Lafiyar jama'a

Lafiyar jama'a
academic discipline (en) da aiki
Bayanai
Ƙaramin ɓangare na	health sciences (en) da Kimiyyar zamantakewa
Fuskar	risk management (en)
Karatun ta	health economics (en)
Gudanarwan	public health scientist (en) da public health physician (en)
NCI Thesaurus ID (en)	C17039

Bangarorin kiwon lafiyar jama'a daban-daban: Daga sama zuwa ƙasa: Ma'aikacin lafiya na al'umma a Mali, misali allurar riga-kafi ( allurar riga-kafi ta COVID-19 a Jamus), hoton tarihi na shigar da najasa daga Amurka, kamfen ɗin hana shan taba a Indiya.

 

Lafiya jama'a ita ce "kimiyya da fasaha na hana cututtuka, tsawaita rayuwa da inganta kiwon lafiya ta hanyar kokarin da aka tsara da zaɓin da aka sani na al'umma, kungiyoyi, jama'a da masu zaman kansu, al'ummomi da mutane". [1] [2] Binciken abubuwan da ke haifar da lafiyar jama'a da barazanar da take fuskanta shine tushen lafiyar jama'ar.[3] Jama'a na iya zama karami kamar mutane kaɗan ko babba kamar ƙauye ko dukan birni; idan akwai annobar zai iya haɗawa da nahiyoyi da yawa. Ma'anar kiwon lafiya tana la'akari da lafiyar jiki, tunanin mutum, da lafiyar jama'a, da sauran dalilai.[4]

Lafiyar jama'a wani bangare ne na hadin gwiwa. Misali, ilmin yaduwar cututtuka, ilmin halitta, kimiyyar zamantakewa da gudanarwa da Ayyukan kiwon lafiya duk sun dace. Sauran mahimman fannoni sun haɗa da kiwon lafiyar muhalli, kiwon lafiyar al'umma, kiwon lafiya, tattalin arzikin kiwon lafiya.[1] Lafiyar jama'a, tare da kulawa ta farko, kulawa ta biyu, da Kulawa ta uku, wani bangare ne na tsarin kiwon lafiya na ƙasa. Ana aiwatar da lafiyar jama'a ta hanyar sa ido kan shari'o'i da alamun kiwon lafiya, da kuma inganta halayen lafiya. Shirye-shiryen kiwon lafiya na jama'a sun haɗa da inganta wanke hannu da shayarwa, isar da allurar rigakafi, inganta iska da ingantaccen iska a cikin gida da waje, Rigakafin kashe kansa, dakatar da shan sigari, ilimin kiba, kara samun damar kiwon lafiya da rarraba condoms don sarrafa yaduwar cututtukan da ake samu ta hanyar jima'i.

Akwai bambanci mai mahimmanci a cikin samun damar kula da kiwon lafiya da shirye-shiryen kiwon lafiya na jama'a tsakanin Kasashe masu tasowa da kasashe masu ci gaba, da kuma cikin kasashe masu bunkasa. A cikin Kasashe masu tasowa, cibiyoyin kiwon lafiya na jama'a har yanzu suna tasowa. Wataƙila ba a sami isasshen horar da Ma'aikatan kiwon lafiya ba, albarkatun kuɗi, ko, a wasu lokuta, isasshen ilimi don samar da matakin kulawa da rigakafin cututtuka.[1][2] Babban damuwa game da lafiyar yara'a a kasashe masu tasowa shine rashin lafiyar uwaye da yara, wanda ya kara tsanantawa ta hanyar Rashin abinci mai gina jiki da talauci da iyakance aiwatar da manufofin kiwon lafiyar jama'ar. Kasashe masu tasowa suna cikin haɗari mafi girma na wasu matsalolin kiwon lafiya na jama'a, gami da kiba na yara, kodayake yawan mutanen da suka fi nauyi a cikin ƙasashe masu karamin karfi da matsakaici suna kamawa.[3]

Tun daga farkon wayewar ɗan adam, al'ummomi suna haɓaka lafiya da yaƙi da cututtuka a matakin jama'a. [1] [2] A cikin al'ummomin da suka riga suka zama masana'antu , shirye-shiryen da aka tsara don rage haɗarin lafiya na iya zama shirin masu ruwa da tsaki daban-daban, kamar janar-janar sojoji, malamai ko masu mulki. Burtaniya ta zama jagora a cikin haɓaka shirye-shiryen kiwon lafiyar jama'a, tun daga ƙarni na 19, saboda gaskiyar cewa ita ce ƙasa ta farko ta zamani a duniya. [3] Shirye-shiryen kiwon lafiyar jama'a waɗanda suka fara fitowa da farko sun mayar da hankali kan tsafta (misali, tsarin najasa na Liverpool da London ), sarrafa cututtuka masu yaɗuwa (gami da allurar rigakafi da keɓewa ) da kuma ci gaban kayayyakin more rayuwa na kimiyya daban-daban, misali ƙididdiga, ilimin halittu masu rai, ilimin cututtuka, kimiyyar injiniya. [3]  

Ma'anar

Ma'aikacin kiwon lafiya na al'umma a Korail Basti, wani kauye a Dhaka, Bangladesh

An bayyana lafiya jama'a a matsayin "kimiyya da fasaha na hana cututtuka", tsawaita rayuwa da inganta ingancin rayuwa ta hanyar kokarin da aka tsara da zaɓin da aka sani na al'umma, kungiyoyi (na jama'a da masu zaman kansu), al'ummomi da mutane.[1] Jama'a na iya zama karami kamar mutane kaɗan ko babba kamar ƙauye ko dukan birni. Ma'anar kiwon lafiya tana la'akari da lafiyar jiki, tunani, da lafiyar jama'a. Saboda haka, a cewar Hukumar Lafiya ta Duniya, "lafiya yanayi ne na cikakkiyar lafiyar jiki, tunani da zamantakewa kuma ba kawai rashin cuta ko nakasa ba".[2]

Kalmomin da suka danganci

WHO ita ce babbar hukumar da ke da alaƙa da kiwon Lafiya ta duniya.

Lafiya jama'a tana da alaƙa da lafiyar duniya wanda shine lafiyar jama'a a cikin yanayin duniya.[1] An bayyana shi a matsayin "yankin karatu, bincike da aiki wanda ke sanya fifiko kan inganta kiwon lafiya da cimma daidaito a cikin "Lafiya ga dukkan" mutane a duk duniya".[2] Kiwon lafiya na kasa da kasa wani bangare ne na kiwon lafiya, yawanci tare da jaddada lafiyar jama'a, yana hulɗa da kiwon lafiya a fadin yankuna ko iyakokin ƙasa.[3] Lafiyar jama'a ba daidai ba ne da kiwon lafiya na jama'a (kiwon lafiya na gwamnati).

Kalmar rigakafin magani tana da alaƙa da lafiyar jama'a. Hukumar Kula da Magunguna ta Amurka ta raba nau'o'i uku na Magungunan rigakafi: kiwon lafiya na sararin samaniya, kiwon lafiya, da kiwon lafiyar jama'a da kuma maganin rigakafi gaba ɗaya. Jung, Boris da Lushniak suna jayayya cewa ya kamata a dauki maganin rigakafi a matsayin ƙwarewar likita don lafiyar jama'a amma lura cewa Kwalejin Magunguna ta Amurka da Hukumar Magunguna ta Rigakafi ta Amurka ba sa amfani da kalmar "lafta jama'a".[1] : 1 Ana horar da kwararru na rigakafi a matsayin likitoci kuma suna magance bukatun kiwon lafiya masu rikitarwa na yawan jama'a kamar ta hanyar kimanta bukatar shirye-shiryen Rigakafin cututtuka, ta amfani da hanyoyin da suka fi dacewa don aiwatarwa, da kuma kimanta tasirin su.[1] : 1 , 3 : 1, 3 

Tun daga shekarun 1990s masana da yawa a fannin kiwon lafiyar jama'a suna amfani da kalmar kiwon lafiyar yawan jama'a.[1] : 3 Babu ƙwarewar kiwon lafiya da ke da alaƙa kai tsaye da lafiyar jama'a.[2] : 4 Valles ya yi jayayya cewa la'akari da daidaito na kiwon lafiya wani muhimmin bangare ne na kiwon lafiyar jama'a. Masana kamar Coggon da Pielke sun nuna damuwa game da kawo batutuwan rarraba dukiya a cikin lafiyar jama'a. Pielke ya damu game da "tallafin batun ɓoye-ɓoye" a cikin lafiyar jama'a.[1] :: 163  Jung, Boris da Lushniak sunyi la'akari da lafiyar jama'a a matsayin manufar aikin da ake kira lafiyar jama'ar da ake yi ta hanyar maganin rigakafi na musamman.[2] : 4 : 4 

Magungunan salon rayuwa suna amfani da gyare-gyaren salon rayuwa na mutum don hanawa ko dawo da cuta kuma ana iya la'akari da su a matsayin wani bangare na maganin rigakafi da lafiyar jama'a. An aiwatar da shi a matsayin wani ɓangare na kulawa ta farko maimakon ƙwarewa a kansa.[1] : 3 Valles ya yi jayayya cewa kalmar maganin zamantakewa tana da ƙanƙanta kuma tana da maida hankali ga ilimin kimiyyar halittu fiye da kalmar lafiyar jama'a.[2] : 7 : 7 

Manufar

Manufar shiga tsakani na kiwon lafiya na jama'a shine hanawa da ragewa cututtuka, raunin, da sauran yanayin kiwon lafiya. Babban burin shine inganta lafiyar mutane da jama'a, da kuma kara Tsawon rayuwa.[1][2]

Abubuwan da aka haɗa

Lafiyar jama'a kalma ce mai rikitarwa, wanda ya ƙunshi abubuwa da yawa da ayyuka daban-daban. Yana da bangarori da yawa, filin da ke da alaƙa da juna.[1] Misali, ilmin yaduwar cututtuka, ilmin halitta, kimiyyar zamantakewa da gudanarwa da ayyukan kiwon lafiya duk sun dace. Sauran mahimman fannoni sun haɗa da kiwon lafiyar muhalli, kiwon lafiyar al'umma, kiwon lafiya, tattalin arzikin kiwon lafiya. [2]

Ayyukan kiwon lafiya na jama'a na zamani suna buƙatar ƙungiyoyi masu yawa na ma'aikatan kiwon lafiya da masu sana'a. Ƙungiyoyin na iya haɗawa da masu ilimin cututtuka, masu ilimin halittu, mataimakan likitoci, ma'aikatan jinya na kiwon lafiya, masu ilimin microbiology, likitocin likitoci. Masana ilimin tattalin arziki, masu ilimin zamantakewa, masu kula da kwayoyin halitta, manajojin bayanai, Jami'an kiwon lafiya na muhalli (masu binciken kiwon lafiya), masu ilimin halittoci, masana jinsi, masana kiwon lafiya da haihuwa, likitoci da likitoci na dabbobi.[1]

Abubuwa da fifiko na kiwon lafiya jama'a sun samo asali a tsawon lokaci, kuma suna ci gaba da canzawa. Shirye-shiryen kiwon lafiya na jama'a sun haɗa da inganta wanke hannu da shayarwa, isar da allurar rigakafi, Rigakafin kashe kansa, dakatar da shan sigari, ilimin kiba, haɓaka samun damar kiwon lafiya da rarraba kwaroron roba don sarrafa yaduwar cututtukan da ake samu ta hanyar jima'i.

