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Sample records for achieving health sector

  1. Colombian public policies contributing to the achievement of Millennium Development Goals in the health sector, 2006

    Directory of Open Access Journals (Sweden)

    Lina M. Grisales

    2008-02-01

    Full Text Available During the General Assembly of the United Nations, in September 2000,189 countries (including Colombia committed to eight objectives leading to a more human and fairer world. Such objectives are called the Millennium Development Goals (mdg and to achieve them it is crucial to incorporate them in the action agendas of each country. The purpose of this monograph is to recognize current public policies in Colombia and Antioquia leading the achievement of the Millennium Development Goals, specifically those related to the reduction of mortality among children less than 5 years of age, improvement of maternal health and fighting against hiv/aids, malaria and dengue.In Colombia, Conpes 91 of 2005 is the only guideline given by the Government establishing goals and strategies to achieve the Millennium Development Goals in 2015. Nevertheless, other policies, programs and projects before and even after the Millennium Statement (but without explicit purpose contribute to achieving such goals. Revision of those policies is an effort for the research project “Degree of contribution of public policies to the achievement of the Millennium Development Goals related to the health sector, Antioquia, 2006”, which will evaluate the impact these guidelines have had in the achievement of the development goals in that particular sector.

  2. Achieving universal health care coverage: Current debates in Ghana on covering those outside the formal sector

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    Abiiro Gilbert

    2012-10-01

    Full Text Available Abstract Background Globally, extending financial protection and equitable access to health services to those outside the formal sector employment is a major challenge for achieving universal coverage. While some favour contributory schemes, others have embraced tax-funded health service cover for those outside the formal sector. This paper critically examines the issue of how to cover those outside the formal sector through the lens of stakeholder views on the proposed one-time premium payment (OTPP policy in Ghana. Discussion Ghana in 2004 implemented a National Health Insurance Scheme, based on a contributory model where service benefits are restricted to those who contribute (with some groups exempted from contributing, as the policy direction for moving towards universal coverage. In 2008, the OTPP system was proposed as an alternative way of ensuring coverage for those outside formal sector employment. There are divergent stakeholder views with regard to the meaning of the one-time premium and how it will be financed and sustained. Our stakeholder interviews indicate that the underlying issue being debated is whether the current contributory NHIS model for those outside the formal employment sector should be maintained or whether services for this group should be tax funded. However, the advantages and disadvantages of these alternatives are not being explored in an explicit or systematic way and are obscured by the considerable confusion about the likely design of the OTPP policy. We attempt to contribute to the broader debate about how best to fund coverage for those outside the formal sector by unpacking some of these issues and pointing to the empirical evidence needed to shed even further light on appropriate funding mechanisms for universal health systems. Summary The Ghanaian debate on OTPP is related to one of the most important challenges facing low- and middle-income countries seeking to achieve a universal health care system. It

  3. Colombian public policies contributing to the achievement of Millennium Development Goals in the health sector, 2006

    OpenAIRE

    Lina M. Grisales; Libardo A. Giraldo

    2008-01-01

    During the General Assembly of the United Nations, in September 2000,189 countries (including Colombia) committed to eight objectives leading to a more human and fairer world. Such objectives are called the Millennium Development Goals (mdg) and to achieve them it is crucial to incorporate them in the action agendas of each country. The purpose of this monograph is to recognize current public policies in Colombia and Antioquia leading the achievement of the Millennium Development Goals, speci...

  4. Public sector achievement in 36 countries

    NARCIS (Netherlands)

    Benedikt Goderis

    2015-01-01

    This report examines the inputs, outputs and outcomes of the public sector in 36 countries (including the EU-28) over the period 1995-2012. We study two sectors – education and health – in some detail, while taking a more general look at the sectors social safety, housing, social security and

  5. An international comparative public health analysis of sex trafficking of women and girls in eight cities: achieving a more effective health sector response.

    Science.gov (United States)

    Macias Konstantopoulos, Wendy; Ahn, Roy; Alpert, Elaine J; Cafferty, Elizabeth; McGahan, Anita; Williams, Timothy P; Castor, Judith Palmer; Wolferstan, Nadya; Purcell, Genevieve; Burke, Thomas F

    2013-12-01

    Sex trafficking, trafficking for the purpose of forced sexual exploitation, is a widespread form of human trafficking that occurs in all regions of the world, affects mostly women and girls, and has far-reaching health implications. Studies suggest that up to 50 % of sex trafficking victims in the USA seek medical attention while in their trafficking situation, yet it is unclear how the healthcare system responds to the needs of victims of sex trafficking. To understand the intersection of sex trafficking and public health, we performed in-depth qualitative interviews among 277 antitrafficking stakeholders across eight metropolitan areas in five countries to examine the local context of sex trafficking. We sought to gain a new perspective on this form of gender-based violence from those who have a unique vantage point and intimate knowledge of push-and-pull factors, victim health needs, current available resources and practices in the health system, and barriers to care. Through comparative analysis across these contexts, we found that multiple sociocultural and economic factors facilitate sex trafficking, including child sexual abuse, the objectification of women and girls, and lack of income. Although there are numerous physical and psychological health problems associated with sex trafficking, health services for victims are patchy and poorly coordinated, particularly in the realm of mental health. Various factors function as barriers to a greater health response, including low awareness of sex trafficking and attitudinal biases among health workers. A more comprehensive and coordinated health system response to sex trafficking may help alleviate its devastating effects on vulnerable women and girls. There are numerous opportunities for local health systems to engage in antitrafficking efforts while partnering across sectors with relevant stakeholders.

  6. Croatian Energy Sector Reform - Results Achieved

    International Nuclear Information System (INIS)

    Nota, R.

    2001-01-01

    During the past ten years, the energy sector has passed through significant changes including fundamental market, economic, legislative and institutional aspects of sector operation. As the main goal of the Republic of Croatia is the integration into the European Union, the energy sector reform ought to be conducted in keeping with the present market development processes of the EU in such a way as to fulfil all safety criteria. In view of the above mentioned, the Croatian Parliament brought a number of laws during its session in July 2001 (''Official Gazette'' 68/01): 1. Energy Law 2. Energy Activities Regulation Law 3. Electricity Market Law 4. Gas Market Law 5. Oil and Oil Derivatives Market Law, which present the commencement of the energy sector reform (www.mingo.hr).(author)

  7. Indian power sector: achievements and failures

    International Nuclear Information System (INIS)

    Sen Gupta, D.P.

    1998-01-01

    The paper deals with the growth of India's power sector over the last 50 years since independence, touching upon some developments that followed. It also highlights the power crisis that presently faces the nation, projecting into the next decade. The role played by the Indian Institute of Science in the development of India's power sector and is now playing to help mitigate the present and future shortages is briefly described. (author)

  8. Analysis of Health Sector Budget of Nepal.

    Science.gov (United States)

    Dulal, R K; Magar, A; Karki, S D; Khatiwada, D; Hamal, P K

    2014-01-01

    Primarily, health sector connects two segments - medicine and public health, where medicine deals with individual patients and public health with the population health. Budget enables both the disciplines to function effectively. The Interim Constitution of Nepal, 2007 has adapted the inspiration of federalism and declared the provision of basic health care services free of cost as a fundamental right, which needs strengthening under foreseen federalism. An observational retrospective cohort study, aiming at examining the health sector budget allocation and outcome, was done. Authors gathered health budget figures (2001 to 2013) and facts published from authentic sources. Googling was done for further information. The keywords for search used were: fiscal federalism, health care, public health, health budget, health financing, external development partner, bilateral and multilateral partners and healthcare accessibility. The search was limited to English and Nepali-language report, articles and news published. Budget required to meet the population's need is still limited in Nepal. The health sector budget could not achieve even gainful results due to mismatch in policy and policy implementation despite of political commitment. Since Nepal is transforming towards federalism, an increased complexity under federated system is foreseeable, particularly in the face of changed political scenario and its players. It should have clear goals, financing policy and strict implementation plans for budget execution, task performance and achieving results as per planning. Additionally, collection of revenue, risk pooling and purchasing of services should be better integrated between central government and federated states to horn effectiveness and efficiency.

  9. Private sector health reform in South Africa.

    Science.gov (United States)

    Van Den Heever, A M

    1998-06-01

    This paper discusses some of the trends, debates and policy proposals in relation to the financing of the private health sector in South Africa. The public and private sectors in South Africa are of equivalent size in terms of overall expenditure, but cover substantially different population sizes. Within this context the government has reached the unavoidable conclusion that the private sector has to play some role in ensuring that equity, access and efficiency objectives are achieved for the health system as a whole. However, the private sector is some way off from taking on this responsibility. Substantial increases in per capita costs over the past 15 years, coupled with a degree of deregulation by the former government, have resulted in increasing instability and volatility. The development of a very competitive medical scheme (health insurance) market reinforced by intermediaries with commercial interests has accelerated trends toward excluding high health risks from cover. The approach taken by the government has been to define a new environment which leaves the market open for extensive competition, but removes from schemes the ability to compete by discriminating against high health risks. The only alternatives left to the private market, policy makers hope, will be to go out of business, or to survive through productivity improvements.

  10. Private sector in public health care systems

    OpenAIRE

    Matějusová, Lenka

    2008-01-01

    This master thesis is trying to describe the situation of private sector in public health care systems. As a private sector we understand patients, private health insurance companies and private health care providers. The focus is placed on private health care providers, especially in ambulatory treatment. At first there is a definition of health as a main determinant of a health care systems, definition of public and private sectors in health care systems and the difficulties at the market o...

  11. Medical and health care sector

    International Nuclear Information System (INIS)

    Ainul Hayati Daud; Hazmimi Kasim

    2010-01-01

    The medical and health care sector in general supplies products and provides services that can be categorized as diagnostic radiology, therapeutic application and nuclear medicine (both, diagnostic and/ or therapeutic). The institutions offer different categories of services. Some provide only one category of service, for example, diagnostic radiology. Others may provide more than one categories, for example, diagnostic nuclear medicine and therapeutic nuclear medicine services. A total of 90 entities comprising 65 public agencies and 34 private companies were selected in this study for this sector. The majority of the entities, 75.6 %, operate in Peninsular Malaysia. The remainders operate in Sabah and Sarawak. The findings of the study on both public agencies and private companies are presented in subsequent sections of this chapter. (author)

  12. Inequalities in health within the health sector.

    OpenAIRE

    Balarajan, R.

    1989-01-01

    Mortality among men employed in the health sector was examined using data surrounding the 1971 (1970-2) and 1981 (1979-83) censuses to assess the differences between social classes in the health service and to study changes over a decade. Relative to men in England and Wales, mortality in the 1980s was significantly lower among dentists (standardised mortality ratio 66), doctors (69), opticians (72), and physiotherapists (79) and significantly higher among hospital porters (151), male nurses ...

  13. Responsible leader behavior in health sectors.

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    Longest, Beaufort

    2017-02-06

    Purpose The purpose of this paper is to expand attention to responsible leader behavior in the world's health sectors by explaining how this concept applies to health sectors, considering why health sector leaders should behave responsibly, reviewing how they can do so, and asserting potential impact through an applied example. Design/methodology/approach This paper is a viewpoint, reflecting conceptualizations rooted in leadership literature which are then specifically applied to health sectors. A definition of responsible leader behavior is affirmed and applied specifically in health sectors. Conceptualizations and viewpoints about practice of responsible leader behavior in health sectors and potential consequences are then discussed and asserted. Findings Leadership failures and debacles found in health, but more so in other sectors, have led leadership researchers to offer insights, many of them empirical, into the challenges of leadership especially by more clearly delineating responsible leader behavior. Practical implications Much of what has been learned in the research about responsible leader behavior offers pathways for health sector leaders to more fully practice responsible leadership. Social implications This paper asserts and provides a supporting example that greater levels of responsible leader behavior in health sectors hold potentially important societal benefits. Originality/value This paper is the first to apply emerging conceptualizations and early empirical findings about responsible leader behavior specifically to leaders in health sectors.

  14. Gender Issues in Health Sector

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    Prakash Prabhakarrao Doke

    2015-04-01

    Full Text Available Gender wise analysis of data brings out biological, behavioural and social variables which indicate inequality in the health parameters in male and female sex. There is discrimination against women. Right to birth is denied by sex selective elimination, right to survival is denied by the neglect of girl child resulting in declining trend of child sex ratio which has reached an alarming low level of 914 in 2011 in spite of the fact that the female sex is biologically stronger. The mortality and morbidity indicators are unfavourable to the females. Maternal mortality in developing countries including India is unacceptably high. There is a failure of achievement of Millennium Development Goals in relation to maternal mortality and gender equality and empowerment of women. Crime against women is increasing. Violence is domestic or at workplace or occurring in public places. Social factors like male dominance and subordinate status of women make them vulnerable to unfair treatment, discrimination, denial of basic human rights to survival, education, health, inheritance, etc. The preventive measures in the form of education of masses for effective change in behaviour against gender discrimination, provision of facilities for achieving gender equality, and legislative measures for controlling violence against women at domestic and public level need intensification to achieve social justice of gender equality.

  15. Perceived Impact of Health Sector Reform on Motivation of Health ...

    African Journals Online (AJOL)

    Perceived Impact of Health Sector Reform on Motivation of Health Workers and Quality of Health Care in Tanzania: the Perspectives of Healthcare Workers and District Council Health Managers in Four Districts.

  16. Gender Issues in Health Sector

    OpenAIRE

    Prakash Prabhakarrao Doke

    2015-01-01

    Gender wise analysis of data brings out biological, behavioural and social variables which indicate inequality in the health parameters in male and female sex. There is discrimination against women. Right to birth is denied by sex selective elimination, right to survival is denied by the neglect of girl child resulting in declining trend of child sex ratio which has reached an alarming low level of 914 in 2011 in spite of the fact that the female sex is biologically st...

  17. HEALTH SECTOR ACTIONS TO IMPROVE NUTRITION ...

    African Journals Online (AJOL)

    Reducing malnutrition-related maternal and childhood morbidity and mortality in Africa requires a systematic and coordinated strategy. This paper discusses a health sector strategy which includes: i) advocating for action in nutrition at all levels; ii) integration of the essential nutrition actions into six key contact points ...

  18. Monopolistic competition and the health care sector.

    Science.gov (United States)

    Hilsenrath, P

    1991-07-01

    The model of monopolistic competition is appropriate for describing the behavior of the health care sector in the United States. Uncertainty about quality of medical and related services promotes product differentiation especially when consumers do not bear the full costs of care. New technologies can be used to signal quality even when their clinical usefulness is unproven. Recent cost containment measures may reduce employment of ineffective technologies but may also inhibit the adaptation of genuinely useful developments.

