Addressing access barriers to health services: an analytical framework for selecting appropriate interventions in low-income Asian countries
Addressing access barriers to health services: an analytical framework for selecting appropriate interventions in low-income Asian countries
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DOI：
10.1093/heapol/czr038
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发表时间：
2012-07-01
影响因子：
3.2
通讯作者：
Van Damme, Wim
中科院分区：
文献类型：
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作者：
Jacobs, Bart;Ir, Por;Van Damme, Wim
虽然世界卫生组织成员国早在2005年就接受了全民覆盖的概念，但很少有低收入国家实现这一目标。这主要是由于阻碍获得所需保健服务的众多障碍。在本文中，我们提供了一个概述的各个方面的障碍，获得医疗保健在低收入国家（地理可及性，可用性，可负担性和可接受性），并概述了现有的干预措施，旨在克服这些障碍。这些障碍和随之而来的干预措施安排在一个分析框架，然后适用于柬埔寨的两个案例研究。其目的是说明框架在确定干预措施所解决的准入障碍方面的用途。研究结果表明，需要采取综合干预措施来解决具体的准入障碍，但其有效性可能会受到背景因素的影响。还必须同时解决需求方和供应方的障碍。这一框架既可用于确定有效解决具体准入障碍的干预措施，也可用于分析某些干预措施为何无法解决具体障碍。
While World Health Organization member countries embraced the concept of universal coverage as early as 2005, few low-income countries have yet achieved the objective. This is mainly due to numerous barriers that hamper access to needed health services. In this paper we provide an overview of the various dimensions of barriers to access to health care in low-income countries (geographical access, availability, affordability and acceptability) and outline existing interventions designed to overcome these barriers. These barriers and consequent interventions are arranged in an analytical framework, which is then applied to two case studies from Cambodia. The aim is to illustrate the use of the framework in identifying the dimensions of access barriers that have been tackled by the interventions. The findings suggest that a combination of interventions is required to tackle specific access barriers but that their effectiveness can be influenced by contextual factors. It is also necessary to address demand-side and supply-side barriers concurrently. The framework can be used both to identify interventions that effectively address particular access barriers and to analyse why certain interventions fail to tackle specific barriers.