Hanyoyi

Labaran jaridu daga ko'ina cikin duniya game da gwajin rigakafin cutar shan inna (13 Afrilu 1955)

Ana cimma burin kiwon lafiya na jama'a ta hanyar sa ido kan shari'o'i da inganta halayyar lafiya, al'ummomi da mahalli. Binciken abubuwan da ke haifar da lafiyar jama'a da barazanar da take fuskanta shine tushen lafiyar jama'ar.[1]

Ana iya hana cututtuka da yawa ta hanyar hanyoyi masu sauƙi, wadanda ba na magani ba. Misali, bincike ya nuna cewa sauƙin wanke hannu da sabulu na iya hana yaduwar cututtukan da ke yaduwa da yawa.[1] A wasu lokuta, magance cuta ko sarrafa kwayar cuta na iya zama da mahimmanci don hana yaduwarta ga wasu, ko dai a lokacin barkewar cutar cututtuka ko ta hanyar gurɓata abinci ko ruwa.

Lafiyar jama'a, tare da kulawa ta farko, kulawa ta biyu, da Kulawa ta uku, wani bangare ne na tsarin Kula da lafiya ƙasa gaba ɗaya. Ana ba da sauye-sauye da yawa na kula da lafiyar jama'a a waje da wuraren kiwon lafiya, kamar sa ido kan lafiyar abinci, rarraba kwaroron roba da Shirye-shiryen musayar allura don rigakafin cututtukan da ake yaduwa.

Lafiyar jama'a tana buƙatar Tsarin Bayanai na Yanayi (GIS) saboda haɗari, rauni da fallasawa sun haɗa da fannoni na ƙasa.[1]

Da'a

Addu'ar Lafiyar Jama'a - Dokta Edmond Fernandes

Wata matsala a cikin ka'idojin kiwon lafiya na jama'a ita ce magance rikici tsakanin haƙƙin mutum da haɓaka haƙƙin kiwon lafiya.[1] : 28 Lafiyar jama'a ta tabbatar da ra'ayoyin mai amfani da sakamako, [1]:(p153)">: 153  amma an hana shi kuma an soki shi ta hanyar masu sassaucin ra'ayi, deontological, principlist da kuma falsafancin 'yanci [1]: 99, 95, 74, 123 Stephen Holland ya yi jayayya cewa yana iya zama da sauƙi a sami wani tsari don tabbatar da duk wani ra'ayi game da batutuwan lafiyar jama'a, amma cewa hanyar da ta dace ita ce samun tsarin da ke bayyana halin da ya fi dacewa game da manufofin kiwon lafiyar jama'ara. : 154 

Ma'anar kiwon lafiya ba ta da tabbas kuma akwai ra'ayoyi da yawa. Ma'anar likitoci kiwon lafiya na jama'a na iya bambanta sosai daga membobin jama'a ko likitoci. Wannan na iya nufin cewa membobin jama'a suna kallon dabi'u a bayan sa hannun kiwon lafiyar jama'a a matsayin baƙo wanda zai iya haifar da fushi tsakanin jama'a game da wasu sa hannun.[1] :: 230  Irin wannan rashin tabbas na iya zama matsala ga inganta kiwon lafiya.[1] :: 241  Masu sukar sun yi jayayya cewa lafiyar jama'a tana mai da hankali kan abubuwan da ke da alaƙa da kiwon lafiya a kan abubuwan da suka shafi yawan jama'a.[2] : 9 : 9 

A tarihi, an soki kamfen ɗin kiwon lafiya jama'a a matsayin wani nau'i na "lafiya", a matsayin ɗabi'a a yanayi maimakon mayar da hankali kan kiwon lafiya. Likitocin kiwon lafiya, Petr Shkrabanek da James McCormick sun rubuta jerin wallafe-wallafe a kan wannan batu a ƙarshen 1980s da farkon 1990s suna sukar yakin neman zabe na Lafiya na Ƙasa na Burtaniya. Wadannan wallafe-wallafen sun fallasa cin zarafin cututtukan cututtuka da kididdiga ta hanyar yunkurin kiwon lafiya na jama'a don tallafawa salon rayuwa da shirye-shiryen tantancewa.[1] : 85 Haɗin haɗuwa da jin tsoron rashin lafiya da ra'ayi mai ƙarfi na alhakin mutum an soki shi a matsayin wani nau'i na "fascism na lafiya" ta hanyar masana da yawa, ba tare da la'akari da motsin rai ko zamantakewa ba. [2][3] : 8 [2]: 7 [4]: 81 : 81

Yankunan da suka fi muhimmanci

Yankunan da aka fi mayar da hankali

An yi wa wani yaro dan kasar Somaliya allurar rigakafin cutar shan inna (Mogadishu, 1993).

Lokacin da shirye-shiryen kiwon lafiya na jama'a suka fara fitowa a Ingila a zamanin yau (karni na 18 zuwa gaba) akwai manyan fannoni uku na kiwon lafiyar jama'a waɗanda duk suna da alaƙa da aikin gwamnati: Bayar da ruwa mai tsabta da tsabta (misali tsarin zubar da ruwa na London); kula da Cututtukan cututtuka masu yaduwa (ciki har da allurar rigakafi da keɓewa); kayan aikin kimiyya daban-daban, misali kididdiga, ilmin microbiology, ilmin yaduwar cututtuka, kimiyyar injiniya.[1] Biritaniya ta kasance jagora a ci gaban lafiyar jama'a a wannan lokacin saboda bukata: Biritaniya ita ce al'ummar birane ta farko ta zamani (a shekara ta 1851 fiye da rabin yawan jama'a sun zauna a ƙauyuka sama da mutane 2000). [1] Wannan ya haifar da wani nau'in wahala wanda ya haifar da shirye-shiryen kiwon lafiya na jama'a.[1]Daga baya wannan damuwa ta ɓace.

Canjin wuraren da aka mayar da hankali da fadadawa

Gargadi na sigari a matsayin wani ɓangare na kamfen ɗin hana shan sigarikamfen na yaki da shan sigari

Tare da farawar canjin annoba kuma yayin da yaduwar cututtukan cututtuka suka ragu a cikin karni na 20, lafiyar jama'a ta fara mai da hankali kan cututtuka masu tsanani kamar ciwon daji da cututtukatattun zuciya. Kokarin da ya gabata a kasashe masu tasowa da yawa sun riga sun haifar da raguwa mai yawa a cikin mutuwar jarirai ta amfani da hanyoyin rigakafi. A Burtaniya, Yawan mutuwar jarirai ya fadi daga sama da 15% a 1870 zuwa 7% a 1930.[1]

Babban damuwa game da lafiyar jama'a a Kasashe masu tasowa shine rashin lafiyar uwaye da yara, wanda ya kara tsanantawa da Rashin abinci mai gina jiki da talauci. WHO ta ba da rahoton cewa rashin shayarwa ta musamman a cikin watanni shida na farko na rayuwa yana taimakawa ga mutuwar yara sama da miliyan daya a kowace shekara.[1]

Kula da lafiyar jama'a ya haifar da ganowa da kuma ba da fifiko ga batutuwan kiwon lafiyar jama'ar da ke fuskantar duniya a yau, gami da HIV / AIDS, Ciwon sukari, cututtukan ruwa, cututsin dabbobi, da juriya ta maganin rigakafi wanda ke haifar da sake fitowar cututtukani masu yaduwa kamar tarin fuka. Tsayayyar maganin rigakafi, wanda aka fi sani da tsayayyar miyagun ƙwayoyi, shine taken Ranar Lafiya ta Duniya ta 2011.

Misali, WHO ta ba da rahoton cewa akalla mutane miliyan 220 a duk duniya suna fama da ciwon suga. Yawan mace-macen yana karuwa cikin sauri, kuma ana hasashen cewa adadin mace-macen masu ciwon suga zai ninka nan da shekarar 2030. A cikin wani sharhi da aka buga a mujallar likitanci ta The Lancet a watan Yunin 2010, marubutan sun yi tsokaci cewa "Gaskiyar cewa ciwon suga na nau'in 2, wanda galibi ana iya hana shi, ya kai ga yawan annoba abin kunya ne ga lafiyar jama'a." Haɗarin ciwon suga na nau'in 2 yana da alaƙa da matsalar kiba . Sabbin kiyasin da WHO ta yi As of Yuni 2016 ya nuna cewa a duniya baki ɗaya, kimanin manya biliyan 1.9 ne suka yi kiba a shekarar 2014, kuma yara miliyan 41 'yan ƙasa da shekara biyar sun yi kiba a shekarar 2014. Da a da ake ɗaukarta a matsayin matsala a ƙasashe masu samun kuɗi mai yawa, yanzu haka tana ƙaruwa a ƙasashe masu ƙarancin kuɗi, musamman a birane.

