基本公共卫生服务项目的实施效果评价研究-以孕产妇健康管理服务为例 医学

目录TOC\o"2-5"\f\p""\h\z\t"标题1,1,一级,1"常用缩略词中英文对照表 基本公共卫生服务项目实施效果评价研究—以孕产妇健康管理服务为例前言1978年世界卫生组织（WorldHealthOrganization,WHO）和联合国儿童基金会（UnitedNationsChildren'sFund,UNICEF）在哈萨克斯坦的阿拉木图召开国际初级卫生保健大会，并发表了《阿拉木图宣言》ADDINEN.CITE<EndNote><Cite><Year>1978</Year><RecNum>2</RecNum><DisplayText>[1]</DisplayText><record><rec-number>2</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1578917280">2</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors></contributors><titles><title>DeclarationofAlma-Ata</title><secondary-title>Lancet</secondary-title></titles><periodical><full-title>Lancet</full-title></periodical><pages>1040-1</pages><volume>2</volume><number>8098</number><edition>1978/11/11</edition><keywords><keyword>CongressesasTopic</keyword><keyword>InternationalCooperation</keyword><keyword>Kazakhstan</keyword><keyword>*PrimaryHealthCare</keyword></keywords><dates><year>1978</year><pub-dates><date>Nov11</date></pub-dates></dates><isbn>0140-6736(Print) 0140-6736</isbn><accession-num>82047</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[1],宣言明确了“2000年人人享有卫生保健（HealthForAllBy2000,HFA）”的全球战略目标，并将初级卫生保健（PrimaryHealthCare,PHC）确立为实现这一全球战略目标的基础与根本途径ADDINEN.CITE<EndNote><Cite><Author>Frost</Author><Year>2015</Year><RecNum>3</RecNum><DisplayText>[2]</DisplayText><record><rec-number>3</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1578917534">3</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>Frost,J.</author><author>Currie,M.J.</author><author>Cruickshank,M.</author></authors></contributors><auth-address>UniversityofCanberra,Canberra,Australiajane.frost@.au. UniversityofCanberra,Canberra,AustraliaAustralianNationalUniversity,Canberra,Australia. UniversityofCanberra,Canberra,Australia.</auth-address><titles><title>AnIntegrativeReviewofEnablementinPrimaryHealthCare</title><secondary-title>JPrimCareCommunityHealth</secondary-title></titles><periodical><full-title>JPrimCareCommunityHealth</full-title></periodical><pages>264-78</pages><volume>6</volume><number>4</number><edition>2015/08/01</edition><keywords><keyword>Humans</keyword><keyword>PatientSatisfaction</keyword><keyword>Patient-CenteredCare</keyword><keyword>Physician-PatientRelations</keyword><keyword>*PrimaryHealthCare/methods/standards</keyword><keyword>*SelfEfficacy</keyword><keyword>TreatmentOutcome</keyword><keyword>communityhealth</keyword><keyword>healthoutcomes</keyword><keyword>patient-centeredness</keyword><keyword>primarycare</keyword><keyword>qualityimprovement</keyword></keywords><dates><year>2015</year><pub-dates><date>Oct</date></pub-dates></dates><isbn>2150-1319</isbn><accession-num>26229059</accession-num><urls></urls><electronic-resource-num>10.1177/2150131915598373</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[2]。宣言给出初级卫生保健的明确定义ADDINEN.CITE<EndNote><Cite><Author>WHO</Author><Year>1978 </Year><RecNum>160</RecNum><DisplayText>[3]</DisplayText><record><rec-number>160</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1583824821">160</key><keyapp="ENWeb"db-id="">0</key></foreign-keys><ref-typename="Report">27</ref-type><contributors><authors><author>WHO</author></authors></contributors><titles><title>DeclarationofAlma-Ata</title></titles><dates><year>1978 </year></dates><pub-location>Geneva</pub-location><publisher>WHO</publisher><urls><related-urls><url>./topics/primary_health_care/Alma_ata_declaration/zh/</url></related-urls></urls></record></Cite></EndNote>[3]：初级卫生保健是一种基本的卫生保健。