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首页> 外文期刊>Gut and Liver >Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 8. summary and recommendations of the Expert Panel
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Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 8. summary and recommendations of the Expert Panel

机译：对基于社区的初级卫生保健在改善孕产妇，新生儿和儿童健康方面的有效性的证据进行全面审查：8.专家小组的总结和建议

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Background The contributions that community–based primary health care (CBPHC) and engaging with communities as valued partners can make to the improvement of maternal, neonatal and child health (MNCH) is not widely appreciated. This unfortunate reality is one of the reasons why so few priority countries failed to achieve the health–related Millennium Development Goals by 2015. This article provides a summary of a series of articles about the effectiveness of CBPHC in improving MNCH and offers recommendations from an Expert Panel for strengthening CBPHC that were formulated in 2008 and have been updated on the basis of more recent evidence. Methods An Expert Panel convened to guide the review of the effectiveness of community–based primary health care (CBPHC). The Expert Panel met in 2008 in New York City with senior UNICEF staff. In 2016, following the completion of the review, the Panel considered the review’s findings and made recommendations. The review consisted of an analysis of 661 unique reports, including 583 peer–reviewed journal articles, 12 books/monographs, 4 book chapters, and 72 reports from the gray literature. The analysis consisted of 700 assessments since 39 were analyzed twice (once for an assessment of improvements in neonatal and/or child health and once for an assessment in maternal health). Results The Expert Panel recommends that CBPHC should be a priority for strengthening health systems, accelerating progress in achieving universal health coverage, and ending preventable child and maternal deaths. The Panel also recommends that expenditures for CBPHC be monitored against expenditures for primary health care facilities and hospitals and reflect the importance of CBPHC for averting mortality. Governments, government health programs, and NGOs should develop health systems that respect and value communities as full partners and work collaboratively with them in building and strengthening CBPHC programs – through engagement with planning, implementation (including the full use of community–level workers), and evaluation. CBPHC programs need to reach every community and household in order to achieve universal coverage of key evidence–based interventions that can be implemented in the community outside of health facilities and assure that those most in need are reached. Conclusions Stronger CBPHC programs that foster community engagement/empowerment with the implementation of evidence–based interventions will be essential for achieving universal coverage of health services by 2030 (as called for by the Sustainable Development Goals recently adopted by the United Nations), ending preventable child and maternal deaths by 2030 (as called for by the World Health Organization, UNICEF, and many countries around the world), and eventually achieving Health for All as envisioned at the International Conference on Primary Health Care in 1978. Stronger CBPHC programs can also create entry points and synergies for expanding the coverage of family planning services as well as for accelerating progress in the detection and treatment of HIV/AIDS, tuberculosis, malaria, hypertension, and other chronic diseases. Continued strengthening of CBPHC programs based on rigorous ongoing operations research and evaluation will be required, and this evidence will be needed to guide national and international policies and programs.
机译：背景技术基于社区的初级卫生保健（CBPHC）并作为重要合作伙伴与社区合作，可以为改善孕产妇，新生儿和儿童健康（MNCH）做出贡献。这种不幸的现实是为什么很少有优先国家未能在2015年前实现与卫生有关的千年发展目标的原因之一。本文概述了CBPHC在改善MNCH方面的有效性的一系列文章，并提供了专家的建议。 2008年成立的加强CBPHC专家组，并根据最新证据进行了更新。方法召集了一个专家小组，以指导对基于社区的初级卫生保健（CBPHC）的有效性进行审查。专家小组于2008年在纽约市与儿童基金会高级工作人员举行了会议。在2016年，审查完成后，小组审议了审查的结果并提出了建议。审查包括对661份独特报告的分析，包括583篇经同行评审的期刊文章，12本书/专着，4本书章节和72篇来自灰色文献的报告。该分析由700项评估组成，因为对39项评估进行了两次分析（一次评估新生儿和/或儿童健康状况，一次评估孕产妇健康）。结果专家小组建议，CBPHC应该成为加强卫生系统，加快实现全民健康覆盖并结束可预防的儿童和孕产妇死亡的优先事项。小组还建议对照主要保健设施和医院的支出对CBPHC的支出进行监测，并反映CBPHC对避免死亡率的重要性。各国政府，政府卫生计划和非政府组织应建立尊重和重视社区作为正式合作伙伴的卫生系统，并与他们合作制定和加强CBPHC计划-通过参与计划，实施（包括充分利用社区级工作者），和评估。 CBPHC计划需要覆盖每个社区和家庭，以实现对主要基于证据的干预措施的普遍覆盖，这些干预措施可以在医疗机构以外的社区中实施，并确保满足最需要的人群。结论强有力的CBPHC计划通过实施循证干预措施来促进社区参与/赋权，对于到2030年实现卫生服务的全民覆盖（如联合国最近通过的可持续发展目标所要求的）至关重要，这将终结可预防的儿童和世界卫生组织，联合国儿童基金会以及世界许多国家的要求，到2030年实现孕产妇死亡，并最终实现1978年国际初级卫生保健大会所设想的全民健康。更强大的CBPHC计划还可以切入点和协同作用，以扩大计划生育服务的覆盖面，并加快在艾滋病毒/艾滋病，结核病，疟疾，高血压和其他慢性病的检测和治疗方面取得进展。需要在严格的持续运营研究和评估的基础上继续加强CBPHC计划，并且需要这些证据来指导国家和国际政策和计划。

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