Yawancin shirye-shiryen kiwon lafiya na jama'a suna ƙara ba da hankali da albarkatu ga batun kiba, tare da manufofi don magance ainihin abubuwan da suka hada da abinci mai kyau da motsa jiki. Cibiyar Nazarin Lafiya da Kulawa ta Kasa (NIHR) ta wallafa wani bita na bincike kan abin da hukumomin yankin zasu iya yi don magance kiba.[1] Binciken ya rufe tsoma baki a cikin yanayin abinci (abin da mutane ke saya da cin), wuraren da aka gina da na halitta, makarantu, da al'umma, da kuma wadanda ke mai da hankali kan tafiye-tafiye masu aiki, Ayyukan nishaɗi da wasanni na jama'a, shirye-shiryen sarrafa nauyi, da Hanyoyin tsarin.[1]

Rashin daidaito na kiwon lafiya, wanda ke haifar da abubuwan da ke tattare da kiwon lafiya na zamantakewa, suma yanki ne mai girma na damuwa a cikin lafiyar jama'a. Babban ƙalubale don tabbatar da daidaito na kiwon lafiya shine cewa irin tsarin zamantakewa wanda ke ba da gudummawa ga rashin daidaito na lafiya suma suna aiki kuma kungiyoyin kiwon lafiya na jama'a ne ke sake su.[1] A wasu kalmomi, kungiyoyin kiwon lafiya na jama'a sun samo asali ne don biyan bukatun wasu kungiyoyi fiye da wasu. Sakamakon shi ne sau da yawa cewa waɗanda suka fi buƙatar tsoma baki na rigakafi ba su da damar karɓar su kuma tsoma baki na iya ƙara rashin daidaito [2] kamar yadda galibi ana daidaita su da bukatun ƙungiyar ƙa'ida.[3][4] Gano nuna bambanci a cikin binciken kiwon lafiya na jama'a da aiki yana da mahimmanci don tabbatar da kokarin kiwon lafiya ya rage kuma bai kara rashin daidaito na kiwon lafiya ba.

Ƙungiyoyin

Hukumar Lafiya ta Duniya (WHO)

Hukumar Lafiya ta Duniya (WHO) hukuma ce ta musamman ta Majalisar Dinkin Duniya da ke da alhakin kiwon lafiyar jama'a ta duniya.[1] Kundin Tsarin Mulki na WHO, wanda ya kafa tsarin mulki da ka'idojin hukumar, ya bayyana babban manufarta a matsayin "samun dukkan mutane na matakin lafiya mafi girma".[2] Babban aikin WHO ya haɗa da bayar da shawarwari don kiwon lafiya na duniya, saka idanu kan haɗarin lafiyar jama'a, daidaita martani ga gaggawa na kiwon lafiya, da inganta lafiyar ɗan adam da jin daɗi.[3] WHO ta taka muhimmiyar rawa a nasarorin kiwon lafiya na jama'a da yawa, musamman kawar da kyanda, kusan kawar da cutar shan inna, da ci gaban Ebola_vaccine" id="mwAkg" rel="mw:WikiLink" title="Ebola vaccine">Allurar rigakafin Ebola. Abubuwan da suka fi muhimmanci a yanzu sun haɗa da cututtukan da ke yaduwa, musamman HIV / AIDS, Ebola, COVID-19, zazzabin cizon sauro da tarin fuka; cututtukansar da ba su yaduwa kamar cututtukani na zuciya da ciwon daji; abinci mai kyau, abinci mai gina jiki, da Tsaro na abinci; Lafiyar aiki; da kuma shan miyagun ƙwayoyi.[4][5]

Sauran

Ma'aikatar kiwon lafiya ta cikin gida a Amurka

Yawancin ƙasashe suna da nasu hukumar kiwon lafiya ta gwamnati, galibi ana kiranta ma'aikatar kiwon lafiya, tare da alhakin batutuwan kiwon lafiya na cikin gida.

Misali, a Amurka, sassan kiwon lafiya na jihohi da na gida suna kan gaba a shirye-shiryen kiwon lafiya. Baya ga ayyukansu na kasa, Hukumar Lafiya ta Jama'a ta Amurka (PHS), karkashin jagorancin Babban Likita na Hukumar Lafiya da Lafiya ta Amurka, da Cibiyoyin Kula da Cututtuka da Rigakafin Cututtuka, da ke da hedkwata a Atlanta, suma suna da hannu a ayyukan kiwon lafiya na duniya.[1]

Shirye-shiryen kiwon lafiya na jama'a

Yawancin gwamnatoci sun fahimci muhimmancin shirye-shiryen kiwon lafiya na jama'a wajen rage abin da ke faruwa na cututtuka, nakasa, da tasirin tsufa da sauran yanayin lafiyar jiki da tunani. Koyaya, lafiyar jama'a gabaɗaya tana karɓar ƙarancin kuɗin gwamnati idan aka kwatanta da magani.[1] Kodayake haɗin gwiwar hukumomin kiwon lafiya da na gwamnati ana ɗaukar su mafi kyawun aiki don inganta lafiyar jama'a, shaidun da ke akwai don tallafawa wannan suna da iyaka.[2] Shirye-shiryen kiwon lafiya na jama'a da ke ba da allurar rigakafi sun sami ci gaba sosai wajen inganta kiwon lafiya, gami da rage yawan kwalara da cutar shan inna da kuma kawar da kyanda, cututtukan da suka addabi bil'adama dubban shekaru.[3]

Tsoffin daraktoci uku na Shirin Yaduwar Kwayar Cutar Duniya suna karanta labarai cewa an kawar da kwayar Cutar a duniya, 1980

Hukumar Lafiya ta Duniya (WHO) ta gano manyan ayyuka na shirye-shiryen kiwon lafiya na jama'a ciki har da:

• samar da jagoranci kan al'amuran da ke da mahimmanci ga kiwon lafiya da shiga cikin haɗin gwiwa inda ake buƙatar aiki tare;
• tsara ajanda na bincike da kuma motsa ƙarni, fassara da rarraba ilimi mai mahimmanci;
• kafa ka'idoji

da ka'idoji da ingantawa da saka idanu kan aiwatarwa;

• bayyana manufofi na ɗabi'a da na hujja;
• saka idanu kan yanayin kiwon lafiya da kimanta yanayin kiwon lafiyar.

Musamman, shirye-shiryen sa ido kan lafiyar jama'a na iya:

• aiki a matsayin Tsarin gargadi na farko don gaggawa na kiwon lafiyar jama'a;
• rubuta tasirin shiga tsakani, ko bin diddigin ci gaba zuwa ga manufofi da aka ƙayyade; da
• saka idanu da kuma bayyana yaduwar cututtukan kiwon lafiya, ba da izinin saita fifiko, da kuma sanar da Manufofin kiwon lafiya da dabarun.
• ganewar asali, bincike, da kuma saka idanu kan matsalolin kiwon lafiya da haɗarin kiwon lafiya na al'umma

Canjin halayyar

Binciken ISCD na 2010 "Hatsarin Magunguna a Burtaniya: bincike na yanke shawara da yawa" ya gano cewa barasa ya sami mafi girma gaba ɗaya kuma a cikin farashin Tattalin Arziki, Raunin, Matsalolin iyali, Lalacewar muhalli, da Lalacewar Al'umma.

Yawancin matsalolin kiwon lafiya sun faru ne saboda halayen mutum marasa kyau. Daga hangen nesa na ilimin halayyar juyin halitta, kan amfani da sababbin abubuwa masu cutarwa shine saboda kunna tsarin lada na juyin halitta don abubuwa kamar kwayoyi, taba, barasa, gishiri mai tsabta, kitse, da carbohydrates. Sabbin fasahohi kamar sufuri na zamani suna haifar da rage yawan aiki na jiki. Bincike ya gano cewa halayyar ta fi canzawa ta hanyar la'akari da motsawar juyin halitta maimakon kawai gabatar da bayanai game da tasirin kiwon lafiya. Masana'antar tallace-tallace ta san muhimmancin haɗa samfuran da ke da matsayi mai girma da jan hankali ga wasu. Ana karuwar gane fina-finai a matsayin kayan aikin kiwon lafiyar jama'a, tare da Makarantar Kiwon Lafiyar Jama'a ta Jami'ar Harvard da ke rarraba irin waɗannan fina-fakka na "matsayi na tasiri". [1] A zahiri, an kafa bukukuwan fina-falla da gasa don inganta fina-fukkuna game da kiwon lafiya. [2] Sabanin haka, an yi jayayya cewa jaddada mummunar tasirin shan taba a kan wasu mutane da kuma sanya haramtacciyar shan taba a wuraren jama'a sun kasance da tasiri sosai wajen rage shan taba.[3] Gidajen karatu na jama'a na iya zama kayan aiki masu amfani don canje-canjen kiwon lafiyar jama'a. Suna ba da damar samun bayanai game da kiwon lafiya, suna haɗa mutane da sabis na kiwon lafiya. Har ma suna iya ba da kulawa kai tsaye a wasu yanayi.[4]

Aikace-aikacen kiwon lafiya

Kazalika da neman inganta lafiyar jama'a ta hanyar aiwatar da takamaiman matakan shiga tsakani na yawan jama'a, lafiyar jama'ar tana ba da gudummawa ga kulawar kiwon lafiya ta hanyar ganowa da kimanta bukatun jama'a don ayyukan kiwon lafiya, gami da:[1][2][3][4]

• Binciken ayyukan yanzu da kimanta ko suna cika manufofin Tsarin kiwon lafiya
• Tabbatar da buƙatu kamar yadda Kwararrun masu kiwon lafiya, jama'a da sauran masu ruwa da tsaki suka bayyana
• Bayyana hanyoyin da suka fi dacewa
• Yin la'akari da tasirin akan albarkatun don shigar da aka tsara da kuma kimanta tasirin su
• Taimaka wa yanke shawara a cikin kiwon lafiya da tsara ayyukan kiwon lafiya gami da duk wani canji da ya dace.
• Bayyanawa, ilimantarwa, da kuma karfafa mutane game da batutuwan kiwon lafiya

Manufofin da suka sabawa juna

Wasu shirye-shirye da manufofi da ke da alaƙa da inganta lafiyar jama'a da rigakafi na iya zama masu kawo rigakafi. Ɗaya daga cikin irin wannan misali shine shirye-shiryen da ke mai da hankali kan rigakafin yaduwar cutar kanjamau ta hanyar kamfen ɗin jima'i mai aminci da shirye-shirye na musayar allura. Wani kuma shine kula da shan taba. Kasashe da yawa sun aiwatar da manyan shirye-shirye don rage shan sigari, kamar kara haraji da haramta shan sigari a wasu ko duk wuraren jama'a. Magoya baya suna jayayya ta hanyar gabatar da shaidar cewa shan sigari yana daya daga cikin manyan masu kisan kai, sabili da haka gwamnatoci suna da aikin rage yawan mutuwar, ta hanyar iyakance shan sigari (hannu na biyu) da kuma samar da karancin damar ga mutane su shan sigari. Masu adawa sun ce wannan yana lalata 'yancin mutum da alhakin mutum, kuma yana damuwa cewa ana iya ƙarfafa jihar ta cire ƙarin zaɓi da sunan mafi kyawun lafiyar jama'a gaba ɗaya.[1]

