Alma-Ata:: Rebirth and revision 2 -: Supporting the delivery of cost-effective interventions in primary health-care systems in low-income and middle-income countries:: an overview of systematic reviews
Alma-Ata:: Rebirth and revision 2 -: Supporting the delivery of cost-effective interventions in primary health-care systems in low-income and middle-income countries:: an overview of systematic reviews
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DOI：
10.1016/s0140-6736(08)61403-8
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发表时间：
2008-09-13
期刊：
影响因子：
168.9
通讯作者：
Haines, Andy
中科院分区：
文献类型：
--
作者：
Lewin, Simon;Lavis, John N.;Haines, Andy
加强卫生系统是改善初级保健中成本效益高的干预措施的交付和实现《阿拉木图宣言》愿景的一个关键挑战。低收入和中等收入国家迫切需要保健系统内的有效治理、财政和交付安排以及有效的执行战略。本综述总结了卫生系统安排和实施战略的系统性审查的证据，特别侧重于在这种情况下的初级卫生保健相关的证据。虽然证据不多，但有几个很有希望的保健系统安排和执行战略可加强初级保健。然而，在采用这些方法的同时，必须进行严格的评估。证据基础迫切需要加强，综合，并在政策和实践中考虑，特别是为了那些被排除在近几十年来医疗保健进步之外的人的利益。
Strengthening health systems is a key challenge to improving the delivery of cost-effective interventions in primary health care and achieving the vision of the Alma-Ata Declaration. Effective governance, financial and delivery arrangements within health systems, and effective implementation strategies are needed urgently in low-income and middle-income countries. This overview summarises the evidence from systematic reviews of health systems arrangements and implementation strategies, with a particular focus on evidence relevant to primary health care in such settings. Although evidence is sparse, there are several promising health systems arrangements and implementation strategies for strengthening primary health care. However, their introduction must be accompanied by rigorous evaluations. The evidence base needs urgently to be strengthened, synthesised, and taken into account in policy and practice, particularly for the benefit of those who have been excluded from the health care advances of recent decades.