Primary health care and sustainable development goals.
Primary health care and sustainable development goals.
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DOI：
10.2471/blt.19.245613
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发表时间：
2020-11-01
影响因子：
11.1
通讯作者：
Tangcharoensathien V
中科院分区：
文献类型：
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作者：
Chotchoungchatchai S;Marshall AI;Witthayapipopsakul W;Panichkriangkrai W;Patcharanarumol W;Tangcharoensathien V
我们研究了初级卫生保健在促进实现与卫生相关的可持续发展目标（SDG）方面的潜力和局限性，并提出了使初级卫生保健系统发挥作用的政策建议。各国政府最近通过2018年《阿斯塔纳宣言》重申了对可持续发展目标的承诺，该宣言将初级卫生保健的三大功能重新定义为：提供服务、多部门行动和增强公民权能。换句话说，与健康相关的可持续发展目标不能仅仅通过提供医疗保健服务来实现。有些健康问题与环境有关，需要地方、国家和国际伙伴共同努力;其他问题则需要公众对可预防疾病的认识（健康知识）。然而，初级卫生保健的提供以及可持续发展目标的实现受到几个问题的阻碍。第一，政府用于保健的开支不足，由于分配给初级保健的比例很小而更加严重。其次，一些国家保健工作人员短缺和分布不均，以及长期缺勤，导致工作人员数量与贫穷和需求成反比。第三，卫生工作人员没有受过多部门行动方面的培训，他们已经承受了巨大的工作量。最后，卫生文盲在人口中很普遍，即使在发达国家也是如此。我们建议各国政府增加卫生和初级卫生保健方面的支出，实施干预措施以留住农村卫生工作者，并更新人员的职前培训课程，以包括多部门合作和加强社区参与的技能。
We examine the potential and limitations of primary health care in contributing to the achievement of the health-related sustainable development goals (SDGs), and recommend policies to enable a functioning primary health-care system. Governments have recently reaffirmed their commitment to the SDGs through the 2018 Declaration of Astana, which redefines the three functions of primary health care as: service provision, multisectoral actions and the empowerment of citizens. In other words, the health-related SDGs cannot be achieved by the provision of health-care services alone. Some health issues are related to environment, necessitating joint efforts between local, national and international partners; other issues require public awareness (health literacy) of preventable illnesses. However, the provision of primary health care, and hence achievement of the SDGs, is hampered by several issues. First, inadequate government spending on health is exacerbated by the small proportions allocated to primary health care. Second, the shortage and maldistribution of the health workforce, and chronic absenteeism in some countries, has led to a situation in which staffing levels are inversely related to poverty and need. Third, the health workforce is not trained in multisectoral actions, and already experiences workloads of an overwhelming nature. Finally, health illiteracy is common among the population, even in developed countries. We recommend that governments increase spending on health and primary health care, implement interventions to retain the rural health workforce, and update the pre-service training curricula of personnel to include skills in multisectoral collaboration and enhanced community engagement.