世卫组织总干事陈冯富珍博士在第四次利益攸关方会议上的开幕词（中英对照）

英文版：Opening Remarks at the Fourth Stakeholder Meeting.doc

中文版：在第四次利益攸关方会议上的开幕词.doc

Opening Remarks at the Fourth Stakeholder Meeting: Accountability for Women’s and Children’s Health – Now and in the Post-2015 Agenda

在第四次利益攸关方会议上的开幕词：妇幼健康问责制——当前和2015年后议程

 

Dr Margaret Chan, Director-General of the World Health Organization

世界卫生组织总干事陈冯富珍博士

 

Geneva, Switzerland

瑞士 日内瓦

 

14 January 2014

2014年1月14日

 

Colleagues in public health, development partners, representatives of sister agencies and civil society organizations, ladies and gentlemen,

 

各位公共卫生界同仁、各位发展伙伴、姊妹机构和民间社会组织各位代表、女士们、先生们：

 

Welcome to this fourth meeting of stakeholders as we continue our efforts to improve accountability for women’s and children’s health. I thank all of you for coming to Geneva. We have a good mix of perspectives, experiences, and contributions at many levels represented in this room.

 

欢迎在我们继续努力加强妇幼健康问责制之际出席第四次利益攸关方会议。我感谢你们所有人莅临日内瓦。在本会议室，我们汇聚了多种视角、经验和贡献。

 

We are at the midpoint in a time-bound process of improving accountability. This is a good time to take stock of where we stand, the lessons we have learned, and how we can institutionalize these lessons as the international community moves into the post-2015 era.

 

我们正处于有时间限制的加强问责制进程的中点。此时此刻，我们应该总结一下我们的现状、我们的经验教训，以及在国际社会走向2015年后时代时，我们如何将这些经验教训制度化。

 

When I was asked to serve as a vice-chair for the Commission on Information and Accountability for Women’s and Children’s Health, I knew we were embarking on a journey into largely uncharted territory.

 

当我应邀担任妇幼健康信息和问责委员会副主席时，我知道，我们正在踏上征途，进入一个大体上未经探索的领域。

 

Accountability for resources and results has long been deeply desired, but rarely tackled in a rigorous and systematic way. I also knew that establishing an accountability framework specifically for women’s and children’s health would be an especially hard test case, perhaps even the hardest test case imaginable.

 

人们早已很希望建立对资源和结果的问责制，但对这个问题，始终没有进行严格和系统的处理。我还知道，专门针对妇幼健康建立问责框架将是一个极其严峻的考验，甚或是人们能够想象的最为严峻的考验。

 

As we all know, maternal and child mortality cannot be brought down without addressing fundamental weaknesses in health systems that have been neglected for decades. Addressing accountability for women’s and children’s health means addressing long-standing problems with health infrastructures and services, inadequate numbers of appropriately trained and motivated staff, and the absence in most countries of reliable systems for civil registration and vital statistics.

 

大家都知道，如果几十年来始终被忽略的卫生系统的基本薄弱环节得不到处理，就无法降低母婴死亡率。妇幼健康问责制意味着解决长期以来的卫生基础设施和服务问题、经适当培训和有积极性的工作人员数量短缺问题，以及在大多数国家缺乏进行民事登记和生命统计的可靠系统问题。

 

Accountability means counting. Transparency is impossible in the absence of reliable data. It means improving the way donors and recipient countries work together, the way information is collected and used, and the capacity to track resource flows throughout the health sector.

 

问责意味着计算。没有可靠的数据，就没有透明度。它意味着改进捐助者和受惠国的合作方式，改进信息的搜集和使用方式，并提高在整个卫生部门跟踪资源流动的能力。

 

It means ensuring equitable access to services, fair financing for care, and, as the independent Expert Review Group so clearly reminds us, high quality care that is person-centred, not intervention-centred.

 

它意味着确保服务的平等享有、卫生保健的公平筹资，以及如独立专家审查小组非常明确地提醒我们注意的，以人为本而不是以干预为本的高质量的卫生保健。

 

I have visited countries that removed fees for maternal and child health services, saw an immediate surge in the use of these services, but did not see improved health, because the quality of care remained poor.

 

我访问过一些取消了孕产妇和儿童卫生服务费用的国家，目睹对这些服务的使用急剧增加，但却没有看到人们的健康有所改善，因为保健服务的质量仍然很低下。

 

Last year, The Lancet published the largest study to date, coordinated by WHO, on severe complications and “near misses” in pregnancy. The study concluded that having life-saving interventions available in health facilities will not reduce maternal mortality in the absence of overall improvements in the quality of maternal care and emergency services.

 

去年，《柳叶刀》杂志与世卫组织合作，发表了迄今为止篇幅最长的一份研究报告，涉及妊娠中的严重并发症和“临近死亡”问题。研究报告得出结论认为，如果没有孕产妇保健和急诊服务质量的整体改善，卫生设施中挽救生命的干预措施并不能减少孕产妇死亡率。

 

These are just some of the challenges before us. During this meeting, you will be considering recommendations from the first two iERG reports. How much progress has been made in meeting recommendations from the first report? And how should we prioritize recommendations from the second report?

