21世纪初期我国农村初级卫生保健实施策略研究——方法与依据

1990年 3月 ,由卫生部会同国家计委、农业部、国家环保局和全国爱卫会 5部委联合制定下发的我国农村初级卫生保健第一个 10年规划《我国农村实现“2 0 0 0年人人享有卫生保健”的规划目标》,在指导我国农村初级卫生保健的发展中发挥了重要作用 ,极大地推进了我国农村初级卫生保健工作的进程 ,促进了我国农村卫生事业的发展。随着新世纪的到来 ,我国政府在第一个 10年规划中提出的初级卫生保健奋斗目标 ,经过我国政府和我国人民的共同努力而逐步实现。我国政府制定的评价“2 0 0 0年人人享有卫生保健”目标进度的指标与标准体系 ,也随着新世…     

我国农村初级卫生保健工作存在的主要问题与启示

我国政府在第一个 10年规划中提出的初级卫生保健奋斗目标 ,经过我国政府和人民的共同努力而逐步实现 ,取得非常显著的成绩。但初级卫生保健的目标任务尚未完成 ,在新世纪我国农村仍将面临许多新的卫生问题 ,实现人人享有卫生保健的目标任重道远。因此 ,在肯定成绩的基础上 ,我们必须坚持一分为二的观点 ,认真分析我国农村初级卫生保健工作中存在的问题 ,发扬成绩 ,弥补不足 ,为新世纪的初级卫生保健探索出一条更好的发展之路。1　我国农村初级卫生保健工作存在的主要问题1.1　对初级卫生保健工作的重要性在认识上存在差异一些地方的领导对…     

努力开创我国初级卫生保健工作的新局面

20世纪90年代，在WHO的指导下，我国开展了波澜壮阔的初级卫生保健工作，对强化我国政府的卫生工作职责，提高卫生组织服务能力，促进卫生服务的公平性，提高群众的健康水平发挥了重要作用。随着我国社会经济的发展和群众对健康需求的不断增加，我国初级卫生保健既要传承，又要面对新形势，解决新问题。我们已经有了很好的进一步开展初级卫生保健的政治基础和政策基础，我们也必须要有新的工作思路，做到与时俱进，掀起新一轮我国初级卫生保健工作的高潮。     

初级卫生保健在我国农村社会经济与卫生工作中的地位与作用

我国开展农村卫生工作几十年来 ,是初级卫生保健真正使农村卫生工作走上规范化和科学化发展之路。没有哪一项卫生工作能象初级卫生保健工作一样受到各级政府和相关部门的如此重视并摆上位置。实践证明 ,初级卫生保健是我国农村卫生工作的龙头和核心 ,抓初保也就抓住了农村卫生工作的关键。初级卫生保健工作的开展 ,有利于农村社会主义精神文明建设 ,加快农民奔小康的步伐 ;有利于缩小农村地区间卫生差异 ,加快实现共同富裕 ;有利于农村科学文明风尚的普及 ,加快农村卫生生活方式的形成。1　初级卫生保健在我国农村社会经济中的地位1.1　实施…     

重振初级卫生保健是实现人人享有健康的必由之路

2008年是世界卫生组织（WHO）《阿拉木图宣言》提出初级卫生保健30周年。2007年11月，世界卫生组织总干事陈冯富珍在我国农村初级卫生保健发展国际研讨会上郑重宣布：WHO将重振初级卫生保健（primary health care，PHC），并决定将初级卫生保健作为2008年世界卫生报告的主题，以此纪念《阿拉木图宣言》发表30周年。本文对30年来我国推行初级卫生保健工作取得的成果，存在的问题，以及重振初级卫生保健的展望做一论述。     

论社区在落实PHC策略中的基础性作用

自《阿拉木图宣言》明确对PHC（初级卫生保健）做出准确的定义和解释之后,认真组织实施初级卫生保健策略已成为世界各国发展本国卫生事业的共识.在各国政府落实初级卫生保健策略的过程中,基层社区的参与发挥着重要作用.针对如何理解并充分发挥社区在落实初级卫生保健策略过程中的作用提出一些有益的探讨,以期推动基层社区更好地参与并促进初级卫生保健体系的建设和完善.     