  19. Improving quality: bridging the health sector divide.

    Science.gov (United States)

    Pringle, Mike

    2003-12-01

    All too often, quality assurance looks at just one small part of the complex system that is health care. However, evidently each individual patient has one set of experiences and outcomes, often involving a range of health professionals in a number of settings across multiple sectors. In order to solve the problems of this complexity, we need to establish high-quality electronic recording in each of the settings. In the UK, primary care has been leading the way in adopting information technology and can now use databases for individual clinical care, for quality assurance using significant event and conventional auditing, and for research. Before we can understand and quality-assure the whole health care system, we need electronic patient records in all settings and good communication to build a summary electronic health record for each patient. Such an electronic health record will be under the control of the patient concerned, will be shared with the explicit consent of the patient, and will form the vehicle for quality assurance across all sectors of the health service.

  20. Health sector governance: should we be investing more?

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    Fryatt, Robert; Bennett, Sara; Soucat, Agnes

    2017-01-01

    Governance is central to improving health sector performance and achieving Universal Health Coverage (UHC). However, the growing body of research on governance and health has not yet led to a global consensus on the need for more investment in governance interventions to improve health. This paper aims to summarise the latest evidence on the influence of governance on health, examines how we can assess governance interventions and considers what might constitute good investments in health sector governance in resource constrained settings. The paper concludes that agendas for improving governance need to be realistic and build on promising in-country innovation and the growing evidence base of what works in different settings. For UHC to be achieved, governance will require new partnerships and opportunities for dialogue, between state and non-state actors. Countries will require stronger platforms for effective intersectoral actions and more capacity for applied policy research and evaluation. Improved governance will also come from collective action across countries in research, norms and standards, and communicable disease control.

  1. Student Health and Academic Achievement

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    ... are consistently linked to poor grades and test scores and lower educational attainment. 1-3 In turn, ... education by early adulthood. Perspectives on Sexual and Reproductive Health 2008;40(3):152–161. Srabstein J, ...

  2. Stakeholder Engagement: Achieving Sustainability in the Construction Sector

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    Damian Fearon

    2013-02-01

    Full Text Available Achieving sustainability-related targets in construction projects is increasingly becoming a key performance driver. Yet sustainability is a complex concept in projects and there are many diverse stakeholders. Some stakeholders are generally recognized as important, i.e., the client and main contractor, yet there are others not always perceived as such and whose absence from the decision-making processes may result in a failure to address sustainability issues. Hence there is a need for a systematic approach to engage with stakeholders with high salience in relation to sustainability. This paper reports the results of an exploratory study involving interviews with construction project practitioners that are involved in sustainability in some way. Data were collected from the practitioners in terms of the processes for engaging with stakeholders to deliver sustainability. The data suggests six steps to a stakeholder engagement process: (i identification; (ii relating stakeholders to different sustainability-related targets; (iii prioritization; (iv managing; (v measuring performance; and (vi putting targets into action. The results suggest that understanding the different sustainability agendas of stakeholders and measuring their performance using key performance indicators are important stages to be emphasized in any stakeholder engagement process to achieve sustainability-related goals.

  3. [Health, hospitality sector and tobacco industry].

    Science.gov (United States)

    Abella Pons, Francesc; Córdoba Garcia, Rodrigo; Suárez Bonel, Maria Pilar

    2012-11-01

    To present the strategies used by the tobacco industry to meet government regulatory measures of its products. To demonstrate the relationship between tobacco industry and the hospitality sector. Note that the arguments and strategies used routinely by the hospitality industry have been previously provided by the tobacco industry. Location of key documents by meta-search, links to declassified documents, specific websites of the tobacco and hospitality industry, news sources and published articles in health journals. This review reveals the close relationship between tobacco industry and hospitality sector. It highlights the strategies carried out by the tobacco industry, including strategic hoarding of information, public relations, lobbying, consultation program, smoker defence groups, building partnerships, intimidation and patronage. The arguments and strategies used by the hospitality industry to match point by point that used by the tobacco industry. These arguments are refutable from the point of view of public health as it is scientifically proven that totally smoke-free environments are the only way to protect non-smokers from tobacco smoke exposure and its harmful effects on health. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  4. Health sector reform and public sector health worker motivation: a conceptual framework.

    Science.gov (United States)

    Franco, Lynne Miller; Bennett, Sara; Kanfer, Ruth

    2002-04-01

    Motivation in the work context can be defined as an individual's degree of willingness to exert and maintain an effort towards organizational goals. Health sector performance is critically dependent on worker motivation, with service quality, efficiency, and equity, all directly mediated by workers' willingness to apply themselves to their tasks. Resource availability and worker competence are essential but not sufficient to ensure desired worker performance. While financial incentives may be important determinants of worker motivation, they alone cannot and have not resolved all worker motivation problems. Worker motivation is a complex process and crosses many disciplinary boundaries, including economics, psychology, organizational development, human resource management, and sociology. This paper discusses the many layers of influences upon health worker motivation: the internal individual-level determinants, determinants that operate at organizational (work context) level, and determinants stemming from interactions with the broader societal culture. Worker motivation will be affected by health sector reforms which potentially affect organizational culture, reporting structures, human resource management, channels of accountability, types of interactions with clients and communities, etc. The conceptual model described in this paper clarifies ways in which worker motivation is influenced and how health sector reform can positively affect worker motivation. Among others, health sector policy makers can better facilitate goal congruence (between workers and the organizations they work for) and improved worker motivation by considering the following in their design and implementation of health sector reforms: addressing multiple channels for worker motivation, recognizing the importance of communication and leadership for reforms, identifying organizational and cultural values that might facilitate or impede implementation of reforms, and understanding that reforms

  5. Africa's health: could the private sector accelerate the progress towards health MDGs?

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    Sambo Luis G

    2011-11-01

    Full Text Available Abstract Background Out of 1.484 billion disability-adjusted life years lost globally in 2008, 369.1 million (25% were lost in the WHO African Region. Despite the heavy disease burden, the majority of countries in the Region are not on track to achieve Millennium Development Goals (MDG 4 (reducing child mortality, 5 (improving maternal health, and 6 (combating HIV/AIDS, malaria and other diseases. This article provides an overview of the state of public health, summarizes 2010-2015 WHO priorities, and explores the role that private sector could play to accelerate efforts towards health MDGs in the African Region. Discussion Of the 752 total resolutions adopted by the WHO Regional Committee for Africa (RC between years 1951 and 2010, 45 mention the role of the private sector. We argue that despite the rather limited role implied in RC resolutions, the private sector has a pivotal role in supporting the achievement of health MDGs, and articulating efforts with 2010-2015 priorities for WHO in the African Region: provision of normative and policy guidance as well as strengthening partnerships and harmonization; supporting the strengthening of health systems based on the Primary Health Care approach; putting the health of mothers and children first; accelerating actions on HIV/AIDS, malaria and tuberculosis; intensifying the prevention and control of communicable and noncommunicable diseases; and accelerating response to the determinants of health. Conclusion The very high maternal and children mortality, very high burden of communicable and non-communicable diseases, health systems challenges, and inter-sectoral issues related to key determinants of health are too heavy for the public sector to address alone. Therefore, there is clear need for the private sector, given its breadth, scope and size, to play a more significant role in supporting governments, communities and partners to develop and implement national health policies and strategic plans

  6. Africa's health: could the private sector accelerate the progress towards health MDGs?

    Science.gov (United States)

    Sambo, Luis G; Kirigia, Joses M

    2011-11-25

    Out of 1.484 billion disability-adjusted life years lost globally in 2008, 369.1 million (25%) were lost in the WHO African Region. Despite the heavy disease burden, the majority of countries in the Region are not on track to achieve Millennium Development Goals (MDG) 4 (reducing child mortality), 5 (improving maternal health), and 6 (combating HIV/AIDS, malaria and other diseases). This article provides an overview of the state of public health, summarizes 2010-2015 WHO priorities, and explores the role that private sector could play to accelerate efforts towards health MDGs in the African Region. Of the 752 total resolutions adopted by the WHO Regional Committee for Africa (RC) between years 1951 and 2010, 45 mention the role of the private sector. We argue that despite the rather limited role implied in RC resolutions, the private sector has a pivotal role in supporting the achievement of health MDGs, and articulating efforts with 2010-2015 priorities for WHO in the African Region: provision of normative and policy guidance as well as strengthening partnerships and harmonization; supporting the strengthening of health systems based on the Primary Health Care approach; putting the health of mothers and children first; accelerating actions on HIV/AIDS, malaria and tuberculosis; intensifying the prevention and control of communicable and noncommunicable diseases; and accelerating response to the determinants of health. The very high maternal and children mortality, very high burden of communicable and non-communicable diseases, health systems challenges, and inter-sectoral issues related to key determinants of health are too heavy for the public sector to address alone. Therefore, there is clear need for the private sector, given its breadth, scope and size, to play a more significant role in supporting governments, communities and partners to develop and implement national health policies and strategic plans; strengthen health systems capacities; and implement

  7. The Healthcare and Public Health Sector Challenges and Strategies to Conducting Sector Wide Assessments

    OpenAIRE

    Meyer, Harry

    2008-01-01

    Our Healthcare and Public Health (HPH) sector is vast, complex and essential to virtually all other sectors of our nation’s infrastructure. Without a healthy workforce modern society quickly grinds to a halt. The often messy networks of healthcare providers, insurance companies, emergency departments, pharmaceutical manufactures and other equally important actors are bound together in fragile alliances to maintain and restore basic health. Thus the HPH sector becomes an important cog in the w...

  8. School Sector and Student Achievement in the Era of Standards Based Reforms

    Science.gov (United States)

    Carbonaro, William; Covay, Elizabeth

    2010-01-01

    The authors examine whether standards based accountability reforms of the past two decades have closed the achievement gap among public and private high school students. They analyzed data from the Education Longitudinal Study (ELS) to examine sector differences in high school achievement in the era of standards based reforms. The authors found…

  9. EMPOWERMENT OF RURAL MASSES IN HEALTH SECTOR

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    J S Mathur

    1995-09-01

    Full Text Available The health status of 80% population residing in rural areas has not improved to desired goals from the basic health services provided to them. Local people have remained indifferent to them. They should be equal partners in the management of health services operating in their areas, therefore, a process needs to be designed to create conditions to know of economic, social and health problems for the whole community with their active participation and fullest possible relience upon the communities initiative to solve them.A community development programme was launched on 2nd Oct. 1952 in first five year plan and was hailed as a programme "of the people, for the people, by the people" to exterminate the triple enemies - poverty illness and ignorance. The community development programmes were envisaged as a multipurpose programme cordinated for agriculture, social welfare, education and health.      .It is currently recognized that despite of expansion of the primary health care infra structure upto village level, a comprehensive and effective approach to community health has not been yet achieved. Local community is not sufficiently involved in its own health care, consequently the impact in terms of community health remains small. A comprehensive and integrated approach to community health for population control and response to family welfare planning depends more than any other factor but on an assurance of survival of the children and by creating the right environment for small family norms. All this and change in attitude for the desire of a male child and improvement in low status of women is possible by community itself. Low rate of literacy in women, early marriage of girls are seriously impending the

  10. Empowerment of rural masses in health sector

    Directory of Open Access Journals (Sweden)

    J S Mathur

    1995-09-01

    Full Text Available The health status of 80% population residing in rural areas has not improved to desired goals from the basic health services provided to them. Local people have remained indifferent to them. They should be equal partners in the management of health services operating in their areas, therefore, a process needs to be designed to create conditions to know of economic, social and health problems for the whole community with their active participation and fullest possible relience upon the communities initiative to solve them. A community development programme was launched on 2nd Oct. 1952 in first five year plan and was hailed as a programme "of the people, for the people, by the people" to exterminate the triple enemies - poverty illness and ignorance. The community development programmes were envisaged as a multipurpose programme cordinated for agriculture, social welfare, education and health.      . It is currently recognized that despite of expansion of the primary health care infra structure upto village level, a comprehensive and effective approach to community health has not been yet achieved. Local community is not sufficiently involved in its own health care, consequently the impact in terms of community health remains small. A comprehensive and integrated approach to community health for population control and response to family welfare planning depends more than any other factor but on an assurance of survival of the children and by creating the right environment for small family norms. All this and change in attitude for the desire of a male child and improvement in low status of women is possible by community itself. Low rate of literacy in women, early marriage of girls are seriously impending the

  11. 'Where is the public health sector?' Public and private sector healthcare provision in Madhya Pradesh, India.

    Science.gov (United States)

    De Costa, Ayesha; Diwan, Vinod

    2007-12-01

    This paper aims to empirically demonstrate the size and composition of the private health care sector in one of India's largest provinces, Madhya Pradesh. It is based on a field survey of all health care providers in Madhya Pradesh (60.4 million in 52,117 villages and 394 towns). Seventy-five percent of the population is rural and 37% live below poverty line. This survey was done as part of the development of a health management information system. The distribution of health care providers in the province with regard to sector of work (public/private), rural-urban location, qualification, commercial orientation and institutional set-up are described. Of the 24,807 qualified doctors mapped in the survey, 18,757 (75.6%) work in the private sector. Fifteen thousand one hundred forty-two (80%) of these private physicians work in urban areas. The 72.1% (67793) of all qualified paramedical staff work in the private sector, mostly in rural areas. The paper empirically demonstrates the dominant heterogeneous private health sector and the overall the disparity in healthcare provision in rural and urban areas. It argues for a new role for the public health sector, one of constructive oversight over the entire health sector (public and private) balanced with direct provision of services where necessary. It emphasizes the need to build strong public private partnerships to ensure equitable access to healthcare for all.

  12. A participação popular em Ipatinga (MG, Brasil: conquistas e desafios do setor de saúde Popular participation in Ipatinga (MG, Brazil: achievements and challenges of the health sector

    Directory of Open Access Journals (Sweden)

    Elizabeth da Costa Batista

    2011-01-01

    referential the Communicative Action Theory of Habermas and, from this theory, a model of democracy which is understood as the institutionalization of the discursive processes of opinion and will formation. The results obtained indicate that there is an important democratic history in the city, but with indications, however, of retrocessions in the participative practices of the health sector, as the reproduction of traditional practices of government is verified

  13. Working in the health sector: implementation of workplace health promotion

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    Eliana Castro S

    2011-11-01

    Full Text Available Objective: to discuss issues that are relevant to the implementation of workplace health promotion (whp in organization processes of the health sector as a strategic tool to manage health and safety at the workplace. Methods: after a conceptual review of whp in 2009, a qualitative case study on the development of this strategy in third level hospitals of Bogotá was carried out. This descriptive and cross-sectional study was approved by the Ethics Committee of the Faculty of Nursing at the National University of Colombia. Results: although there are occupational health programs that convey the spirit of whp in their content, its level of development is not consistently linked to it. The following criteria were analyzed: strategy and commitment, human resources and organization, social responsibility, planning, and development and results, all of which were not well valued by workers. Final considerations: the traditional approach to occupational health and the poor integration of the WHP principles into organizational processes are reflected in the actions taken and the expectations regarding the subject. Therefore, actions should be taken in terms of public policies to strengthen the institutional capacity to ensure the feasibility of whp in the health sector.

