Strengthening integrated primary health care in Sofala, Mozambique.
Strengthening integrated primary health care in Sofala, Mozambique.
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DOI：
10.1186/1472-6963-13-s2-s4
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发表时间：
2013
影响因子：
2.8
通讯作者：
Gloyd S
中科院分区：
文献类型：
--
作者：
Sherr K;Cuembelo F;Michel C;Gimbel S;Micek M;Kariaganis M;Pio A;Manuel JL;Pfeiffer J;Gloyd S
卫生部门投资的大幅增加以及有利于升级和扩大公共部门卫生网络的政策，使莫桑比克优先考虑妇幼保健，在过去十年中，莫桑比克的妇幼健康指标取得了显着改善。同一时期，莫桑比克政府继续将公共部门资源的管理权下放到地区一级，包括卫生部门，目的是让决策和资源更贴近服务受益人。区级管理能力薄弱阻碍了权力下放进程，而建设这种能力是确保资源转化为改善服务提供和进一步改善人口健康的重要环节。卫生部、国际健康联盟、爱德华多·蒙德拉内大学和华盛顿大学组成的联盟正在莫桑比克中部索法拉省实施卫生系统强化模式。莫桑比克人口健康实施和培训（PHIT）伙伴关系的重点是通过适当的工具提高常规数据的质量及其使用，以促进卫生系统管理者的决策；加强管理和规划能力并为地区卫生计划提供资金；建设运筹学能力以指导系统强化工作。这项为期七年的努力涵盖了索法拉省的所有 13 个地区和 146 个卫生机构。将采用准实验受控时间序列设计，通过检查索法拉省与邻近马尼卡省相比实施前后死亡率的变化，评估伙伴关系战略对 5 岁以下儿童死亡率的总体影响。评估将比较广泛的投入、过程、产出和结果变量，以加强伙伴关系战略导致卫生系统改善和随后的人口健康影响的合理性。莫桑比克 PHIT 合作伙伴关系期望提供证据，证明提高数据质量的努力以及引入工具、培训和监督以改进循证决策的效果。这种对加强卫生系统的知识库的贡献具有高度可复制性，可以迅速推广到莫桑比克的其他省份以及资源有限且致力于全面初级卫生保健的其他撒哈拉以南非洲国家。
Large increases in health sector investment and policies favoring upgrading and expanding the public sector health network have prioritized maternal and child health in Mozambique and, over the past decade, Mozambique has achieved substantial improvements in maternal and child health indicators. Over this same period, the government of Mozambique has continued to decentralize the management of public sector resources to the district level, including in the health sector, with the aim of bringing decision-making and resources closer to service beneficiaries. Weak district level management capacity has hindered the decentralization process, and building this capacity is an important link to ensure that resources translate to improved service delivery and further improvements in population health. A consortium of the Ministry of Health, Health Alliance International, Eduardo Mondlane University, and the University of Washington are implementing a health systems strengthening model in Sofala Province, central Mozambique. The Mozambique Population Health Implementation and Training (PHIT) Partnership focuses on improving the quality of routine data and its use through appropriate tools to facilitate decision making by health system managers; strengthening management and planning capacity and funding district health plans; and building capacity for operations research to guide system-strengthening efforts. This seven-year effort covers all 13 districts and 146 health facilities in Sofala Province. A quasi-experimental controlled time-series design will be used to assess the overall impact of the partnership strategy on under-5 mortality by examining changes in mortality pre- and post-implementation in Sofala Province compared with neighboring Manica Province. The evaluation will compare a broad range of input, process, output, and outcome variables to strengthen the plausibility that the partnership strategy led to health system improvements and subsequent population health impact. The Mozambique PHIT Partnership expects to provide evidence on the effect of efforts to improve data quality coupled with the introduction of tools, training, and supervision to improve evidence-based decision making. This contribution to the knowledge base on what works to enhance health systems is highly replicable for rapid scale-up to other provinces in Mozambique, as well as other sub-Saharan African countries with limited resources and a commitment to comprehensive primary health care.