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新冠疫情应对:减轻对其他健康领域的负面影响。

COVID-19 response: mitigating negative impacts on other areas of health.

机构信息

Health and Nutrition Cluster, Institute of Development Studies, Brighton, UK

Health and Nutrition Cluster, Institute of Development Studies, Brighton, UK.

出版信息

BMJ Glob Health. 2021 Apr;6(4). doi: 10.1136/bmjgh-2020-004110.

Abstract

'Vertical' responses focused primarily on preventing and containing COVID-19 have been implemented in countries around the world with negative consequences for other health services, people's access to and use of them, and associated health outcomes, especially in low-income and middle-income countries (LMICs). 'Lockdowns' and restrictive measures, especially, have complicated service provision and access, and disrupted key supply chains. Such interventions, alongside more traditional public health measures, interact with baseline health, health system, and social and economic vulnerabilities in LMICs to compound negative impacts. This analysis, based on a rapid evidence assessment by the Social Science in Humanitarian Action Platform in mid-2020, highlights the drivers and evidence of these impacts, emphasises the additional vulnerabilities experienced by marginalised social groups, and provides insight for governments, agencies, organisations and communities to implement more proportionate, appropriate, comprehensive and socially just responses that address COVID-19 in the context of and alongside other disease burdens. In the short term, there is an urgent need to monitor and mitigate impacts of pandemic responses on health service provision, access and use, including through embedding COVID-19 response within integrated health systems approaches. These efforts should also feed into longer-term strategies to strengthen health systems, expand universal healthcare coverage and attend to the social determinants of health-commitments, both existing and new-which governments, donors and international agencies must make and be held accountable to. Crucially, affected communities must be empowered to play a central role in identifying health priorities, allocating resources, and designing and delivering services.

摘要

“垂直”应对措施主要集中在预防和控制 COVID-19 上,在世界各国实施这些措施对其他卫生服务、人们获得和使用这些服务以及相关健康结果产生了负面影响,尤其是在低收入和中等收入国家(LMICs)。特别是“封锁”和限制措施使服务提供和获得变得复杂,并破坏了关键的供应链。这些干预措施与更传统的公共卫生措施一起,与 LMICs 的基线健康、卫生系统以及社会和经济脆弱性相互作用,加剧了负面影响。这项分析基于社会科学人道主义行动平台在 2020 年年中进行的快速证据评估,强调了这些影响的驱动因素和证据,强调了边缘化社会群体所经历的额外脆弱性,并为政府、机构、组织和社区提供了见解,以便在其他疾病负担的背景下和与之同时,实施更具比例性、适当性、全面性和社会公正性的应对措施来应对 COVID-19。短期内,迫切需要监测和减轻大流行应对措施对卫生服务提供、获得和使用的影响,包括通过将 COVID-19 应对措施纳入综合卫生系统方法。这些努力还应纳入加强卫生系统、扩大全民医疗保健覆盖范围以及关注健康决定因素的长期战略——政府、捐助者和国际机构必须作出这些承诺,并对此负责。至关重要的是,必须赋予受影响社区权力,使其能够在确定卫生优先事项、分配资源以及设计和提供服务方面发挥核心作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa0d/8053814/2a031c1add61/bmjgh-2020-004110f01.jpg

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