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首页> 外文期刊>Archives of disease in childhood >Review of Integrated Management of Childhood Illness (IMCI) in 16 countries in Central Asia and Europe: implications for primary healthcare in the era of universal health coverage
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Review of Integrated Management of Childhood Illness (IMCI) in 16 countries in Central Asia and Europe: implications for primary healthcare in the era of universal health coverage

机译：审查中亚和欧洲16个国家的儿童疾病（IMCI）综合管理：对普遍健康覆盖时代的原发性医疗保健的影响

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The Integrated Management of Childhood Illness (IMCI) was introduced in Central Asia and Europe to address the absence of evidence-based guidelines, antibiotics misuse, polypharmacy and overhospitalisation. This study in 16 countries analyses status, strengths of and barriers to IMCI implementation and investigates how health systems affect the problems IMCI aims to address. 220 key informants were interviewed ranging from 5 to 37 per country (median 12). Data were analysed for arising themes and peer-reviewed. IMCI has not been fully used either as a strategy or as an algorithmic diagnostic and treatment decision tool. Inherent incentives include: economic factors taking precedence over evidence and the best interest of the child in treatment decisions; financing mechanisms and payment schemes incentivising unnecessary or prolonged hospitalisation; prescription of drugs other than IMCI drugs for revenue generation or because believed superior by doctors or parents; parents' perception that the quality of care at the primary healthcare level is poor; preference for invasive treatment and medicalised care. Despite the long-standing recognition that supportive health systems are a requirement for IMCI implementation, efforts to address health system barriers have been limited. Making healthcare truly universal for children will require a shift towards health systems designed around and for children and away from systems centred on providers' needs and parents' expectations. Prerequisites will be sufficient remuneration, sound training, improved health literacy among parents, conducive laws and regulations and reimbursement systems with adequate checks and balances to ensure the best possible care.
机译：童年疾病（IMCI）的综合管理是在中亚和欧洲引入的，以解决缺乏基于证据的准则，抗生素滥用，多酚疾病和过度研究。本研究在16个国家分析了IMCI实施的地位，优势和障碍，并调查了卫生系统如何影响IMCI旨在解决的问题。 220个主要信息人员接受采访的约5至37名（中位数12）。分析数据以产生主题和同行评审。 IMCI尚未充分使用作为策略或作为算法诊断和治疗决策工具。固有的激励措施包括：经济因素优先于证据和儿童治疗决策的最佳利益;融资机制和支付计划，不必要或长期住院;除了IMCI药物以外的药物的处方，或者由于医生或父母而闻名;父母的看法是，主要医疗水平的护理质量差;偏爱侵入性治疗和医学护理。尽管支撑卫生系统的长期承认是IMCI实施要求，但解决卫生系统障碍的努力受到限制。制定医疗保健真正普遍的儿童将需要转向周围和儿童的卫生系统，远离以供应商的需求和父母的期望为中心的系统。先决条件将是足够的薪酬，合理的培训，改善父母的健康识字，有利于支票和平衡的父母，有利法律和法规和报销系统，以确保最佳的护理。

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