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使南亚的卫生系统重新转向初级卫生保健

Reorienting health systems towards Primary Health Care in South Asia.

作者信息

Perera Susie, Ramani Sudha, Joarder Taufique, Shukla Rajendra S, Zaidi Shehla, Wellappuli Nalinda, Ahmed Syed Masud, Neupane Dinesh, Prinja Shankar, Amatya Archana, Rao Krishna D

机构信息

Ministry of Health, Sri Lanka.

India Primary Health Care Support Initiative, Johns Hopkins India Pvt Ltd, India.

出版信息

Lancet Reg Health Southeast Asia. 2024 Aug 20;28:100466. doi: 10.1016/j.lansea.2024.100466. eCollection 2024 Sep.

Abstract

UNLABELLED

This series, "Primary health care in South Asia", is an effort to provide region-specific, evidence-based insights for reorienting health systems towards PHC. Led by regional thinkers, this series draws lessons from five countries in South Asia: Bangladesh, India, Nepal, Pakistan, and Sri Lanka. This is the last paper in the series that outlines points for future action. We call for action in three areas. First, the changing context in the region, with respect to epidemiological shifts, urbanisation, and privatisation, presents an important opportunity to appraise existing policies on PHC and reformulate them to meet the evolving needs of communities. Second, reorienting health systems towards PHC requires concrete efforts on three pillars-integrated services, multi-sectoral collaboration, and community empowerment. This paper collates nine action points that cut across these three pillars. These action points encompass contextualising policies on PHC, scaling up innovations, allocating adequate financial resources, strengthening the governance function of health ministries, establishing meaningful public-private engagements, using digital health tools, reorganising service delivery, enabling effective change-management processes, and encouraging practice-oriented research. Finally, we call for more research-policy-practice networks on PHC in South Asia that can generate evidence, bolster advocacy, and provide spaces for cross-learning.

FUNDING

WHO SEARO funded this paper. This source did not play any role in the design, analysis or preparation of the manuscript.

摘要

未标注

本系列文章“南亚的初级卫生保健”旨在提供针对该地区的、基于证据的见解,以促使卫生系统重新定位到初级卫生保健。由该地区的思想者牵头,本系列文章从南亚的五个国家——孟加拉国、印度、尼泊尔、巴基斯坦和斯里兰卡汲取经验教训。这是本系列的最后一篇文章,概述了未来行动要点。我们呼吁在三个领域采取行动。首先,该地区在流行病学转变、城市化和私有化方面不断变化的背景,为评估现有的初级卫生保健政策并重新制定这些政策以满足社区不断变化的需求提供了重要契机。其次,使卫生系统重新定位到初级卫生保健需要在三个支柱方面做出具体努力——综合服务、多部门协作和社区赋权。本文整理了贯穿这三个支柱的九个行动要点。这些行动要点包括将初级卫生保健政策因地制宜、扩大创新规模、分配充足的财政资源、加强卫生部的治理职能、建立有意义的公私合作关系、使用数字卫生工具、重新组织服务提供、推动有效的变革管理流程以及鼓励以实践为导向的研究。最后,我们呼吁在南亚建立更多关于初级卫生保健的研究-政策-实践网络,这些网络能够产生证据、加强宣传并提供相互学习的空间。

资金来源

世卫组织东南亚区域办事处资助了本文。该资助方在稿件的设计、分析或撰写过程中未发挥任何作用。

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本文引用的文献

1
The state of primary health care in south Asia.南亚的初级卫生保健状况。
Lancet Glob Health. 2024 Oct;12(10):e1693-e1705. doi: 10.1016/S2214-109X(24)00119-0. Epub 2024 Aug 20.
3
Improving urban health through primary health care in south Asia.通过南亚初级卫生保健改善城市健康。
Lancet Glob Health. 2024 Oct;12(10):e1720-e1729. doi: 10.1016/S2214-109X(24)00121-9. Epub 2024 Aug 20.
4
Who is absent and why? Factors affecting doctor absenteeism in Bangladesh.谁缺勤了,原因何在?影响孟加拉国医生缺勤的因素。
PLOS Glob Public Health. 2024 Apr 4;4(4):e0003040. doi: 10.1371/journal.pgph.0003040. eCollection 2024.
6
Human Resources for Health in South-East Asia: Challenges and Strategies.东南亚地区卫生人力资源:挑战与策略
WHO South East Asia J Public Health. 2023 Jan-Jun;12(1):1-3. doi: 10.4103/2224-3151.386476.
7
Offline: Primary healthcare is not enough.线下:初级医疗保健是不够的。
Lancet. 2023 Sep 2;402(10404):760. doi: 10.1016/S0140-6736(23)01843-3.

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