摘要
目的系统总结和分析我国卫生适宜技术筛选、组织、推广模式,为各地区建立本土化的卫生适宜技术长效推广机制提供参考。方法检索CBM、VIP、CNKI和WanFang Data数据库,检索时限均从建库至2016年2月,搜集有关卫生适宜技术筛选、组织和推广的相关研究。由两位研究者独立进行文献筛选和资料提取,然后进行描述性分析。结果最终纳入26篇文献,其中卫生适宜技术推广具体模式研究21篇,筛选指标体系5篇。各省市卫生适宜技术的筛选原则主要参照国家推荐技术结合本地自选技术,考虑当地需求,从技术的安全、有效、经济、适宜进行评估;筛选指标体系一级指标包括安全性、有效性、经济性、技术特性和可接受性,二级指标差异较大,指标体系根据专家意见制定;各省市分别成立了省县级领导协调小组、技术专家组,负责项目的领导协调及技术的指导工作,以确定相关课题组或项目承担单位具体实施;形成了县-乡-村三级或省-县-乡-村四级的纵向推广网络和以县、乡为中心的以点带面辐射推广的模式。结论卫生适宜技术推广无客观、统一、可操作性强的筛选体系;推广模式以政府部门为主导的"由上而下"的强制模式,不能满足基层实际需求。提示需建立一套能满足基层实际需求的"由下而上"的卫生适宜技术筛选、组织和推广机制。
Objective To systematically summarize and analysis the patterns of the screening, organization and promotion of appropriate health technology, to provide references for establishing the localization and long-term mechanism of appropriate health technology promotion for different regions. Methods Databases including CBM, CNKI, WanFang Data and VIP databases were searched from their inception to February 2016, to collect studies about the promotion and application of appropriate health technology in China. Two reviewers independently screened literature, and extracted data. Then, a descriptive analysis was conducted. Results A total of 26 studies were included, of which, 21 studies were related to specific patterns of the appropriate health technologies promotion and 5 studies were related to indicators screening system. The screening principle of appropriate health technology was a reference to national screening recommendation technology with local optional technology, taking into account locals needs and four aspects of technology： safety, effectiveness, economy and suitability. At the provincial and county levels, a leading group and a technical experts＇ group were established to take responsibility for project coordination and management, and provide technical guidance. Two patterns were being formed, one is a three or four level vertical promotion network, such as from the county to the townships and villages, the other is a radiation promotion from the point to the surface revolving around county and township. Conclusion The screening of appropriate health technology is lack of objectivity, unified and strong operability index system. The ＂top-down＂ model led by the government could not meet the reality requirement of grassroots. It is necessary to establish a ＂bottom-up＂ mechanisms for the screening, organization and promotion of appropriate health technology, which can meet the reality requirement ofgrassroots.
出处
《中国循证医学杂志》
CSCD
2016年第7期835-841,共7页
Chinese Journal of Evidence-based Medicine
基金
2013湖州师范学院人才引进科研启动经费(编号:RK30030)
关键词
卫生适宜技术
推广模式
系统评价
Appropriate health technology
Promotion models
Systematic review
