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新计划帮助发展中国家病患得到更好医疗

Major donors² are changing the way they fund health programs in low-income countries. The results in maternal³ and child health have been so successful that the World Bank and the Global Fund are working together to add programs on AIDS, tuberculosis⁴ and malaria⁵. The change in financing focuses on motivating health care workers to provide better care and on helping⁶ patients obtain it.

主要赞助方正在对资助低收入国家医疗项目的方式进行改革。这一改变在妇幼保健方面取得了巨大成功，因此世界银行和全球基金正在合作，希望将艾滋病、肺结核和疟疾的项目也加入到其中。改革主要是鼓励医务人员给患者提供更好的照料并且让患者真正得到这些照料。

When pregnant women get good health care and have a trained midwife or doctor at their side when giving birth, mothers and babies are more likely to survive.

当孕妇能够得到良好的医疗，在分娩时又一名经过培训的助产士或医生在旁边的话，母亲和孩子存活的可能性就会大大提高。

And when children get vaccinated⁷ against preventable diseases and get quality care when they're sick, they're more likely to reach their fifth birthday.

当儿童接种疫苗预防各种疾病并且在生病时得到良好照料的时候，他们5岁前的死亡率就会大大下降。

The World Health Organization said that last year, 6.5 million children did not live to see their fifth birthday.

世界卫生组织称，世界上有650万儿童在没有度过5岁生日就离开了这个世界。

Children born in sub-Saharan Africa have the greatest risk of dying in their first five years. Most of the deaths are preventable.

非洲撒哈拉以南地区的儿童5岁前的死亡率最高。但实际上，很多婴幼儿死亡都是可以避免的。

The World Bank and other major donors have launched a plan to help children survive.

世行和其他主要捐助方启动了一项计划，旨在提高婴幼儿存活率。

Tim Evans, who heads the program at the World Bank, said, “We want women to have access to ante-natal [post-birth] care. We want children who are born with a skilled birth attendant, with access to emergency obstetric care. If we want that coverage⁸ for the population, how do we organize the system and invest in it in such a way to achieve those results?”

世界银行该项目负责人蒂姆?埃文斯说：“我们希望妇女能够得到产后检查。我们希望有熟练接生技巧的医护人员去接生，产妇在紧急情况下能够得到救助。如果我们想实现这些的活，我们该如何组建一套体系，让这套体系发挥作用？”

The plan is called "results-based financing." It links incentives¹⁰ with results. For example, in some countries, women are paid to have their babies in a hospital. Midwives get extra money for delivering healthy babies. Doctors might get extra pay if they immunize a certain number of children.

这一计划名为“结果说了算” 资助体系(results-based financing)。比如，在一些国家，妇女在医院生产可以得到奖励，助产士接生了健康的婴儿就可以得到奖金。医生如果给一定数量的患者接种疫苗也可以得到奖金。

The program provides incentives to direct medical care to patients or get the patient to the clinic.

这一项目让病患有动力去得到直接的医疗服务，去诊所看病。

"It’s a function of giving an incentive⁹ to those people on the ground to solve those problems, because the incentive for them is to achieve the results," said Evans.

世界银行的埃文斯说：“是这一奖励机制发挥了作用，让一线医护人员有动力去解决问题，因为这一机制是建立在能够取得具体成效的基础上的。”

Aid can also target programs in middle-income countries. Babies are most vulnerable in the first 28 days of life. The incentive program helped Argentina reduced infant deaths by 74 percent.

这一项目也可在中等收入国家发挥作用。婴儿在出生后的28天内最为脆弱。奖励机制帮助阿根廷将婴儿死亡率减少了74%。

Since 2007, the World Bank has funded results-based programs in 31 countries, enough to see that the program saves lives and stretches donor¹ funds.

自2007年以来，世行给31个国家的类似项目提供了资助。这些项目的成就有目共睹，也让捐助方的善款发挥了更多的作用。

The Bank is now collaborating¹¹ with the Global Fund to Fight AIDS, Tuberculosis and Malaria - to help it adopt results-based financing in fighting these deadly diseases.

世行目前正在与全球基金合作，对抗艾滋病、肺结核和疟疾。双方希望能够建立起一套以成果说了算的资助机制应对这些致命疾病。

Other major funding groups also are studying the plan. Similar programs might help keep girls in school where they can learn job skills and, at the same time, discourage child marriages and prevent teen pregnancy¹². The end result would be healthier mothers and babies.

其它主要资助组织也在研究这一计划。类似的项目可以有助于让女童留在学校读书学习工作技能，同时减少童婚和青少年怀孕。最终的结果将是更健康的妈妈和更健康的宝宝。