缩小差距:印度尼西亚为促进健康和预防疾病提供资金。

IF 3.6 2区 医学 Q1 HEALTH POLICY & SERVICES Health Research Policy and Systems Pub Date : 2024-10-15 DOI:10.1186/s12961-024-01206-7
Ahmad Fuady, Mariska Anindhita, Matsna Haniifah, Abdillah Ahsan, Agus Sugiharto, Marinda Asiah Nuril Haya, Trevino Pakasi, Dian Kusuma, Dewi Amila Solikha, Pungkas Bahjuri Ali, Indah Suci Widyahening
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引用次数: 0

摘要

背景:包括印度尼西亚在内的中低收入国家在预防性保健方面的支出远远低于治疗性保健支出。因此,迫切需要制定一条明确的途径来增加预防性保健的支出。本研究旨在评估印尼目前的健康促进和疾病预防融资状况,并随后为该国未来的健康促进融资制定框架和建议:我们采用混合方法,在 2022 年 12 月至 2023 年 6 月期间从所有相关利益方收集信息。在定性方法中,我们进行了(a)深度访谈(IDIs)和(b)焦点小组讨论(FGDs),访谈对象包括国家和地区一级的政府官员、学者、专业组织、初级医疗保健中心(PHCs)的医护人员、社区卫生志愿者、非政府组织和私营公司。在定量方法方面,我们对初级保健中心从事健康促进工作的医护人员进行了全国性在线调查。我们还在国家层面、印尼全国五个选定地区以及 15 个初级卫生保健办公室及其社区内,与特意挑选的专家进行了 IDI 和 FGD。所有定性数据均经过记录、转录、编码、解释,然后与全国调查结果进行三角验证,以制定筹资框架:结果:我们发现了健康促进和疾病预防理论与实践之间的差距。结果:我们发现了健康促进和疾病预防理论与实践之间的差距,其中包括:健康促进活动的范围有限;各部委、机构和各级政府之间缺乏指导和协调;健康促进人员的可用性和能力有限;资金来源多样但缺乏协调;资金使用缺乏灵活性。为了缩小差距,我们制定的框架建议加强法律和监管基础,从战略上优先考虑筹资安排,促进以证据为基础的健康促进活动,发展健康促进者的能力,加强健康筹资信息系统,改善监测和评估:已查明的健康促进和疾病预防措施方面的差距和挑战为我们制定未来的健康促进筹资框架提供了依据。该框架有助于国家政府组织国家健康促进筹资战略,并有可能成为其他低收入和中等收入国家的宝贵典范。
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Bridging the gap: financing health promotion and disease prevention in Indonesia.

Background: Spending on preventive care in low- and middle-income countries (LMICs), including Indonesia, is much lower than spending on curative care. There has been a pressing need to develop a clear pathway to increase spending on preventive care. This study aimed to assess the current financing landscape for health promotion and disease prevention in Indonesia and, subsequently, to develop a framework and recommendations for future health promotion financing in the country.

Methods: We adopted a mixed-method approach to gather information from all relevant stakeholders from December 2022 to June 2023. For the qualitative approach, we conducted (a) in-depth interviews (IDIs) and (b) focus group discussions (FGDs) with government officials at national and district levels, academics, professional organizations, healthcare workers in primary healthcare centres (PHCs), community health volunteers, non governmental organizations and private companies. For the quantitative approach, we applied a national online survey to healthcare workers involved in health promotion in PHCs. IDIs and FGDs were conducted with purposefully selected resource persons at the national level, five selected districts across Indonesia, and within 15 primary health offices and their communities. All qualitative data were recorded, transcribed, coded, interpreted, and then triangulated with national survey findings to develop the financing framework.

Results: We identified gaps between the theory and practice of health promotion and disease prevention. These included the limited scope of health promotion initiatives, lack of direction and coordination between ministries, agencies and government levels, limited availability and capacity of health promoters, various yet uncoordinated funding resources and inflexibility in using the funds. To bridge the gap, the framework we developed suggests strengthening the legal and regulatory basis, strategically prioritizing financing arrangements, promoting evidence-based health promotion activities, developing the capacity of health promoters, enhancing the health financing information system and improving monitoring and evaluation.

Conclusions: Identified gaps and challenges in health promotion and disease prevention initiatives inform the development of our framework for future health promotion financing. This framework assists the national government in organizing national health promotion financing strategies and potentially serves as a valuable model for other LMICs.

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来源期刊
Health Research Policy and Systems
Health Research Policy and Systems HEALTH POLICY & SERVICES-
CiteScore
7.50
自引率
7.50%
发文量
124
审稿时长
27 weeks
期刊介绍: Health Research Policy and Systems is an Open Access, peer-reviewed, online journal that aims to provide a platform for the global research community to share their views, findings, insights and successes. Health Research Policy and Systems considers manuscripts that investigate the role of evidence-based health policy and health research systems in ensuring the efficient utilization and application of knowledge to improve health and health equity, especially in developing countries. Research is the foundation for improvements in public health. The problem is that people involved in different areas of research, together with managers and administrators in charge of research entities, do not communicate sufficiently with each other.
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