  14. The Korean economic crisis and coping strategies in the health sector: pro-welfarism or neoliberalism?

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    Kim, Chang-Yup

    2005-01-01

    In South Korea, there have been debates on the welfare policies of the Kim Dae-jung government after the economic crisis beginning in late 1997, but it is unquestionable that health and health care policies have followed the trend of neoliberal economic and social polices. Public health measures and overall performance of the public sector have weakened, and the private health sector has further strengthened its dominance. These changes have adversely affected the population's health status and access to health care. However, the anti-neoliberal coalition is preventing the government's drive from achieving a full success.

  15. Roundtable discussion: what is the future role of the private sector in health?

    Science.gov (United States)

    Stallworthy, Guy; Boahene, Kwasi; Ohiri, Kelechi; Pamba, Allan; Knezovich, Jeffrey

    2014-06-24

    The role for the private sector in health remains subject to much debate, especially within the context of achieving universal health coverage.This roundtable discussion offers diverse perspectives from a range of stakeholders--a health funder, a representative from an implementing organization, a national-level policy-maker, and an expert working in a large multi-national company--on what the future may hold for the private sector in health. The first perspective comes from a health funder, who argues that the discussion about the future role of the private sector has been bogged down in language. He argues for a 'both/and' approach rather than an 'either/or' when it comes to talking about health service provision in low- and middle-income countries.The second perspective is offered by an implementer of health insurance in sub-Saharan Africa. The piece examines the comparative roles of public sector actors, private sector actors and funding agencies, suggesting that they must work together to mobilize domestic resources to fund and deliver health services in the longer term.Thirdly, a special advisor working in the federal government of Nigeria considers the situation in that country. He notes that the private sector plays a significant role in funding and delivering health services there, and that the government must engage the private sector or forever be left behind.Finally, a representative from a multi-national pharmaceutical corporation gives an overview of global shifts that are creating opportunities for the private sector in health markets. Overall, the roundtable discussants agree that the private sector will play an important role in future health systems. But we must agree a common language, work together, and identify key issues and gaps that might be more effectively filled by the private sector.

  16. Using climate information in the health sector

    Directory of Open Access Journals (Sweden)

    T. A. Ghebreyesus

    2010-09-01

    Full Text Available Many infectious and chronic diseases are either directly or indirectly sensitive to the climate. Managing this climate sensitivity more effectively requires new working relationships between the health sector and the providers of climate data and information. In Africa, where communities are particularly vulnerable, Ministries of Health and National Meteorological Services need to collaborate to reduce the burden of climate related ill health. The Ministry of Health and the National Meteorological Agency of Ethiopia have made significant progress towards the development of a climate-informed early warning and response system for diseases such as malaria and other climate-sensitive diseases. An important enabling mechanism is a Climate and Health Working Group, which is a multi-sectoral partnership created to spearhead the use of climate information for health interventions. While this is a work in progress, the key ingredients necessary to sustain such a joint venture are described to encourage similar activities in other countries faced with a growing climate-sensitive disease burden, to facilitate networking and to increase the return from the investment.De nombreuses infections et maladies chroniques sont sensibles, directement ou indirectement, au climat. Une gestion plus efficace de cette sensibilité au climat passe par l’instauration d’une coopération entre le secteur de la santé et les fournisseurs de données et d’informations sur le climat. En Afrique, où les communautés sont particulièrement vulnérables, le ministère de la Santé et les Services de météorologie nationale doivent collaborer pour réduire le fardeau des maladies liées au climat.Le ministère de la Santé et l’Agence de météorologie nationale d’Ethiopie ont fait des progrès considérables dans le développement d’un système d’alerte et de réponse précoces basé sur les informations climatiques pour des maladies comme le paludisme et d

  17. Health sector employment: a tracer indicator for universal health coverage in national Social Protection Floors.

    Science.gov (United States)

    Scheil-Adlung, Xenia; Behrendt, Thorsten; Wong, Lorraine

    2015-08-31

    Health sector employment is a prerequisite for availability, accessibility, acceptability and quality (AAAQ) of health services. Thus, in this article health worker shortages are used as a tracer indicator estimating the proportion of the population lacking access to such services: The SAD (ILO Staff Access Deficit Indicator) estimates gaps towards UHC in the context of Social Protection Floors (SPFs). Further, it highlights the impact of investments in health sector employment equity and sustainable development. The SAD is used to estimate the share of the population lacking access to health services due to gaps in the number of skilled health workers. It is based on the difference of the density of the skilled health workforce per population in a given country and a threshold indicating UHC staffing requirements. It identifies deficits, differences and developments in access at global, regional and national levels and between rural and urban areas. In 2014, the global UHC deficit in numbers of health workers is estimated at 10.3 million, with most important gaps in Asia (7.1 million) and Africa (2.8 million). Globally, 97 countries are understaffed with significantly higher gaps in rural than in urban areas. Most affected are low-income countries, where 84 per cent of the population remains excluded from access due to the lack of skilled health workers. A positive correlation of health worker employment and population health outcomes could be identified. Legislation is found to be a prerequisite for closing access as gaps. Health worker shortages hamper the achievement of UHC and aggravate weaknesses of health systems. They have major impacts on socio-economic development, particularly in the world's poorest countries where they act as drivers of health inequities. Closing the gaps by establishing inclusive multi-sectoral policy approaches based on the right to health would significantly increase equity, reduce poverty due to ill health and ultimately contribute

  18. Health care financing in Nigeria: Implications for achieving universal health coverage.

    Science.gov (United States)

    Uzochukwu, B S C; Ughasoro, M D; Etiaba, E; Okwuosa, C; Envuladu, E; Onwujekwe, O E

    2015-01-01

    The way a country finances its health care system is a critical determinant for reaching universal health coverage (UHC). This is so because it determines whether the health services that are available are affordable to those that need them. In Nigeria, the health sector is financed through different sources and mechanisms. The difference in the proportionate contribution from these stated sources determine the extent to which such health sector will go in achieving successful health care financing system. Unfortunately, in Nigeria, achieving the correct blend of these sources remains a challenge. This review draws on relevant literature to provide an overview and the state of health care financing in Nigeria, including policies in place to enhance healthcare financing. We searched PubMed, Medline, The Cochrane Library, Popline, Science Direct and WHO Library Database with search terms that included, but were not restricted to health care financing Nigeria, public health financing, financing health and financing policies. Further publications were identified from references cited in relevant articles and reports. We reviewed only papers published in English. No date restrictions were placed on searches. It notes that health care in Nigeria is financed through different sources including but not limited to tax revenue, out-of-pocket payments (OOPs), donor funding, and health insurance (social and community). In the face of achieving UHC, achieving successful health care financing system continues to be a challenge in Nigeria and concludes that to achieve universal coverage using health financing as the strategy, there is a dire need to review the system of financing health and ensure that resources are used more efficiently while at the same time removing financial barriers to access by shifting focus from OOPs to other hidden resources. There is also need to give presidential assent to the national health bill and its prompt implementation when signed into law.

  19. Sectoral job training as an intervention to improve health equity.

    Science.gov (United States)

    Tsui, Emma K

    2010-04-01

    A growing literature on the social determinants of health strongly suggests the value of examining social policy interventions for their potential links to health equity. I investigate how sectoral job training, an intervention favored by the Obama administration, might be conceptualized as an intervention to improve health equity. Sectoral job training programs ideally train workers, who are typically low income, for upwardly mobile job opportunities within specific industries. I first explore the relationships between resource redistribution and health equity. Next, I discuss how sectoral job training theoretically redistributes resources and the ways in which these resources might translate into improved health. Finally, I make recommendations for strengthening the link between sectoral job training and improved health equity.

  20. Health sector reforms for 21 st century healthcare

    Directory of Open Access Journals (Sweden)

    Darshan Shankar

    2015-01-01

    Full Text Available The form of the public health system in India is a three tiered pyramid-like structure consisting primary, secondary, and tertiary healthcare services. The content of India′s health system is mono-cultural and based on western bio-medicine. Authors discuss need for health sector reforms in the wake of the fact that despite huge investment, the public health system is not delivering. Today, 70% of the population pays out of pocket for even primary healthcare. Innovation is the need of the hour. The Indian government has recognized eight systems of healthcare viz., Allopathy, Ayurveda, Siddha, Swa-rigpa, Unani, Naturopathy, Homeopathy, and Yoga. Allopathy receives 97% of the national health budget, and 3% is divided amongst the remaining seven systems. At present, skewed funding and poor integration denies the public of advantage of synergy and innovations arising out of the richness of India′s Medical Heritage. Health seeking behavior studies reveal that 40-70% of the population exercise pluralistic choices and seek health services for different needs, from different systems. For emergency and surgery, Allopathy is the first choice but for chronic and common ailments and for prevention and wellness help from the other seven systems is sought. Integrative healthcare appears to be the future framework for healthcare in the 21 st century. A long-term strategy involving radical changes in medical education, research, clinical practice, public health and the legal and regulatory framework is needed, to innovate India′s public health system and make it both integrative and participatory. India can be a world leader in the new emerging field of "integrative healthcare" because we have over the last century or so assimilated and achieved a reasonable degree of competence in bio-medical and life sciences and we possess an incredibly rich and varied medical heritage of our own.

  1. Health sector reforms for 21(st) century healthcare.

    Science.gov (United States)

    Shankar, Darshan

    2015-01-01

    The form of the public health system in India is a three tiered pyramid-like structure consisting primary, secondary, and tertiary healthcare services. The content of India's health system is mono-cultural and based on western bio-medicine. Authors discuss need for health sector reforms in the wake of the fact that despite huge investment, the public health system is not delivering. Today, 70% of the population pays out of pocket for even primary healthcare. Innovation is the need of the hour. The Indian government has recognized eight systems of healthcare viz., Allopathy, Ayurveda, Siddha, Swa-rigpa, Unani, Naturopathy, Homeopathy, and Yoga. Allopathy receives 97% of the national health budget, and 3% is divided amongst the remaining seven systems. At present, skewed funding and poor integration denies the public of advantage of synergy and innovations arising out of the richness of India's Medical Heritage. Health seeking behavior studies reveal that 40-70% of the population exercise pluralistic choices and seek health services for different needs, from different systems. For emergency and surgery, Allopathy is the first choice but for chronic and common ailments and for prevention and wellness help from the other seven systems is sought. Integrative healthcare appears to be the future framework for healthcare in the 21(st) century. A long-term strategy involving radical changes in medical education, research, clinical practice, public health and the legal and regulatory framework is needed, to innovate India's public health system and make it both integrative and participatory. India can be a world leader in the new emerging field of "integrative healthcare" because we have over the last century or so assimilated and achieved a reasonable degree of competence in bio-medical and life sciences and we possess an incredibly rich and varied medical heritage of our own.

  2. How does retiree health insurance influence public sector employee saving?

    Science.gov (United States)

    Clark, Robert L; Mitchell, Olivia S

    2014-12-01

    Economic theory predicts that employer-provided retiree health insurance (RHI) benefits have a crowd-out effect on household wealth accumulation, not dissimilar to the effects reported elsewhere for employer pensions, Social Security, and Medicare. Nevertheless, we are unaware of any similar research on the impacts of retiree health insurance per se. Accordingly, the present paper utilizes a unique data file on respondents to the Health and Retirement Study, to explore how employer-provided retiree health insurance may influence net household wealth among public sector employees, where retiree healthcare benefits are still quite prevalent. Key findings include the following: Most full-time public sector employees anticipate having employer-provided health insurance coverage in retirement, unlike most private sector workers.Public sector employees covered by RHI had substantially less wealth than similar private sector employees without RHI. In our data, Federal workers had about $82,000 (18%) less net wealth than private sector employees lacking RHI; state/local workers with RHI accumulated about $69,000 (or 15%) less net wealth than their uninsured private sector counterparts.After controlling on socioeconomic status and differences in pension coverage, net household wealth for Federal employees was $116,000 less than workers without RHI and the result is statistically significant; the state/local difference was not. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Trends in Health Care Spending by the Private Sector

    National Research Council Canada - National Science Library

    1997-01-01

    A recent dramatic slowdown in the rate at which private-sector spending for health insurance increases each year has raised many questions about the meaning of the trend and its implications for the future...

  4. HEALTH SECTOR CORRUPTION AS THE ARCHENEMY OF UNIVERSAL HEALTH CARE IN INDONESIA

    OpenAIRE

    Juwita, Ratna

    2017-01-01

    AbstractThis article argues that health sector corruption is a direct threat towards universal health care in Indonesia. Three Indonesian legal cases of health sector corruption are selected to exemplify the reality of health sector corruption and it’s detrimental effect to the realization of the right to health. This article emphasizes that corruption causes misallocation and embezzlement of the fund that hampers the State party to optimally provide universal health care for the people. This...

  5. Interventions to reduce corruption in the health sector

    OpenAIRE

    Gaitonde, Rakhal; Oxman, Andrew D; Okebukola, Peter O; Rada, Gabriel

    2016-01-01

    Background Corruption is the abuse or complicity in abuse, of public or private position, power or authority to benefit oneself, a group, an organisation or others close to oneself; where the benefits may be financial, material or non-material. It is wide-spread in the health sector and represents a major problem. Objectives Our primary objective was to systematically summarise empirical evidence of the effects of strategies to reduce corruption in the health sector. Our secondary objective w...

  6. Performance of private sector health care: implications for universal health coverage

    OpenAIRE

    Morgan, R; Ensor, T; Waters, H

    2016-01-01

    Although the private sector is an important health-care provider in many low-income and middle-income countries, its role in progress towards universal health coverage varies. Studies of the performance of the private sector have focused on three main dimensions: quality, equity of access, and efficiency. The characteristics of patients, the structures of both the public and private sectors, and the regulation of the sector influence the types of health services delivered, and outcomes. Combi...

