Schistosomiasis control and the health system in P.R. China.
Schistosomiasis control and the health system in P.R. China.
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DOI：
10.1186/2049-9957-1-8
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发表时间：
2012-11-01
影响因子：
8.1
通讯作者：
Tang S
中科院分区：
文献类型：
--
作者：
Collins C;Xu J;Tang S
在过去的六十年里，中国在血吸虫病防治方面取得了进展。然而，仍有一些艰巨的挑战有待应对。这篇文章着眼于卫生系统在多大程度上为控制疾病提供了积极的环境。首先追溯了血吸虫病控制的三个阶段：灭螺灭病战略(20世纪50年代至80年代初)；以化疗为基础的发病率控制战略(80年代中期至2003年)；综合控制战略(2004+)。每个阶段都发生在不同的决策环境中。本文件部分利用这些阶段阐述了疾病控制的五个问题，并结合卫生系统及其最近的趋势对这些问题进行了讨论。这些措施包括决策过程、卫生、公平和获得卫生服务的部门间行动、为公共产品和外部性提供资金以及加强资源管理和规划。这些问题构成了整合研究和加强中国卫生系统能力的议程的基础，以期为血吸虫病控制创造一个更积极的有利环境。在这样做的过程中，必须强调公共部门相对于其商业化的作用和正直、公平的基本价值、全系统的视角以及宣传的作用。
Over the last sixty years advances have been made in the control of schistosomiasis in P.R. China. There are, however, difficult challenges still to be met. This paper looks at the extent to which the health system offers a positive environment for the control of the disease. It starts by tracing three phases in schistosomiasis control: disease elimination strategy through snail control (1950s-early 1980s); morbidity control strategy based on chemotherapy (mid 1980s to 2003); integrated control strategy (2004+). Each one of these phases took place in distinct policy-making environments. The paper partly draws on these phases to set out five issues of disease control and discusses them in the context of the health system and its recent trends. These cover the policy-making process, intersectoral action for health, equity and access to health services, funding for public goods and externalities, and strengthening resource management and planning. These issues form the basis of an agenda for integrating research and capacity strengthening in the Chinese health system with a view to creating a more positive enabling environment for schistosomiasis control. In so doing it is important to emphasize the role and integrity of the public sector against its commercialization, the underlying value of equity, a systems wide perspective, and the role of advocacy.
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