Weakness of primary health-care (PHC) systems has represented a challenge to the achievement of the targets of disease control programmes (DCPs) despite the availability of substantial development assistance for health, in resource-poor settings. Since 2005, Ethiopia has embraced a diagonal investment approach to strengthen its PHC systems and concurrently scale up DCPs. This approach has led to a substantial improvement in PHC-system capacity that has contributed to increased coverage of DCPs and improved health status, although gaps in equity and quality in health services remain to be addressed. Since 2013, Ethiopia has had a decline in development assistance for health. Nevertheless, the Ethiopian Government has been able to compensate for this decline by increasing domestic resources. We argue that the diagonal investment approach can effectively strengthen PHC systems, achieve DCP targets, and sustain the gains. These goals can be achieved if a visionary and committed leadership coordinates its development partners and mobilises the local community, to ensure financial support to health services and improve population health. The lessons learnt from Ethiopia's efforts to improve its health services indicate that global-health initiatives should have a proactive and balanced investment approach to concurrently strengthen PHC systems, achieve programme targets, and sustain the gains, in resource-poor settings.

中文翻译：

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加强埃塞俄比亚初级卫生保健系统的对角投资方法的有效性和可持续性。

尽管在资源匮乏的环境中可以获得大量的健康发展援助，但初级卫生保健（PHC）系统的薄弱代表了对实现疾病控制计划（DCP）目标的挑战。自2005年以来，埃塞俄比亚采用了对角投资方式来加强其PHC系统并同时扩大DCP。这种方法已导致PHC系统容量的显着提高，这有助于增加DCP的覆盖范围并改善健康状况，尽管卫生服务公平性和质量方面的差距仍有待解决。自2013年以来，埃塞俄比亚对卫生的发展援助有所下降。尽管如此，埃塞俄比亚政府已经能够通过增加国内资源来弥补这一下降。我们认为对角投资方法可以有效地加强PHC系统，实现DCP目标并维持收益。如果有远见卓识的领导者能够协调其发展伙伴并动员当地社区，以确保对卫生服务的财政支持和改善人口健康，就可以实现这些目标。从埃塞俄比亚改善其卫生服务的努力中吸取的教训表明，在资源匮乏的环境中，全球卫生倡议应采取积极和平衡的投资方法，以同时加强初级保健中心系统，实现计划目标和维持增长。确保对卫生服务的财政支持并改善人口健康。从埃塞俄比亚改善其卫生服务的努力中吸取的教训表明，在资源匮乏的环境中，全球卫生倡议应采取积极和平衡的投资方法，以同时加强初级保健中心系统，实现计划目标和维持增长。确保对卫生服务的财政支持并改善人口健康。从埃塞俄比亚改善其卫生服务的努力中吸取的教训表明，在资源匮乏的环境中，全球卫生倡议应采取积极和平衡的投资方法，以同时加强初级保健中心系统，实现计划目标和维持增长。