Changing Donor Funding and the Challenges of Integrated HIV Treatment.
Changing Donor Funding and the Challenges of Integrated HIV Treatment.
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DOI：
10.1001/journalofethics.2016.18.7.ecas3-1607
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发表时间：
2016-07-01
影响因子：
--
通讯作者：
Cluver, Lucie
中科院分区：
文献类型：
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作者：
Nattrass, Nicoli;Hodes, Rebecca;Cluver, Lucie
捐助方为艾滋病毒预防和治疗提供的资金已从支持特定疾病（“纵向”）规划转向支持旨在整合所有护理方面的卫生系统加强（“横向”）规划。我们从三个角度研究资源转移的后果：首先，通过对不断变化的卫生保健融资政策背景的广泛分析；第二，通过对南非艾滋病毒治疗优先事项变化的说明；第三，通过描述作者在一项检查青少年坚持抗逆转录病毒治疗（ART）和性健康的研究中观察到的一些临床后果。我们注意到，艾滋病防治工作既不是完全垂直的，也不是横向的，而是越来越呈对角线关系，因为针对特定疾病的方案与综合供应链管理、人力资源开发和预防性筛查同时开展。我们的结论是，医疗保健计划最好被视为需要不同程度融入社区的政策网络。
Donor financing for HIV prevention and treatment has shifted from supporting disease-specific ("vertical") programs to health systems strengthening ("horizontal") programs intended to integrate all aspects of care. We examine the consequences of shifting resources from three perspectives: first, through a broad analysis of the changing policy context of health care financing; second, through an account of changing priorities for HIV treatment in South Africa; and third, through a description of some clinical consequences that the authors observed in a research study examining adherence to antiretroviral therapy (ART) and sexual health among adolescents. We note that AIDS responses are neither completely vertical nor horizontal but rather increasingly diagonal, as disease-specific protocols operate alongside integrated supply chain management, human resource development, and preventive screening. We conclude that health care programs are better conceived of as networks of policies requiring different degrees of integration into communities.