水和环境卫生服务供给评价及研究——以陕西志丹县为例

目的:了解和评估农村水和环境卫生服务供给是否满足公众需求,为今后的政策制定和推进提供参考.方法:以陕西省志丹县为样本,应用供给分析理论,使用联合国儿童基金会3A评估步骤,对200户村民进行问卷调查.结果:水和环境卫生服务供给使大多数农民更容易获取安全饮用水、使用卫生厕所,妇女、儿童等焦点人群满意度也大幅度提升.结论:农村水和环境卫生服务供给是一个长期的过程,政府应进一步加强联动,加强工程基础设施的管理和维护工作,并鼓励群众更积极主动参与到改水改厕项目中.     

应用数理统计研究判断农村水和环境卫生改善与经济增长的关系

目的对农村水和环境卫生改变程度与经济增长的关系进行分析和探讨。方法以公开数据为基础,运用统计分析工具,建立统计分析模型。结果农村无害化厕所普及率、农村饮用水普及率与人均国内生产总值(GDP)之间存在密切的关系,且在其他条件不变的情况下,当农村自来水普及率、农村卫生厕所普及率提高时,人均GDP将有一定增加。结论建议各级政府应将环境卫生改善纳入到经济和社会发展的总体规划,列入各级政府的重要议事日程,促进经济和社会的健康和可持续发展。     

论影响我国农村环境卫生的四个因素

农村环境卫生的好坏,直接影响着农村人口的健康、农民生活水平的提高和农业生产的发展。如何采取措施,使农村环境卫生得到改善,是PHC中的一个重要课题。要改善环境卫生,就必须首先认清影响农村环境卫生的主要问题,然后针对这些问题,采取有效措施加以改进。笔者认为在我国农村环境卫生的改善工作中,存在着以下四个影响因素: 1.政府支持、部门配合是改善农村环境卫生的首要条件。在我国农村环境卫生还较差的情况下,要改善环境卫生,就必须依靠政府部门的重视和支持,依靠各有关职能部门的密切配合。政府在工作中,重视环境卫生队伍的建设,制定     

农村水和环境卫生服务供给及效用研究回顾

目的:农村水和环境卫生服务的改善是提高贫困人口生活质量、转变生活方式、促进经济增长的重要途径,其经济和社会意义日渐凸显.方法:借助检索工具对国际、国内相关研究进行了全面梳理与回顾,并对近几年涉及中国、印度等发展中国家的英文文献进行了分析.结论:将水和环境卫生的研究分为两个阶段:初级阶段——20世纪70年代到90年代初,深入阶段——21世纪至今.     

西部地区农村安全饮用水和环境卫生服务供给问题及对策研究——以青海和云南为例

农村安全饮用水和环境卫生改善效果的地区性差异使得供给问题成为焦点。以青海和云南实地调查研究为基础,通过对西部地区经济发展水平、自然地理环境、农户参与意识等因素的调查,发现农村改水改厕存在的问题,提出未来改水改厕的方向。为解决西部农村安全饮水和环境卫生服务供给中存在的问题,其建设应与新农村建设协调发展,在多元化供给结构的支持下需要公民民主意识的提高。     

我国农村卫生服务供给体系的构建思路

我国有9亿人口在农村。为占全国人口总数80％的农村人口提供适宜的的卫生保健服务,是实现卫生工作目标的重要内容。当前,我国农村卫生筹资、卫生服务供给及其利用等方面存在许多新问题。近年来,安徽省肥西县卫生局局长徐杰同志受国家工生部的委托,以农村工生工作为主题,就我国农村卫生服务的供给体系、管理体制、组织结构、资金运营等方面提出了颇有见地的现点。从本期起,本刊将连续刊发徐杰同志的文章。同时,也欢迎广大读者参与这方面的研究,为各级政府制定农村卫生经济政策提供依据。     

关于改革和加强农村卫生工作的十点思考

健康是每个人的一项基本权利。保护并增进人民健康,不仅是卫生事业的基本任务,也是国家和世界发展的重要社会目标。如何发展农村卫生事业,使占我国绝大多数的农民群众得到基本的卫生服务,提高农村人群健康水平,这是摆在我们各级政府和卫生部门面前的严峻任务。国务     

蓟县改水成果及水质污染情况的评估

蓟县改水成果及水质污染情况的评估李建明，周素芹改善农村饮水卫生状况是“国际给水和环境卫生十年”的主要指标，也是农村实施初级保健的内容，我县随着农村经济的发展，农村在改水方面取得了较大的进展，为了解改水成果，我们进行了全县饮水状况普查和水污染监测。此项...     

