School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia.
Nossal Institute for Global Health, School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia.
Int J Environ Res Public Health. 2022 Mar 30;19(7):4108. doi: 10.3390/ijerph19074108.
In 1995, Pacific Health Ministers articulated their vision of a healthy Pacific as 'a place where children are nurtured in body and mind; environments invite learning and leisure; people work and age with dignity; where ecological balance is a source of pride; and where the ocean is protected.' Central to this vision is the achievement of universal health coverage (UHC). To provide an indication of the UHC-related priorities of Pacific health authorities and promote alignment of domestic and international investments in health sector development, we thematically analyzed the discussion, resolutions, and recommendations from 5 years (2015-2020) of senior-level Pacific health meetings. Five main themes emerged: (i) the Healthy Islands vision has (and continues to have) a unifying influence on action for UHC; (ii) adoption of appropriate service delivery models that support integrated primary health care at the community level are needed; (iii) human resources for health are critical if efforts to achieve UHC are to be successful; (iv) access to reliable health information is core to health sector improvement; and (v) while not a panacea for all challenges, digital health offers many opportunities. Small and isolated populations, chronic workforce limitations, weak governance arrangements, ageing and inadequate health facilities, and supply chain and logistics difficulties (among other issues) interact to challenge primary health care delivery across the Pacific Islands. We found evidence that the Healthy Islands vision is a tool that garners support for UHC; however, to realize the vision, a realistic understanding of needed political, human resource, and economic investments is required. The significant disruptive effect of COVID-19 and the uncertainty it brings for implementation of the medium- to long-term health development agenda raises concern that progress may stagnate or retreat.
1995 年，太平洋地区的卫生部长们阐述了他们对健康太平洋的愿景，即“一个儿童身心健康得到呵护的地方；一个人们乐于学习和休闲的环境；一个人们有尊严地工作和老去的地方；一个生态平衡成为骄傲源泉的地方；以及一个海洋得到保护的地方。”这一愿景的核心是实现全民健康覆盖（UHC）。为了表明太平洋地区卫生当局在 UHC 方面的优先事项，并促进国内和国际对卫生部门发展的投资保持一致，我们对 5 年来（2015-2020 年）太平洋地区高级别卫生会议的讨论、决议和建议进行了主题分析。五个主要主题出现了：（i）“健康岛屿”愿景对 UHC 行动具有（并继续具有）统一的影响力；（ii）需要采用适当的服务提供模式，支持社区一级的综合初级卫生保健；（iii）人力资源对于实现 UHC 的努力至关重要；（iv）获得可靠的卫生信息是改善卫生部门的核心；（v）虽然数字健康不是解决所有挑战的万能药，但它提供了许多机会。小而孤立的人口、长期的劳动力限制、薄弱的治理安排、人口老龄化和不足的卫生设施以及供应链和物流困难（以及其他问题）相互作用，挑战着整个太平洋岛屿的初级卫生保健提供。我们有证据表明，“健康岛屿”愿景是争取 UHC 支持的工具；然而，要实现这一愿景，需要对所需的政治、人力资源和经济投资有一个现实的认识。COVID-19 带来的重大破坏性影响及其对中长期卫生发展议程实施带来的不确定性令人担忧，进展可能会停滞不前或倒退。
