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构建一个实用的国家一体化健康平台:以坦桑尼亚为例。

Building a functional national One Health platform: the case of Tanzania.

作者信息

Kitua Andrew Y, Scribner Susan, Rasmuson Mark, Kambarage Dominic, Mghamba Janneth, Mwakapeje Elibariki R, Chinyuka Harrison, Bernard Jubilate, Zimmerman Kate, Duale Sambe, Mutonga David

机构信息

DAI Global Health / USAID/EPT-2 Preparedness and Response Project, Kampala, Uganda.

Public Health and Environment Advancement Interventions NGO 'NGALAKERI', Kihonda, Plot 980/81, White House, P.O. Box 5465, Morogoro, United Republic of Tanzania.

出版信息

One Health Outlook. 2019 Nov 27;1:3. doi: 10.1186/s42522-019-0003-0. eCollection 2019.

Abstract

BACKGROUND

The USAID Preparedness and Response (P&R) project's publication on Multisectoral Coordination that Works identified five dimensions most critical to creating effective and sustainable One Health platforms: political commitment, institutional structure, management and coordination capacity, technical and financial resources, and joint planning and implementation. This case study describes Tanzania experience in using these dimensions to establish a functional One Health platform. The main objective of this case study was to document the process of institutionalizing the One Health approach in Tanzania.

METHODS

An analysis of the process used to establish and institutionalize the MCM in Tanzania through addressing the five dimensions mentioned above was conducted between August 2018 and January 2019. Progress activity reports, annual reports and minutes of meetings and consultations regarding the establishment of the Tanzania national One Health platform were examined. Relevant One Health publications were studied as reference material.

RESULTS

This case study illustrates the time and level of effort required of multiple partners to build a functional multi-sectoral coordinating mechanism (MCM). Key facilitating factors were identified and the importance of involving policy and decision makers at all stages of the process to facilitate policy decisions and the institutionalization process was underscored. The need for molding the implementation process using lessons learnt along the way -- "sailing the ship as it was being built" -- is demonstrated.

CONCLUSIONS

Tanzania now has a functioning and institutionalized MCM with a sound institutional structure and capacity to prevent, detect early and respond to health events. The path to its establishment required the patient commitment of a core group of One Health champions and stakeholders along the way to examine carefully and iteratively how best to structure productive multisectoral coordination in the country. The five dimensions identified by the Preparedness and Response project may provide useful guidance to other countries working to establish functional MCM.

摘要

背景

美国国际开发署备灾与应对(P&R)项目关于有效多部门协调的出版物确定了对建立有效且可持续的一体化健康平台最为关键的五个维度:政治承诺、机构结构、管理与协调能力、技术和财政资源以及联合规划与实施。本案例研究描述了坦桑尼亚在利用这些维度建立一个有效的一体化健康平台方面的经验。本案例研究的主要目的是记录坦桑尼亚将一体化健康方法制度化的过程。

方法

2018年8月至2019年1月期间,通过探讨上述五个维度,对坦桑尼亚建立多部门协调机制并使其制度化的过程进行了分析。审查了关于建立坦桑尼亚国家一体化健康平台的进展活动报告、年度报告以及会议和磋商记录。研究了相关的一体化健康出版物作为参考资料。

结果

本案例研究说明了多个伙伴建立一个有效的多部门协调机制(MCM)所需的时间和努力程度。确定了关键促进因素,并强调在该过程的各个阶段让政策和决策者参与以促进政策决策和制度化进程的重要性。展示了利用沿途吸取的经验教训塑造实施过程的必要性——“边造船边航行”。

结论

坦桑尼亚现在拥有一个运作良好且制度化的多部门协调机制,具备健全的机构结构以及预防、早期发现和应对健康事件的能力。其建立之路需要一群核心的一体化健康倡导者和利益相关者的耐心投入,他们在这个过程中仔细且反复地审视如何以最佳方式构建该国高效的多部门协调。备灾与应对项目确定的五个维度可能为其他致力于建立有效多部门协调机制的国家提供有益指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63b1/7990094/aa7f1bb97ee9/42522_2019_3_Fig1_HTML.jpg

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