卫生服务体制改革中的公平与效率

进入 2 0世纪 90年代 ,我国卫生服务体制改革便随着社会经济体制改革的深入发展而提到了各级政府的重要议事日程 ,经过近 10年的改革探索和试点 ,现已逐步进入全面改革阶段。打破旧的不适应的体制 ,建立新型的适应经济发展的卫生服务管理体制 ,是我国社会经济发展的要求 ,也是历史发展的必然结果。一、问题的提出2 0多年经济体制改革 ,中国的社会经济状况发生了巨大的变化 ,城乡居民的物质文化生活水平得到了前所未有的提高 ,社会卫生状况和卫生服务设施也有了明显改善。随着经济体制改革的深入和市场化程度的提高 ,卫生服务体制在很多方面…     

“新医改”中医疗服务的供求问题探析

我国"新医改"方案突出了医疗服务的公益化取向与基本医疗政府主导性供给,以促进社会公平与和谐的目标的实现。但是,这里存在两个值得关注的问题,即有效供给不足与过度需求的问题。可能的解决思路是,政府主导并与市场有效配合,采取财政手段,对供给进行有效的利益激励,对社会资本进行吸引,发展医疗服务的多元化有效供给,以满足不同的医疗服务需求。     

Water,sanitation and hygiene: a situation analysis paper for Lao PDR

The Lao People's Democratic Republic (Lao PDR) is located in the Greater Mekong sub-region in East Asia, neighbouring with China, Cambodia, Myanmar, Thailand and Vietnam, with a land area of 236,800 square kilometres, and an average population density of 22 persons per square kilometre. The population of Lao PDR is 5.5 million with 49 ethnic groups. Most of the population is located in rural areas, with a significant number of the neediest villages in remote localities. In the past decade, there have been many positive developments in the rural water supply and sanitation (RWSS) sector. Despite improved coverage in latrine and water supply services, health remains a serious problem. The improved services were often not sustained or poorly maintained, while hygiene received inadequate attention. In Lao PDR, as in many other countries, the provision of a safe and reliable water supply and appropriate sanitation services, based on sustainable approaches, therefore, remains a challenge. This paper will provide an overview of the Lao PDR's RWSS Sector. Special emphasis is placed on actual field level application of informed choices for water supply, sanitation and hygiene awareness.     

宿州市市县级自来水厂卫生现状及影响因素探析

目的　分析宿州市市、县级自来水水厂供水卫生现状和影响因素 ,以加强我市集中式供水卫生管理。方法　采用现场调查和对 2 0 0 0年水质抽样检查结果进行分析。结果　宿州市自来水水源均为 70～32 0米深层地下水 ,没经净化、消毒 ,直接向管网用户供水。所查水源 30m范围内有污染源的占 13.3%,10 0m范围有农田使用化肥的占 5 3.33%。抽查 131份水样合格率为 45 .0 4%,影响水质的主要超标指标是氟化物占 44 .19%,总大肠菌群占 17.44 %,细菌总数占 13.95 %,总硬度占 11.6 3%,硫酸盐占 9.30 %。结论　宿州市城镇集中式供水面临的主要问题是改水降氟、饮水消毒和水源卫生防护。     

The prominence of health in donor policy for water supply and sanitation: a review

Improved water supply, sanitation and hygiene used in combination are effective at achieving better health for poor people in developing countries. However, donor policy has been dominated by interventions in water supply, at the expense of achieving the potential health benefits of improved sanitation and hygiene. Commitments recently made by the international community require greater emphasis on improved sanitation and hygiene and their impacts on health. This review assesses whether such a shift in emphasis is apparent in donor policy. It examines the prominence given to achieving better health in water supply and sanitation policies of three donors: the World Bank, the European Union and the Department for International Development of the British Government. It finds that health benefits are explicit and integral in recently updated policy documentation concerning water supply and sanitation. This has taken place in an environment focused on poverty reduction and demand-led, financially sustainable interventions. Mechanisms that have enabled donors to prioritise the health impacts in this environment are discussed, including adoption of an asset-based conceptualisation of poverty and a cross-sectoral approach.     

Water systems and urban sanitation: A historical comparison of Tokyo and Singapore

The importance of a water supply and sewage treatment for urban sanitation is recognized in the modern world. Their contributions to public health have not, however, been well demonstrated by historical data, especially in Asian cities. In this research, we focused on the Asian cities of Tokyo and Singapore, which both developed significantly in the 20th century. We analysed their development processes statistically to determine what the key elements for the protection of urban sanitation have been. Although both cities constructed modern water supply systems at almost same time (Tokyo in 1898 and Singapore in 1878), and similarly modern wastewater treatment systems (Tokyo in 1922 and Singapore in 1913), the prevalence of water-borne diseases in Tokyo was more serious than it was in Singapore, in spite of Singapore's high infant mortality rate. The main reason for this was the differences in the systems of night-soil transport. We found that the water supply system in itself was not enough to resolve all urban sanitation problems, and appropriate night-soil removal was also crucial. In addition, historical trends and water consumption vary by city, so the appropriate technology and system are also different according to the unique characteristics and needs of each.     