初级卫生保健的内涵及其在我国的发展回顾

由世界卫生组织及其成员国于1978年《阿拉木图宣言》提出的“初级卫生保健”,是指最基本的、人人都能得到的、体现社会平等权利的、人民群众和政府都能负担得起的卫生保健服务。初级卫生保健所反映的核心价值观是社会公平,所信奉的理论是“健康乃人类的基本权利”,所追求的目标是“人人享有健康”,所采用的技术是适宜技术。中国初级卫生保健实践始于建国之初,20世纪50年代初确定的“面向工农兵、预防为主、团结中西医、卫生工作与群众运动相结合”四大方针,已包含了初级卫生保健的基本思想和内容。建国后的前30年取得的成就为国际上形成初级卫生保健策略奠定了实证基础,随后20年是我国初级卫生保健发展阶段,政府承诺实现2000年人人享有卫生保健的目标,但取得的健康效果有限。21世纪以来,政府仍然把初级卫生保健作为农村卫生的中心任务,但是可持续性问题还没有解决。     

初级卫生保健的特点与医务人员的责任

自从世界卫生组织提出2000年人人享有卫生保健的战略目标以来,我国城乡的初级卫生保健工作有了迅速发展。初级卫生保健与各级卫生组织各类卫生人员有什么关系?这是涉及到初级卫生保健深入     

论初级卫生保健的质量保障

WHO在其工作报告中多次强调“要对初级卫生保健的质量问题给予更大的关注”,“要提高初级卫生保健的质量”。随着初级卫生保健的实施进程在全国的广泛深入开展,初级卫生保健质量保障问题越来越被列入政府议事日程,而且将是今后初级卫生保健建设     

凸显政府职责，打造新型初级卫生保健

文章介绍了杭州市萧山区实施初级卫生保健的基本做法和取得的工作成果，并就打造新型初级卫生保健工作中如何凸显政府职责提出了若干思考。     

重庆市农村初级卫生保健发展概况研究

农村初级卫生保健工作是农村卫生的龙头和核心内容。2010年是全国农村初级卫生保健工作第二个10年规划结束,第三个10年规划即将开始的关键时期。文章对重庆市20年来的农村初级卫生保健工作概况进行总结,并结合新医改的大背景分析重庆市农村初级卫生保健工作面临的新形势,以期记录重庆市农村初级卫生保健工作的历史,并对新一轮农村初级卫生保健工作的发展提供历史经验。     

中德初级卫生保健的比较研究

初级卫生保健无论在发达国家还是发展中国家都是卫生保健系统的一个明显特征。根据Starfield提出的不同国家初级卫生保健发展状况要素,对中德两国的初级卫生保健人员、资金来源和支付方式、服务方式及改革和发展趋势等进行比较研究。通过分析借鉴德国的初级卫生保健和全科医生制度,探讨我国初级卫生保健的实现途径,以促进卫生体制的深化改革。     

新时期农村初级卫生保健事业发展的思考

21世纪的新一轮农村初级卫生保健取得了新进展。在新时期推进农村初级卫生保健意义重大。要正确认识现阶段农村初级卫生保健面临的新问题和挑战。农村初级卫生保健重点要抓好农村卫生服务体系建设、人才队伍建设和新型农村合作医疗制度建设,要立足于建立长效机制促进农村初级卫生保健工作任务的落实。     

Primary Health Care: A Darling Downs Focus

ABSTRACT: Primary health care is a policy model Which integrates social principles into the functioning of the health system at the local level. There is increasing interest in primary health care policy development and in the implementation of primary health care due in part to: the challenge which primary health care raises to existing practice in health service planning and delivery; the changes in roles of health service professionals and consumers which primary health care demands, and the claims on resources which the implementation of primary health care may engender.
The conceptual basis of primary health care demands that decision-making be devolved to the local level. The organisational structure of the public health care system in Queensland, since regionalisation in July 1991, provides an environment which favours this localised decision-making. The Darling Downs Regional Health Authority, one of 13 regional health authorities in Queensland, released a 'Primary Health Care Discussion Paper' as an element in its strategy for primary health care implementation at the regional level. This paper was intended to demystify the concept, raise the level of debate and stimulate discussion about how primary health care might affect health professionals and the community.
This article analyses that discussion paper to illuminate the concept of primary health care emerging in the region and in Queensland Health. It also identifies potential barriers to the implementation of primary health care and outlines activities being undertaken in the region which illustrate ways in which primary health care can be manifested in local communities.     