Binciken ilimin halayyar dan adam ya tabbatar da wannan tashin hankali tsakanin damuwa game da lafiyar jama'a da damuwa game da 'yancin mutum: (i) mafi kyawun mai tsinkaya na bin shawarwarin kiwon lafiyar jama'ar kamar wanke hannu, sanya abin rufe fuska, da zama a gida (sai dai don muhimmiyar aiki) a lokacin annobar COVID-19 aikin da mutane ke ɗauka don hana lahani amma (ii) mafi kyawun tsinkaya game da irin waɗannan shawarwarin kifin lafiyar jama'ara yana darajar 'yanci fiye da daidaito.[1]

A lokaci guda, yayin da cututtukan da ke yaduwa a tarihi sun kasance mafi girma a matsayin fifiko na kiwon Lafiya ta duniya, cututtukani marasa yaduwa da abubuwan haɗari da ke tattare da halayyar sun kasance a kasa. Wannan yana canzawa, duk da haka, kamar yadda Majalisar Dinkin Duniya ta nuna ta shirya taron koli na musamman na farko kan batun cututtukan da ba sa yaduwa a watan Satumbar 2011. [1]

Ra'ayoyin Duniya

Wani ma'aikacin kiwon lafiya na ƙauye a Zimbabwe yana gudanar da jarrabawar yara

Bambance-bambance a cikin sabis da samun dama

Akwai bambanci mai mahimmanci a cikin samun damar kula da kiwon lafiya da shirye-shiryen kiwon lafiya na jama'a tsakanin Kasashe masu tasowa da kasashe masu ci gaba, da kuma cikin kasashe masu bunkasa. A cikin Kasashe masu tasowa, cibiyoyin kiwon lafiya na jama'a har yanzu suna tasowa. Wataƙila ba a sami isasshen Ma'aikatan kiwon lafiya da aka horar da su ba, albarkatun kuɗi ko, a wasu lokuta, isasshen ilimi don samar da matakin kulawa da rigakafin cututtuka.[1][2] A sakamakon haka, yawancin cututtuka da mutuwa a kasashe masu tasowa suna haifar da kuma taimakawa ga matsanancin talauci. Misali, gwamnatocin Afirka da yawa suna kashe kasa da $ 100 USD ga kowane mutum a kowace shekara a kan kiwon lafiya, yayin da, a Amurka, Gwamnatin tarayya ta kashe kusan $ 10,600 USD ga kowane kowane mutum a cikin 2019.[3] Koyaya, bai kamata a rikita kashe kuɗi a kan kiwon lafiya da kashe kuɗi a lafiyar jama'a ba. Matakan kiwon lafiya na jama'a bazai iya la'akari da "kiwon lafiya" a cikin mafi tsauri. Misali, ba da umarnin amfani da belin wurin zama a cikin motoci na iya ceton rayuka da yawa kuma ya ba da gudummawa ga lafiyar jama'a, amma yawanci kuɗin da aka kashe don aiwatar da wannan doka ba zai ƙidaya a matsayin kuɗin da aka yi amfani da shi a kula da lafiya ba.

Gwajin zazzabin cizon sauro a Kenya. Duk da cewa ana iya hana shi kuma ana iya warkar da shi, zazzabin cizon sauro shine babban dalilin mutuwa a kasashe masu tasowa da yawa.

Yawancin sassan duniya sun kasance suna fama da cututtukan cututtukani masu yaduwa da za a iya hanawa ko magani. Baya ga wannan duk da haka, kasashe masu tasowa da yawa suna fuskantar canjin annoba da kuma rikice-rikice wanda yawan jama'a yanzu ke fuskantar ƙarin tasirin cututtukan da ba su da tsanani yayin da tsammanin rayuwa ke ƙaruwa, al'ummomin da suka fi fama da cututtukani masu tsanani da cutututtuka masu yaduwa.[1] Wani babban damuwa game da lafiyar jama'a a kasashe masu tasowa shine rashin lafiyar uwaye da yara, wanda ya kara tsanantawa ta hanyar Rashin abinci mai gina jiki da talauci. WHO ta ba da rahoton cewa rashin shayarwa ta musamman a cikin watanni shida na farko na rayuwa yana taimakawa ga mutuwar yara sama da miliyan daya a kowace shekara.[2] Magungunan rigakafi na lokaci-lokaci da nufin magance da hana cutar zazzabin cizon sauro tsakanin mata masu juna biyu da yara ƙanana shine matakin kiwon lafiyar jama'a a cikin ƙasashe masu fama da cutar.

Tun daga shekarun 1980s, karuwar yawan jama'a ta fadada mayar da hankali ga lafiyar jama'a daga halayen mutum da Abubuwan haɗari zuwa batutuwan matakin jama'a kamar rashin daidaito, talauci, da ilimi. Lafiyar jama'a ta zamani galibi tana damuwa da magance abubuwan da ke haifar da kiwon lafiya a duk faɗin jama'a. Akwai amincewa cewa abubuwa da yawa da suka shafi kiwon lafiya sun hada da aji, kabilanci, kudin shiga, matsayin ilimi, yankin zama, da alaƙar zamantakewa; waɗannan an san su da "masu ƙayyade zamantakewar kiwon lafiya". Direbobin da ke sama kamar su muhalli, ilimi, aiki, samun kudin shiga, tsaro na abinci, gidaje, hada jama'a da sauransu da yawa suna haifar da rarraba kiwon lafiya tsakanin da cikin jama'a kuma galibi ana tsara su ta hanyar manufofi.[1] Halin zamantakewa a cikin kiwon lafiya yana gudana ta hanyar al'umma. Wadanda suka fi talauci galibi suna da mafi munin lafiya, amma har ma da matsakaicin matsakaicin za su sami mummunar sakamako na kiwon lafiya fiye da waɗanda ke da matsayi mafi girma.[2] Sabon kiwon lafiyar jama'a yana ba da shawara ga manufofin da suka danganci yawan jama'a waɗanda ke inganta kiwon lafiya ta hanyar adalci.

Sashin kiwon lafiya yana daya daga cikin masana'antun da suka fi aiki a Turai. A ƙarshen 2020, ya kai sama da ma'aikata miliyan 21 a Tarayyar Turai lokacin da aka haɗa shi da aikin zamantakewa.[1] A cewar WHO, kasashe da yawa sun fara Cutar COVID-19 tare da ƙwararrun ƙwararrun kiwon lafiya da kulawa, ƙwararrun da ba su dace ba, da rarraba ƙasa mara daidaituwa. Wadannan batutuwan sun kara muni saboda annobar, suna sake jaddada muhimmancin lafiyar jama'a.[2] A Amurka, tarihin rashin saka hannun jari a cikin lafiyar jama'a ya lalata ma'aikatan kiwon lafiya na jama'a da tallafi ga lafiyar jama'ar, tun kafin annobar ta kara da damuwa, damuwa, rashin gamsuwa da aiki, da hanzarta tashi tsakanin ma'aikatan lafiya na jamaʼa.[3]

Taimako na kiwon lafiya a kasashe masu tasowa

 

Wani likitan Cuban ya yi aikin iska a Guinea-Bissau. Cuba ta aika da ma'aikatan kiwon lafiya zuwa kasashe masu tasowa fiye da dukkan kasashe na G8 da aka haɗa.

Taimako na kiwon lafiya ga kasashe masu tasowa muhimmiyar tushe ce ta kudaden kiwon lafiya na jama'a ga kasashe da yawa masu tasowa.[1] Taimako na kiwon lafiya ga kasashe masu tasowa ya nuna karuwa mai yawa bayan Yaƙin duniya na II yayin da damuwa game da yaduwar cutar ta duniya ta karu kuma annobar HIV / AIDS a yankin Sahara ta bayyana.[2][3] Daga 1990 zuwa 2010, jimlar taimakon kiwon lafiya daga kasashe masu tasowa ya karu daga biliyan 5.5 zuwa biliyan 26.87 tare da kasashe masu arziki suna ci gaba da ba da gudummawar biliyoyin daloli a kowace shekara tare da burin inganta lafiyar jama'a.[3] Wasu kokarin, duk da haka, suna karɓar adadi mai yawa na kudade kamar HIV wanda ya sami karuwar kudade sama da dala biliyan 6 tsakanin 2000 da 2010 wanda ya kasance fiye da sau biyu na karuwar da aka gani a kowane bangare a cikin waɗannan shekarun.[1] Taimako na kiwon lafiya ya ga fadada ta hanyar tashoshi da yawa ciki har da taimakon jama'a masu zaman kansu, kungiyoyi masu zaman kansu kamar Gidauniyar Rockefeller ko Gidauniya ta Bill & Melinda Gates, masu ba da gudummawa na biyu, da masu ba da kyauta na duniya kamar Bankin Duniya ko UNICEF . [3] Sakamakon ya kasance hauhawar gagarumin tallafi da ba a daidaita ba kuma an raba shi da yawa daga shirye-shirye da ayyukan. Don inganta hadin gwiwar dabarun da daidaitawa tsakanin abokan hulɗa, musamman tsakanin hukumomin ci gaba na biyu da kungiyoyin tallafi, Hukumar hadin gwiwoyin ci gaban kasa da kasa ta Sweden (Sida) ta jagoranci kafa ESSENCE, wani shiri don sauƙaƙe tattaunawa tsakanin masu ba da gudummawa / masu ba da kuɗi, yana ba su damar gano haɗin kai.[4] ESSENCE ta haɗu da hukumomin tallafi da yawa don daidaita kokarin tallafi.

A shekara ta 2009 taimakon kiwon lafiya daga OECD ya kai dala biliyan 12.47 wanda ya kai 11.4% na jimlar taimakon ta biyu.[1] A shekara ta 2009, an gano masu ba da gudummawa na Multilateral sun kashe kashi 15.3% na jimlar taimakon su don inganta kiwon lafiyar jama'a.[1]

Tattaunawar taimakon kiwon lafiya ta kasa da kasa

Akwai muhawara da ke tambayar ingancin taimakon kiwon lafiya na kasa da kasa. Masu goyon bayan agaji suna da'awar cewa taimakon kiwon lafiya daga kasashe masu arziki ya zama dole don kasashe masu tasowa su tsere daga tarkon talauci. Masu adawa da taimakon kiwon lafiya suna da'awar cewa taimakon kiwon lafiyar kasa da kasa a zahiri yana rushe hanyar ci gaban kasashe masu tasowa, yana haifar da dogaro da taimako, kuma a lokuta da yawa taimakon ya kasa isa ga masu karɓa. Misali, kwanan nan, an ba da taimakon kiwon lafiya ga shirye-shirye kamar tallafawa sabbin fasahohi kamar maganin antiretroviral, hanyoyin sauro da aka yi da maganin kwari, da sabbin allurar rigakafi. Ana iya ganin tasirin tasirin waɗannan shirye-shiryen a cikin kawar da kyanda da cutar shan inna; duk da haka, masu sukar suna da'awar cewa rashin amfani ko rashin amfani da kudade na iya haifar da yawancin waɗannan ƙoƙarin da ba su taɓa samun nasara ba.

