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语境化在加强非传染性疾病规划和政策执行以实现全民健康中的作用。

The role of contextualisation in enhancing non-communicable disease programmes and policy implementation to achieve health for all.

机构信息

The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.

Department of Preventive Medicine and Center for Global Cardiovascular Health, Northwestern University's Feinberg School of Medicine, Chicago, United States of America.

出版信息

Health Res Policy Syst. 2020 Apr 17;18(1):38. doi: 10.1186/s12961-020-00553-5.

Abstract

The September 2019 United Nations' High-Level Meeting renewed political commitments to invest in universal health coverage by strengthening health systems, programmes and policies to achieve 'health for all'. This Political Declaration is relevant to addressing the increasing global burden of non-communicable diseases, but how can evidence-based programmes and policies be meaningfully implemented and integrated into local contexts? In this Commentary, we describe how the process of contextualisation and associated tools, such as ecological frameworks, implementation research frameworks, health system indicators, effective system strengthening strategies and evidence mapping databases with priority-setting, can enhance the implementation and integration of non-communicable disease prevention and control policies and programmes. Examples across health platforms include (1) population approaches to reducing excess sodium intake, (2) fixed-dose combination therapy for cardiovascular disease prevention and control, and (3) health systems strengthening for improving the quality and safety of cardiovascular care. Contextualisation is needed to transfer evidence into locally relevant and impactful policies and programmes. The systematic and comprehensive use of contextualisation tools leverages key implementation research principles to achieve 'health for all'.

摘要

2019 年 9 月举行的联合国高级别会议再次作出政治承诺,通过加强卫生系统、方案和政策投资于全民健康覆盖,以实现“人人享有健康”。本《政治宣言》与应对不断增加的全球非传染性疾病负担有关,但如何才能切实执行循证方案和政策并将其纳入地方情况?在本述评中,我们描述了使方案和政策本土化的过程以及相关工具(如生态框架、实施研究框架、卫生系统指标、加强系统的有效战略和具有优先排序的循证绘图数据库)如何增强非传染性疾病预防和控制政策及方案的执行和整合。各卫生平台上的例子包括:(1) 减少过量钠摄入量的人群方法,(2) 用于心血管疾病预防和控制的固定剂量联合疗法,以及 (3) 为提高心血管护理质量和安全而加强卫生系统。需要使证据适应当地情况,以将其转化为有意义和有影响力的政策和方案。系统和全面地使用使方案和政策本土化的工具,可以利用实施研究的关键原则来实现“人人享有健康”。

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