School of Public Health, University of Health and Allied Sciences, Ho, GH.
Legon Centre for International Affairs and Diplomacy, University of Ghana, Accra, GH.
Ann Glob Health. 2019 Aug 16;85(1):113. doi: 10.5334/aogh.2514.
Meeting health security capacity in sub-Saharan Africa will require strengthening existing health systems to prevent, detect, and respond to any threats to health. The purpose of this review was to examine the literature on health workforce, surveillance, and health governance issues for health systemsstrengthening.
We searched PubMed, Science Direct, Cochrane library, CINAHL, Web of Science, EMBASE, EBSCO, Google scholar, and the WHO depository library databases for English-language publications between January 2007 and February 2017. Electronic searches for selected articles were supplemented by manual reference screening. The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.
Out of 1,548 citations retrieved from the electronic searches, 31 articles were included in the review. Any country health system that trains a cadre of health professionals on the job, reduces health workforce attrition levels, and builds local capacity for health care workers to apply innovative mHealth technologies improves health sector performance. Building novel surveillance systems can improve clinical care and improve health system preparedness for health threats. Effective governance processes build strong partnerships for health and create accountability mechanisms for responding to health emergencies.
Overall, policy shifts in African countries' health systems that prioritize training a cadre of willing and able workforce, invest in robust and cost-effective surveillance capacity, and create financial accountability and good governance are vital in health strengthening efforts.
要实现撒哈拉以南非洲地区的卫生安全保障能力，就需要加强现有的卫生系统，以预防、发现和应对任何对健康的威胁。本文旨在对卫生系统强化方面的卫生人力、监测和卫生治理问题的文献进行审查。
我们在 2007 年 1 月至 2017 年 2 月期间，检索了 PubMed、Science Direct、Cochrane 图书馆、CINAHL、Web of Science、EMBASE、EBSCO、Google Scholar 和世界卫生组织文献库数据库中的英文文献。对选定文章的电子检索通过手动参考筛选进行补充。综述遵循系统评价和荟萃分析的首选报告项目 (PRISMA) 指南。
从电子检索中检索到的 1548 条引文，有 31 篇文章被纳入综述。任何国家的卫生系统，如果能在职培训卫生专业人员、降低卫生人力流失水平，并为卫生工作者应用创新的移动医疗技术建立本地能力，都将提高卫生部门的绩效。建立新的监测系统可以改善临床护理，并为应对卫生威胁做好卫生系统的准备。有效的治理过程为卫生建立了强大的伙伴关系，并为应对卫生紧急情况创造了问责机制。
总的来说，非洲国家卫生系统的政策转变，优先培训有意愿和能力的卫生人力、投资于强大和具有成本效益的监测能力，并建立财务问责制和良好的治理，对于卫生强化工作至关重要。
