【全非资讯·尼日利亚】 尼日利亚与莫桑比克展示卫生系统如何抵御资金短缺

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#尼日利亚 #莫桑比克 #西非 #南部非洲

几十年来，整个 sub-Saharan Africa 的许多卫生项目一直依赖于一种人们熟悉的模式：捐赠方资助针对特定疾病的项目，围绕这些项目建立起平行的服务交付体系，而医疗服务则随着资金周期的波动而扩张或收缩。\n\n随着双边援助的缩减，严重依赖外部资金的国家正面临系统碎片化所带来的脆弱性。然而，Nigeria 和 Mozambique 的经验表明，提升系统韧性并不一定意味着要填补流失的每一分资金。在某些情况下，这或许可以从改变现有资源的组织方式开始。\n\n在这两个国家，当地的卫生部门领导人一直在探索新的方法，旨在让政府更牢固地掌握主导权，整合医疗服务与资金，并减少不同项目和合作伙伴之间的重复建设。\n\n关注我们的 WhatsApp | LinkedIn 获取最新头条新闻。\n\n这一成果带来了一个更具普遍意义的启示：当卫生系统围绕政府的优先事项而非单一的资金渠道进行设计时，它们往往能更好地抵御财政冲击。\n\n在全球捐赠资金不确定性日益增加的背景下，Nigeria 的经验正迅速成为一个典范，展示了各国如何通过在资金和医疗服务交付方面掌握更大的自主权，来增强自身卫生系统的韧性。\n\nAcasus 的 Nigeria 项目总监 Folake Oni 表示，这一转变建立在两大支柱之上：一是将碎片化的、由捐赠方驱动的项目整合到政府主导的统一架构中；二是扩大国内对基层医疗卫生的资金投入。\n\n她表示：“从我们的角度来看，Nigeria 在加强其卫生系统方面，有两点与众不同的举措尤为突出。”首先是“从过去孤立的、针对特定疾病的捐赠方资助项目，转向一种由政府主导的统一架构。”

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原文原文 / Original Text

For decades, many health programmes across sub-Saharan Africa have relied on a familiar model: donors fund disease-specific projects, parallel delivery structures are built around them, and services expand or contract with the funding cycle.

As bilateral aid shrinks, countries that have relied heavily on external financing are confronting the vulnerabilities created by fragmented systems. But experiences in Nigeria and Mozambique suggest that resilience may not always require replacing every dollar lost. In some cases, it may begin with changing how existing resources are organised.

In both countries, local health leaders have been testing approaches that put governments more firmly in control, integrate services and financing, and reduce duplication between programmes and partners.

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The results point to a broader lesson: when health systems are designed around government priorities rather than individual funding streams, they may be better equipped to absorb financial shocks.

Nigeria's experience is fast becoming a reference point for how countries can strengthen their health systems by taking greater ownership of financing and delivery, even as global donor funding grows less certain.

Folake Oni, Project Director for Nigeria at Acasus, said that the shift is built on two pillars: consolidating fragmented, donor-driven projects into a single government-led architecture, and expanding domestic financing for primary healthcare.

"There are two key things that stand out just from our perspective on what Nigeria has done differently to strengthen its health system," she said. The first is "shifting from where you have siloed disease-specific donor-funded projects towards a single government-owned sort of architecture."

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来源：AllAfrica (https://allafrica.com/)
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