Taking Systems Thinking to the Global Level: Using the WHO Building Blocks to Describe and Appraise the Global Health System in Relation to COVID-19.
Taking Systems Thinking to the Global Level: Using the WHO Building Blocks to Describe and Appraise the Global Health System in Relation to COVID-19.
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DOI：
10.1111/1758-5899.13081
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发表时间：
2022-05
期刊：
影响因子：
1.9
通讯作者：
Brown, Garrett W.
中科院分区：
文献类型：
--
作者：
Borghi, Josephine;Brown, Garrett W.
为COVID-19等全球性冲击做好充分准备并加以遏制，是全球卫生系统面临的一项关键挑战。COVID-19突出表明，卫生系统是多层次的系统，是从地方到全球的连续体。目标和监测指标一直是加强国家卫生系统的关键，但在超国家一级却缺失。迫切需要一个加强全球系统的框架--全球卫生行动者及其运作的治理、融资和交付安排。在这篇文章中，我们说明了世界卫生组织的积木框架，它已被用于监测国家卫生系统的性能，可以被应用于描述和评估全球卫生系统及其对COVID-19的反应，并确定潜在的改革。全球对策的主要弱点包括：分散和自愿筹资;药品和供应品定价不透明，质量标准差，采购和分配不公平;领导和治理薄弱。我们还确定了积极的成就，并确定了全球卫生系统的潜在改革，以提高对未来冲击的抵御能力。我们讨论了积木框架的局限性和未来的研究方向，并反映了政治经济学的挑战，改革。
Adequately preparing for and containing global shocks, such as COVID‐19, is a key challenge facing health systems globally. COVID‐19 highlights that health systems are multilevel systems, a continuum from local to global. Goals and monitoring indicators have been key to strengthening national health systems but are missing at the supranational level. A framework to strengthen the global system—the global health actors and the governance, finance, and delivery arrangements within which they operate—is urgently needed. In this article, we illustrate how the World Health Organization Building Blocks framework, which has been used to monitor the performance of national health systems, can be applied to describe and appraise the global health system and its response to COVID‐19, and identify potential reforms. Key weaknesses in the global response included: fragmented and voluntary financing; non‐transparent pricing of medicines and supplies, poor quality standards, and inequities in procurement and distribution; and weak leadership and governance. We also identify positive achievements and identify potential reforms of the global health system for greater resilience to future shocks. We discuss the limitations of the Building Blocks framework and future research directions and reflect on political economy challenges to reform.
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