它依靠切实可行、学术上可靠又受社会欢迎的方式和技术，是社区的个人和家庭通过积极参与普遍能够享受的，费用也是社区或国家依靠自力更生精神能够负担的卫生服务。初级卫生保健主要包括：对当前主要卫生问题及其预防与控制方法的健康教育；改善食品供应与合理营养；安全饮用水的供应及基本环境卫生健康；妇幼卫生保健；主要传染病的免疫接种；地方病的预防及控制以及基本药物的提供等内容。《宣言》发表后，加拿大ADDINEN.CITEADDINEN.CITE.DATA[4]、澳大利亚ADDINEN.CITE<EndNote><Cite><Author>Smith</Author><Year>2014</Year><RecNum>5</RecNum><DisplayText>[5]</DisplayText><record><rec-number>5</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1578920004">5</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>Smith,J.A.</author></authors></contributors><titles><title>Reflectionsontheframingof'healthequity'intheNationalPrimaryHealthCareStrategicFramework:acauseforcelebrationorconcern?</title><secondary-title>HealthPromotJAustr</secondary-title></titles><periodical><full-title>HealthPromotJAustr</full-title></periodical><pages>42-5</pages><volume>25</volume><number>1</number><edition>2014/04/18</edition><keywords><keyword>Australia</keyword><keyword>*HealthPolicy</keyword><keyword>HealthPromotion/methods/*standards</keyword><keyword>*HealthStatusDisparities</keyword><keyword>Humans</keyword><keyword>PrimaryHealthCare/methods/*standards</keyword><keyword>*SocialDeterminantsofHealth</keyword><keyword>*SocialJustice</keyword></keywords><dates><year>2014</year><pub-dates><date>Apr</date></pub-dates></dates><isbn>1036-1073(Print) 1036-1073</isbn><accession-num>24739778</accession-num><urls></urls><electronic-resource-num>10.1071/he13106</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[5]、希腊ADDINEN.CITE<EndNote><Cite><Author>Groenewegen</Author><Year>2013</Year><RecNum>4</RecNum><DisplayText>[6]</DisplayText><record><rec-number>4</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1578919947">4</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>Groenewegen,P.P.</author><author>Jurgutis,A.</author></authors></contributors><auth-address>NIVEL-NetherlandsInstituteforHealthServicesResearch,POBox1568,3500BNUtrecht,TheNetherlands.P.Groenewegen@nivel.nl. DepartmentofPublicHealth,KlaipedaUniversity,Klaipeda,Lithuania.</auth-address><titles><title>AfutureforprimarycarefortheGreekpopulation</title><secondary-title>QualPrimCare</secondary-title></titles><periodical><full-title>QualPrimCare</full-title></periodical><pages>369-78</pages><volume>21</volume><number>6</number><edition>2014/02/12</edition><keywords><keyword>EconomicRecession</keyword><keyword>Forecasting</keyword><keyword>Greece</keyword><keyword>*HealthCareReform</keyword><keyword>Humans</keyword><keyword>PrimaryHealthCare/*trends</keyword><keyword>*QualityAssurance,HealthCare</keyword></keywords><dates><year>2013</year></dates><isbn>1479-1072(Print) 1479-1064</isbn><accession-num>24512835</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[6]等多个国家均将初级卫生保健作为卫生改革与人群健康水平提高的主要战略措施。国际组织也将初级卫生保健作为实践卫生工作的理论基础与现实选择ADDINEN.CITE<EndNote><Cite><Author>Walley</Author><Year>2008</Year><RecNum>7</RecNum><DisplayText>[7]</DisplayText><record><rec-number>7</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1578920845">7</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>Walley,J.</author><author>Lawn,J.E.</author><author>Tinker,A.</author><author>deFrancisco,A.</author><author>Chopra,M.</author><author>Rudan,I.</author><author>Bhutta,Z.A.</author><author>Black,R.E.