The dynamics of disease prevalence and healthcare systems continue to change dramatically in low- and middle-income countries (LMICs). This is a result of multiple factors including the demands of an ageing population in the context of increasing life expectancy and the rise of non-communicable diseases putting an additional burden on an already weak healthcare system. Further healthcare deficiency is attributable to additional factors such as low financial budgets, political conflicts and civil war, as well as continuing burden of communicable diseases, which are known to be the major risk to health in LMICs. Surgical needs largely remain unmet despite a Lancet report published in 2015. Various deficient aspects of healthcare systems need to be addressed immediately to provide any hope of creating a sustainable healthcare environment in the coming decades. These include developing strong primary and secondary care structures as well as strengthening tertiary care hospitals with an adequately trained healthcare workforce. The facilities required to improve patients’ access to healthcare cannot be developed and sustained solely within the local budget allocation and require major input from international organizations such as the World Bank and the World Health Organization as well as a chain of donor networks. To create and retain a local healthcare workforce, improved training and living conditions and greater financial security need to be provided. Finally, healthcare economics need to be addressed with financial models that can provide insurance and security to the underprivileged population to achieve universal health coverage, which remains the goal of several global organizations promoting equity in high-standard healthcare provision.

中文翻译：

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在低收入和中等收入国家建立可持续的医疗环境

在低收入和中等收入国家 (LMIC)，疾病流行和医疗保健系统的动态继续发生巨大变化。这是多种因素的结果，包括人口老龄化在预期寿命延长的背景下的需求以及非传染性疾病的增加给本已薄弱的医疗保健系统带来了额外的负担。进一步的医疗保健不足归因于其他因素，例如低财政预算、政治冲突和内战，以及传染病的持续负担，众所周知，这些是中低收入国家健康的主要风险。尽管 2015 年发表了《柳叶刀》报告，但手术需求在很大程度上仍未得到满足。需要立即解决医疗保健系统的各种不足之处，以便为在未来几十年创造可持续的医疗保健环境提供任何希望。其中包括发展强大的初级和二级保健结构，以及通过训练有素的医疗保健人员加强三级保健医院。改善患者获得医疗保健所需的设施不能仅在当地预算拨款范围内开发和维持，需要世界银行和世界卫生组织等国际组织以及一系列捐助网络的大力投入。为了创造和留住当地的医疗保健队伍，需要提供更好的培训和生活条件以及更大的财务保障。最后，