这项研究旨在评估四种易流行传染病的健康结果,在泰国-缅甸边境长期难民环境中实施的初级卫生保健项目。
在泰缅边境定居的难民完全依赖医疗服务的支持,庇护所,食物,教育,水,和卫生。非政府组织MalteserInternational与在其监督下的两个定居点的训练有素的营地居民密切合作,制定了一项综合初级保健计划。该项目由欧洲委员会民事保护和人道主义援助行动(DGECHO)资助。
这是一项回顾性初级卫生保健项目评估。全因死亡率;疟疾发病率趋势,下呼吸道感染(LRTIs),水样腹泻,和痢疾;并评估了18年时间跨度的卫生服务利用率。研究了初级卫生保健(PHC)项目中的程序变化以及对目标人群健康有潜在影响的事件。
尽管训练有素的医护人员不断流失,动荡的难民涌入,以及两个营地的孤立位置,最初的基本治疗保健发展成为一个综合和全面的PHC项目,包括符合SPHERE标准的水,卫生,和卫生计划。疟疾,LRTIs,水样腹泻,痢疾发病率下降了12,三,两个,五倍,分别,在评估的18年期间,卫生服务利用率从每个难民每年7.1次咨询降至2.9次。国际社会可能面临难民无法融入东道国保健服务的情况。在这样的背景下,由一个卫生机构充分资助和实施的综合循证PHC是在半永久性生活条件限制下减少传染病负担的有效和相关方法。
This study aimed to assess the health outcome of four epidemic-prone infectious diseases, in the context of a Primary Health Care project implemented in a protracted refugee setting along the Thai-Myanmar border.
Refugees settled at the Thai-Myanmar border are fully dependent on support for health services, shelter, food, education, water, and sanitation. The Non-Governmental Organization Malteser International developed an integrated Primary Health Care program in close cooperation with trained camp residents over 25 years in the two settlements under its supervision. The project has been funded by the European Commission Civil Protection and Humanitarian Aid Operations (DG ECHO).
This was a retrospective primary health care project evaluation. All-cause mortality; morbidity trends in malaria, lower respiratory tract infections (LRTIs), watery diarrhea, and dysentery; and health service utilization covering a time span of 18 years were assessed. Programmatic changes in the Primary Health Care (PHC) project and events with a potential effect on health of the target population were examined.
Despite the continuous drain of trained health care workers, the volatile influx of refugees, and the isolated location of the two camps, the initial basic curative health care developed into an integrated and comprehensive PHC project including a SPHERE-compliant water, sanitation, and hygiene program. Malaria, LRTIs, watery diarrhea, and dysentery morbidity dropped twelve, three, two, and fivefold, respectively, over the 18-year period evaluated while the health services utilization dropped from 7.1 to 2.9 consultations per refugee/year. The international community may face situations where integration of refugees into the health services of the host country is not possible. In such a context, integrated and evidence-based PHC adequately funded and implemented by one health agency is an effective and relevant approach to reduce the infectious diseases burden under the constraints of semipermanent living conditions.