  7. Mitigating India's health woes: Can health insurance be a remedy to achieve universal health coverage?

    Directory of Open Access Journals (Sweden)

    B Savitha

    2016-01-01

    Full Text Available A low level of public investments in preventive health facilities and medical care facilities and health professionals has given rise to poor health status for an average Indian. Insufficient government funding for health care, inadequate and ineffective health financing mechanisms, poor delivery of health care, especially in public facilities, and excessive reliance on unregulated high-cost private providers have contributed to the poor accomplishment of Millennium Development Goals, especially in the informal sector. Sustainable Development Goals (SDGs consider health to be one of the important objectives to be achieved by all the nations in the world. This paper reappraises the current status, unmet needs, challenges, and the way forward to implement and achieve universal health coverage (UHC in India by thrusting the focus on three elements (pillars of universal access to health services. Despite seven decades of independence, India does still face the formidable challenge of providing health services to its population at an affordable cost. One of the major obstacles in reaching universal coverage and universal health entitlement of every Indian citizen has been the absence of effective health financing mechanism that promotes affordable access to weaker and vulnerable sections of the society. In this respect, health insurance certainly does have the potential to expedite the process of UHC if various stakeholders work in cohesion under the government stewardship. In rural India, the health infrastructure and workforce are inadequate to serve the unserved and underserved population. Hence, the government should invest in public health facilities while promoting pan-India health insurance to ensure and guarantee easy access and affordability for its citizens. The way forward should not only be centered on financial protection, but also to have renewed emphasis on restructuring the health-care system, ensuring the adequate availability of

  8. The Free Trade Agreement and the Mexican health sector.

    Science.gov (United States)

    Laurell, A C; Ortega, M E

    1992-01-01

    This article presents a discussion of the probable implications for the Mexican health sector of the Free Trade Agreement (FTA) between the United States, Canada, and Mexico. The authors argue that the FTA should be seen as part of neoliberal policies adopted by the Mexican government in 1983 that are based on large-scale privatization and deregulation of labor relations. In this general context the health sector, which traditionally has been dominated by public institutions, is undergoing a deep restructuring. The main trends are the decapitalization of the public sector and a selective process of privatization that tends to constitute the private health sector in a field of capital accumulation. The FTA is likely to force a change in Mexican health legislation, which includes health services in the public social security system and recognizes the right to health, and to accelerate selective privatization. The U.S. insurance industry and hospital corporations are interested in promoting these changes in order to gain access to the Mexican market, estimated at 20 to 25 million persons. This would lead to further deterioration of the public institutions, increasing inequalities in health and strengthening the private sector. The historical trend toward the integration of a National Health Service in Mexico would be interrupted in favor of formation of a dual private-public system.

  9. Drivers of improved health sector performance in Rwanda: a qualitative view from within.

    Science.gov (United States)

    Sayinzoga, Felix; Bijlmakers, Leon

    2016-04-08

    Rwanda has achieved great improvements in several key health indicators, including maternal mortality and other health outcomes. This raises the question: what has made this possible, and what makes Rwanda so unique? We describe the results of a web-based survey among district health managers in Rwanda who gave their personal opinions on the factors that drive performance in the health sector, in particular those that determine maternal health service coverage and outcomes. The questionnaire covered the six health systems building blocks that make up the WHO framework for health systems analysis, and two additional clusters of factors that are not directly covered by the framework: community health and determinants beyond the health sector. Community health workers and health insurance come out as factors that are considered to have contributed most to Rwanda's remarkable achievements in the past decade. The results also indicate the importance of other health system features, such as managerial skills and the culture of continuous monitoring of key indicators. In addition, there are factors beyond the health sector per se, such as the widespread determination of people to increase performance and achieve targets. This determination appears multi-levelled and influenced by both intrinsic and extrinsic motivation. It is the comprehensiveness and combination of interventions that drive performance in Rwanda, rather than a single health systems strengthening intervention or a set of interventions that target a specific disease. There is need for policy makers and scholars to acknowledge the complexity of health systems, and the fact that they are dynamic and influenced by society's fabric, including the overall culture of performance management in the public sector. Rwanda's robust model is difficult to replicate and fast-tracking elsewhere in the world of some of the interventions that form part of its success will require a holistic approach.

  10. Competition in the Dutch Health Care Sector

    NARCIS (Netherlands)

    F.T. Schut (Erik)

    1995-01-01

    textabstractFor more than two decades, Dutch health policy has been marked by a search for a suitable market order in health care. Suitable in the sense of maintaining universal access, containing the growth of health care expenditure and improving the technical and allocative efficiency of

  11. Energy efficiency achievements in China's industrial and transport sectors: How do they rate?

    International Nuclear Information System (INIS)

    Wu, Libo; Huo, Hong

    2014-01-01

    China is experiencing intensified industrialisation and motorisation. In the world's largest emerging economy, energy efficiency is expected to play a critical role in the ever-rising demand for energy. Based on factual overviews and numerical analysis, this article carries out an in-depth investigation into the effectiveness of policies announced or implemented in recent decades targeted at energy conservation in the energy intensive manufacturing and transportation sectors. It highlights nine energy intensive sectors that achieved major improvements in their energy technology efficiency efforts. Under the umbrella of the 11th Five-Year Plan, these sectors' performances reflect the effectiveness of China's energy conservation governance. Numerous actions have been taken in China to reduce the road transport sector's demand for energy and its GHG emissions by implementing fuel economy standards, promoting advanced energy efficient vehicles, and alternative fuels. Coal-based energy saving technologies, especially industrial furnace technologies, are critical for China's near and medium-term energy saving. In the long run, renewable energy development and expanding the railway transport system are the most effective ways to reduce energy use and GHG emissions in China. Fuel economy standards could reduce oil consumption and GHGs by 34–35 per cent. - Highlights: • This article makes an investigation into the effectiveness of energy conservation policies in China. • Efficiency improvement reflects the effective governance of energy conservation in China. • Numerous actions have been taken to reduce the road transport sector's demand for energy. • Coal-based energy saving technologies are critical for China's near and medium-term energy saving. • In the long run, renewable energy and expanding the railway transport system are the most effective ways

  12. [Collaboration between public health nurses and the private sector].

    Science.gov (United States)

    Marutani, Miki; Okada, Yumiko; Hasegawa, Takashi

    2016-01-01

    We clarified collaborations between public health nurses (PHNs) and the private sector, such as nonprofit organizations. Semi-structured interviews were conducted with 11 private sector organizations and 13 PHNs who collaborate with them between December 2012 to October 2013. Interview guides were: overall suicide preventive measurements, details of collaboration between private sector organizations and PHNs, and suicide prevention outcomes/issues. Data from private sector organizations and PHNs were separately analyzed and categories created using qualitative and inductive design. Private sector organizations' and PHNs' categories were compared and separated into core categories by similarities. Six categories were created: 1. establishing a base of mutual understanding; 2. raising public awareness of each aim/characteristic; 3. competently helping high suicidal risk persons detected during each activity; 4. guarding lives and rehabilitating livelihoods after intervention; 5. restoring suicide attempters/bereaved met in each activity; and 6. continuing/expanding activities with reciprocal cohesion/evaluation. PHNs are required to have the following suicide prevention tasks when collaborating with private sector organizations: understanding the private sector civilization, sharing PHN experiences, improving social determinants of health, meeting basic needs, supporting foundation/difficulties each other (Dear editor. Thank you for kind comments. I was going to explain that PHNs and NPOs support each other their foundation of activity and difficulties in their activities. The foundations include knowledge, information, budgets, manpower etc. The difficulties mean like suffering faced with suicide during activities.), and enhancing local governments' flexibilities/ promptness.

  13. Chiropractic practice in the Danish public health care sector

    DEFF Research Database (Denmark)

    Myburgh, Corrie

    2009-01-01

    This commentary offers preliminary considerations around a phenomenological investigation of chiropractic services in a Danish public sector setting. In this narrative description, the main venue for chiropractic public (secondary) sector practice in the Danish context is briefly described...... and defined. Furthermore, a contextually relevant definition of an integral health care service is presented; and the professional importance for chiropractic in providing such services is also discussed. Finally, salient questions requiring empirical investigation in this context are posed; and selected...

  14. Managing risk selection incentives in health sector reforms.

    Science.gov (United States)

    Puig-Junoy, J

    1999-01-01

    The object of the paper is to review theoretical and empirical contributions to the optimal management of risk selection incentives ('cream skimming') in health sector reforms. The trade-off between efficiency and risk selection is fostered in health sector reforms by the introduction of competitive mechanisms such as price competition or prospective payment systems. The effects of two main forms of competition in health sector reforms are observed when health insurance is mandatory: competition in the market for health insurance, and in the market for health services. Market and government failures contribute to the assessment of the different forms of risk selection employed by insurers and providers, as the effects of selection incentives on efficiency and their proposed remedies to reduce the impact of these perverse incentives. Two European (Netherlands and Spain) and two Latin American (Chile and Colombia) case studies of health sector reforms are examined in order to observe selection incentives, their effects on efficiency and costs in the health system, and regulation policies implemented in each country to mitigate incentives to 'cream skim' good risks.

  15. Exploring corruption in the South African health sector.

    Science.gov (United States)

    Rispel, Laetitia C; de Jager, Pieter; Fonn, Sharon

    2016-03-01

    Recent scholarly attention has focused on weak governance and the negative effects of corruption on the provision of health services. Employing agency theory, this article discusses corruption in the South African health sector. We used a combination of research methods and triangulated data from three sources: Auditor-General of South Africa reports for each province covering a 9-year period; 13 semi-structured interviews with health sector key informants and a content analysis of print media reports covering a 3-year period. Findings from the Auditor-General reports showed a worsening trend in audit outcomes with marked variation across the nine provinces. Key-informants indicated that corruption has a negative effect on patient care and the morale of healthcare workers. The majority of the print media reports on corruption concerned the public health sector (63%) and involved provincial health departments (45%). Characteristics and complexity of the public health sector may increase its vulnerability to corruption, but the private-public binary constitutes a false dichotomy as corruption often involves agents from both sectors. Notwithstanding the lack of global validated indicators to measure corruption, our findings suggest that corruption is a problem in the South African healthcare sector. Corruption is influenced by adverse agent selection, lack of mechanisms to detect corruption and a failure to sanction those involved in corrupt activities. We conclude that appropriate legislation is a necessary, but not sufficient intervention to reduce corruption. We propose that mechanisms to reduce corruption must include the political will to run corruption-free health services, effective government to enforce laws, appropriate systems, and citizen involvement and advocacy to hold public officials accountable. Importantly, the institutionalization of a functional bureaucracy and public servants with the right skills, competencies, ethics and value systems and whose

  16. Engagement of Sectors Other than Health in Integrated Health Governance, Policy, and Action.

    Science.gov (United States)

    de Leeuw, Evelyne

    2017-03-20

    Health is created largely outside the health sector. Engagement in health governance, policy, and intervention development and implementation by sectors other than health is therefore important. Recent calls for building and implementing Health in All Policies, and continued arguments for intersectoral action, may strengthen the potential that other sectors have for health. This review clarifies the conceptual foundations for integral health governance, policy, and action, delineates the different sectors and their possible engagement, and provides an overview of a continuum of methods of engagement with other sectors to secure integration. This continuum ranges from institutional (re)design to value-based narratives. Depending on the lens applied, different elements can be identified within the continuum. This review is built on insights from political science, leadership studies, public health, empirical Health in All Policy research, knowledge and evidence nexus approaches, and community perspectives. Successful integration of health governance, policy, and action depends on integration of the elements on the continuum.

  17. Organizing the health sector for response to disasters

    Directory of Open Access Journals (Sweden)

    Kimberley Shoaf

    2014-09-01

    Full Text Available Each year millions of people around the world are affected by natural and manmade disasters. The consequences of natural disasters in terms of health are complex. Disasters directly impact the health of the population resulting in physical trauma, acute disease, and emotional trauma. Furthermore, disasters may increase the morbidity and mortality associated with chronic and infectious diseases due to the impact on the health system. The health sector must be organized for adequate preparedness, mitigation, response and recuperation from a plethora of potential disasters. This paper examines the various potential impacts of disasters on health, the components of the health sector and their roles in emergency medical care and disaster situations, as well as the coordination and organization necessary within the system to best meet the health needs of a population in the aftermath of a disaster.

  18. COMMENTARY: GLOBALIZATION, HEALTH SECTOR REFORM, AND THE HUMAN RIGHT TO HEALTH: IMPLICATIONS FOR FUTURE HEALTH POLICY.

    Science.gov (United States)

    Schuftan, Claudio

    2015-01-01

    The author here distills his long-time personal experience with the deleterious effects of globalization on health and on the health sector reforms embarked on in many of the more than 50 countries where he has worked in the last 25 years. He highlights the role that the "human right to health" framework can and should play in countering globalization's negative effects on health and in shaping future health policy. This is a testimonial article.

  19. Rethinking health sector procurement as developmental linkages in East Africa.

    Science.gov (United States)

    Mackintosh, Maureen; Tibandebage, Paula; Karimi Njeru, Mercy; Kariuki Kungu, Joan; Israel, Caroline; Mujinja, Phares G M

    2018-03-01

    Health care forms a large economic sector in all countries, and procurement of medicines and other essential commodities necessarily creates economic linkages between a country's health sector and local and international industrial development. These procurement processes may be positive or negative in their effects on populations' access to appropriate treatment and on local industrial development, yet procurement in low and middle income countries (LMICs) remains under-studied: generally analysed, when addressed at all, as a public sector technical and organisational challenge rather than a social and economic element of health system governance shaping its links to the wider economy. This article uses fieldwork in Tanzania and Kenya in 2012-15 to analyse procurement of essential medicines and supplies as a governance process for the health system and its industrial links, drawing on aspects of global value chain theory. We describe procurement work processes as experienced by front line staff in public, faith-based and private sectors, linking these experiences to wholesale funding sources and purchasing practices, and examining their implications for medicines access and for local industrial development within these East African countries. We show that in a context of poor access to reliable medicines, extensive reliance on private medicines purchase, and increasing globalisation of procurement systems, domestic linkages between health and industrial sectors have been weakened, especially in Tanzania. We argue in consequence for a more developmental perspective on health sector procurement design, including closer policy attention to strengthening vertical and horizontal relational working within local health-industry value chains, in the interests of both wider access to treatment and improved industrial development in Africa. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Health Sector Coordination in Disasters: Barriers & Facilitators

    Directory of Open Access Journals (Sweden)

    Mohammadkarim Bahadori

    2016-07-01

    Full Text Available Background: Coordination is a critical factor in successful organization and appropriate response to disasters. In this regard, a centralized coordination mechanism is the first step towards an effective, efficient, and sustainable response in order to be ensured of the short- and long-term recovery. Thus, this study aimed to identify and prioritize the barriers and facilitators of coordination in disasters. Materials and Methods: This research was a descriptive and cross-sectional study, conducted in 2016. The participants comprised 22 experts in field of disaster. Data collection tool was a researcher-made questionnaire according to the analytical hierarchy process approach. For data analysis, we used Expert Choice software. Results: Based on the results, “dominance of organizational approach instead of national points of view when addressing the health management during disasters,” took the first priority rank, earning the score of 0.344 among the barriers. Furthermore, among the facilitators, “having a processive and organizational view in health management during disasters,” took the first priority rank, earning the score of 0.374. Conclusion: To increase the effective coordination in health area, we should develop infrastructure and structural measures, which include bolstering authorities’ belief about the health system’s role in the response to disasters, reinforcing the national approach rather than organizational approach in the field of health at disasters, implementing the coordination requirements, attending sufficiently and specifically to public participation, reducing the organizational friction in the health field for sharing resources and information, raising the level of readiness with a focus on people and training programs, and finally creating an evolutionary process in the health field at disasters.