</author></authors></contributors><auth-address>NuffieldCentreforHealthandDevelopment,LeedsInstituteofHealthSciences,UniversityofLeeds,Leeds,UK.</auth-address><titles><title>Primaryhealthcare:makingAlma-Ataareality</title><secondary-title>Lancet</secondary-title></titles><periodical><full-title>Lancet</full-title></periodical><pages>1001-7</pages><volume>372</volume><number>9642</number><edition>2008/09/16</edition><keywords><keyword>CommunityHealthServices/organization&administration/*statistics&numerical</keyword><keyword>data/trends</keyword><keyword>*GlobalHealth</keyword><keyword>Goals</keyword><keyword>*HealthPriorities</keyword><keyword>Humans</keyword><keyword>PrimaryHealthCare/organization&administration/*statistics&numerical</keyword><keyword>data/trends</keyword></keywords><dates><year>2008</year><pub-dates><date>Sep13</date></pub-dates></dates><isbn>0140-6736</isbn><accession-num>18790322</accession-num><urls></urls><electronic-resource-num>10.1016/s0140-6736(08)61409-9</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[7]，联合国2000年提出的千年发展目标（MillenniumDevelopmentGoals,MDGs）ADDINEN.CITE<EndNote><Cite><Author>Sachs</Author><Year>2004</Year><RecNum>161</RecNum><DisplayText>[8]</DisplayText><record><rec-number>161</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1583885777">161</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>Sachs,J.D.</author></authors></contributors><auth-address>CommissiononMacroeconomicsandHealth,ColumbiaUniversity,314LowLibraryMC4327,535West116thStreet,NewYork,NY10027,USA.sachs@</auth-address><titles><title>Healthinthedevelopingworld:achievingtheMillenniumDevelopmentGoals</title><secondary-title>BullWorldHealthOrgan</secondary-title></titles><periodical><full-title>BullWorldHealthOrgan</full-title></periodical><pages>947-9;discussion950-2</pages><volume>82</volume><number>12</number><edition>2005/01/18</edition><keywords><keyword>AdvisoryCommittees</keyword><keyword>DevelopingCountries/*economics</keyword><keyword>*Financing,Organized</keyword><keyword>*HealthPriorities</keyword><keyword>*HealthyPeoplePrograms</keyword><keyword>Humans</keyword><keyword>Investments</keyword><keyword>OrganizationalObjectives</keyword><keyword>PublicHealthAdministration/*economics</keyword></keywords><dates><year>2004</year><pub-dates><date>Dec</date></pub-dates></dates><isbn>0042-9686(Print) 0042-9686</isbn><accession-num>15654410</accession-num><urls></urls><custom2>PMC2623094</custom2><electronic-resource-num>/s0042-96862004001200012</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[8]和2015年提出的可持续发展目标（SustainableDevelopmentGoals,SDGs）ADDINEN.CITE<EndNote><Cite><Author>Morton</Author><Year>2017</Year><RecNum>162</RecNum><DisplayText>[9]</DisplayText><record><rec-number>162</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1583886207">162</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>Morton,S.</author><author>Pencheon,D.</author><author>Squires,N.</author></authors></contributors><auth-address>SustainabilityandPublicHealthBenefits,PublicHealthEngland. SustainableDevelopmentUnitforNHSEnglandandPublicHealthEngland. GlobalPublicHealth,PublicHealthEngland.