进行了评估。首先,构建了两种情景,以反映围绕全球融资机制模式可筹集资源的保守和乐观假设,这是基于26亿美元的全球融资机制信托基金资源。接下来,通过在这些资源情景下扩大优先RMNCAH-N干预措施的覆盖范围来估计全球融资机制的影响。使用基于Excel的模型预测资源可用性,并使用挽救生命工具(V.5.69 b9)估计健康影响和成本。

结果

我们估计,全球融资机制伙伴关系总共可以筹集500亿至750亿美元的额外资金,用于扩大提供挽救生命的健康和营养干预措施,到2030年使大多数干预措施的覆盖范围至少达到70%。与覆盖范围停滞不前相比,这可以避免3470万例死亡,包括可预防的母亲、新生儿、儿童死亡及死产;与延续历史趋势相比,可避免1240万例死亡。估计五岁以下儿童和新生儿死亡率分别下降35%和34%,死产率下降33%。

结论

全球融资机制伙伴关系通过根据各国情况确定优先事项和创新融资方式,在增加RMNCAH-N支出和弥合现有资源差距方面可以大有作为。虽然仅靠全球融资机制平台取得的成果并非所有国家都能实现可持续发展目标,但全球融资机制为各国提供了一个机会,通过在资源分配方面进行切实可行、方向明确的改变,显著改善RMNCAH-N成果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ad9/6254741/d4d26e9dce4a/bmjgh-2018-001126f01.jpg

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