  1. Universal health coverage and the health Sustainable Development Goal: achievements and challenges for Sri Lanka.

    Science.gov (United States)

    de Silva, Amala; Ranasinghe, Thushara; Abeykoon, Palitha

    2016-09-01

    With state-funded health care that is free at the point of delivery, a sound primary health-care policy and widespread health-care services, Sri Lanka seems a good example of universal health coverage. Yet, health transition and disparities in provision and financing threaten this situation. Sri Lanka did well on the Millennium Development Goal health indicators, but the Sustainable Development Goal (SDG) for health has a wider purview, which is to "ensure healthy lives and promote well-being for all at all ages". The gender gap in life expectancy and the gap between life expectancy and healthy life expectancy make achievement of the health SDG more challenging. Although women and children do well overall, the comparative health disadvantage for men in Sri Lanka is a cause for concern. From a financing perspective, high out-of-pocket expenditure and high utilization of the private sector, even by those in the lowest income quintile, are concerns, as is the emerging "third tier", where some individuals accessing state health care that is free at the point of delivery actually bear some of the costs of drugs, investigations and surgery. This cost sharing is resulting in catastrophic health expenditure for individuals, and delays in and non-compliance with treatment. These concerns about provision and financing must be addressed, as health transition will intensify the morbidity burden and loss of well-being, and could derail plans to achieve the health SDG.

  2. Climate cure 2020 measures and instruments to achieve Norwegian climate goals by 2020. Chapter 10 - the transport sector analysis

    Energy Technology Data Exchange (ETDEWEB)

    2010-11-15

    This document is a translation of Chapter 10, Sector analysis of transport, in the Norwegian report Climate Cure 2020, Measures and Instruments for Achieving Norwegian Climate Goals by 2020. The sector analysis has been prepared by an inter agency working group, conducted by the Norwegian Public Road Administration. (Author)

  3. Health sector employment growth calls for improvements in labor productivity.

    Science.gov (United States)

    Hofmarcher, Maria M; Festl, Eva; Bishop-Tarver, Leslie

    2016-08-01

    While rising costs of healthcare have put increased fiscal pressure on public finance, job growth in the health sector has had a stabilizing force on overall employment levels - not least in times of economic crises. In 2014 EU-15 countries employed 21 million people in the health and social care sector. Between 2000 and 2014 the share of employed persons in this sector rose from 9.5% to 12.5% of the total labor force in EU-15 countries. Over time labor input growth has shifted towards residential care activities and social work while labor in human health activities including hospitals and ambulatory care still comprises the major share. About half of the human health labor force works in hospital. Variation of health and social care employment is large even in countries with generally comparable institutional structures. While standard measures of productivity in health and social care are not yet comparable across countries, we argue that labor productivity of a growing health work force needs more attention. The long-term stability of the health system will require care delivery models that better utilize a growing health work force in concert with smart investments in digital infrastructure to support this transition. In light of this, more research is needed to explain variations in health and social care labor endowments, to identify effective policy measures of labor productivity enhancement including enhanced efforts to develop comparable productivity indicators in these areas. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Building health research systems to achieve better health

    Directory of Open Access Journals (Sweden)

    González Block Miguel

    2006-11-01

    Full Text Available Abstract Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for example those in Canada and the UK, show that progress is possible. However, radical steps are required to achieve this. Such steps should be based on evidence not anecdotes. Health Research Policy and Systems (HARPS provides a vehicle for the publication of research, and informed opinion, on a range of topics related to the organisation of health research systems and the enormous benefits that can be achieved. Following the Mexico ministerial summit on health research, WHO has been identifying ways in which it could itself improve the use of research evidence. The results from this activity are soon to be published as a series of articles in HARPS. This editorial provides an account of some of these recent key developments in health research systems but places them in the context of a distinguished tradition of debate about the role of science in society. It also identifies some of the main issues on which 'research on health research' has already been conducted and published, in some cases in HARPS. Finding and retaining adequate financial and human resources to conduct health research is a major problem, especially in low and middle income countries where the need is often greatest. Research ethics and agenda-setting that responds to the demands of the public are issues of growing concern. Innovative and collaborative ways are being found to organise the conduct and utilisation of research so as to inform policy, and improve health and health equity. This is crucial, not least to achieve the health-related Millennium Development Goals. But much more progress is needed. The editorial ends by listing a wide range of topics

  5. How to improve collaboration between the public health sector and other policy sectors to reduce health inequalities? - A study in sixteen municipalities in the Netherlands.

    Science.gov (United States)

    Storm, Ilse; den Hertog, Frank; van Oers, Hans; Schuit, Albertine J

    2016-06-22

    The causes of health inequalities are complex. For the reduction of health inequalities, intersectoral collaboration between the public health sector and both social policy sectors (e.g. youth affairs, education) and physical policy sectors (e.g. housing, spatial planning) is essential, but in local practice difficult to realize. The aim of this study was to examine the collaboration between the sectors in question more closely and to identify opportunities for improvement. A qualitative descriptive analysis of five aspects of collaboration within sixteen Dutch municipalities was performed to examine the collaboration between the public health sector and other policy sectors: 1) involvement of the sectors in the public health policy network, 2) harmonisation of objectives, 3) use of policies by the relevant sectors, 4) formalised collaboration, and 5) previous experience. Empirical data on these collaboration aspects were collected based on document analysis, questionnaires and interviews. The study found that the policy workers of social sectors were more involved in the public health network and more frequently supported the objectives in the field of health inequality reduction. Both social policy sectors and physical policy sectors used policies and activities to reduce health inequalities. More is done to influence the determinants of health inequality through policies aimed at lifestyle and social setting than through policies aimed at socioeconomic factors and the physical environment. Where the physical policy sectors are involved in the public health network, the collaboration follows a very similar pattern as with the social policy sectors. All sectors recognise the importance of good relationships, positive experiences, a common interest in working together and coordinated mechanisms. This study shows that there is scope for improving collaboration in the field of health inequality reduction between the public health sector and both social policy sectors

  6. [Central purchasing bodies and spending review in health sector].

    Science.gov (United States)

    Spampinato, Luigi

    2017-01-01

    The aim of this paper is to analyze the new model of centralization of purchases in Italy after the approval of the 2016 Stability Law, with particular reference to the health sector. In fact, the spending review process in Italy in the health sector has had a strong evolution with the 2016 Stability Law, which has introduced the obligation for the institutions of the National Health Service to obtain supplies, exclusively, from aggregators subjects, for certain product categories of the health sector. The legislature, over the years, was mainly characterized by measures to reduce the spending limits for purchases of goods and services or by resetting the fees, including the provision of an obligation for the renegotiation of health goods and services contracts, in order to ensure the effective implementation of the expenditure rationalization by aggregation of goods and services. From 2016, the legislature has provided an innovative model of centralization of purchases based on a new network governance model on several levels, national and regional, which should ensure an efficiency of procurement processes. The proper functioning of the governance model adopted can be an important driver of economic policy in order to understand that it is important not only to spend less, but to spend better. This can be realized in the public administration with a strong innovation process in this administration and also with a strong investment in skills, in order to ensure the same service quality throughout the national territory to the health sector.

  7. Health care financing in Nigeria: Implications for achieving universal ...

    African Journals Online (AJOL)

    The way a country finances its health care system is a critical determinant for reaching universal health coverage (UHC). This is so because it determines whether the health services that are available are affordable to those that need them. In Nigeria, the health sector is financed through different sources and mechanisms.

  8. Performance of private sector health care: implications for universal health coverage.

    Science.gov (United States)

    Morgan, Rosemary; Ensor, Tim; Waters, Hugh

    2016-08-06

    Although the private sector is an important health-care provider in many low-income and middle-income countries, its role in progress towards universal health coverage varies. Studies of the performance of the private sector have focused on three main dimensions: quality, equity of access, and efficiency. The characteristics of patients, the structures of both the public and private sectors, and the regulation of the sector influence the types of health services delivered, and outcomes. Combined with characteristics of private providers-including their size, objectives, and technical competence-the interaction of these factors affects how the sector performs in different contexts. Changing the performance of the private sector will require interventions that target the sector as a whole, rather than individual providers alone. In particular, the performance of the private sector seems to be intrinsically linked to the structure and performance of the public sector, which suggests that deriving population benefit from the private health-care sector requires a regulatory response focused on the health-care sector as a whole. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Ideologies in the Swedish health sector today

    DEFF Research Database (Denmark)

    Diderichsen, Finn

    1982-01-01

    Sweden has a long tradition of social democracy and corporate cooperation. Social problems are treated as technological questions that always should be solved through rational and neutral means. Today Sweden faces a crisis of economy as well as a crisis of medicine. In the spirit of consensus, th...... system of primary care and prevention. However, in the context of the current economic crisis, the struggle against health hazards and cuts in public spending has intensified and the gap between the ideology of technological rationalism and reality has widened....

  10. Private Sector An Important But Not Dominant Provider Of Key Health Services In Low- And Middle-Income Countries.

    Science.gov (United States)

    Grépin, Karen A

    2016-07-01

    There is debate about the role of the private sector in providing services in the health systems of low- and middle-income countries and about how the private sector could help achieve the goal of universal health coverage. Yet the role that the private sector plays in the delivery of health services is poorly understood. Using data for the period 1990-2013 from 205 Demographic and Health Surveys in seventy low- and middle-income countries, I analyzed the use of the private sector for the treatment of diarrhea and of fever or cough in children, for antenatal care, for institutional deliveries, and as a source of modern contraception for women. I found that private providers were the dominant source of treatment for childhood illnesses but not for the other services. I also found no evidence of increased use of the private sector over time. There is tremendous variation in use of the private sector across countries and health services. Urban and wealthier women disproportionately use the private sector, compared to rural and poorer women. The private sector plays an important role in providing coverage, but strategies to further engage the sector, if they are to be effective, will need to take into consideration the variation in its use. Project HOPE—The People-to-People Health Foundation, Inc.

  11. Achieving reductions in greenhouse gases in the US road transportation sector

    International Nuclear Information System (INIS)

    Kay, Andrew I.; Noland, Robert B.; Rodier, Caroline J.

    2014-01-01

    It is well established that GHG emissions must be reduced 50 to 80% by 2050 in order to limit global temperature increase to 2 °C. Achieving reductions of this magnitude in the transportation sector is a challenge and requires a multitude of policies and technology options. The research presented here analyzes three scenarios: changes in the perceived price of travel, land use intensification, and increases in transit. Elasticity estimates are derived using an activity-based travel model for the state of California and broadly representative of the US. The VISION model is used to forecast changes in technology and fuel options that are currently forecast to occur in the US for the period 2000–2040, providing a life-cycle GHG forecast for the road transportation sector. Results suggest that aggressive policy action is required, especially pricing policies, but also more on the technology side, especially increases in the carbon efficiency of medium and heavy-duty vehicles. - Highlights: • Travel elasticities are calculated for policy scenarios using an activity-based travel model. • These elasticities are used to estimate changes in total life-cycle greenhouse gas emissions. • Current technology and fuel policy and the strongest behavioral policy will not meet targets. • Heavy and medium-duty trucks need more aggressive technology and fuel options

  12. Intellectual Capital and Predefined Headings in Swedish Health Care Sector

    Directory of Open Access Journals (Sweden)

    Terner Annika

    2017-01-01

    Full Text Available The heavily decentralized Swedish health care sector is facing massive challenges, e.g. to even out differences in health care performance. Intellectual Capital can partly be used to explain these differences. In the research field it is difficult to find contributions regarding the study of intellectual capital management in the health care sector and there is also a lack of studies on semantic interoperability. It is semantic interoperability which allows the right information to be available to the right people at the right time across products and organizations. Structured and standardized headings can be a tool to enable semantic interoperability. The aim of this article is to argue for predefined headings as intellectual capital and as base for a national shared and standardized terminology in the health care sector. The study shows that there is a lack of national management of predefined headings deployed in both electronic health records and national quality registries. This lack causes multiple documentation which is time-consuming, impacts health professionals’ workloads, data quality and partly the performance of health care. We argue that predefined headings can be a base for semantic interoperability and that there is a need for the management of predefined headings on a national level.

  13. Population health improvement: a community health business model that engages partners in all sectors.

    Science.gov (United States)

    Kindig, David A; Isham, George

    2014-01-01

    Because population health improvement requires action on multiple determinants--including medical care, health behaviors, and the social and physical environments--no single entity can be held accountable for achieving improved outcomes. Medical organizations, government, schools, businesses, and community organizations all need to make substantial changes in how they approach health and how they allocate resources. To this end, we suggest the development of multisectoral community health business partnership models. Such collaborative efforts are needed by sectors and actors not accustomed to working together. Healthcare executives can play important leadership roles in fostering or supporting such partnerships in local and national arenas where they have influence. In this article, we develop the following components of this argument: defining a community health business model; defining population health and the Triple Aim concept; reaching beyond core mission to help create the model; discussing the shift for care delivery beyond healthcare organizations to other community sectors; examining who should lead in developing the community business model; discussing where the resources for a community business model might come from; identifying that better evidence is needed to inform where to make cost-effective investments; and proposing some next steps. The approach we have outlined is a departure from much current policy and management practice. But new models are needed as a road map to drive action--not just thinking--to address the enormous challenge of improving population health. While we applaud continuing calls to improve health and reduce disparities, progress will require more robust incentives, strategies, and action than have been in practice to date. Our hope is that ideas presented here will help to catalyze a collective, multisectoral response to this critical social and economic challenge.

