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重建加沙地带卫生系统的挑战:迈向可持续性的叙述性综述

The Challenge of Rebuilding Gaza's Health System: A Narrative Review Towards Sustainability.

作者信息

Missoni Eduardo, Sen Kasturi

机构信息

Master of International Healthcare Management Economics and Policy (MIHMEP), SDA Bocconi Management School, 20136 Milan, Italy.

Wolfson College, University of Oxford (CR) United Kingdom, Oxford OX2 6UD, UK.

出版信息

Healthcare (Basel). 2025 Jul 30;13(15):1860. doi: 10.3390/healthcare13151860.

Abstract

: Since the election of Hamas in 2006, Gaza has endured eight major military conflicts, culminating in the ongoing 2023-2025 war, now surpassing 520 days. This protracted violence, compounded by a 17-year blockade, has resulted in the near-total collapse of Gaza's health system. Over 49,000 deaths, widespread displacement, and the destruction of more than 60% of health infrastructure have overwhelmed both local capacity and international humanitarian response. : This narrative review aims to examine and synthesize the current literature (October 2023-April 2025) on the health crisis in Gaza, with a specific focus on identifying key themes and knowledge gaps relevant to rebuilding a sustainable health system. The review also seeks to outline strategic pathways for recovery in the context of ongoing conflict and systemic deprivation. : Given the urgency and limitations of empirical data from conflict zones, a narrative review approach was adopted. Fifty-two sources-including peer-reviewed articles, editorials, reports, and correspondence-were selected through targeted searches using Medline and Google Scholar. The analysis was framed within a public health and political economy perspective, also taking health system building blocks into consideration. : The reviewed literature emphasizes emergency needs: trauma care, infectious disease control, and supply chain restoration. Innovations such as mobile clinics and telemedicine offer interim solutions. Gaps include limited attention to mental health (including that of health workers), local governance, and sustainable planning frameworks. : Sustainable reconstruction requires a durable ceasefire; international stewardship aligned with local ownership; and a phased, equity-driven strategy emphasizing primary care, mental health, trauma management, and community engagement.

摘要

自2006年哈马斯当选以来,加沙地带经历了八次重大军事冲突,最终演变成目前仍在持续的2023 - 2025年战争,现已超过520天。这种长期暴力,再加上长达17年的封锁,导致加沙地带的卫生系统几乎全面崩溃。超过49000人死亡、大规模流离失所,以及60%以上的卫生基础设施遭到破坏,使当地能力和国际人道主义应对措施不堪重负。

本叙述性综述旨在审视和综合当前(2023年10月至2025年4月)关于加沙地带卫生危机的文献,特别关注确定与重建可持续卫生系统相关的关键主题和知识空白。该综述还试图勾勒出在持续冲突和系统性匮乏背景下的恢复战略路径。

鉴于冲突地区实证数据的紧迫性和局限性,采用了叙述性综述方法。通过使用Medline和谷歌学术进行有针对性的搜索,选取了52个来源,包括同行评议文章、社论、报告和通信。分析是在公共卫生和政治经济视角下进行的,同时也考虑了卫生系统的组成部分。

综述文献强调了紧急需求

创伤护理、传染病控制和供应链恢复。移动诊所和远程医疗等创新提供了临时解决方案。存在的空白包括对心理健康(包括卫生工作者的心理健康)、地方治理和可持续规划框架的关注有限。

可持续重建需要持久停火;与地方自主权相一致的国际管理;以及一项分阶段、公平驱动的战略,强调初级保健、心理健康、创伤管理和社区参与。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3143/12346039/0283c9661503/healthcare-13-01860-g001.jpg

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