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在发展议程上提高卫生工作的优先地位。

Towards a higher priority for health on the development agenda.

作者信息

Yach D, von Schirnding Y E

机构信息

Medical Research Council, Pretoria, South Africa.

出版信息

Public Health Rev. 1994;22(3-4):339-74.

PMID:7708944
Abstract

Over the last few years major international agencies (particularly the World Health Organisation and the World Bank) have increasingly recognised that investing in health is crucial for development. Development policies have the potential to enhance or impede progress in achieving Health for All. At the macro-economic level it is broadly recognised that the state of the economy of a country has a strong influence on its health level. The growing number of the population below the poverty line in sub-Saharan Africa is expected to have a substantial impact on health in the future. Further, structural adjustment programmes' impact on health has yet to be adequately evaluated. Rapid population growth in sub-Saharan Africa needs to be innovatively addressed as a matter of extreme urgency. The education of women is strongly related to child survival. Over the next few years the prospects for global disarmament are increasing. Options for using both the technology, financial savings, and personnel for improving health need to be investigated. A broader range of policy options for health needs to be considered by governments. A greater focus on information, education, and communication for health is needed that draws upon both the private and the public sector; greater use of regulation and legislation as solid policy instruments, for example, for pollution control, and banning tobacco and alcohol advertising, is required. Financial strategies using a combination of taxes and subsidies have not been adequately used in developing countries. The previous emphasis on urban-based expensive hospitals has proved to be inappropriate, resulting in severe inefficiency and inequity in the health systems of developing countries. Greater attention must be given to funding those areas with a high potential for positive externalities and that yield public goods. The final policy instrument involves using research to extend the options for intervention choice.

摘要

在过去几年里,主要国际机构(尤其是世界卫生组织和世界银行)越来越认识到投资于健康对发展至关重要。发展政策有可能促进或阻碍实现全民健康的进程。在宏观经济层面,人们普遍认识到一个国家的经济状况对其健康水平有很大影响。预计撒哈拉以南非洲地区生活在贫困线以下的人口数量不断增加,未来将对健康产生重大影响。此外,结构调整方案对健康的影响尚未得到充分评估。撒哈拉以南非洲地区人口的快速增长迫切需要创新地加以应对。妇女教育与儿童生存密切相关。在未来几年里,全球裁军的前景正在增加。需要研究利用技术、节省的资金和人员来改善健康的各种选择。各国政府需要考虑更广泛的卫生政策选择。需要更加注重利用私营部门和公共部门的资源开展卫生信息、教育和宣传工作;需要更多地将监管和立法用作有力的政策工具,例如用于控制污染以及禁止烟草和酒精广告。发展中国家尚未充分利用税收和补贴相结合的财政战略。过去对城市昂贵医院的重视已被证明是不恰当的,导致发展中国家卫生系统严重低效和不公平。必须更加关注为那些具有很大正外部性潜力并能产生公共产品的领域提供资金。最后的政策工具是利用研究来扩大干预选择的范围。

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