Tsarin tattalin arziki wanda ya danganci Cibiyar Kula da Lafiya da Bincike da Hukumar Lafiya ta Duniya sun nuna alaƙa tsakanin taimakon kiwon lafiya na kasa da kasa a kasashe masu tasowa da raguwar yawan mutuwar manya. Koyaya, binciken da aka yi a shekara ta 2014-2016 ya nuna cewa yiwuwar canzawa mai rikitarwa ga wannan sakamakon shine yiwuwar cewa an ba da taimako ga ƙasashe da zarar sun riga sun kasance a kan hanya don ingantawa. Wannan binciken, duk da haka, ya kuma nuna cewa dala biliyan 1 a cikin taimakon kiwon lafiya yana da alaƙa da mutuwar 364,000 da ke faruwa tsakanin shekaru 0 zuwa 5 a cikin 2011.

Manufofin ci gaba mai ɗorewa don 2030

  Don magance kalubalen yanzu da na gaba wajen magance matsalolin kiwon lafiya a duniya, Majalisar Dinkin Duniya ta haɓaka Manufofin Ci Gaban Ci Gaban mai ɗorewa da za a kammala su a shekara ta 2030. Wadannan manufofi gabaɗaya sun haɗa da dukkan fannoni na ci gaba a duk faɗin ƙasashe, duk da haka Manufofin 1-6 kai tsaye suna magance bambancin kiwon lafiya, da farko a ƙasashe masu tasowa. Wadannan manufofi guda shida suna magance mahimman batutuwa a cikin Lafiyar jama'a ta duniya, talauci, yunwa da Tsaro na abinci, kiwon lafiya, ilimi, daidaito tsakanin jinsi da Ƙarfafa mata, da ruwa da tsabta. Jami'an kiwon lafiya na jama'a na iya amfani da waɗannan manufofi don saita ajanda da kuma tsara shirye-shiryen karamin sikelin ga ƙungiyoyinsu. Wadannan manufofi an tsara su ne don rage nauyin cututtuka da rashin daidaito da kasashe masu tasowa ke fuskanta kuma su haifar da kyakkyawar makoma. Haɗin tsakanin manufofi daban-daban na ci gaba mai ɗorewa da lafiyar jama'a suna da yawa kuma an kafa su sosai.

Tarihi

Har zuwa karni na 18

Kabarin mutane da yawa a lokacin annobar annoba ta biyu (a.k.a. Black Death; 1346-1353) ya kara martani na birane ga bala'i bisa ga ayyukan da suka gabata. Karamin hoto daga "The Chronicles of Gilles Li Muisis" (1272-1352). Royal Library of Belgium, MS 13076-77, f. 24v.

Daga farkon wayewar ɗan adam, al'ummomi sun inganta kiwon lafiya kuma sun yi yaƙi da cututtuka a matakin yawan jama'a. Ma'anar kiwon lafiya da hanyoyin da za a bi shi sun bambanta bisa ga kungiyoyin kiwon lafiya, addini da na falsafar na halitta da aka gudanar, albarkatun da suke da su, da kuma sauye-sauyen yanayin da suka rayu. Duk da haka 'yan al'ummomi na farko sun nuna rashin tsabta ko ma rashin kulawa da ake danganta da su. Wannan sunan na ƙarshe ya dogara ne akan rashin masu nuna alamun halittu na yanzu, musamman kayan aikin rigakafi da kididdiga da aka haɓaka cikin hasken ka'idar kwayar Cutar ta yaduwar cuta.

An haifi lafiyar jama'a a Turai ko kuma a matsayin martani ga Juyin Juya Halin Masana'antu. Ana tabbatar da tsoma baki na kiwon lafiya kusan ko'ina al'ummomin tarihi sun bar alamar su. A Kudu maso gabashin Asiya, alal misali, maganin Ayurvedic da kuma Addinin Buddha daga baya sun inganta tsarin sana'a, abinci da jima'i wanda ya yi alkawarin daidaitattun jiki, rayuwa da al'ummomi, ra'ayi mai karfi a cikin maganin gargajiya na kasar Sin. Daga cikin Mayans, Aztecs da sauran wayewar farko a Amurka, cibiyoyin jama'a sun bi shirye-shiryen tsabta, gami da gudanar da kasuwannin ganye na magani. Kuma a tsakanin 'Yan asalin Australiya, dabarun adanawa da kare ruwa da tushen abinci, micro-zoning don rage gurɓataccen yanayi da haɗarin wuta, da fuska don kare mutane daga kwari sun zama ruwan dare, har ma a sansanoni na wucin gadi.

Hoton wadanda ke fama da cutar kyanda ta Aztec

Yammacin Turai, Byzantine da Musulunci wayewa, waɗanda gabaɗaya suka karɓi tsarin kiwon lafiya na Hippocrates, Galenic ko humoral, sun haɓaka shirye-shiryen rigakafi. Wadannan an haɓaka su ne bisa kimanta ingancin yanayin yanayi na gida, gami da Yanayin ƙasa, yanayin iska da fallasawa ga rana, da kaddarorin da wadatar ruwa da abinci, ga mutane da Dabbobi marasa mutane. Marubutan likita, gine-gine, injiniya da Littattafan soja sun bayyana yadda za a yi amfani da irin waɗannan ra'ayoyin ga kungiyoyi daban-daban da kuma yanayi daban-daban. Wannan yana da mahimmanci, tun da a ƙarƙashin Galenism ana tunanin tsarin mulki na jiki yana da tsari mai tsanani ta hanyar mahalli na kayan aiki, don haka ma'auni na buƙatar takamaiman tsarin mulki yayin da suke tafiya a lokutan yanayi daban-daban da kuma tsakanin yankunan yanayi.

A cikin al'ummomi masu rikitarwa, wadanda suka riga sun kasanCE masana'antu, tsoma baki da aka tsara don rage haɗarin kiwon lafiya na iya zama shirin masu ruwa da tsaki daban-daban. Misali, a zamanin Girka da Romawa, janar din sojoji sun koyi samar da lafiyar sojoji, gami da a fagen yaƙi, inda yawancin mayakan suka mutu kafin karni na ashirin. A cikin Masallatai na Kirista a fadin Gabashin Bahar Rum da yammacin Turai tun aƙalla ƙarni na biyar AZ, 'yan majami'a da nuns sun bi tsarin mulki mai tsauri amma mai daidaituwa, gami da abinci mai gina jiki, wanda aka haɓaka a bayyane don tsawaita rayuwarsu. Kuma kotunan sarauta, na sarauta da na papal, waɗanda galibi suna motsawa, Hakanan sun daidaita halayensu don dacewa da yanayin muhalli a wuraren da suka mamaye. Hakanan za su iya zaɓar shafukan da suka ɗauka masu lafiya ga membobinsu kuma wani lokacin suna canza su.

A cikin birane, mazauna da sarakuna sun haɓaka matakai don amfanin yawan jama'a, waɗanda ke fuskantar haɗarin kiwon lafiya da aka sani. Wadannan suna ba da wasu daga cikin shaidu masu dorewa don matakan kariya a cikin wayewar da ta gabata. A shafuka da yawa an gabatar da kiyaye ababen more rayuwa, gami da hanyoyi, canals da kasuwanni, da kuma manufofin yanki, a bayyane don adana lafiyar mazauna. Jami'ai irin su muhtasib a Gabas ta Tsakiya da kuma Road master a Italiya, sun yi yaƙi da haɗakar barazanar gurɓata ta hanyar zunubi, shiga cikin ido da miasma. ƙungiyoyi sana'a sun kasance mahimman wakilai na zubar da sharar gida kuma suna inganta Rage lahani ta hanyar gaskiya da aminci na aiki tsakanin membobinsu. Likitocin kiwon lafiya, gami da likitocin jama'a, sun hada kai da gwamnatocin birane wajen tsinkaya da shirya bala'i da ganowa da ware mutanen da aka ɗauka a matsayin kuturu, cuta mai karfi na ɗabi'a. Makwabta sun kasance masu aiki don kare lafiyar mutanen yankin, ta hanyar saka idanu kan wuraren da ke da haɗari a kusa da su da kuma daukar matakan zamantakewa da shari'a masu dacewa game da masu gurɓataccen sana'a da masu kula da dabbobi. Cibiyoyin addini, mutane da kungiyoyin agaji a cikin Islama da Kristanci suma suna inganta lafiyar ɗabi'a da ta jiki ta hanyar ba da abubuwan more rayuwa na birane kamar rijiyoyi, maɓuɓɓugar ruwa, makarantu da gadoji, kuma a cikin hidimar mahajjata. A yammacin Turai da Byzantium, ana gudanar da zanga-zangar addini, wanda aka yi niyyar aiki a matsayin matakan kariya da warkarwa ga dukan al'umma.

Mazauna birane da sauran kungiyoyi sun kuma samar da matakan kariya don mayar da martani ga bala'o'i kamar yaƙi, yunwa, ambaliyar ruwa da yaduwar cututtuka. A lokacin da kuma bayan Black Death (1346-53), alal misali, mazaunan Gabashin Bahar Rum da Yammacin Turai sun amsa ga raguwar yawan jama'a a wani bangare bisa ga ka'idojin kiwon lafiya da ladabi na yanzu, alal misali game da cin nama da binnewa, kuma a wani bangarorin ta hanyar bunkasa sabbin. Wannan na ƙarshe ya haɗa da kafa wuraren keɓewa da allon kiwon lafiya, wasu daga cikinsu sun zama ofisoshin birane na yau da kullun (kuma daga baya na ƙasa). Matakan da suka biyo baya don kare birane da yankunansu sun haɗa da bayar da fasfo na kiwon lafiya ga matafiya, tura masu gadi don ƙirƙirar igiyoyin tsabta don kare mazauna yankin, da tattara ƙididdigar cututtuka da mutuwa. Irin waɗannan matakan sun dogara da ingantaccen sufuri da hanyoyin sadarwa, ta hanyar da labarai game da cututtukan mutane da dabbobi suka bazu yadda ya kamata.