  14. The Netherlands: Industrial relations in the health care sector

    NARCIS (Netherlands)

    Schaapman, M.

    2011-01-01

    The most important development in the health care sector in the Netherlands over the past five years had been the introduction and development of market regulation. Unions are critical of this development and point at contraproductive effects of specialisation and large scale companies. Employers

  15. An empirical investigation into health sector absenteeism.

    Science.gov (United States)

    Walker, Vivienne; Bamford, David

    2011-08-01

    The purpose of this research was to consider why absenteeism in Health and Social Care is so high and to suggest proactive changes in organization activity to address this. The research took a multimethod approach with a quantitative emphasis; there were three parts: (i) quantitative survey questionnaire; (ii) analysis of absenteeism and related secondary data; and (iii) qualitative data from other questions in survey and discussion groups. The quantitative emphasis in the research is appropriate, given the gap identified in the literature. Perceived limitations are that the study considers just one part of the overall system. The research indicates that managers underestimate staff absence levels and almost half believe absenteeism cannot reduce. Professional managers were more negative and over half of nurse managers believed that absence could not reduce. Unless there is a systematic systemic change in organizations, which changes managers' attitudes and understanding of absence with a consequent change in activity across the absence continuum, there is no prospect of a sustained reduction in absence levels. Manager impact and role in absence management are poorly covered in research, so this research helps inform those gaps.

  16. Adaptation to climate change in the Ontario public health sector

    Directory of Open Access Journals (Sweden)

    Paterson Jaclyn A

    2012-06-01

    Full Text Available Abstract Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%, severe weather (68% and poor air-quality (57%. Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into

  17. Adaptation to climate change in the Ontario public health sector

    Science.gov (United States)

    2012-01-01

    Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%), severe weather (68%) and poor air-quality (57%). Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into policies and programs

  18. Promoting a Culture of Health Through Cross-Sector Collaborations.

    Science.gov (United States)

    Martsolf, Grant R; Sloan, Jennifer; Villarruel, Antonia; Mason, Diana; Sullivan, Cheryl

    2018-04-01

    In this study, we explore the experiences of innovative nurses who have developed cross-sector collaborations toward promoting a culture of health, with the aim of identifying lessons that can inform similar efforts of other health care professionals. We used a mixed-methods approach based on data from both an online survey and telephone interviews. A majority of the participants had significant collaborations with health care providers and non-health care providers. Strong partners included mental health providers, specialists, and primary care providers on the health side, and for non-health partners, the strongest collaborations were with community leaders, research institutions, and local businesses. Themes that emerged for successful collaborations included having to be embedded in both the community and in institutions of power, ensuring that a shared vision and language with all partners are established, and leading with strength and tenacity. A focus on building a culture of health will grow as payment policy moves away from fee-for-service toward models that focus on incentivizing population health. Effective efforts to promote a culture of health require cross-sector collaborations that draw on long-term, trusting relationships among leaders. Health care practitioners can be important leaders and "bridgers" in collaborations, but they must possess or develop the knowledge, attitudes, and skills of "bilingual" facilitators, partners, and "relationship builders."

  19. New indicators of innovation in the health sector

    OpenAIRE

    Sivertsen, Gunnar; Kværner, Kari J.

    2016-01-01

    This paper reports on a new model for the measurement and stimulation of service innovation and commercialization in the health sector which has been developed for the Norwegian Ministry of Health and will be piloted in 2016. Data for the indicators are recorded from a new shared national innovation management and information system in which the primary function (independent of measurement) is to aid the phase-to-phase efficiency and valuation work in daily innovation processes, and to create...

  20. Stakeholder learning for health sector reform in Lao PDR.

    Science.gov (United States)

    Phillips, Simone; Pholsena, Soulivanh; Gao, Jun; Oliveira Cruz, Valeria

    2016-09-01

    Development organizations and academic institutions have expressed the need for increased research to guide the development and implementation of policies to strengthen health systems in low- and middle-income countries. The extent to which evidence-based policies alone can produce changes in health systems remains a point of debate; other factors, such as a country's political climate and the level of actor engagement, have been identified as influential variables in effective policy development and implementation. In response to this debate, this article contends that the success of health sector reform depends largely on policy learning-the degree to which research recommendations saturate a given political environment in order to successfully inform the ideas, opinions and perceived interests of relevant actors. Using a stakeholder analysis approach to analyze the case of health sector reform in Lao PDR, we examine the ways that actors' understanding and interests affect the success of reform-and how attitudes towards reform can be shaped by exposure to policy research and international health policy priorities. The stakeholder analysis was conducted by the WHO during the early stages of health sector reform in Lao PDR, with the purpose of providing the Ministry of Health with concrete recommendations for increasing actor involvement and strengthening stakeholder support. We found that dissemination of research findings to a broad array of actors and the inclusion of diverse stakeholder groups in policy design and implementation increases the probability of a sustainable and successful health sector reform. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Corporate Social Responsibility In The Health Sector For Papua Indonesia

    Directory of Open Access Journals (Sweden)

    Otniel Safkaur

    2015-08-01

    Full Text Available This research aims to investigate Corporate Social Responsibility CSR issues in the case of health sector in Papua province Indonesia. With particular focus on the importance of CSR the main objective of research is to construct a conceptual model of CSR comprehensively describing essential aspects of CSR relevant to the context of health sector for Papua. The CSR issues addressed in this research will integrate economic and social concerns which place ethical and discretionary expectation into a rational economic and legal framework. The model presented will articulate key aspects in the conceptual framework of CSR developed by Carrolls pyramid of CSR taking into consideration the social issues involved in the health sector. The research found that the medical workers except nurse health care coverage and facilities in Papua show unfavorable conditions. In addition to this condition the finance issue has then influenced organizationseffort to meet the health needs of people. Despite all maximum services customer satisfaction and profitability are not being met. The organizations have shown ethical conduct and obeyed all law and regulation in delivering the health service however the ability to meet all different varieties of expectations of the society is difficult to meet.

  2. Bargaining and idle public sector capacity in health care

    OpenAIRE

    Barros, Pedro Pita

    2005-01-01

    A feature present in countries with a National Health Service is the co−existence of a públic and a private sector. Often, the public payer contracts with private providers while holding idle capacity. This is often seen as inefficiency from the management of public facilities. We present here a different rationale for the existence of such idle capacity: the public sector may opt to have idle capacity as a way to gain bargaining power vis−à−vis the private provider, under the assumption of a...

  3. Bargaining and idle public sector capacity in health care

    OpenAIRE

    Xavier Martinez-Giralt; Barros Pedro Pita

    2005-01-01

    A feature present in countries with a National Health Service is the co-existence of a public and a private sector. Often, the public payer contracts with private providers while holding idle capacity. This is often seen as inefficiency from the management of public facilities. We present here a different rationale for the existence of such idle capacity: the public sector may opt to have idle capacity as a way to gain bargaining power vis-Ã -vis the private provider, under the assumption of ...

  4. Promoting Occupational Safety and Health for Cambodian Entertainment Sector Workers.

    Science.gov (United States)

    Hsu, Lee-Nah; Howard, Richard; Torriente, Anna Maria; Por, Chuong

    2016-08-01

    Cambodia has developed booming textile, garment, tourism, and entertainment service industries since the mid-1990s. The 2007 global financial crisis pushed many garment workers, who lost their jobs, into the entertainment sector. Entertainment workers are typically engaged informally by their employers and are subjected to long working hours, sexual harassment, and violence. Many who sell beverages are forced into excessive alcohol consumption as part of their work. Many are also expected by their employers and clients to provide sexual services. To address unsafe and unhealthy working conditions for these workers, an innovative occupational safety and health regulation was adopted in 2014. This first-of-its-kind occupational safety and health regulation was developed jointly by the Cambodian Ministry of Labour and Vocational Training and employers' and workers' organizations in the entertainment sector. The implementation of this regulation can also be a viable contribution of occupational safety and health to HIV interventions for these workers. © The Author(s) 2016.

  5. Third sector primary health care in New Zealand.

    Science.gov (United States)

    Crampton, P; Dowell, A C; Bowers, S

    2000-03-24

    To describe key organisational characteristics of selected third sector (non-profit and non-government) primary health care organisations. Data were collected, in 1997 and 1998, from 15 third sector primary care organisations that were members of a network of third sector primary care providers, Health Care Aotearoa (HCA). Data were collected by face-to-face interviews of managers and key informants using a semi-structured interview schedule, and from practice computer information systems. Overall the populations served were young: only 4% of patients were aged 65 years or older, and the ethnicity profile was highly atypical, with 21.8% European, 36% Maori, 22.7% Pacific Island, 12% other, and 7.5% not stated. Community services card holding rates were higher than recorded in other studies, and registered patients tended to live in highly deprived areas. HCA organisations had high patient to doctor ratios, in general over 2000:1, and there were significant differences in management structures between HCA practices and more traditional general practice. Third sector organisations provide services for populations that are disadvantaged in many respects. It is likely that New Zealand will continue to develop a diverse range of primary care organisational arrangements. Effort is now required to measure quality and effectiveness of services provided by different primary care organisations serving comparable populations.

  6. Trends in Health Care Spending by the Private Sector

    Science.gov (United States)

    1997-04-01

    private - sector spending for health insurance increases each year has raised many questions about the meaning of the trend and its implications for the future. According to the federal government’s national health accounts (NHA), the annual growth rate of private health insurance expenditures tumbled from around 14 percent in 1990 to less than 3 percent in 1994 and 1995. Understanding the factors that contribute to that reduction is of particular concern to policymakers who are seeking ways to slow the growth of Medicare spending. At the same time that fundamental

  7. A Rising Female Empire? : Exploring the potential barriers women face in achieving leadership positions in the humanitarian sector

    OpenAIRE

    Eriksson, Lina Elisabeth

    2015-01-01

    This research aims to explore how women and men view and perceive potential barriers to women achieving leadership positions in the humanitarian sector. Female leadership is so far an under-researched area within the humanitarian sector, so it is unknown whether females encounter any barriers in accessing and attaining leadership positions. Three categories were identified; identity, perception and challenges through which the views and barriers are explored. Semi-structured interviews were c...

  8. Dual practice in the health sector: review of the evidence

    Directory of Open Access Journals (Sweden)

    Hipólito Fátima

    2004-10-01

    Full Text Available Abstract This paper reports on income generation practices among civil servants in the health sector, with a particular emphasis on dual practice. It first approaches the subject of public–private overlap. Thereafter it focuses on coping strategies in general and then on dual practice in particular. To compensate for unrealistically low salaries, health workers rely on individual coping strategies. Many clinicians combine salaried, public-sector clinical work with a fee-for-service private clientele. This dual practice is often a means by which health workers try to meet their survival needs, reflecting the inability of health ministries to ensure adequate salaries and working conditions. Dual practice may be considered present in most countries, if not all. Nevertheless, there is surprisingly little hard evidence about the extent to which health workers resort to dual practice, about the balance of economic and other motives for doing so, or about the consequences for the proper use of the scarce public resources dedicated to health. In this paper dual practice is approached from six different perspectives: (1 conceptual, regarding what is meant by dual practice; (2 descriptive, trying to develop a typology of dual practices; (3 quantitative, trying to determine its prevalence; (4 impact on personal income, the health care system and health status; (5 qualitative, looking at the reasons why practitioners so frequently remain in public practice while also working in the private sector and at contextual, personal life, institutional and professional factors that make it easier or more difficult to have dual practices; and (6 possible interventions to deal with dual practice.

  9. Improving the public health sector in South Africa: eliciting public preferences using a discrete choice experiment.

    Science.gov (United States)

    Honda, Ayako; Ryan, Mandy; van Niekerk, Robert; McIntyre, Diane

    2015-06-01

    The introduction of national health insurance (NHI), aimed at achieving universal coverage, is the most important issue currently on the South African health policy agenda. Improvement in public sector health-care provision is crucial for the successful implementation of NHI as, regardless of whether health-care services become more affordable and available, if the quality of the services provided is not acceptable, people will not use the services. Although there has been criticism of the quality of public sector health services, limited research is available to identify what communities regard as the greatest problems with the services. A discrete choice experiment (DCE) was undertaken to elicit public preferences on key dimensions of quality of care when selecting public health facilities in South Africa. Qualitative methods were applied to establish attributes and levels for the DCE. To elicit preferences, interviews with community members were held in two South African provinces: 491 in Western Cape and 499 in Eastern Cape. The availability of necessary medicine at health facilities has the greatest impact on the probability of attending public health facilities. Other clinical quality attributes (i.e. provision of expert advice and provision of a thorough examination) are more valued than non-clinical quality of care attributes (i.e. staff attitude, treatment by doctors or nurses, and waiting time). Treatment by a doctor was less valued than all other attributes. Communities are prepared to tolerate public sector health service characteristics such as a long waiting time, poor staff attitudes and lack of direct access to doctors if they receive the medicine they need, a thorough examination and a clear explanation of the diagnosis and prescribed treatment from health professionals. These findings prioritize issues that the South African government must address in order to meet their commitment to improve public sector health-care service provision. Published

  10. Technical quality of delivery care in private- and public-sector health facilities in Enugu and Lagos States, Nigeria.

    Science.gov (United States)

    Hirose, Atsumi; Yisa, Ibrahim O; Aminu, Amina; Afolabi, Nathanael; Olasunmbo, Makinde; Oluka, George; Muhammad, Khalilu; Hussein, Julia

    2018-06-01

    Private-sector providers are increasingly being recognized as important contributors to the delivery of healthcare. Countries with high disease burdens and limited public-sector resources are considering using the private sector to achieve universal health coverage. However, evidence for the technical quality of private-sector care is lacking. This study assesses the technical quality of maternal healthcare during delivery in public- and private-sector facilities in resource-limited settings, from a systems and programmatic perspective. A summary index (the skilled attendance index, SAI), was used. Two-staged cluster sampling with stratification was used to select representative samples of case records in public- and private-sector facilities in Enugu and Lagos States, Nigeria. Information to assess criteria was extracted, and the SAI calculated. Linear regression models examined the relationship between SAI and the private and public sectors, controlling for confounders. The median SAI was 54.8% in Enugu and 85.7% in Lagos. The private for-profit sector's SAI was lower than and the private not-for-profit sector's SAI was higher than the public sector in Enugu [coefficient = -3.6 (P = 0.018) and 12.6 (P private for-profit sector's SAI was higher and the private not-for-profit sector's SAI was lower than the public sector [3.71 (P = 0.005) and -3.92 (P private for-profit providers' care was poorer than public providers where the public provision of care was weak, while private for-profit facilities provided better technical quality care than public facilities where the public sector was strong and there was a relatively strong regulatory body. Our findings raise important considerations relating to the quality of maternity care, the public-private mix and needs for regulation in global efforts to achieve universal healthcare.