</auth-address><titles><title>SustainableDevelopmentGoals(SDGs),andtheirimplementation:Anationalglobalframeworkforhealth,developmentandequityneedsasystemsapproachateverylevel</title><secondary-title>BrMedBull</secondary-title></titles><periodical><full-title>BrMedBull</full-title></periodical><pages>81-90</pages><volume>124</volume><number>1</number><edition>2017/10/27</edition><keywords><keyword>*ConservationofNaturalResources</keyword><keyword>*GlobalHealth</keyword><keyword>Goals</keyword><keyword>HealthEquity</keyword><keyword>Humans</keyword><keyword>ProgramDevelopment</keyword><keyword>QualityofLife</keyword><keyword>SocialResponsibility</keyword><keyword>SystemsAnalysis</keyword><keyword>UnitedNations</keyword><keyword>globalgoals</keyword><keyword>globalhealth</keyword><keyword>implementation</keyword><keyword>sustainabledevelopment</keyword></keywords><dates><year>2017</year><pub-dates><date>Dec1</date></pub-dates></dates><isbn>0007-1420</isbn><accession-num>29069332</accession-num><urls></urls><electronic-resource-num>10.1093/bmb/ldx031</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[9]均与初级卫生保健工作有着密切的联系。为保障初级卫生保健工作的实施效果与效率，世界银行在1993年公布的世界发展报告中提出了“基本卫生服务包”（PackageofEssential/BasicHealthService）概念ADDINEN.CITE<EndNote><Cite><Author>Bank</Author><Year>2003</Year><RecNum>163</RecNum><DisplayText>[10]</DisplayText><record><rec-number>163</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1583886546">163</key><keyapp="ENWeb"db-id="">0</key></foreign-keys><ref-typename="Report">27</ref-type><contributors><authors><author>WorldBank</author></authors></contributors><titles><title>Investigationinhealth.Worlddevelopmentreport2003</title></titles><pages>51-60</pages><dates><year>2003</year></dates><pub-location>NewYork.OxfordUniversityPress</pub-location><urls></urls></record></Cite></EndNote>[10]，概念指出基本卫生服务包是基本公共卫生服务包和基本医疗服务包的卫生服务项目的集合。主要服务内容包括：计划免疫、学校健康服务、计划生育和营养服务的健康教育、结核病控制、性病艾滋病控制、幼儿常见病护理等。为进一步明确基本公共卫生服务的功能框架，1997年世界卫生组织执行委员会通过Delphi法ADDINEN.CITE<EndNote><Cite><Author>Bettcher</Author><Year>1998</Year><RecNum>15</RecNum><DisplayText>[11]</DisplayText><record><rec-number>15</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1580787272">15</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>Bettcher,D.W.</author><author>Sapirie,S.</author><author>Goon,E.H.</author></authors></contributors><auth-address>DivisionofDevelopmentofPolicy,ProgrammeandEvaluation,WorldHealthOrganization,Geneva.</auth-address><titles><title>Essentialpublichealthfunctions:resultsoftheinternationalDelphistudy</title><secondary-title>WorldHealthStatQ</secondary-title></titles><periodical><full-title>WorldHealthStatQ</full-title></periodical><pages>44-54</pages><volume>51</volume><number>1</number><edition>1998/07/24</edition><keywords><keyword>DelphiTechnique</keyword><keyword>Forecasting</keyword><keyword>GlobalHealth</keyword><keyword>HealthKnowledge,Attitudes,Practice</keyword><keyword>HealthPolicy/*trends</keyword><keyword>*HealthPriorities</keyword><keyword>Humans</keyword><keyword>*PublicHealthAdministration</keyword><keyword>WorldHealthOrganization</keyword></keywords><dates><year>1998</year></dates><isbn>0379-8070(Print) 0379-8070</isbn><accession-num>9675808</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[11]确认了基本公共卫生服务体系包含的九大基本类别与功能，具体包括：传染病与非传染疾病的预防监测、健康水平监测、健康促进、职业健康、健康环境保护、公共卫生立法和管理、公共卫生管理、特定的公共卫生服务和个人健康以及高危人群健康。随着功能框架的确立，各国政府也明确了公共卫生服务的核心内容与核心领域ADDINEN.CITE<EndNote><Cite><Author>Forslin</Author><Year>2013</Year><RecNum>165</RecNum><DisplayText>[12]</DisplayText><record><rec-number>165</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1583892663">165</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>Forslin,B.M.