通過改進挽留政策提高農村和邊遠地區衛生人力的可及性：WHO2010全球政策建議解讀_《中國循證醫學雜志》

作者：

蘭州大學循證醫學中心，GRADE中國中心（蘭州 730000）;

關鍵詞：

衛生人力農村和邊遠地區 GRADE系統政策指南循證決策

DOI：

10.7507/1672-2531.20130179

視頻：

導出 下載 收藏 掃碼 引用

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農村和邊遠地區衛生人力資源不足是世界各國普遍關注的衛生問題之一，嚴重影響衛生公平的實現。對此，WHO提出全球政策建議——通過改進挽留政策提高農村和邊遠地區衛生人力的可及性。本文重點從循證醫學方法學和指南制定角度，對該政策指南制定的關鍵步驟進行解讀，主要包括背景及問題的提出、證據的檢索與遴選、證據質量分級與推薦方案形成，從而進一步探討衛生決策過程中如何正確認識、獲得、評價與應用當前可得的研究證據，以及如何基于證據，利用GRADE系統做出科學可行的推薦，強調證據及GRADE系統在循證衛生決策中的重要作用。

引用本文： 李秀霞,陳耀龍,王小琴,吳瓊芳,王琪,韋當,姚亮,張宗久,楊克虎. 通過改進挽留政策提高農村和邊遠地區衛生人力的可及性：WHO2010全球政策建議解讀. 中國循證醫學雜志, 2013, 13(9): 1037-1042. doi: 10.7507/1672-2531.20130179 復制

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18.	陳耀龍, 楊克虎, 姚亮, 等. GRADE系統方法學進展. 中國循證兒科雜志, 2013, 8(1): 1-2.
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1. WHO. Increasing access to health workers in remote and rural areas through improved retention: Global policy recommendations. 2010. WHO Press, World Health Organization. 20 Avenue Appia, 1211 Geneva 27, Switzerland.
2. http://www.who.int/rpc/guidelines/en/ [2013-01-07].
3. 劉曉云. 吸引和留住農村衛生人力的國際經驗及啟示. 中國衛生政策研究, 2012, 5(10): 33-8.
4. WHO handbook for guideline development. World Health Organization. 2010. Available at: http://www.who.int/hiv/topics/mtct/grc_handbook_mar2010_1.pdf.
5. The world health report 2006 – Working together for health. Geneva, World Health Organization. 2006.
6. World Urbanization Prospects: The 2007 Revision Population Database. New York. NY, United Nations Department of Economic and Social Affairs. 2008.
7. Grobler L, Marais BJ, Mabunda SA, et al. Interventions for increasing the proportion of health professionals practising in rural and other underserved areas. Cochrane Database Syst Rev, 2009, (1): CD005314.
8. Wilson NW, Couper ID, De Vries E, et al. A critical review of interventions to redress the inequitable distribution of healthcare professionals to rural and remote areas. Rural Remote Health, 2009, 9(2): 1060.
9. Gruen RL, Weeramanthri TS, Knight SE, et al. Specialist outreach clinics in primary care and rural hospital settings. Cochrane Database Syst Rev, 2004, (1): CD003798.
10. Bärnighausen T, Bloom DE. Financial incentives for return of service in underserved areas: a systematic review. BMC Health Serv Res, 2009, 9: 86.
11. Frehywot S, et al. Compulsory service programme as a means of deploying and retaining health workers in rural, remote and underserved areas – a global analysis. World Health Organization. 2010.
12. Dieleman M, et al. Realist review and synthesis on retention studies for health workers in rural and remote areas. Geneva, World Health Organization. 2010.
13. De Roodenbeke E, et al. Outreach services as a strategy to increase access to health workers in remote and rural areas. Geneva, World Health Organization. 2010.
14. http://www.gradeworkinggroup.org. [2013-01-14].
15. Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008, 336(7650): 924-926.
16. 李幼平, 王莉, 文進, 等. 注重證據，循證決策. 中國循證醫學雜志, 2008, 8(1): 1-3.
17. Moat KA, Lavis JN, Wilson MG, et al. Twelve myths about systematic reviews for health system policymaking rebutted. J Health Serv Res Policy, 2013, 18(1): 44-50.
18. 陳耀龍, 楊克虎, 姚亮, 等. GRADE系統方法學進展. 中國循證兒科雜志, 2013, 8(1): 1-2.
19. Bosch-Capblanch X. Handbook for Supporting the Development of Health System Guidance. Basel: Swiss Centre for International Health. 2011.

《中國循證醫學雜志》

通過改進挽留政策提高農村和邊遠地區衛生人力的可及性：WHO2010全球政策建議解讀

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《中國循證醫學雜志》

通過改進挽留政策提高農村和邊遠地區衛生人力的可及性：WHO2010全球政策建議解讀

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