Pathology and laboratory medicine in low-income and middle-income countries 1: Access to pathology and laboratory medicine services: a crucial gap
Pathology and laboratory medicine in low-income and middle-income countries 1: Access to pathology and laboratory medicine services: a crucial gap
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DOI：
10.1016/s0140-6736(18)30458-6
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发表时间：
2018-05-12
期刊：
影响因子：
168.9
通讯作者：
Ru, Kun
中科院分区：
文献类型：
--
作者：
Wilson, Michael L.;Fleming, Kenneth A.;Ru, Kun
随着全球努力加速实现可持续发展目标，特别是全民健康覆盖，将需要获得高质量和及时的病理学和实验室医学服务，以支持负责实现这些目标的卫生保健系统。在低收入和中等收入国家实现这一目标将是最具挑战性的，因为这些国家在全球疾病负担中所占比例过大，但在全球卫生保健资源，特别是PALM服务中所占比例过低。在这篇关于中低收入国家PALM的三篇系列论文中的第一篇中，我们描述了PALM服务在准确诊断和检测疾病、告知预后和指导治疗、促进疾病筛查、公共卫生监测和疾病登记以及支持医疗法律系统方面的关键和核心作用。我们还描述了如何，即使数据稀少，这些服务的范围和质量不足，在卫生保健系统中发挥关键作用，在中低收入国家。最后，我们确定了在资源有限的环境中提供最佳PALM服务的四个关键障碍：人力资源或劳动力能力不足、教育和培训不足、基础设施不足以及质量、标准和认证不足。
As global efforts accelerate to implement the Sustainable Development Goals and, in particular, universal health coverage, access to high-quality and timely pathology and laboratory medicine (PALM) services will be needed to support health-care systems that are tasked with achieving these goals. This access will be most challenging to achieve in low-income and middle-income countries (LMICs), which have a disproportionately large share of the global burden of disease but a disproportionately low share of global health-care resources, particularly PALM services. In this first in a Series of three papers on PALM in LMICs, we describe the crucial and central roles of PALM services in the accurate diagnosis and detection of disease, informing prognosis and guiding treatment, contributing to disease screening, public health surveillance and disease registries, and supporting medical-legal systems. We also describe how, even though data are sparse, these services are of both insufficient scope and inadequate quality to play their key role in health-care systems in LMICs. Lastly, we identify four key barriers to the provision of optimal PALM services in resource-limited settings: insufficient human resources or workforce capacity, inadequate education and training, inadequate infrastructure, and insufficient quality, standards, and accreditation.