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识别非洲医疗系统面临的关键挑战及潜在解决方案。

Identifying Key Challenges Facing Healthcare Systems In Africa And Potential Solutions.

作者信息

Oleribe Obinna O, Momoh Jenny, Uzochukwu Benjamin Sc, Mbofana Francisco, Adebiyi Akin, Barbera Thomas, Williams Roger, Taylor-Robinson Simon D

机构信息

Excellence and Friends Management Care Centre (EFMC), Abuja, Nigeria.

Department of Epidemiology and Community Medicine, Federal University Lafia, Nasarawa State, Nigeria.

出版信息

Int J Gen Med. 2019 Nov 6;12:395-403. doi: 10.2147/IJGM.S223882. eCollection 2019.

Abstract

INTRODUCTION

Healthcare systems in Africa suffer from neglect and underfunding, leading to severe challenges across the six World Health Organization (WHO) pillars of healthcare delivery. We conducted this study to identify the principal challenges in the health sector in Africa and their solutions for evidence-based decisions, policy development and program prioritization.

METHODS

The study was conducted as part of a recent African Epidemiological Association Meeting in Maputo, Mozambique with participants drawn from 11 African countries, Cuba, Portugal and the United Kingdom. Participants were divided into 10 groups, consisting of 7 to 10 persons each. Brainstorming approaches were used in a structured, modified nominal group process exercise to identify key challenges and strategies to mitigate healthcare service challenges in Africa. Identified challenges and solutions were prioritised by ranking 1-5, with 1 most important and 5 being least important.

RESULTS

The first three challenges identified were inadequate human resources (34.29%), inadequate budgetary allocation to health (30%) and poor leadership and management (8.45%). The leading solutions suggested included training and capacity building for health workers (29.69%), increase budgetary allocation to health (20.31%) and advocacy for political support and commitment (12.31%).

CONCLUSION

The underdeveloped healthcare systems in Africa need radical solutions with innovative thought to break the current impasse in service delivery. For example, public-private initiatives should be sought, where multinational companies extracting resources from Africa might be encouraged to plough some of the profits back into healthcare for the communities providing the workforce for their commercial activities. Most problems and their solutions lie within human resources, budget allocation and management. These should be accorded the highest priority for better health outcomes.

摘要

引言

非洲的医疗保健系统受到忽视且资金不足,这在世界卫生组织(WHO)医疗保健服务的六大支柱方面引发了严峻挑战。我们开展这项研究,旨在确定非洲卫生部门的主要挑战及其解决方案,以便做出基于证据的决策、制定政策以及确定项目优先级。

方法

该研究是最近在莫桑比克马普托举行的非洲流行病学协会会议的一部分,参与者来自11个非洲国家、古巴、葡萄牙和英国。参与者被分成10组,每组7至10人。在结构化的、经过改进的名义小组流程练习中采用头脑风暴法来确定非洲医疗保健服务面临的关键挑战以及缓解这些挑战的策略。通过1至5的排名对确定的挑战和解决方案进行优先级排序,1表示最重要,5表示最不重要。

结果

确定的前三大挑战分别是人力资源不足(34.29%)、卫生预算分配不足(30%)以及领导力和管理不善(8.45%)。提出的主要解决方案包括对卫生工作者进行培训和能力建设(29.69%)、增加卫生预算分配(20.31%)以及争取政治支持和承诺的宣传(12.31%)。

结论

非洲欠发达的医疗保健系统需要激进的解决方案和创新思维来打破当前服务提供方面的僵局。例如,应寻求公私合作举措,鼓励从非洲开采资源的跨国公司将部分利润投入到为其商业活动提供劳动力的社区的医疗保健中。大多数问题及其解决方案都集中在人力资源以及预算分配和管理方面。为了取得更好的健康成果,应将这些方面列为最优先事项。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faa8/6844097/f41f4911bfc4/IJGM-12-395-g0001.jpg

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