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基于社区的方法在实现全民健康覆盖中的作用:解读尼日利亚的情况

The role of community-based approaches in achieving universal health coverage: addressing the Nigerian narrative.

作者信息

Effiong Fortune B, Ogbonna Chiemela P, Agughalam Prosper I, Okwukwu Miracle O, Dike Innocent C, Elebesunu Emmanuel E, Uwishema Olivier

机构信息

Directorate of Research, TORASIF, Calabar.

Department of Clinical Chemistry and Immunology, Faculty of Medical Laboratory Science, University of Calabar, Calabar.

出版信息

Ann Med Surg (Lond). 2023 Apr 3;85(5):1769-1773. doi: 10.1097/MS9.0000000000000443. eCollection 2023 May.

Abstract

Universal health coverage (UHC) is aimed at ensuring that individuals and communities have affordable access to essential health care services without facing financial hardship. Achieving UHC and the third sustainable development goal of the United Nations requires that health systems transition from a vertical, top-down, curative approach toward one that puts people at the core of health care services, such as community-centered health interventions. Nigeria operates a decentralized health care system with the least focus on primary health care, making access to quality, and affordable health care for several citizens a challenge as the major percentage of the Nigerian population relies on primary health care services. The limited number of health care workers, the poor economic state, the inadequate health financing structures and high illiteracy rates have led to challenges such as low health service availability, hesitancy to utilize health interventions, high out-of-pocket expenditure rates, and health misinformation. These can be effectively tackled at the community level by revamping primary health care services, adequate and sustainable health financing, establishing Ward Development Committees, and the involvement of community stakeholders in health policy implementation. Employing such community-based approaches will ensure continuous progress of the Nigerian health care system toward UHC.

摘要

全民健康覆盖(UHC)旨在确保个人和社区能够在不面临经济困难的情况下,以可承受的费用获得基本医疗服务。实现全民健康覆盖以及联合国的第三个可持续发展目标,要求卫生系统从垂直、自上而下的治疗方法转向以人群为医疗服务核心的方法,例如以社区为中心的卫生干预措施。尼日利亚实行的是分散型医疗体系,对初级卫生保健的关注最少,这使得为众多公民提供优质且负担得起的医疗服务成为一项挑战,因为尼日利亚大部分人口依赖初级卫生保健服务。医护人员数量有限、经济状况不佳、卫生筹资结构不完善以及高文盲率导致了诸如医疗服务可及性低、对利用卫生干预措施犹豫不决、自付费用率高以及卫生信息错误等问题。通过改进初级卫生保健服务、提供充足且可持续的卫生筹资、设立病房发展委员会以及让社区利益相关者参与卫生政策实施,这些问题能够在社区层面得到有效解决。采用此类基于社区的方法将确保尼日利亚医疗体系在实现全民健康覆盖方面持续取得进展。

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