 

这只是我们面临的一些挑战。在本次会议期间，大家将审议头两份独立专家审查小组报告的建议。自第一份报告以来，会议建议取得了哪些进展？我们如何设定第二份报告建议的重点？

 

The Commission on Information and Accountability envisioned accountability as a cyclical process involving monitoring, review, and remedial action. We depend on the iERG to uncover problems and make recommendations for remedial action.

 

信息和问责制委员会设想问责制是一个包含监测、审查和补救行动的周期性进程。我们依赖独立专家审查小组发现问题，并提出补救行动建议。

 

The iERG reports encourage all stakeholders to think in very concrete terms. What are the barriers that have slowed down progress? What tools are missing or underutilized? Which innovations can be seized and applied for immediate gains? The iERG has also given us some very useful guidance as we think about ways to institutionalize the lessons learned and maintain the momentum in the post-2015 era.

 

独立专家审查小组的报告鼓励所有利益攸关方非常具体地去考虑问题。有哪些障碍拖延了进展？有哪些工具缺少或利用不足？可以掌握和适用哪些立竿见影的干预措施？我们在思索如何将有关经验教训制度化，并保持2015年后时代的势头时，独立专家审查小组也可以给我们一些非常有用的指导意见。

 

In my view, rigorous and independent mechanisms for accountability hold great promise as a way of spending resources wisely, honouring commitments, fine-turning programme strategies in line with evidence of results, maintaining the confidence of donors, and winning the support of parliamentarians and ministers of finance.

 

我认为，严密和独立的问责机制是一种大有希望的方式，有助于我们合理地使用资源、履行承诺、根据成果证据调整规划战略、维持捐助者的信任以及赢得国会议员和财政部长的支持。

 

Also in my view, our joint work on accountability is a grand experiment. Can an accountability framework expedite progress? If ways can be found to get and use better information, will this start a chain of events, with better health outcomes as the endpoint? If the answer to these questions turns out to be “yes”, I believe that accountability will become a permanent feature on the development agenda.

 

我还认为，我们关于问责制的联合工作是一次规模宏大的实验。问责制框架能否加快进展？如果能设法搜集和利用更加精准的信息，是否可触发一系列行动，并以改进卫生成果为终点？如果对这些问题的答复是肯定的，我相信，问责制将成为发展议程的恒定特征。

 

The iERG reports have given us a good inventory of challenges and remedial actions. But I think we also have some things to celebrate, some good reasons to continue to build momentum. Stimulated by the Commission’s 10 recommendations, we are seeing some progress, and also some new ways of dealing with some very old and stubborn problems.

 

独立专家审查小组的报告帮我们全面清点了所面临的挑战和补救行动。但我认为，我们还有一些事情让人欢欣，一些很好的理由来继续加强有关势头。受信息和问责制委员会10项建议的激励，我们看到了一些进展，也看到了一些处理根深蒂固的老问题的新方式。

 

Of the 75 targeted countries, 70 have developed country accountability frameworks through a process which brings together government and donors and includes civil society, parliamentarians, and the media. More and more countries are introducing scorecards to track progress.

 

在75个目标国家中，有70个国家通过政府，包括民间社会的捐助者、议员和媒体携手合作的进程，建立了国家问责框架。越来越多的国家采用记分卡来跟踪进展。

 

Some 53 countries have received full or partial catalytic funding to stimulate implementation of the recommendations. We have witnessed an upsurge in health sector interventions to track vital events, notably births, deaths, and causes of death.

 

有大约53个国家得到了全部或部分催化资金，推动落实有关建议。我们目睹了卫生部门用以跟踪重大事件，主要是出生、死亡和死亡原因的干预措施急剧增加。

 

Work on accountability has brought a shift from maternal death reviews to maternal death surveillance and response, an approach which aims to identify all maternal deaths and make each one a notifiable event. This new approach also investigates causes of death, paving the way for targeted interventions to prevent maternal deaths and improve the quality of care. More than 50 countries have adopted the new approach and are taking steps to implement it.

 

问责制方面的工作促使人们从孕产妇死亡审查转向孕产妇死亡监督和应对，这一方针的目的是查明所有孕产妇死亡，使每一例死亡都成为法定报告事件。这一新的方针还将调查死亡原因，为采取有的放矢的干预措施，预防孕产妇死亡，提高卫生保健质量铺平道路。有50多个国家采纳了这一新方针，并采取步骤加以执行。

 

National eHealth strategies have been developed and mHealth solutions are being scaled up in more and more countries. But more needs to be done to tap the full power of innovations in information and communication technology.

 

越来越多的国家制定了国家电子卫生战略，并加强移动卫生解决办法。但仍有很多事情有待去做，以充分利用在信通技术领域干预措施的力量。

 

The Commission’s recommendations have stimulated the use of National Health Accounts as a standard platform for tracking resource flows throughout the health sector. You will be hearing more about this today.

 

该委员会的建议促使利用国家卫生账户作为标准平台，跟踪整个卫生部门的资源流动。今天，大家将获悉这方面的更多情况。