“一带一路”沿线66国全民健康覆盖现状与预测

Current situation and projection of universal health coverage for 66 countries participating in the Belt and Road Initiative

目的对与中国签订"一带一路"倡议的65个国家的全民健康覆盖(UHC)情况进行评价和预测。方法利用全球疾病负担开放数据获得"一带一路"沿线66个国家(含中国)1990-2017年每年分国别的UHC指标值,使用百分数缩放法计算得分(0~100分),结合社会人口学指数(SDI)进行相关性分析。使用年均变化率对联合国提出的UHC指标2030年可持续发展目标(SDG)各国实现情况进行预测。结果2017年"一带一路"沿线66国UHC指标得分中位数为75.3分,其中中国得分为80.8分,排名第22位。排名最高的塞浦路斯为100分,排名最低的是阿富汗,仅为30.6分。UHC指标得分与SDI值呈高度相关性(r=0.89)。预计到2030年,能够实现SDG目标的国家只有塞浦路斯和新加坡,中国则要在2031年。结论"一带一路"沿线国家在UHC上表现不平衡,发展程度越高的国家UHC表现越好,"一带一路"沿线各国应加强多边合作,优势互补,促进沿线各国的全民健康覆盖水平。

Objective To evaluate the performance of universal health coverage (UHC) in 65 countries participating in the Belt and Road Initiative (BRI). Methods Using the open access data of Global Burden of Disease (GBD) study, we first got the UHC index values of the 66 countries (including China) from 1990-2017 and transformed the values into a scale of 0-100 in percentile. We then examined the association of UHC index scores with socio-demographic index (SDI) values. Finally, we used annualised rates of change during 1990-2017 to forecast achievement of the United Nation (UN) UHC target by 2030 for sustainable development goals (SDG) in each country. Results The integral median of UHC index score in 2017 was 75.3 for the 66 countries. China was scored as 80.8, ranking 22th in the countries. The country with the highest UHC index (100) was Cyprus and that with the lowest (40) was Afghanistan. A significant positive correlation (r = 0.89) between UHC index scores and SDI values was observed. It is estimated that only Cyprus and Singapore would meet the SDG target on UHC by 2030, and China would meet the SDG by 2031. Conclusion The performance of UHC is unbalanced by country among countries participating in BRI. In general, the countries with higher development have a better UHC.