Evidence-based public health: what does it offer developing countries?
Evidence-based public health: what does it offer developing countries?
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DOI：
10.1093/pubmed/fdi024
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发表时间：
2005-06-01
影响因子：
4.4
通讯作者：
Volmink, J
中科院分区：
文献类型：
--
作者：
McMichael, C;Waters, E;Volmink, J
全球疾病负担主要发生在发展中国家。由于发展中国家的资源有限，特别重要的是投资于有效的公共卫生和健康促进战略。系统评价是循证公共卫生和健康促进实践和政策的核心。本文讨论了循证公共卫生和系统评价与发展中国家健康的相关性。报告认为，缺乏与发展中国家卫生优先事项有关的系统审查;审查的许多干预措施无法在资源贫乏的情况下实施;在发展中国家进行的初级研究数量有限。本文进一步认为，公共卫生的改善不仅取决于有效的卫生服务和干预措施，而是通过一种包括其他部门并影响更广泛的结构性和系统性健康障碍的方法。鉴于人类发展的社会复杂性，以及不同发展目标之间的相互联系，毫无疑问，发展中国家公共卫生方面的收益不太可能仅仅来自系统审查，而需要就部门间合作和社会政策举措作出决定。尽管如此，有关干预措施有效性的证据在处理发展中国家和资源贫乏地区的卫生优先事项方面可发挥重要作用。公共卫生证据库迫切需要加强，并致力于提高主要证据和系统审查的相关性。
The global burden of disease and illness is primarily situated in developing countries. As developing countries have limited resources, it is particularly important to invest in public health and health promotion strategies that are effective. Systematic reviews are central to evidence-based public health and health promotion practice and policy. This paper discusses issues surrounding the relevance of evidence-based public health and systematic reviews to the health of developing countries. It argues that there is a lack of systematic reviews relevant to the health priorities of developing countries; many interventions reviewed can not be implemented in resource-poor situations; and, a limited amount of primary research is conducted in developing countries.The paper further argues that improvements in public health are determined not only by effective health services and interventions, but through an approach that includes other sectors and influences broader structural and systematic barriers to health. Given the social complexity of human development, and the inter-sections amongst different development goals, there is no question that gains in developing country public health are unlikely to emerge from systematic reviews alone, but will require decisions about inter-sectoral collaboration and social policy initiatives. Nonetheless, evidence around intervention effectiveness has an important role to play in addressing health priorities in developing countries and resource-poor areas. The public health evidence base urgently needs strengthening, with dedicated effort towards increasing the relevance of primary evidence and systematic reviews.