</author><author>Moller,H.E.</author><author>Andersson,R.I.</author><author>Sohlberg,E.M.</author><author>Tillgren,P.E.</author></authors></contributors><auth-address>DepartmentofPublicHealth,CountyCouncilofVasternorrland,Harnosand,Sweden.barbro.forslin@lvn.se</auth-address><titles><title>Thehealth-promotionperspectiveinpublic-healthplansinaSwedishregionoverthreedecades</title><secondary-title>HealthPromotInt</secondary-title></titles><periodical><full-title>HealthPromotInt</full-title></periodical><pages>269-80</pages><volume>28</volume><number>2</number><edition>2012/03/27</edition><keywords><keyword>HealthPolicy/history</keyword><keyword>HealthPromotion/*history/methods/organization&administration</keyword><keyword>History,20thCentury</keyword><keyword>History,21stCentury</keyword><keyword>Humans</keyword><keyword>PolicyMaking</keyword><keyword>Politics</keyword><keyword>PublicHealth/history/methods</keyword><keyword>Sweden</keyword><keyword>healthpolicy</keyword><keyword>healthpolicyprocesses</keyword><keyword>healthpolitics</keyword><keyword>health-promotingpolicies</keyword></keywords><dates><year>2013</year><pub-dates><date>Jun</date></pub-dates></dates><isbn>0957-4824</isbn><accession-num>22447353</accession-num><urls></urls><electronic-resource-num>10.1093/heapro/das009</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[12]，为实现人们健康效益最大化提供了依据ADDINEN.CITE<EndNote><Cite><Author>WHO</Author><Year>2003</Year><RecNum>166</RecNum><DisplayText>[13]</DisplayText><record><rec-number>166</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1583892940">166</key><keyapp="ENWeb"db-id="">0</key></foreign-keys><ref-typename="Report">27</ref-type><contributors><authors><author>WHO</author></authors></contributors><titles><title>Essentialpublichealthfunctions:athree-countrystudyintheWesternPacificRegion</title></titles><dates><year>2003</year></dates><urls></urls></record></Cite></EndNote>[13]。2005年，WHO所有成员国做出了实现全民健康覆盖（UniversalHealthCoverage,UHC）的承诺ADDINEN.CITEADDINEN.CITE.DATA[14]，其内涵在于确保所有人都获得其所需要的卫生服务，而在付费时不必经历经济困难，使健康促进、疾病预防、疾病治疗等主要卫生保健措施实现全民可及。全民健康覆盖是21世纪卫生系统的核心目标。《2013年世界卫生报告：全民健康覆盖研究》ADDINEN.CITE<EndNote><Cite><Author>Odugleh-Kolev</Author><Year>2018</Year><RecNum>169</RecNum><DisplayText>[15]</DisplayText><record><rec-number>169</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1583893739">169</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>Odugleh-Kolev,A.</author><author>Parrish-Sprowl,J.</author></authors></contributors><auth-address>WorldHealthOrganization,avenueAppia20,1211Geneva27,Switzerland. GlobalHealthCommunicationCenter,IndianaUniversity,Indianapolis,UnitedStatesofAmerica.</auth-address><titles><title>Universalhealthcoverageandcommunityengagement</title><secondary-title>BullWorldHealthOrgan</secondary-title></titles><periodical><full-title>BullWorldHealthOrgan</full-title></periodical><pages>660-661</pages><volume>96</volume><number>9</number><edition>2018/09/29</edition><keywords><keyword>ClinicalCompetence/standards</keyword><keyword>CommunityParticipation/*methods</keyword><keyword>CooperativeBehavior</keyword><keyword>Financing,Organized/organization&administration</keyword><keyword>HealthPersonnel/*organization&administration/standards</keyword><keyword>HealthStatusDisparities</keyword><keyword>Humans</keyword><keyword>Internationality</keyword><keyword>Patient-CenteredCare/economics/*organization&administration/standards</keyword><keyword>SocialDeterminantsofHealth</keyword><keyword>UniversalHealthInsurance/economics/*organization&administration/standards</keyword></keywords><dates><year>2018</year><pub-dates><date>Sep1</date></pub-dates></dates><isbn>0042-9686</isbn><accession-num>30262948</accession-num><urls></urls><custom2>PMC6154062</custom2><electronic-resource-num>10.2471/blt.17.202382</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[15]中指出，以社区为基础的干预是预防疾病甚至减少死亡的有力措施，因此立足于社区及基层医疗卫生机构的公共卫生服务是实现全民健康覆盖的重要途径之一。建立可持续的全民覆盖的医疗保健体系离不开初级卫生保健服务，特别是公共卫生服务的支撑ADDINEN.CITEADDINEN.CITE.DATA[16]。2018年是《阿拉木图宣言》发表的40周年，全球目标已经从“2000年人人享有健康”发展成为全民健康覆盖ADDINEN.CITEADDINEN.CITE.DATA[14]。为纪念《阿拉木图宣言》的发表，2018年10月世界卫生组织和联合国儿童基金会在阿斯塔纳召开全球初级卫生保健会议，并发表《阿斯塔纳宣言》ADDINEN.CITE<EndNote><Cite><Author>The</Author><Year>2018</Year><RecNum>12</RecNum><DisplayText>[17]</DisplayText><record><rec-number>12</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1580784709">12</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>The,Lancet</author></authors></contributors><titles><title>TheAstanaDeclaration:thefutureofprimaryhealthcare?</title><secondary-title>Lancet</secondary-title></titles><periodical><full-title>Lancet</full-title></periodical><pages>1369</pages><volume>392</volume><number>10156</number><edition>2018/10/23</edition><keywords><keyword>*CommunityHealthServices</keyword><keyword>Forecasting</keyword><keyword>GlobalHealth</keyword><keyword>HealthServicesAccessibility</keyword><keyword>Humans</keyword><keyword>PrimaryHealthCare/*standards</keyword><keyword>Workforce</keyword></keywords><dates><year>2018</year><pub-dates><date>Oct20</date></pub-dates></dates><isbn>0140-6736</isbn><accession-num>30343840</accession-num><urls></urls><electronic-resource-num>10.1016/s0140-6736(18)32478-4</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[17]。宣言再次强调初级卫生保健是实现人类社会健康理想的根本途径ADDINEN.CITE<EndNote><Cite><Author>Walraven</Author><Year>2019</Year><RecNum>168</RecNum><DisplayText>[18]</DisplayText><record><rec-number>168</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1583893252">168</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>Walraven,G.</author></authors></contributors><auth-address>AgaKhanDevelopmentNetwork,Geneva,Switzerland.</auth-address><titles><title>The2018AstanaDeclarationonPrimaryHealthCare,isituseful?</title><secondary-title>JGlobHealth</secondary-title></titles><periodical><full-title>JGlobHealth</full-title></periodical><pages>010313</pages><volume>9</volume><number>1</number><edition>2019/04/18</edition><keywords><keyword>GlobalHealth</keyword><keyword>Humans</keyword><keyword>*PrimaryHealthCare</keyword></keywords><dates><year>2019</year><pub-dates><date>Jun</date></pub-dates></dates><isbn>2047-2978</isbn><accession-num>30992983</accession-num><urls></urls><custom2>PMC6445497at/coi_disclosure.pdf(availableuponrequestfromthecorrespondingauthor),anddeclaresnoconflictsofinterest.</custom2><electronic-resource-num>10.7189/jogh.09.010313</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[18]，并指出经过各国政府及国际社会40年的共同努力，全球健康水平得到了明显的提高，但现阶段全球的初级卫生保健水平依然呈现不平衡的趋势ADDINEN.CITE<EndNote><Cite><Author>Steinhubl</Author><Year>2018</Year><RecNum>13</RecNum><DisplayText>[19]</DisplayText><record><rec-number>13</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1580785235">13</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>Steinhubl,S.R.