Bayan karni na 18

Tare da farawar Juyin Juya Halin masana'antu, yanayin rayuwa tsakanin ma'aikata ya fara muni, tare da ƙuntataccen yanayin birane marasa tsabta. A cikin shekaru arba'in na farko na karni na 19 kadai, yawan mutanen Landan ya ninka sau biyu kuma an rubuta yawan ci gaba a cikin sabbin garuruwan masana'antu, kamar Leeds da Manchester. Wannan saurin birni ya kara yaduwar cutar a cikin manyan birane da aka gina a kusa da gidajen aiki da masana'antu. Wadannan ƙauyuka sun kasance masu ƙuntatawa kuma ba su da tsari na tsabta. Cutar ba za a iya gujewa ba kuma rayuwarta a cikin waɗannan yankuna ta karfafa ta hanyar rayuwar talakawa ta mazauna. Gidajen da ba a samu ba sun haifar da saurin ci gaban ƙauyuka kuma yawan mutuwar kowane mutum ya fara tashi da tsoro, kusan ninka sau biyu a Birmingham da Liverpool. Thomas Malthus ya yi gargadi game da haɗarin yawan jama'a a cikin shekara ta 1798. Ra'ayoyinsa, da na Jeremy Bentham, sun zama masu tasiri sosai a cikin hukumomin gwamnati a farkon shekarun karni na 19. Sashe na ƙarshe na karni ya kawo kafa tsarin inganta lafiyar jama'a a cikin ƙarni biyu masu zuwa: an gano mugunta ta zamantakewa, masu ba da agaji masu zaman kansu sun jawo hankali ga shi, kuma canza ra'ayin jama'a ya haifar da matakin gwamnati. Karni na 18 ya ga ci gaba mai sauri a asibitoci na son rai a Ingila.

Ayyukan allurar rigakafi sun fara ne a cikin shekarun 1800, biyo bayan aikin farko na Edward Jenner wajen magance kyanda. Binciken James Lind game da abubuwan da ke haifar da scurvy tsakanin ma'aikatan jirgin ruwa da rage shi ta hanyar gabatar da 'Ya'yan itace a kan tafiye-tafiye masu tsawo an buga shi a cikin 1754 kuma ya haifar da karɓar wannan ra'ayin ta Royal Navy. An kuma yi ƙoƙari don gabatar da batutuwan kiwon lafiya ga jama'a; a cikin 1752 likitan Burtaniya Sir John Pringle ya buga Observations on the Diseases of the Army in Camp and Garrison, inda ya ba da shawarar muhimmancin isasshen iska a cikin Bariki soja da samar da bayan gida ga sojoji.

Dokokin kiwon lafiya na jama'a a Ingila

Sir Edwin Chadwick ya kasance babban tasiri a kan yakin neman lafiyar jama'a na farko.

An yi yunkurin farko na sake fasalin tsabta da kafa cibiyoyin kiwon lafiya na jama'a a cikin shekarun 1840. Thomas Southwood Smith, likita a Asibitin zazzabi na London, ya fara rubuta takardu game da muhimmancin lafiyar jama'a, kuma yana ɗaya daga cikin likitoci na farko da aka kawo don ba da shaida a gaban Hukumar Kula da Talakawa a cikin shekarun 1830, tare da Neil Arnott da James Phillips Kay . Smith ya shawarci gwamnati game da muhimmancin keɓewa da inganta tsabta don iyakance yaduwar cututtukan cututtuka irin su kwalara da zazzabin rawaya.

Hukumar Kula da Talakawa ta ruwaito a cikin 1838 cewa "kudin da ake buƙata don karɓar da kiyaye matakan rigakafi zai zama ƙasa da farashin cutar da ke faruwa yanzu". Ya ba da shawarar aiwatar da manyan ayyukan injiniya na gwamnati don sauƙaƙe yanayin da ya ba da damar yaduwar cutar. An kafa Kungiyar Lafiya ta Garuruwa a Exeter Hall London a ranar 11 ga watan Disamba na shekara ta 1844, kuma ta yi yakin neman ci gaban lafiyar jama'a a Ingila. Kafa ta biyo bayan kafa Hukumar Lafiya ta Birane a 1843, wanda Sir Edwin Chadwick ke jagoranta, wanda ya samar da jerin rahotanni game da yanayin talauci da rashin hankali a biranen Burtaniya.

Ofishin Lafiya na Jama'a, Bristol, 1900

Wadannan ƙungiyoyi na ƙasa da na gida sun haifar da Dokar Lafiya ta Jama'a, a ƙarshe ta wuce a 1848. Ya yi niyyar inganta yanayin tsabtace garuruwa da wuraren da ke da yawan jama'a a Ingila da Wales ta hanyar sanya samar da ruwa, magudanar ruwa, magunguna, tsaftacewa da shimfiɗa a ƙarƙashin jiki ɗaya tare da Babban Hukumar Lafiya a matsayin babban iko. gwamnati Liberal ta Lord John Russell ce ta zartar da Dokar, don mayar da martani ga roƙon Edwin Chadwick. An buga rahoton Chadwick na asali game da Yanayin Sanitary na Laburaren Jama'a a cikin 1842 kuma an bi shi da ƙarin rahoto shekara guda bayan haka. A wannan lokacin, James Newlands (wanda aka nada bayan wucewar Dokar Sanatorial ta Liverpool ta 1846 wanda Kwamitin Lafiya na Birane na Liverpool ya goyi bayan) ya tsara tsarin farko na duniya, a Liverpool (1848-1869), tare da Joseph Bazalgette daga baya ya kirkiro tsarin sharar gida na London (1858-1875).

Dokar Allurar rigakafi ta 1853 ta gabatar da allurar rigakafin kyanda a Ingila da Wales. A shekara ta 1871 doka ta buƙaci cikakken tsarin rajista wanda jami'an allurar rigakafi suka nada ke gudanarwa.

An ci gaba da shiga tsakani ta hanyar jerin ayyukan kiwon lafiya na jama'a, musamman Dokar 1875. Gyaran sun haɗa da gina magudanar ruwa, tattara shara na yau da kullun sannan a ƙonewa ko zubar da shi a cikin shara, samar da ruwa mai tsabta da kuma zubar da ruwa mai tsaye don hana haihuwar sauro.

Dokar Cututtukan Cututtuka (Sanarwa) ta 1889 (52 & 53 Vict. c. 72) ta ba da umarnin bayar da rahoton cututtukan cututtuka ga hukumomin tsabtace gida, wanda zai iya bin matakai kamar cire mai haƙuri zuwa asibiti da kuma kashe cututtukani na gidaje da dukiya.

Dokokin kiwon lafiya na jama'a a wasu ƙasashe

Misali na shawarwarin kiwon lafiyar jama'a na tarihi a lokacin annobar mura ta 1918 a New Haven, Connecticut, Amurka

A Amurka, an kafa kungiyar kiwon lafiya ta farko ta jama'a da ke da tushe a sashen kiwon lafiya na jihar da kuma allon kiwon lafiya a Birnin New York a 1866.

A lokacin Jamhuriyar Weimar, Jamus ta fuskanci bala'o'in kiwon Lafiyar jama'a da yawa. Jam'iyyar Nazi tana da burin inganta kiwon lafiya na zamani tare da Volksgesundheit, Jamusanci don lafiyar jama'a; wannan sabuntawa ya dogara ne akan karuwar filin eugenics da matakan da ke ba da fifiko ga lafiyar rukuni fiye da kowane kulawa ga lafiyar mutane. Ƙarshen Yaƙin Duniya na 2 ya haifar da Dokar Nuremberg, saitin ka'idojin bincike game da gwajin ɗan adam.

Yaduwar cututtuka

Masanin cututtukan cututtuka na farko John Snow ya tsara taswirar tarin cututtuken kwalara a London.

Kimiyya ta yaduwar cututtuka ta samo asali ne daga ganowar John Snow na gurɓataccen ruwan jama'a da kuma tushen barkewar kwalara a 1854 a London. Snow ya yi imani da Ka'idar kwayar cuta kamar yadda ya saba da ka'Ka'idar miasma. Ta hanyar magana da mazauna yankin (tare da taimakon Reverend Henry Whitehead), ya gano tushen barkewar cutar a matsayin famfo na ruwa na jama'a a kan Broad Street (yanzu Broadwick Street). Kodayake binciken sinadarai da microscope na Snow na samfurin ruwa daga famfo na Broad Street bai tabbatar da haɗarinsa ba, bincikensa game da tsarin cutar ya isa ya shawo kan majalisa ta gida don rufe famfo ta hanyar cire hannunsa.

Snow daga baya ya yi amfani da Taswirar dot don kwatanta tarin lokuta na kwalara a kusa da famfo. Ya kuma yi amfani da kididdiga don kwatanta alaƙar da ke tsakanin ingancin tushen ruwa da shari'ar kwalara. Ya nuna cewa Kamfanin Ruwa na Southwark da Vauxhall suna shan ruwa daga sassan da aka gurɓata na Thames kuma suna isar da ruwa zuwa gidaje, wanda ke haifar da karuwar cutar kwalara. Nazarin Snow babban abin da ya faru ne a tarihin kiwon lafiyar jama'a da yanayin ƙasa. An dauke shi a matsayin taron kafa kimiyya na ilmin annoba.

Kula da cututtukan cututtuka

Paul-Louis Simond yana yin allurar rigakafin annoba a Karachi, 1898

Tare da aikin farko a cikin ilmin ƙwayoyin cuta na likitan Faransa Louis Pasteur da masanin kimiyya na Jamus Robert Koch, an haɓaka hanyoyin ware ƙwayoyin ƙwayoyin da ke da alhakin cutar da aka ba su da allurar rigakafi don magani a farkon karni na 20. Likitan Burtaniya Ronald Ross ya gano sauro a matsayin mai ɗaukar zazzabin cizon sauro kuma ya kafa harsashi don yaki da cutar. Joseph Lister ya sauya aikin tiyata ta hanyar gabatar da aikin tiyata na antiseptic don kawar da kamuwa da cuta. Masanin ilimin cututtukan Faransa Paul-Louis Simond ya tabbatar da cewa annoba ta kai ta kwari a bayan beraye, kuma masanin kimiyya na Cuba Carlos J. Finlay da Amurkawa Walter Reed da James Carroll sun nuna cewa sauro suna dauke da Kwayar cuta da ke da alhakin zazzabin rawaya. : Masanin kimiyya na Brazil Carlos Chagas ya gano cutar ta wurare masu zafi da kuma mai cutarwa. : 481 

Al'umma da al'adu

Ilimi da horo

Ilimi da horar da masu sana'a da lafiyar jama'a suna samuwa a duk faɗin duniya a Makarantun Kiwon Lafiya, Makarantun Kiwo, Makarantun Kula da Dabbobi, Makarantun Nursing, da Makarantun Harkokin Jama'a. Horarwar yawanci tana buƙatar digiri na jami'a tare da mai da hankali kan manyan fannoni na Biostatistics, epidemiology, Gudanar da ayyukan kiwon lafiya, Manufofin kiwon lafiya ilimin kiwon lafiya.

A cikin yanayin duniya, fagen ilimin kiwon lafiya na jama'a ya samo asali sosai a cikin 'yan shekarun nan, wanda cibiyoyin kamar Hukumar Lafiya ta Duniya da Bankin Duniya suka goyi bayan, da sauransu. Tsarin aiki an tsara shi ta hanyar ka'idojin dabarun, tare da hanyoyin ilimi da aiki da ke jagorantar tsarin ƙwarewa, duk suna buƙatar gyare-gyare bisa ga gaskiyar gida, ƙasa da duniya. Bugu da ƙari, haɗa fasaha ko dandamali na dijital don haɗawa da ƙananan ƙwarewar kiwon lafiya na LHL na iya zama hanyar haɓaka ƙwarewar lafiya. Yana da mahimmanci ga lafiyar jama'a cewa kasashe suna tantance bukatun lafiyar jama'ar su da kuma bunkasa ikon su na isar da wannan damar, kuma ba su dogara da wasu ƙasashe don samar da shi ba.

Makarantu na kiwon lafiyar jama'a: hangen nesa na Amurka

In the United States, the Welch-Rose Report of 1915 has been viewed as the basis for the critical movement in the history of the institutional schism between public health and medicine because it led to the establishment of schools of public health supported by the Rockefeller Foundation. The report was authored by William Welch, founding dean of the Johns Hopkins Bloomberg School of Public Health, and Wickliffe Rose of the Rockefeller Foundation. The report focused more on research than practical education. Some have blamed the Rockefeller Foundation's 1916 decision to support the establishment of schools of public health for creating the schism between public health and medicine and legitimizing the rift between medicine's laboratory investigation of the mechanisms of disease and public health's nonclinical concern with environmental and social influences on health and wellness.

Kodayake an riga an kafa makarantun kiwon lafiyar jama'a a Kanada, Turai da Arewacin Afirka, Amurka har yanzu tana kula da tsarin gargajiya na gidaje na kiwon lafiyar Jama'a a cikin cibiyoyin kiwon lafiya. Kyautar $ 25,000 daga ɗan kasuwa Samuel Zemurray ya kafa Makarantar Kiwon Lafiyar Jama'a da Magungunan Tropical a Jami'ar Tulane a 1912 yana ba da digiri na farko na kiwon lafiyar jama'a a shekara ta 1914. Charles-Edward Amory Winslow ne ya kafa Makarantar Kiwon Lafiyar Jama'a ta Yale a shekarar 1915. An kafa Makarantar Kiwon Lafiyar Jama'a ta Johns Hopkins a 1916 kuma ta zama cibiyar mai zaman kanta, mai ba da digiri don bincike da horo a cikin lafiyar jama'a, kuma babbar cibiyar horar da lafiyar jama'ar a Amurka. A shekara ta 1922, an kafa makarantun kiwon lafiyar jama'a a Columbia da Harvard a kan tsarin Hopkins. A shekara ta 1999 akwai makarantu ashirin da tara na kiwon lafiyar jama'a a Amurka, suna yin rajista kusan dalibai dubu goma sha biyar.

A cikin shekaru, nau'ikan ɗalibai da horo da aka bayar sun canza. A farkon, ɗaliban da suka shiga makarantun kiwon lafiya na jama'a yawanci sun riga sun sami digiri na likita; horar da makarantar kiwon lafiya ta jama'a ya kasance digiri na biyu ga masu sana'a na kiwon lafiya. Koyaya, a cikin 1978, kashi 69% na ɗaliban Amurka da suka shiga makarantun kiwon lafiya na jama'a suna da digiri na farko kawai.

Digiri a cikin lafiyar jama'a

Makarantar Landan ta Kiwon Lafiya da Magunguna ita ce tsohuwar makarantar kiwon lafiyar jama'a a cikin Anglosphere .

Makarantu na kiwon lafiyar jama'a suna ba da digiri iri-iri gabaɗaya suna fada cikin rukuni biyu: ƙwararru ko ilimi. Manyan digiri biyu na digiri sune Master of Public Health (MPH) ko Master of Science in Public Health (MSPH). Nazarin digiri a wannan fagen ya haɗa da Doctor of Public Health (DrPH) da Doctor of Philosophy (PhD) a cikin ƙwarewar manyan fannonin kiwon lafiyar jama'a. Ana ɗaukar DrPH a matsayin digiri na ƙwararru da PhD a matsayin ƙarin digiri na ilimi.

An tsara digiri na sana'a don yin aiki a cikin saitunan kiwon lafiya na jama'a. Jagoran Lafiya na Jama'a'a, Dokta na Lafiya ta Jama'a, Doctor na Kimiyya ta Lafiya (DHSc / DHS) da Jagoran Kula da Lafiya misalai ne na digiri waɗanda aka tsara wa mutanen da ke son aiki a matsayin masu kula da lafiyar jama'a a cikin sassan kiwon lafiya, kulawa da kungiyoyin da ke da al'umma, asibitoci da kamfanonin ba da shawara, da sauransu. Digiri na Master of Public Health ya fada cikin rukuni biyu, waɗanda suka fi mai da hankali kan fahimtar ilimin annoba da kididdiga a matsayin tushen kimiyya na aikin kiwon lafiya na jama'a da waɗanda suka haɗa da hanyoyin da suka fi yawa. Jagoran Kimiyya na Kiwon Lafiyar Jama'a yayi kama da MPH amma ana daukar shi digiri na ilimi (kamar yadda ya saba da digiri na sana'a) kuma yana mai da hankali kan hanyoyin kimiyya da bincike. Ana iya yin wannan bambanci tsakanin DrPH da DHSc: Ana ɗaukar DrPH a matsayin digiri na ƙwararru kuma DHSc digiri ne na ilimi.

Digiri na ilimi sun fi dacewa da waɗanda ke da sha'awa a cikin tushen kimiyya na kiwon lafiyar jama'a da maganin rigakafi waɗanda ke son neman aiki a cikin bincike, koyarwar jami'a a cikin shirye-shiryen digiri, nazarin manufofi da ci gaba, da sauran manyan mukamai na kiwon lafiya na jama'a. Misalan digiri na ilimi sune Jagoran Kimiyya, Dokta na Falsafa, Dokta ya Kimiyya (ScD), da Dokta na Kimiyya na Lafiya (DHSc). Shirye-shiryen digiri sun bambanta da MPH da sauran shirye-shiryen kwararru ta hanyar karawa da ci gaba da kuma yanayin da kuma girman aikin bincike.

Shahararrun mutane

• John Graunt (1620-1674) ɗan ƙasar Burtaniya ne wanda ya kafa harsashin ilimin annoba.
• Edward Jenner (1749-1823) ya kirkiro allurar rigakafin kyanda, allurar rigakawa ta farko a duniya. Sau da yawa an san shi da "mahaifin rigakafi".
• Benjamin Waterhouse (1753-1846) ya gabatar da allurar rigakafin kyanda a Amurka.
• An bayyana Lemuel Shattuck (1793-1859) a matsayin "masanin gine-gine" da "annabci" na lafiyar jama'ar Amurka
• John Snow (1813-1858) shi ne 'mahaifin ilimin cututtukan zamani'.
• Sir Joseph William Bazalgette (1819-1891) ya kirkiro hanyar sadarwa ta tsakiya a tsakiyar London don mayar da martani ga Babban Stink na 1858. Wannan ya zama kayan aiki wajen ceton birnin daga annobar kwalara.
• Louis Pasteur (1822-1895) ya gudanar da bincike wanda ya kafa tushe don fahimtarmu game da abubuwan da ke haifar da rigakafin cututtuka.
• Robert Koch (1843-1910) ya yi amfani da abubuwan da ya gano don tabbatar da cewa ƙwayoyin cuta "za su iya haifar da takamaiman cuta" kuma kai tsaye ya ba da hujjoji ga wannan ka'idar ƙwayoyin cututtuka, saboda haka ya haifar da tushen kimiyya na lafiyar jama'a, yana ceton rayuka miliyoyin.
• Charles V. Chapin (1856-1941) mai ba da shawara kan lafiyar jama'a kuma mai bincike wanda aka yaba da dasa "tushen inganci a lafiyar jama'ar" a Amurka
• Sara Josephine Baker (1873-1945) ta kasance "ƙarfiyar kayan aiki a cikin yara da lafiyar uwaye"
• Nora Wattie (1900-1994) ta jagoranci ci gaban ayyukan kiwon lafiya na jama'a da tsabtace muhalli, da ilimi wajen inganta lafiyar mata da yara a cikin mafi talauci na Glasgow, wanda ta sami OBE.
• Jonas Salk (1914-1995) ya kirkiro daya daga cikin Allurar rigakafin cutar shan inna ta farko kuma ya yi kamfen sosai don yin allurar rigakawa.
• Ruth Huenemann (1910-2005) Ta zama majagaba a cikin nazarin kiba na yara a cikin shekarun 1960s tana nazarin abinci da halaye na motsa jiki na matasa na Berkeley.
• Edmond Fernandes (1990-) Ya nuna tabbacin ra'ayi don kawo karshen nauyin Rashin abinci mai gina jiki a Indiya da kuma duniya baki daya.
• Dilip Mahalanabis - An ba da izinin samo asali kuma ya yi amfani da ORS don ceton dubban rayuka a lokacin Yakin 'yanci.

Misalan ƙasashe

Kanada

A Kanada, Hukumar Lafiya ta Jama'a ta Kanada ita ce hukumar kasa da ke da alhakin kiwon lafiyar jama'a, shirye-shiryen gaggawa da martani, da kuma kula da cututtukan cututtuka da cututfumen da ke ci gaba.

