Primary health care system responses to non-communicable disease prevention and control: a scoping review of national policies in Mainland China since the 2009 health reform.

初级卫生保健系统对非传染性疾病预防和控制的反应 ： 自 2009 年卫生改革以来中国大陆国家政策的范围审查。

• 影响指数: 8.559
• 发表时间: Feb 2023
• 来源期刊: Lancet Reg Health West Pac
• DOI: 10.1016/j.lanwpc.2022.100390
• PMID: 36879784
• 文章类型: Journal Article
• 作者列表: Xiong S,Cai C,Jiang W,Ye P,Ma Y,Liu H,Li B,Zhang X,Wei T,Sun H,Hone T,Peiris D,Mao L,Tian M

关键词: CVD, Cardiovascular disease; China; Health reform; LMICs, Low-and middle-income countries; NCD, Non-communicable disease; Non-communicable disease; PHC, Primary health care; Policy review; Primary health care; WHO, World Health Organization

Abstract

This study aims to review China\'s national policies related to non-communicable disease (NCD) prevention and control at the primary health care (PHC) level since China\'s 2009 health system reform. Policy documents from official websites of China\'s State Council and 20 affiliated ministries were screened, where 151 out of 1,799 were included. Thematic content analysis was performed, and fourteen \'major policy initiatives\' were identified, including the basic health insurance schemes and essential public health services. Several areas showed to have strong policy support, including service delivery, health financing, and leadership/governance. Compared with WHO recommendations, several gaps remain, including lack of emphasis on multi-sectoral collaboration, underuse of non-health-professionals, and lack of quality-oriented PHC services evaluations. Over the past decade, China continues to demonstrate its policy commitment to strengthen the PHC system for NCD prevention and control. We recommend future policies to facilitate multi-sectoral collaboration, enhance community engagement, and improve performance evaluation mechanisms.

摘要

本研究旨在回顾自2009年中国卫生体制改革以来中国在初级卫生保健（PHC）层面的非传染性疾病（NCD）预防和控制方面的国家政策。筛选了来自中国国务院和20个部委官方网站的政策文件，其中包括1,799人中的151人。进行了主题内容分析，确定了十四个“主要政策举措”，包括基本健康保险计划和基本公共卫生服务。几个领域显示出强有力的政策支持，包括服务交付，卫生筹资，领导/治理。与世卫组织的建议相比，仍然存在一些差距，包括缺乏对多部门合作的重视，未充分利用非卫生专业人员，缺乏以质量为导向的PHC服务评估。在过去的十年里，中国继续表现出加强非传染性疾病预防和控制PHC系统的政策承诺。我们建议未来的政策，以促进多部门合作，加强社区参与，完善绩效评价机制。