  11. Health sector reform in Brazil: a case study of inequity.

    Science.gov (United States)

    Almeida, C; Travassos, C; Porto, S; Labra, M E

    2000-01-01

    Health sector reform in Brazil built the Unified Health System according to a dense body of administrative instruments for organizing decentralized service networks and institutionalizing a complex decision-making arena. This article focuses on the equity in health care services. Equity is defined as a principle governing distributive functions designed to reduce or offset socially unjust inequalities, and it is applied to evaluate the distribution of financial resources and the use of health services. Even though in the Constitution the term "equity" refers to equal opportunity of access for equal needs, the implemented policies have not guaranteed these rights. Underfunding, fiscal stress, and lack of priorities for the sector have contributed to a progressive deterioration of health care services, with continuing regressive tax collection and unequal distribution of financial resources among regions. The data suggest that despite regulatory measures to increase efficiency and reduce inequalities, delivery of health care services remains extremely unequal across the country. People in lower income groups experience more difficulties in getting access to health services. Utilization rates vary greatly by type of service among income groups, positions in the labor market, and levels of education.

  12. Co-operative bidding of SMEs in health care sector.

    Science.gov (United States)

    Mezgár, István; Kovács, György; Bonfatti, Fabio

    2002-01-01

    Tendering become an important process for customers in the health care sector to select products and services from the market for the lowest price, with the highest quality and with the shortest delivery time. The number of SMEs (Small and Medium-sized Enterprises) delivering products or services for the health care sector is increasing, but they have usually limited capital and expertise to participate in tenders. The paper introduces a possible solution for this problem, when SMEs form special groups, so called Smart Bidding Organisations (SBO), to prepare a bid for the tender jointly. The SBO appears for the customer (tender issuer) as a single enterprise and the bidding procedure will be faster and less expensive in this way.

  13. Organization and Finance of China’s Health Sector

    Directory of Open Access Journals (Sweden)

    Hui Li PhD

    2016-01-01

    Full Text Available China has exploded onto the world economy over the past few decades and is undergoing rapid transformation toward relatively more services. The health sector is an important part of this transition. This article provides a historical account of the development of health care in China since 1949. It also focuses on health insurance and macroeconomic structural adjustment to less saving and more consumption. In particular, the question of how health insurance impacts precautionary savings is considered. Multivariate analysis using data from 1990 to 2012 is employed. The household savings rate is the dependent variable in 3 models segmented for rural and urban populations. Independent variables include out-of-pocket health expenditures, health insurance payouts, housing expenditure, education expenditure, and consumption as a share of gross domestic product (GDP. Out-of-pocket health expenditures were positively correlated with household savings rates. But health insurance remains weak, and increased payouts by health insurers have not been associated with lower levels of household savings so far. Housing was positively correlated, whereas education had a negative association with savings rates. This latter finding was unexpected. Perhaps education is perceived as investment and a substitute for savings. China’s shift toward a more service-oriented economy includes growing dependence on the health sector. Better health insurance is an important part of this evolution. The organization and finance of health care is integrally linked with macroeconomic policy in an environment constrained by prevailing institutional convention. Problems of agency relationships, professional hegemony, and special interest politics feature prominently, as they do elsewhere. China also has a dual approach to medicine relying heavily on providers of traditional Chinese medicine. Both of these segments will take part in China’s evolution, adding another layer of

  14. Collaboration across private and public sector primary health care services: benefits, costs and policy implications.

    Science.gov (United States)

    McDonald, Julie; Powell Davies, Gawaine; Jayasuriya, Rohan; Fort Harris, Mark

    2011-07-01

    Ongoing care for chronic conditions is best provided by interprofessional teams. There are challenges in achieving this where teams cross organisational boundaries. This article explores the influence of organisational factors on collaboration between private and public sector primary and community health services involved in diabetes care. It involved a case study using qualitative methods. Forty-five participants from 20 organisations were purposively recruited. Data were collected through semi-structured interviews and from content analysis of documents. Thematic analysis was used employing a two-level coding system and cross case comparisons. The patterns of collaborative patient care were influenced by a combination of factors relating to the benefits and costs of collaboration and the influence of support mechanisms. Benefits lay in achieving common or complementary health or organisational goals. Costs were incurred in bridging differences in organisational size, structure, complexity and culture. Collaboration was easier between private sector organisations than between private and public sectors. Financial incentives were not sufficient to overcome organisational barriers. To achieve more coordinated primary and community health care structural changes are also needed to better align funding mechanisms, priorities and accountabilities of the different organisations.

  15. Health sector reform in South Asia: new challenges and constraints.

    Science.gov (United States)

    Islam, Anwar; Tahir, M Zaffar

    2002-05-01

    In early 1990s, Jamison, Mosley and others concluded that a profound demographic and consequent epidemiological transition is taking place in developing countries. According to this classical model, by the year 2015, infectious diseases will account for only about 20% of deaths in developing countries as chronic diseases become more pronounced. These impending demographic and epidemiological transitions were to dominate the health sector reform agenda in developing countries. Following an analysis of fertility, mortality and other demographic and epidemiological data from South Asian and other developing countries, the paper argues that the classical model is in need of re-evaluation. A number of new 'challenges' have complicated the classical interplay of demographic and epidemiological factors. These new challenges include continuing population growth in some countries, rapid unplanned urbanization, the HIV/AIDS pandemic in Sub-Saharan Africa (and its impending threat in South Asia), and globalization and increasing marginalisation of developing countries. While the traditional lack of investment in human development makes the developing countries more vulnerable to the vicissitudes of globalization, increasing economic weakness of their governments forces them to retreat further from the social sector. Pockets of poverty and deprivation, therefore, persist giving rise to three simultaneous burdens for South Asia and much of the rest of the developing world: continuing communicable diseases, increasing burden of chronic diseases, and increasing demand for both primary and tertiary levels of health care services. While these complex factors, on the one hand, underscore the need for health sector reform, on the other, they make the task much more difficult and challenging. The paper emphasizes the need to revisit the classical model of demographic and epidemiological transition. It is argued that the health sector in developing countries must be aware of and

  16. "Desa Siaga": Community Empowerment in Health Sector Through Midwives Participation

    OpenAIRE

    Hargono, Rahmat; Qomarrudin, M. Bagus; Nawalah, Hoirun

    2012-01-01

    “Desa Siaga” is the one of government's program for empowering community in health sector, especially to decrease maternal and infantmortality in village areas. This program actually plays as the implementation of empowerment concept. In this paper we elaborate the stephow to implementing the concepts of empowerment, and also make an explanation of the empowerment theory as a program and process whichis infl uence by the role of the midwives at village level. Some research revealed that facto...

  17. Site, Sector, Scope: Mapping the Epistemological Landscape of Health Humanities.

    Science.gov (United States)

    Charise, Andrea

    2017-12-01

    This essay presents a critical appraisal of the current state of baccalaureate Health Humanities, with a special focus on the contextual differences currently influencing the implementation of this field in Canada and, to a lesser extent, the United States and United Kingdom. I argue that the epistemological bedrock of Health Humanities goes beyond that generated by its written texts to include three external factors that are especially pertinent to undergraduate education: site (the setting of Health Humanities education), sector (the disciplinary eligibility for funding) and scope (the critical engagement with a program's local context alongside an emergent "core" of Health Humanities knowledge, learning, and practice). Drawing largely from the Canadian context, I discuss how these differences can inform or obstruct this field's development, and offer preliminary recommendations for encouraging the growth of baccalaureate Health Humanities-in Canada and elsewhere-in light of these factors.

  18. Health resources in a 200,000 urban Indian population argues the need for a policy on private sector health services.

    Science.gov (United States)

    Furtado, Kheya Melo; Kar, Anita

    2014-04-01

    There are limited primary data on the number of urban health care providers in private practice in developing countries like India. These data are needed to construct and test models that measure the efficacy of public stewardship of private sector health services. This study reports the number and characteristics of health resources in a 200 000 urban population in Pune. Data on health providers were collected by walking through the 15.46 sq km study area. Enumerated data were compared with existing data sources. Mapping was carried out using a Global Positioning System device. Metrics and characteristics of health resources were analyzed using ArcGIS 10.0 and Statistical Package for the Social Sciences, Version 16.0 software. Private sector health facilities constituted the majority (424/426, 99.5%) of health care services. Official data sources were only 39% complete. Doctor to population ratios were 2.8 and 0.03 per 1000 persons respectively in the private and public sector, and the nurse to doctor ratio was 0.24 and 0.71, respectively. There was an uneven distribution of private sector health services across the area (2-118 clinics per square kilometre). Bed strength was forty-fold higher in the private sector. Mandatory registration of private sector health services needs to be implemented which will provide an opportunity for public health planners to utilize these health resources to achieve urban health goals.

  19. El contexto de las reformas del sector de la salud The context surrounding health sector reforms

    Directory of Open Access Journals (Sweden)

    Carlos Vergara

    2000-08-01

    oportunidades para todo el mundo. Acostumbradas al proteccionismo del antiguo modelo de desarrollo, hoy en día las sociedades latinoamericanas perciben la amenaza de un modelo nuevo que no les ofrece ninguna red de protección social. La viabilidad de las políticas de reforma económica y social de las segunda fase, que se ajustan a las exigencias de un mundo "globalizado", depende, entonces, de poder vencer la desconfianza de la población y de lograr el respaldo de una mayoría política, social e institucional.In Latin America, health sector reforms have gone hand in hand with social and economic trends during the latter half of the twentieth century and have reflected the particular concept of "development" that has been in vogue at different times. Economic stagnation and increased social spending, both hallmarks of the 1960s, led to the decline of the "import substitution" development model, which had prevailed since the beginning of the century, and slowly gave way in the 1980s to the "globalization"model. From the earlier model, a transition took place toward a restructuring of production and a series of economic adjustment policies that led, ironically, to an increase in poverty in Latin America. Implementation of the new model has occurred in two phases. The first, known as the "social reform" or "first generation "phase, sprang from the notion that poverty is the sum of a number of material shortages that can be corrected through an equitable redistribution of a fixed volume of goods belonging to society. This conceptual framework, which was completely devoid of all historical linkages and separated from economic policy, led to social policies whose entire purpose was to mitigate poverty through subsidies targeting the poorest persons in the society. In the second phase of the globalization model, which arose in the 1990s and became known as the "second generation" or "postadjustment" phase, new economic rules came into play that were based primarily on

  20. Understanding human resource management practices in Botswana's public health sector.

    Science.gov (United States)

    Seitio-Kgokgwe, Onalenna Stannie; Gauld, Robin; Hill, Philip C; Barnett, Pauline

    2016-11-21

    Purpose The purpose of this paper is to assess the management of the public sector health workforce in Botswana. Using institutional frameworks it aims to document and analyse human resource management (HRM) practices, and make recommendations to improve employee and health system outcomes. Design/methodology/approach The paper draws from a large study that used a mixed methods approach to assess performance of Botswana's Ministry of Health (MOH). It uses data collected through document analysis and in-depth interviews of 54 key informants comprising policy makers, senior staff of the MOH and its stakeholder organizations. Findings Public health sector HRM in Botswana has experienced inadequate planning, poor deployment and underutilization of staff. Lack of comprehensive retention strategies and poor working conditions contributed to the failure to attract and retain skilled personnel. Relationships with both formal and informal environments affected HRM performance. Research limitations/implications While document review was a major source of data for this paper, the weaknesses in the human resource information system limited availability of data. Practical implications This paper presents an argument for the need for consideration of formal and informal environments in developing effective HRM strategies. Originality/value This research provides a rare system-wide approach to health HRM in a Sub-Saharan African country. It contributes to the literature and evidence needed to guide HRM policy decisions and practices.

  1. A decision Enhancement Service for Stakeholder Analysis to Achieve Transformations in the Public Sector

    NARCIS (Netherlands)

    Knol, Arjan; Janssen, Marijn; Sol, H G

    2015-01-01

    Sourcing has become a popular practice for public sector managers aiming for transformations to save costs and improve service delivery. Nevertheless, public sector sourcing often fails due to stakeholder resistance and power struggles, stressing the need for stakeholder analysis. This paper

  2. Data Hemorrhages in the Health-Care Sector

    Science.gov (United States)

    Johnson, M. Eric

    Confidential data hemorrhaging from health-care providers pose financial risks to firms and medical risks to patients. We examine the consequences of data hemorrhages including privacy violations, medical fraud, financial identity theft, and medical identity theft. We also examine the types and sources of data hemorrhages, focusing on inadvertent disclosures. Through an analysis of leaked files, we examine data hemorrhages stemming from inadvertent disclosures on internet-based file sharing networks. We characterize the security risk for a group of health-care organizations using a direct analysis of leaked files. These files contained highly sensitive medical and personal information that could be maliciously exploited by criminals seeking to commit medical and financial identity theft. We also present evidence of the threat by examining user-issued searches. Our analysis demonstrates both the substantial threat and vulnerability for the health-care sector and the unique complexity exhibited by the US health-care system.