Cuba

Tun daga Juyin Juya Halin Cuba na 1959, Gwamnatin Cuba ta ba da albarkatu masu yawa don inganta yanayin kiwon lafiya ga dukan jama'arta ta hanyar samun damar kiwon lafiya ta duniya. Mutuwar jarirai ta ragu. : Cuban medical internationalism a matsayin manufofi ya ga gwamnatin Cuban ta aika likitoci a matsayin wani nau'i na taimako da fitarwa zuwa ƙasashe masu bukata a Latin Amurka, musamman Venezuela, da kuma ƙasashen Oceania da Afirka.

Colombia da Bolivia

Lafiyar jama'a tana da mahimmanci a wasu wurare a Latin Amurka wajen karfafa ikon jihar da kuma haɗa yawan mutanen da aka ware a cikin ƙasa. A Colombia, lafiyar jama'a wata hanya ce don ƙirƙirar da aiwatar da ra'ayoyin zama ɗan ƙasa. A Bolivia, irin wannan turawa ta zo ne bayan juyin juya halin su na 1952.

Ghana

Yara na Ghana suna karɓar tarkon gado da aka yi da maganin kwari don hana kamuwa da sauro da ke yaduwar zazzabin cizon sauro.

Kodayake ana iya warkarwa da rigakafi, zazzabin cizon sauro ya kasance babban batun kiwon lafiyar jama'a kuma shine na uku da ke haifar da mutuwa a Ghana. Idan babu allurar rigakafi, kula da sauro, ko samun damar maganin zazzabin cizon sauro, hanyoyin kiwon lafiyar jama'a sun zama babbar dabarar rage yaduwar da tsananin zazzabin sauro. Wadannan hanyoyin sun hada da rage wuraren kiwo, tantance kofofin da windows, yaduwar maganin kwari, magani mai sauri bayan kamuwa da cuta, da kuma amfani da hanyoyin kwari da aka kula da sauro. Rarraba da siyar da sauro da aka yi da maganin kwari abu ne na yau da kullun, mai tsada mai inganci na kiwon lafiya na jama'a; duk da haka, akwai shingen da za a yi amfani da shi ciki har da farashi, gida da ƙungiyoyin iyali, samun damar albarkatu, da abubuwan zamantakewa da halayyar da ba a nuna su kawai suna shafar yawan cutar zazzabin sauro ba har ma da amfani da sauro.

Amurka

A karkashin jagorancin Massachusetts, jihohin sun haɓaka shirye-shiryen kiwon lafiyar jama'a a ƙarshen karni na 19.

Amurka ba ta da tsarin da ya dace don tallafawa lafiyar jama'a, tana dogaro da hukumomi da shirye-shirye iri-iri a matakin tarayya, jiha da ƙananan hukumomi. Tsakanin 1960 da 2001, kashe kuɗin kiwon lafiyar jama'a a Amurka ya kasance yana ƙaruwa, bisa ga ƙaruwar kuɗaɗen da gwamnatocin jihohi da ƙananan hukumomi ke kashewa, wanda ya kai kashi 80-90% na jimillar kuɗin da ake kashewa wajen kula da lafiyar jama'a. Kuɗaɗen da ake kashewa don tallafawa lafiyar jama'a a Amurka sun kai kololuwa a 2002 kuma sun ragu a cikin shekaru goma masu zuwa. Rage kuɗaɗen da jihohi ke kashewa kan lafiyar jama'a a lokacin Babban Koma bayan Tattalin Arziki na 2007-2008 ba a dawo da su ba a cikin shekarun da suka biyo baya. Ya zuwa shekarar 2012, wani kwamitin kwamitin Cibiyar Magunguna ta Amurka ya yi gargaɗin cewa Amurka tana kashe kuɗi mai yawa akan kula da lafiya fiye da yadda take kashewa kan lafiyar jama'a, tana yin watsi da "ayyukan da suka dogara da jama'a waɗanda ke ba da hanyoyi masu inganci da tasiri don inganta lafiyar ƙasa." As of 2018 , kusan kashi 3% na kuɗaɗen da gwamnati ke kashewa wajen kula da lafiya an mayar da su ne ga lafiyar jama'a da rigakafi. An bayyana wannan yanayi a matsayin "aikin gyara mara daidaito" da kuma "rashin isassun kuɗaɗen shiga na yau da kullun". An ga annobar COVID-19 tana jan hankali ga matsalolin da ke cikin tsarin kiwon lafiyar jama'a a Amurka da kuma rashin fahimtar lafiyar jama'a da kuma muhimmiyar rawar da take takawa a matsayin alheri na gama gari .

Taiwan

 

Alamar Inshorar Lafiya ta Taiwan

Taiwan tana da ingantaccen kayan aikin kiwon lafiya na jama'a wanda aka kafa ta hanyar Inshorar Lafiya ta Kasa (NHI) wanda aka gabatar a 1995 kuma yana ba da kusan kusan kusan duniya, ya kai kimanin 99.9% na mazauna. Kudin kiwon lafiya na al'ada yana da matsakaici; hada kudade na jama'a da masu zaman kansu sun kai kashi 6.1-6.5% na GDP a cikin 'yan shekarun nan, ƙasa da matsakaicin OECD na sama da 9%. Ana ba da kuɗin NHI ta hanyar daidaitaccen haɗin kuɗin shiga - an raba kusan daidai tsakanin mutane, ma'aikata, da gwamnati - da ƙarin haraji akan tanadi da cin nasarar caca. Duk da amfani mai yawa, farashin gudanarwa suna da ƙarancin gaske, a kusa da 1-1.6%, yana ba da damar ingantaccen rabon albarkatu da tasirin tsarin.

Tsarin kiwon lafiya na jama'a na Taiwan yana samun goyon baya daga cibiyoyi masu karfi kamar Cibiyoyin Kula da Cututtuka na Taiwan (CDC) da Cibiyar Kula da Cututtukan Cututtuka ta Tsakiya (CECC), waɗanda aka kirkira bayan barkewar SARS ta 2002-2004. A lokacin annobar COVID-19, waɗannan hukumomin nan da nan sun aiwatar da binciken tafiye-tafiye, bin diddigin lamba, rarraba abin rufe fuska, tsarin keɓewa na dijital, da sadarwa ta yau da kullun ta hanyar faɗakarwar rubutu da kafofin sada zumunta. An gane Taiwan a cikin 2020 a matsayin daya daga cikin martani mafi tasiri na annobar a duniya, tare da ƙananan kulle-kulle da ƙarancin kamuwa da cuta da mutuwar musamman bisa ga kimantawa da Wired, Time, Asusun Commonwealth, da sauran masu lura da duniya.

Baya ga annobar cututtuka, abubuwan da suka fi muhimmanci a lafiyar jama'a sun haɗa da kamfen ɗin rigakafin da ke gudana - ya kai sama da kashi 90% na COVID na farko a shekarar 2022 - rigakafin cututtukan cututtuka masu yaduwa, da kuma kula da cututtukatattun cututtuka. Koyaya, Taiwan tana fuskantar ƙalubale masu tsanani kamar ƙaruwar yawan jama'a, tare da tsinkaye da ke nuna kusan kashi 37% na yawan jama'ar za su wuce 65 nan da shekara ta 2050. Bugu da ƙari, tsarin kiwon lafiya yana fama da batutuwa kamar yawan jama'a a asibiti saboda son haƙuri ga manyan cibiyoyin kiwon lafiya, da kuma karuwar matsin lamba na kasafin kuɗi akan dorewar NHI a cikin karuwar amfani da farashi na kiwon lafiya. Wadannan kalubalen suna haifar da canji zuwa karfafa kulawa ta farko, inganta tsarin turawa, da daidaita hanyoyin samun kudin shiga don adana tsarin kiwon lafiyar jama'a na Taiwan.

  

Ƙarin karantawa

• Berridge, Virginia. Lafiyar Jama'a: Takaitaccen Gabatarwa (Oxford UP, 2016)
• [Hasiya] Encyclopedia of Public Health (MacMillan, 2002).
• [Inda Aka Ɗauko Hoto da ke shafi na 9] Tarihin Lafiya ta Jama'a: Daga Da Ya gabata zuwa Yanzu (Jones & Bartlett, 2022)
• Hollingsworth, J. Rogers, Jerald Hage, da Robert Hanneman . Shiga tsakani na jihar a cikin kula da lafiya: sakamakon ga Burtaniya, Faransa, Sweden, da Amurka, 1890-1970 (Cornell University Press, 2019).
• [Hotuna a shafi na 9] Raba bayanan kiwon lafiya da bayanai a fadin iyakoki: darussan daga kudu maso gabashin Asiya. Duniyar Duniya da Lafiya, 14 (1), 94.

Ƙasar Ingila

• [Hasiya] Sir Arthur Newsholme da likitancin Jiha, 1885-1935 (Cambridge University Press, 1997).
• Harris, James Jeffrey. "Jiki Siyasa: Tarihin Lafiya da Siyasa a Burtaniya, 1885-1922" (PhD dissertation, . Jami'ar Jihar Ohio, 2017) kan layi.
• Rosen, George Tarihin Lafiya ta Jama'a (1958). kan layi, daidaitattun tarihin ilimi.
• Schneider, Dona, da David E. Lilienfeld, eds. Lafiya ta Jama'a: Ci gaban horo, Daga Zamanin Hippocrates zuwa Zamanin Ci gaba (2008), Tsawon sassan daga. 24 manyan takardu. kafin 1920, daga Amurka da Ingila. ya fito da
  • Lafiyar jama'a: ci gaban horo. Fashewa. 2 kalubalen karni na ashirin (2011), ya rufe 1920 zuwa 2010.
• Sigsworth, Michael, da Michael Worboys . "Ra'ayin jama'a game da lafiyar jama'a a tsakiyar Victorian Birtaniya. " Tarihin Urban 21.2 (1994): 237-250. kan layi
• Wohl, Anthony S. Rayuwa mai haɗari: lafiyar jama'a a Biritaniya ta Victoria (1983) a kan layi.

Amurka

• Duffy, John. The sanitarians: tarihin lafiyar jama'a ta Amurka (1992) kan layi
• Schneider, Dona, da David E. Lilienfeld, eds. Lafiya ta Jama'a: Ci gaban horo, Daga Zamanin Hippocrates zuwa Zamanin Ci gaba (2008), Tsawon sassan daga. 24 manyan takardu. kafin 1920, daga Amurka da Ingila. ya fito da
  • Lafiyar jama'a: ci gaban horo. Fashewa. 2 kalubalen karni na ashirin (2011), ya rufe 1920 zuwa 2010.