Building the infrastructure for primary health care: an overview of vertical and integrated approaches.
Building the infrastructure for primary health care: an overview of vertical and integrated approaches.
复制标题
建设初级卫生保健基础设施：垂直和综合方法概述。
DOI：
10.1016/0277-9536(88)90411-x
复制
发表时间：
1988
影响因子：
5.4
通讯作者：
J. Bryant
中科院分区：
文献类型：
--
作者：
D. Smith;J. Bryant
在过去的四十年里，出现了一系列不同的方法来发展提供卫生服务的基础设施。在许多不同的国家，特别是在发展中国家，这些方法在方向和时机上都有惊人的相似之处。虽然总的趋势是朝着建立一个更全面、综合的卫生基础设施的方向发展，但这条道路上出现了重大倒退。有人认为，最近对提供“有选择的”一揽子干预措施的关注，往往转移了发展全面、综合的卫生基础设施这一基本任务的精力和资源，本文首先回顾了近几十年来卫生服务基础设施发展的历史趋势。它继续分析卫生服务的组织和资源分配的影响时，卫生服务基础设施被视为一个卫生系统的基础上初级healthcare.Finally的一部分，我们认为，基于初级卫生保健的地区卫生系统提供了一个很好的实用模式，为卫生发展，包括适当的卫生系统基础设施。在这一模式中，既考虑到了对加速应用已知和有效技术的关注，也考虑到了对加强社区参与和部门间保健行动的关注。地区卫生系统为涉及卫生和社会发展的专业人员和非专业人员的对话和规划提供了一个现实的环境。
In the past four decades there has been a succession of different approaches to the development of infrastructure for the delivery of health services. There have been striking similarities among these approaches in both direction and timing in many different countries, particularly in the developing world. While the general trend has been strongly in the direction of a more comprehensive, integrated health infrastructure, there have been important regressions from this path. It is suggested that the recent attention given to the delivery of ‘selective’ packages of interventions has often diverted energy and resources from the essential task of developing comprehensive, efficient and effective health services.This paper begins with an historical review of trends in the development of health services infrastructure in recent decades. It proceeds to analyse the implications for the organization of health services and for resource allocation when the health services infrastructure is viewed as part of a health system based on primary health care.Finally, we maintain that district health systems based on primary health care provide an excellent practical model for health development, including an appropriate health system infrastructure. Within this model the concerns with accelerating the application of known and effective technologies and the concerns with strengthening of community involvement and intersectoral action for health are both accommodated. The district health system provides a realistic setting for dialogue and planning involving both professionals and non-professionals concerned with health and social development.