Water systems and urban sanitation: a historical comparison of Tokyo and Singapore

The importance of a water supply and sewage treatment for urban sanitation is recognized in the modern world. Their contributions to public health have not, however, been well demonstrated by historical data, especially in Asian cities. In this research, we focused on the Asian cities of Tokyo and Singapore, which both developed significantly in the 20th century. We analysed their development processes statistically to determine what the key elements for the protection of urban sanitation have been. Although both cities constructed modern water supply systems at almost same time (Tokyo in 1898 and Singapore in 1878), and similarly modern wastewater treatment systems (Tokyo in 1922 and Singapore in 1913), the prevalence of water-borne diseases in Tokyo was more serious than it was in Singapore, in spite of Singapore's high infant mortality rate. The main reason for this was the differences in the systems of night-soil transport. We found that the water supply system in itself was not enough to resolve all urban sanitation problems, and appropriate night-soil removal was also crucial. In addition, historical trends and water consumption vary by city, so the appropriate technology and system are also different according to the unique characteristics and needs of each.     

Environmental health education in Micronesia

Water supply and sanitation programmes in Micronesia require substantial capital investments. In the past, many of these projects have failed to achieve their maximum impact on preventing water-related diseases. Cases of cholera and the continuation of frequently occurring gastro-intestinal diseases undermine the expectations that new and planned water and sanitation systems will result in disease prevention. This report indicates that knowledge of water-related diseases and the understanding of the benefits of safe water supply and sanitation are limited as programmes in Micronesia that would educate the different sectors of the community have never been institutionalised. We have developed the first comprehensive system for teaching about water supply, sanitation and health in a Micronesian environment. The educational materials will be used as curricula in public education and as information resources for appropriate individuals in these remote and scattered communities of the Pacific.     

A case-control study of the effect of environmental sanitation on diarrhoea morbidity in Malawi.

A case-control design has been applied in the evaluation of improved environmental sanitation on diarrhoeal diseases in rural Malawi. The study demonstrates the feasibility of using such an approach to evaluate two levels of water supply and sanitation service quickly and at moderate cost. Sample sizes would need to be increased substantially to evaluate multiple levels of service or to investigate interactions between water supply and sanitation. The results indicate that children living in families who use good quality water supplies and latrines experience 20% less diarrhoea as reported to the health clinics during the warm, rainy season.     

Public-private partnership in water supply and sanitation in Sub-Saharan Africa

Purely public water supply systems are characterized by highcosts, insufficient supplies and chronic deficits that are coveredby central government transfers. The private water supply programmein Abidjan has not met its coverage targets either, but thesystem has remained financially solvent and fostered a rapidgrowth in capacity through the informal sector. The materialreviewed here and the experience of developing country watersystems in general support several conclusions. (1) Water vendingis common in developing countries, which suggests that chargingfor water is not culturally unacceptable. Demand for wastewaterservices is low, but surcharges could be imposed on water usageto cover some sanitation costs. (2) Incentives are criticalto sound management of water supply and sanitation services.They are typically part of the structure of private firms, butare rare in publicly run systems. (3) The private sector's rolein the provision of water supply and sanitation can be extensive.Regulation of private activity and quality control by publicauthorities is essential to maintain competition and ensureproper and fair operation. (4) Public efforts to supply watercan be supplemented by a government-regulated, parallel systemto increase the amount of water available. Normally these systemsinvolve trucked water, but private sales outlets with pipe infrastructureshould be encouraged where feasible. (5) Even where the publicsector decides to control and operate the water supply and sanitationsystem, some partnership with the private sector is possiblethrough contracting out specific tasks such as billing, metering,maintenance of various components or tracking water losses.Finally, the supply of water is an ideal activity for a public-privatepartnership. Both sectors have comparative advantages that arebest applied in conjunction with the other.     

Situation analysis and epidemiology of infectious disease transmission: a South-East Asian regional perspective

This paper analyses the situation in countries comprising the WHO South-East Asia Region with respect to water supply and sanitation services, hygiene and the epidemiology of related infectious diseases. Recently, published data from the WHO/UNICEF Global Water Supply and Sanitation Assessment 2000 report was reviewed to depict the situation with respect to consumers' access to improved water supply and sanitation services. It was shown that access to improved drinking water supplies is among the lowest in the world, and that sanitation coverage in this region is below all others. The paper also reviews selected surveys of hygiene behaviours in several countries of the region. Associations are suggested between access to services, hygienic practices and specific infectious diseases. The need is acknowledged to improve the evidence base on linkages between infectious diseases and water, sanitation and hygiene, and specific recommendations are made in this regard. There is a need now and for the foreseeable future to promote low-cost household-level interventions, including behaviour change strategies, that mitigate the health consequences of the current situation with respect to water supply, sanitation and hygiene. The role of health authorities in meeting this challenge, and as advocates for accelerating development of the water and sanitation sector, is highlighted.