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农村和边远地区卫生人力资源不足是世界各国普遍关注的卫生问题之一,严重影响卫生公平的实现。对此,WHO提出全球政策建议——通过改进挽留政策提高农村和边远地区卫生人力的可及性。本文重点从循证医学方法学和指南制定角度,对该政策指南制定的关键步骤进行解读,主要包括背景及问题的提出、证据的检索与遴选、证据质量分级与推荐方案形成,从而进一步探讨卫生决策过程中如何正确认识、获得、评价与应用当前可得的研究证据,以及如何基于证据,利用GRADE系统做出科学可行的推荐,强调证据及GRADE系统在循证卫生决策中的重要作用。
The shortage of human resources for health in rural and remote areas is one of the health problems of common concern to all countries in the world, seriously affecting the achievement of health fairness. In response, WHO makes global policy recommendations to improve access to health workforce in rural and remote areas by improving retention policies. This article focuses on the interpretation of the key steps in the development of this policy guideline from the point of view of EBM methodology and guideline development, including the background and issues raised, the retrieval and selection of evidences, the grading of evidence quality and the formation of recommended programs to further explore the health How to correctly understand, obtain, evaluate and apply the research evidence available in the decision-making process and how to make scientific and feasible recommendations based on the evidence using GRADE system and emphasize the important role of evidence and GRADE system in evidence-based health decision-making.