Assessment of the health system and policy environment as a critical complement to tracking intervention coverage for maternal, newborn, and child health
Assessment of the health system and policy environment as a critical complement to tracking intervention coverage for maternal, newborn, and child health
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DOI：
10.1016/s0140-6736(08)60563-2
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发表时间：
2008-04-12
期刊：
影响因子：
168.9
通讯作者：
Shankar, Anuraj
中科院分区：
文献类型：
--
作者：
Cavagnero, Eleonora;Daelmans, Bernadette;Shankar, Anuraj
2008年，2015年倒计时倡议确定了68个优先国家，以便在孕产妇、新生儿和儿童健康方面采取行动。对监测国家一级在实现高和公平覆盖率方面取得的进展给予了很大关注，采取干预措施有效降低母亲、新生儿和5岁以下儿童的死亡率。更广泛地了解提供保健服务和产生保健成果的环境对于扩大干预措施的覆盖面至关重要。解决孕产妇和新生儿保健问题的方案依靠卫生系统提供有效决策和实现预期成果所需的信息。在整个过程中，不仅需要治理和领导来制定和执行政策，而且还需要确保保健的质量和效率，以公平的方式为保健服务提供充足的资金，并管理保健工作人员队伍。我们提出了一种系统的方法来评估更广泛的卫生系统和政策环境，以实现孕产妇，新生儿和儿童健康的积极成果。我们报告了13个指标的结果，并显示了政策采纳方面的差距以及其他卫生系统构件的弱点。我们确定了未来在衡量关键指标及其用于支持决策方面采取行动的领域。我们希望，这一信息将为关于可行和可持续解决办法的讨论提供一个新的层面，以便在全球一级，但最重要的是在个别国家，加快实现千年发展目标4和5的进展。
In 2008, the Countdown to 2015 initiative identified 68 priority countries for action on maternal, newborn, and child health. Much attention was paid to monitoring country-level progress in achieving high and equitable coverage with interventions effective in reducing mortality of mothers, newborn infants, and children up to 5 years of age. To have a broader understanding of the environment in which health services are delivered and health outcomes are produced is essential to increase intervention coverage. Programmes to address MNCH rely on health systems to generate information needed for effective decisions and to achieve the expected outcomes. Governance and leadership are needed throughout the process not only to create policies and implement them but also to assure quality and efficiency of care, to finance health services sufficiently and in an equitable way, and to manage the health workforce. We present a systematic approach to assess the wider health system and policy environment needed to achieve positive outcomes for maternal, newborn, and child health. We report on results from 13 indicators and show gaps in policy adoption as well as weaknesses in other health system building blocks. We identify areas for future action in measurement of key indicators and their use to support decision making. We hope that this information will provide an additional dimension to the discussions on feasible and sustainable solutions to accelerate progress towards Millennium Development Goals 4 and 5, both at the global level but most importantly in individual countries.