Alma-Ata: Rebirth and revision 7 - Integrating health interventions for women, newborn babies, and children: a framework for action
Alma-Ata: Rebirth and revision 7 - Integrating health interventions for women, newborn babies, and children: a framework for action
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DOI：
10.1016/s0140-6736(08)61408-7
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发表时间：
2008-09-13
期刊：
影响因子：
168.9
通讯作者：
Liljestrand, Jerker
中科院分区：
文献类型：
--
作者：
Ekman, Bjorn;Pathmanathan, Indra;Liljestrand, Jerker
对于妇女和儿童，特别是贫困和处境不利的妇女和儿童，要从初级卫生保健中受益，他们需要获得和使用具有成本效益的孕产妇、新生儿和儿童健康干预措施。脆弱的卫生系统面临的挑战是如何递送这样的包裹。来自伊朗、马来西亚、斯里兰卡和中国等国以及坦桑尼亚和印度等国的项目的经验表明，孕产妇、新生儿和儿童健康方面的成果可以通过根据卫生系统的能力逐步实施的具有成本效益的一揽子综合卫生保健干预措施得到改善。这类一揽子计划应包括以社区为基础的干预措施，与教育、基础设施和减贫方面的社会保护和部门间行动相结合。需要在地区一级规划和实施干预措施，这需要加强地区规划和管理技能。此外，各地区需要得到国家战略和政策的支持，就最不发达国家而言，还需要得到国际捐助者和其他伙伴的支持。如果孕产妇、新生儿和儿童保健一揽子方案能够纳入逐步加强的初级保健系统，护理的连续性将得到改善，包括在怀孕前和怀孕期间、分娩期间、产后和整个童年期间获得基本转诊护理。
For women and children, especially those who are poor and disadvantaged, to benefit from primary health care, they need to access and use cost-effective interventions for maternal, newborn, and child health. The challenge facing weak health systems is how to deliver such packages. Experiences from countries such as Iran, Malaysia, Sri Lanka, and China, and from projects in countries like Tanzania and India, show that outcomes in maternal, newborn, and child health can be improved through integrated packages of cost-effective health-care interventions that are implemented incrementally in accordance with the capacity of health systems. Such packages should include community-based interventions that act in combination with social protection and intersectoral action in education, infrastructure, and poverty reduction. Interventions need to be planned and implemented at the district level, which requires strengthening of district planning and management skills. Furthermore, districts need to be supported by national strategies and policies, and, in the case of the least developed countries, also by international donors and other partners. If packages for maternal, newborn and child health care can be integrated within a gradually strengthened primary health-care system, continuity of care will be improved, including access to basic referral care before and during pregnancy, birth, the postpartum period, and throughout childhood.