基层医疗践行高价值医疗卫生服务的机遇、挑战及对策

基层医疗在我国医疗卫生体系发展中的地位和作用日益凸显,在迎来发展机遇的同时也面临着如医疗卫生资源分配不合理、定位不清晰、人民信任度较低等困难和挑战.对此,基层医疗应从降低服务成本、提升服务质量、改善患者体验感等方面出发,全面提升服务能力,切实践行高价值医疗卫生服务,促进我国基层医疗卫生事业持续健康发展.     

Health expenditure on primary care in Spain: not enough to provide attractive services to patients and health professionals. SESPAS Report 2012

The relatively low health expenditure on primary care in Spain is a result of the status quo in the health system, in which hospital/specialized care is much more widespread and better financed than primary care. Another cause consists of the health policies developed in the last 30 years, which have prioritized the development of the private ambulatory health sector over primary care.     

Health care in the Netherlands

This article analyzes Dutch experiences of health care reform--in particular in primary care--with emphasis on lessons for current United States health care reforms. Recent major innovations were the introduction of private insurance based on the principles of primary care-led health care and including all citizens irrespective of their financial, employment, or health status; introduction of primary care collaboratives for out-of-hour services and chronic disease management; and primary care team building, including practice nurses. These innovations were introduced on top of a strong primary care tradition of family practices with defined populations based on patient panels, practice-based research, evidence-based medicine, large-scale computerization, and strong primary care health informatics. Dutch health reform redirected payment to support introduction of innovative health plans and strengthening of primary care to respond to public health objectives. Five recommendations for US primary care follow from this Dutch experience: (1) a private insurance model is compatible with thriving primary care, but it must include all people, especially the most vulnerable in society, and espouse a primary care-led health care system; (2) patient panels or practice lists strengthen continuity of care and community orientation to focus on and respond to local needs; (3) reward collaboration within primary care and between primary care, hospital care, and public health; (4) stimulate primary care professionals to exert their passion and expertise through participation in primary care research and development; and (5) health informatics should be primary care based, preferably adopting the International Classification of Primary Care. With these recommendations, it will be possible for the United States to obtain better population health for its population.     

Gasto sanitario en atención primaria en España: insuficiente para ofrecer servicios atrayentes para pacientes y profesionales. Informe SESPAS 2012

The relatively low health expenditure on primary care in Spain is a result of the status quo in the health system, in which hospital/specialized care is much more widespread and better financed than primary care. Another cause consists of the health policies developed in the last 30 years, which have prioritized the development of the private ambulatory health sector over primary care.     

Primary health services at district level in South Africa: a critique of the primary health care approach

Background

The rhetoric of primary health care philosophy in the district health system is widely cited as a fundamental component of the health transformation process in post-apartheid South Africa. Despite South Africa??s progress and attempts at implementing primary health care, various factors still limit its success.

Discussion

Inconsistencies and poor understanding of primary care and primary health care raises unrealistic expectations in service delivery and health outcomes, and blame is apportioned when expectations are not met. It is important for all health practitioners to consider the contextual influences on health and ill-health and to recognise the role of the underlying determinants of ill-health, namely, social, economic and environmental influences. The primary health care approach provides a strong framework for this delivery but it is not widely applied. There is a need for renewed political and policy commitments toward quality primary health care delivery, re-orientation of health care workers, integration of primary health care activities into other community-based development, improved management skills and effective coordination at all levels of the health system. There should also be optimal capacity building, and skills development in problem-solving, communication, networking and community participation.

Summary

A well-functioning district health system is required for the re-engineering of primary health care. This strategy requires a strong leadership, a strengthening of the current district heath system and a greater emphasis on health promotion, prevention, and community participation and empowerment.