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将营养服务纳入医疗保健系统平台:我们现在在哪里,从哪里出发。

Integrating nutrition services into health care systems platforms: Where are we and where do we go from here.

机构信息

Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA.

Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.

出版信息

Matern Child Nutr. 2019 Jan;15 Suppl 1(Suppl 1):e12743. doi: 10.1111/mcn.12743.

Abstract

Integrating maternal-child nutrition into health care services is a desirable but complex task that requires implementation research studies. This special supplement, entitled "How to Strengthen Nutrition into the Health Platform: Programmatic Evidence and Experience from Low- and Middle-Income Countries" presents a collection of mixed-methods research and case studies mostly conducted in sub-Saharan Africa that help us gain a better understanding of the barriers and facilitators for this integration to happen. Collectively, the evidence confirms that integrating nutrition services as part of health care systems and other platforms is feasible, but for that to be successful, there is a need to address strong barriers related to all six key health care systems building blocks identified by the World Health Organization. These include financing, health information systems, health workforce, supplies and technology, governance, and service delivery. Moving forward, it is crucial that more robust implementation science research is conducted within the rough and tumble of real-world programming to better understand how to best integrate and scale up nutrition services across health care systems and other platforms based on dynamic complex adaptive systems frameworks. This research can help better understand how the key health care systems building blocks need to interlock and communicate with each other to improve the policymakers' ability to integrate and scale up nutrition services in a more timely and cost-effective way.

摘要

将母婴营养纳入医疗保健服务是一项理想但复杂的任务,需要实施研究。本特刊题为“如何将营养融入卫生平台:来自中低收入国家的方案证据和经验”,收录了一系列在撒哈拉以南非洲进行的混合方法研究和案例研究,帮助我们更好地理解这一整合所面临的障碍和促进因素。总的来说,这些证据证实,将营养服务纳入医疗保健系统和其他平台是可行的,但要想成功,就需要解决与世界卫生组织确定的所有六个关键医疗保健系统组成部分相关的强烈障碍。这些组成部分包括融资、卫生信息系统、卫生人力、用品和技术、治理以及服务提供。展望未来,必须在真实的方案规划中开展更有力的实施科学研究,以便更好地了解如何根据动态复杂适应系统框架,在医疗保健系统和其他平台中更好地整合和扩大营养服务。这项研究可以帮助更好地理解关键医疗保健系统组成部分如何相互关联和沟通,以提高决策者更及时、更具成本效益地整合和扩大营养服务的能力。

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