</author><author>Kim,K.I.</author><author>Ajayi,T.</author><author>Topol,E.J.</author></authors></contributors><auth-address>ScrippsTranslationalScienceInstitute,LaJolla,California,CA92037,USA;WaveResearchCenter,LaJolla,California,USA.Electronicaddress:steinhub@. ScrippsTranslationalScienceInstitute,LaJolla,California,CA92037,USA;SeoulNationalUniversityBundangHospital,Seongnam,SouthKorea. ScrippsTranslationalScienceInstitute,LaJolla,California,CA92037,USA. ScrippsTranslationalScienceInstitute,LaJolla,California,CA92037,USA;WaveResearchCenter,LaJolla,California,USA.</auth-address><titles><title>Virtualcareforimprovedglobalhealth</title><secondary-title>Lancet</secondary-title></titles><periodical><full-title>Lancet</full-title></periodical><pages>419</pages><volume>391</volume><number>10119</number><edition>2018/02/07</edition><keywords><keyword>*GlobalHealth</keyword><keyword>Humans</keyword><keyword>*User-ComputerInterface</keyword></keywords><dates><year>2018</year><pub-dates><date>Feb3</date></pub-dates></dates><isbn>0140-6736</isbn><accession-num>29407024</accession-num><urls></urls><electronic-resource-num>10.1016/s0140-6736(18)30109-0</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[19]，这种不平衡表现在不同的国家之间，不同的地域之间甚至国家的不同地区之间。现阶段我们依旧不得不面对全球至少有一半的人口无法获得基本卫生服务的事实ADDINEN.CITE<EndNote><Cite><Author>Dressel</Author><Year>2019</Year><RecNum>16</RecNum><DisplayText>[20]</DisplayText><record><rec-number>16</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1580788351">16</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>Dressel,A.</author><author>Mkandawire-Valhmu,L.</author></authors></contributors><titles><title>CelebrateWorldHealthDay:NursingandGlobalHealth</title><secondary-title>JContinEducNurs</secondary-title></titles><periodical><full-title>JContinEducNurs</full-title></periodical><pages>145-147</pages><volume>50</volume><number>4</number><edition>2019/04/04</edition><keywords><keyword>*AnniversariesandSpecialEvents</keyword><keyword>ClimateChange</keyword><keyword>CulturallyCompetentCare</keyword><keyword>*Education,Nursing</keyword><keyword>*Faculty,Nursing</keyword><keyword>GlobalHealth/*education</keyword><keyword>Humans</keyword><keyword>WorldHealthOrganization</keyword></keywords><dates><year>2019</year><pub-dates><date>Apr1</date></pub-dates></dates><isbn>0022-0124</isbn><accession-num>30942887</accession-num><urls></urls><electronic-resource-num>10.3928/00220124-20190319-02</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[20]：10多亿人的高血压未获得有效控制ADDINEN.CITEADDINEN.CITE.DATA[21]；2亿多的妇女无法充分获得卫生保健服务，还有近2000万婴儿未接种所需要的疫苗ADDINEN.CITE<EndNote><Cite><Author>Peck</Author><Year>2019</Year><RecNum>170</RecNum><DisplayText>[22]</DisplayText><record><rec-number>170</rec-number><foreign-keys><keyapp="EN"db-id="pfpfz5tt4fzp9qedxzk5wz0v2aeav0z025rz"timestamp="1583896615">170</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>Peck,M.</author><author>Gacic-Dobo,M.</author><author>Diallo,M.S.</author><author>Nedelec,Y.</author><author>Sodha,S.V.</author><author>Wallace,A.S.</author></authors></contributors><titles><title>GlobalRoutineVaccinationCoverage,2018</title><secondary-title>MMWRMorbMortalWklyRep</secondary-title></titles><periodical><full-title>MMWRMorbMortalWklyRep</full-title></periodical><pages>937-942</pages><volume>68</volume><number>42</number><edition>2019/10/28</edition><keyw