Tuberculosis 7 Health-system strengthening and tuberculosis control
Tuberculosis 7 Health-system strengthening and tuberculosis control
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DOI：
10.1016/s0140-6736(10)60493-x
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发表时间：
2010-06-19
期刊：
影响因子：
168.9
通讯作者：
Mwakyusa, David
中科院分区：
文献类型：
--
作者：
Atun, Rifat;Weil, Diana E. C.;Mwakyusa, David
薄弱的卫生系统正在阻碍全球结核病护理和控制的努力，但几乎没有证据表明可以采取有效干预措施来解决系统瓶颈。本报告审查了已发表的证据、项目审查和案例研究，以确定系统设计和结核病控制方面的创新，以解决这些瓶颈。我们概述了与治理、融资、供应链管理、人力资源、卫生信息系统和服务提供相关的系统瓶颈；以及快速引入次优系统设计带来的不利影响。该报告还记录了疾病控制和系统设计的创新解决方案。各个国家寻求的解决方案取决于结核病流行的性质、基本的国家卫生系统以及参与的贡献者：没有一种方法适合所有情况。孟加拉国、柬埔寨、印度、坦桑尼亚、泰国和越南等国家的调查结果表明，疾病控制和系统强化方面的进展是相辅相成的。结核病护理和控制是卫生系统的重要组成部分，系统创新和疾病应对的同时努力是相辅相成的。针对结核病的多种多样且针对具体情况的应对措施表明，需要记录和比较解决方案，以制定基于证据的政策和实践。
Weak health systems are hindering global efforts for tuberculosis care and control, but little evidence is available on effective interventions to address system bottlenecks. This report examines published evidence, programme reviews, and case studies to identify innovations in system design and tuberculosis control to resolve these bottlenecks. We outline system bottlenecks in relation to governance, financing, supply chain management, human resources, health-information systems, and service delivery; and adverse effects from rapid introduction of suboptimum system designs. This report also documents innovative solutions for disease control and system design. Solutions pursued in individual countries are specific to the nature of the tuberculosis epidemic, the underlying national health system, and the contributors engaged: no one size fits all. Findings from countries, including Bangladesh, Cambodia, India, Tanzania, Thailand, and Vietnam, suggest that advances in disease control and system strengthening are complementary. Tuberculosis care and control are essential elements of health systems, and simultaneous efforts to innovate systems and disease response are mutually reinforcing. Highly varied and context-specific responses to tuberculosis show that solutions need to be documented and compared to develop evidence-based policies and practice.