필수외과적진료를 통한 아프리카 보건의료 국제개발협력 연구 - WHO EESC 활동을 중심으로
Revisiting Importance of Essential Surgical Care in Global Health - Based on WHO EESC Program in Africa
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참고문헌
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초록
본 연구는 아프리카를 중심으로 저소득국가의 보건의료 개선을 위한 필수외과적진료(ESC: Essential Surgical Care) 사업에 관한 것이다. 새천년개발목표(MDGs)로 대표되는 국제개발협력 보건의료 영역에서 이루어져왔던 영역은 주로 모자보건, 말라리아, HIV/AIDS 개선, 보건의료시스템 강화 측면이었고, 이들과 연계된 외과적 진료는 우리나라 개발협력 논점에서 주목하지 않았던 분야이다. 본 연구는 개발협력 효과성이 뛰어난 국제기구, 특별히 세계보건기구(WHO)의 앞서가는 활동과 또한 포스트-2015 논의를 통한 국제개발협력 영역의 확장이라는 변화에 주목함으로써 시작하게 되었다. 연구의 내용은 필수외과적진료의 수요 및 공급 차원에서 필수외과적진료의 중요도와 아프리카 현황 그리고 향후과제로 구성한다. 필수외과적진료는 외과적 상황이 필요한 영역 중 간단하고 비용효과적 방법을 통해 사망 혹은 평생장애의 부담을 경감하는 외과적 진료이다. 수요적 차원에서 필수외과적진료의 가치를 MDGs, 일차보건의료 강화 및 보편적 건강보장 관점으로 평가한다. 공급적 차원에서는 저소득국가에서의 비용효과성, 실행용이성, 자원동원력을 통해 실현타당성을 조명한다. 아프리카의 필수외과적진료 현황에 대해서는 현재 수요 현황을 조사하고, 공급 차원에서는 WHO 활동을 중심으로 상황분석조사와 계획수립, 교육훈련, 모니터링 및 연구 사업을 살펴본다. 향후 필수외과적진료를 통한 사망률 감소를 위해 관심과 노력이 필요하다는 제언으로 마치며, 연구방법론은 본 연구의 성격이 개념적 연구임에 따라 주로 문헌연구를 통하여 이루어졌다.
Abstract
This study investigates the essential surgical care(ESC) for strengthening primary health in low income countries. Although surgery has been neglected component of primary care in the field of global health in Korea, the motive of this study is stimulated by the advanced programme of the World Health Organization with its reputable effectiveness and the health priority on Post-2015 agenda. The research deals with the importance, the current capacity and the future direction of the ESC in Africa in the perspectives of demand as well as supply. In the demand side, the recognition of the ESC can be gained in terms of MDGs, the primary health care and universal health coverage. In the supply side, the feasibility of the ESC is described in terms of cost-effectiveness, simpleness and resource availability. As for the ESC status, we study the lack of adequate capacities at the primary referral level. We also examines the global and country activities of the WHO about the implementation of IMEESC tools in supply representing infrastructure, supply, equipment and human resources. Greater emphasis should be made to meet the need for lifesaving surgical services. The method of the research is based on literature review since of this study's conceptual nature.
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