  3. Private health care sector investment in Brazil: opportunities and obstacles.

    Science.gov (United States)

    Brandt, Reynaldo

    2003-01-01

    The Brazilian health system is based upon the constitutional right formulated in 1988, according to which health is the peoples' right and duty of the State. So being, it is essentially the government's responsibility, expressed in the so-called Sistema Unico de Saúde--SUS (single health system) Since its creation, however, it admits the existence of a supplementary health system, left to the private sector. In general terms, the public system is considered unsatisfactory in the services it renders. Its resources are distributed heterogeneously, favoring centers of advanced medical practice, to the detriment of basic health care. The supplementary system is considered of better quality, however with great variations and frequent accusations of being essentially profit driven, instead of being driven to the needs of the assisted population. The growing search for health plans is a direct consequence of the image perceived by the population regarding the quality and accessibility of the public services, as well as of the peoples' growing consciousness of their needs, rights and duties as citizens. The need for continuous quality improvement and cost reduction offers numberless opportunities for actions and investments. Initiatives to identify and implement the best medical practices, medical guidelines and actions are essential regarding those illnesses which are most frequent, of higher cost and of greater risk. Health plans and healthcare providers will necessarily have to focus on their common client. Therefore, organizations must be created in order to develop initiatives aimed to the quality of patient care, as well as to the collection and dissemination of data regarding the production and results of the main service providers. Consequently, immense opportunities are being opened for investments in the area of Information Technology, collection, analysis, and data dissemination. This paper analyses the main trends in the Brazilian health sector and from the

  4. Health sector reform in Argentina: a cautionary tale.

    Science.gov (United States)

    Lloyd-Sherlock, Peter

    2005-04-01

    In November 2002 the World Bank published a report on the Argentine health sector. The report accurately portrays the complexity and severity of the problems facing the health care system. It stresses that these problems are not purely a product of the country's economic collapse, noting that the system has suffered from long-standing structural problems and inefficiencies. Curiously, the report makes no mention of the leading role played by the World Bank in health reform efforts during the 1990s. This paper demonstrates that these reforms did much to worsen pre-existing weaknesses of the sector. The paper criticises the content of the reform agenda and the manner in which it was produced, arguing that these were reforms in which considerations of public health were less significant than conformity to the wider model of neo-liberal social and economic development prevailing at the time. It also highlights problems of implementing the reform agenda, which reduced the coherency of the reforms. The paper goes on to examine the impact of the crisis, noting links with the preceding reforms. It identifies a number of insights and lessons of potential value to other countries which are pursuing similar policies.

  5. Mental health policy and development in Egypt - integrating mental health into health sector reforms 2001-9

    Directory of Open Access Journals (Sweden)

    Siekkonen Inkeri

    2010-06-01

    Full Text Available Abstract Background Following a situation appraisal in 2001, a six year mental health reform programme (Egymen 2002-7 was initiated by an Egyptian-Finnish bilateral aid project at the request of a former Egyptian minister of health, and the work was incorporated directly into the Ministry of Health and Population from 2007 onwards. This paper describes the aims, methodology and implementation of the mental health reforms and mental health policy in Egypt 2002-2009. Methods A multi-faceted and comprehensive programme which combined situation appraisal to inform planning; establishment of a health sector system for coordination, supervision and training of each level (national, governorate, district and primary care; development workshops; production of toolkits, development of guidelines and standards; encouragement of intersectoral liaison at each level; integration of mental health into health management systems; and dedicated efforts to improve forensic services, rehabilitation services, and child psychiatry services. Results The project has achieved detailed situation appraisal, epidemiological needs assessment, inclusion of mental health into the health sector reform plans, and into the National Package of Essential Health Interventions, mental health masterplan (policy guidelines to accompany the general health policy, updated Egyptian mental health legislation, Code of Practice, adaptation of the WHO primary care guidelines, primary care training, construction of a quality system of roles and responsibilities, availability of medicines at primary care level, public education about mental health, and a research programme to inform future developments. Intersectoral liaison with education, social welfare, police and prisons at national level is underway, but has not yet been established for governorate and district levels, nor mental health training for police, prison staff and teachers. Conclusions The bilateral collaboration programme

  6. Strengthening Health Systems to Accelerate Achievement of ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    to urban area due to unavailability of the service facilities. ... established to improve access and quality of health care in Ghana. ... programmes de planification et de services de santé à base communautaire ont été mis en place pour améliorer .... pregnancies, they can reduce the body's reserve ... emergency prenatal care.

  7. Microeconomic principles in the health sector: The demand for health services in the Republic of Serbia

    Directory of Open Access Journals (Sweden)

    Stošić Sanja

    2015-01-01

    Full Text Available Health has become a dominant economic and political issue over the past years, where many nations experience rapid rises in health care spending. The main reason why the health care sector does not operate entirely in accordance with economic market principles is the fact that inequalities in health and access to health care are understood as the lack of humanity and justice. Health care demands might seem as quite inelastic, but because of the health insurance, it shows a certain degree of price, income, cross - price and time elasticity. The subject of this study was the demand for health services in the Republic of Serbia in order to assess the ability of the public sector to meet the demand for providing these services. The underlying assumption was that public health can not adequately meet the needs of citizens due to insufficient investment in the sector and inefficient allocation of resources. To confirm this assumption, basic characteristics of health care market and the factors affecting the supply and demand for health services were discussed. Based on the analysis of investment in the health sector, the existing capacity and organization of health services, our research has shown that the public health system in the Republic of Serbia is not able to adequately meet the demand for health services. In the current economic situation in the Republic of Serbia, which already spends a significant portion of its GDP on health, there is no realistic possibility of increased spending on public health care system, although it can be expected that there will be increasing demand for health services and increase of costs. The health sector is not, and does not have the ability to be a perfectly competitive market, and the questions of its financing, rational and efficient organization is extremely delicate. However, health care economists and experts in health economics should give a significantly higher contribution in organizing health sector

  8. Just How Big is the Schism Between the Health Sector and the Water and Sanitation Sector in Developing Countries?

    Directory of Open Access Journals (Sweden)

    A. A. Cronin

    2008-01-01

    Full Text Available Water, sanitation and hygiene are all key aspects to a healthy environment but often they suffer from a lack of coherence within the sector itself and also a lack of synergy with the health sector. This is not acceptable given one quarter of all child deaths are directly attributable to water-borne disease. This lack of synergy is evident at many different layers including planning, resource allocation and donor commitment. Developing countries must, in consultation with their communities, examine their biggest health risks and allocate resources accordingly. Sustained dialogue and increased in-depth analysis are needed to find consensus and an improved synergy across these vital sectors.

  9. Achieve real gender equality for adolescent health | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-11-03

    Nov 3, 2016 ... Achieve real gender equality for adolescent health ... yet limited access to sexual and reproductive health services is preventing women and girls ... forms of sexual violence, trafficking, and abuse and gender discrimination.

  10. The problem of wastes in the health sector

    International Nuclear Information System (INIS)

    Faysal, Al-Kak

    1998-01-01

    The article presents the management of hospital wastes in Lebanon. Hospital wastes considered as solid wastes, are divided into three main categories: radioactive wastes, contaminated wastes and chemical wastes. The treatment of wastes in the health sector in Lebanon is reduced to the incinerators. This method causes the major air pollution by emitting toxic substances as Dioxin. Advantages and disadvantages of alternate methods of wastes treatment are discussed such as: steam sterilization, bio-conversion, coal-burning, electronic radiation sterilization and chemical sterilization

  11. The effect of herd formation among healthcare investors on health sector growth in China.

    Science.gov (United States)

    Lulin, Zhou; Antwi, Henry Asante; Wang, Wenxin; Yiranbon, Ethel; Marfo, Emmanuel Opoku; Acheampong, Patrick

    2016-07-19

    China has become the world's second largest healthcare market based on a recent report by the World Health Organization. Eventhough China achieved universal health insurance coverage in 2011, representing the largest expansion of insurance coverage in human history achieved; health inequality remains endemic in China. Lessons from the effect of market crisis on health equity in Europe and other places has reignited interest in exploring the potential healthcare market aberrations that can trigger distributive injustice in healthcare resource allocation among China's provinces. Recently, many healthcare investors in China have become more concerned about capital preservation, and are responding by abandoning long term investments strategies in healthcare. This investment withdrawal en mass is perceived to be influenced by herding tendencies and can trigger or consolidate endemic health inequality. Our study simultaneously employs four testing models (two state spaced models and two return dispersion models) to establish the existence of procyclical (herding) behavior among the stocks and its health equity implications. These are applied to a large set of data to compare and contrast results of herd formation among investors in fourteen healthcare sectors in China. The study reveals that apart from the cross sectional standard deviation (CSSD) model, the remaining two models and our augmented state space model yields significant evidence of herding in all subsectors of the healthcare market. We also find that the herding effect is more prominent during down movements of the market. Herding behavior may lead to contemporaneous loss of investor confidence and capital withdrawal and thereby deprive the healthcare sector of the much needed capital for expansion. Thus there may be obvious delay in efforts to bridge the gap in access to healthcare facilities, medical support services, medical supplies, pharmaceuticals, biotechnology, diagnostic substances, medical

  12. Health care inequities in north India: role of public sector in universalizing health care.

    Science.gov (United States)

    Prinja, Shankar; Kanavos, Panos; Kumar, Rajesh

    2012-09-01

    Income inequality is associated with poor health. Inequities exist in service utilization and financing for health care. Health care costs push high number of households into poverty in India. We undertook this study to ascertain inequities in health status, service utilization and out-of-pocket (OOP) health expenditures in two States in north India namely, Haryana and Punjab, and Union Territory of Chandigarh. Data from National Sample Survey 60 th Round on Morbidity and Health Care were analyzed by mean consumption expenditure quintiles. Indicators were devised to document inequities in the dimensions of horizontal and vertical inequity; and redistribution of public subsidy. Concentration index (CI), and equity ratio in conjunction with concentration curve were computed to measure inequity. Reporting of morbidity and hospitalization rate had a pro-rich distribution in all three States indicating poor utilization of health services by low income households. Nearly 57 and 60 per cent households from poorest income quintile in Haryana and Punjab, respectively faced catastrophic OOP hospitalization expenditure at 10 per cent threshold. Lower prevalence of catastrophic expenditure was recorded in higher income groups. Public sector also incurred high costs for hospitalization in selected three States. Medicines constituted 19 to 47 per cent of hospitalization expenditure and 59 to 86 per cent OPD expenditure borne OOP by households in public sector. Public sector hospitalizations had a pro-poor distribution in Haryana, Punjab and Chandigarh. Our analysis indicates that public sector health service utilization needs to be improved. OOP health care expenditures at public sector institutions should to be curtailed to improve utilization of poorer segments of population. Greater availability of medicines in public sector and regulation of their prices provide a unique opportunity to reduce public sector OOP expenditure.

  13. How to achieve care coordination inside health care organizations

    DEFF Research Database (Denmark)

    Prætorius, Thim; C. Becker, Markus

    2015-01-01

    Understanding how health care organizations can achieve care coordination internally is essential because it is difficult to achieve, but essential for high quality and efficient health care delivery. This article offers an answer by providing a synthesis of knowledge about coordination from...

  14. Mobile Phone Health Applications for the Federal Sector.

    Science.gov (United States)

    Burrows, Christin S; Weigel, Fred K

    2016-01-01

    As the US healthcare system moves toward a mobile care model, mobile phones will play a significant role in the future of healthcare delivery. Today, 90% of American adults own a mobile phone and 64% own a smartphone, yet many healthcare organizations are only beginning to explore the opportunities in which mobile phones can improve and streamline care. After searching Google Scholar, the Association for Computing Machinery Database, and PubMed for articles related to mobile phone health applications and cell phone text message health, we selected articles and studies related to the application of mobile phones in healthcare. From our initial review, we identified the potential application areas and continued to refine our search, identifying a total of 55 articles for additional review and analysis. From the literature, we identified 3 main themes for mobile phone implementation in improving healthcare: primary, preventive, and population health. We recommend federal health leaders pursue the value and potential in these areas; not only because 90% of Americans already own mobile phones, but also because mobile phone integration can provide substantial access and potential cost savings. From the positive findings of multiple studies in primary, preventive, and population health, we propose a 5-year federal implementation plan to integrate mobile phone capabilities into federal healthcare delivery. Our proposal has the potential to improve access, reduce costs, and increase patient satisfaction, therefore changing the way the federal sector delivers healthcare by 2021.

  15. Financing of health systems to achieve the health Millennium Development Goals in low-income countries.

    Science.gov (United States)

    Fryatt, Robert; Mills, Anne; Nordstrom, Anders

    2010-01-30

    Concern that underfunded and weak health systems are impeding the achievement of the health Millennium Development Goals in low-income countries led to the creation of a High Level Taskforce on Innovative International Financing for Health Systems in September, 2008. This report summarises the key challenges faced by the Taskforce and its Working Groups. Working Group 1 examined the constraints to scaling up and costs. Challenges included: difficulty in generalisation because of scarce and context-specific health-systems knowledge; no consensus for optimum service-delivery approaches, leading to wide cost differences; no consensus for health benefits; difficulty in quantification of likely efficiency gains; and challenges in quantification of the financing gap owing to uncertainties about financial commitments for health. Working Group 2 reviewed the different innovative mechanisms for raising and channelling funds. Challenges included: variable definitions of innovative finance; small evidence base for many innovative finance mechanisms; insufficient experience in harmonisation of global health initiatives; and inadequate experience in use of international investments to improve maternal, newborn, and child health. The various mechanisms reviewed and finally recommended all had different characteristics, some focusing on specific problems and some on raising resources generally. Contentious issues included the potential role of the private sector, the rights-based approach to health, and the move to results-based aid. The challenges and disagreements that arose during the work of the Taskforce draw attention to the many issues facing decision makers in low-income countries. International donors and recipient governments should work together to improve the evidence base for strengthening health systems, increase long-term commitments, and improve accountability through transparent and inclusive national approaches. Copyright 2010 Elsevier Ltd. All rights reserved.

  16. Development trends in the Azerbaijan oil and gas sector: Achievements and challenges

    International Nuclear Information System (INIS)

    Ciarreta, Aitor; Nasirov, Shahriyar

    2012-01-01

    This article is study of Azerbaijan oil and gas industry. It illustrates the business climate, the impact of this sector on Azerbaijan's economy including role of SOFAZ and highlights recent developments in the energy production and the main concepts of . Meanwhile, the article establishes the government policy by indentifying several factors that influenced to attract foreign investment to oil and gas sector and examines significant challenges that still remain for further development of the country's oil industry. - Highlights: ► In this study, we review the oil and gas sector in Azerbaijan and describe the main government policies for attracting foreign investment to the sector. ► We showed that providing a predictable legislative and regulatory framework and attractive conditions for oil contracting encourages foreign investment inflows to the country. ► Issues such as the lack of independent regulatory institutions, rehabilitation of oil refineries and resolution of the legal status of the Caspian Sea remain major challenges for further development of the oil and gas industries.

  17. The voluntary sector and conservation for England: achievements, expanding roles and uncertain future.

    Science.gov (United States)

    Cook, Hadrian; Inman, Alax

    2012-12-15

    The voluntary sector is value driven, issue focussed and considered economically efficient due to volunteer engagement and low administrative overheads in meeting conservation objectives. Independence and flexibility make it an intermediary between stakeholders and government and it is proving an effective vehicle for public engagement. NGOs are emerging as a key player in environmental action, making them a partial replacement for 'big government action' and may be heralding a 'Big Green Society'. The sector ranges in scale from small, local conservation charities to nationally important organisations. This article focuses on functionality because resource issues relate to funding, competences of personnel, continuity of mission and access to expertise, and all are affected during times of austerity. NGOs were largely task-oriented, yet they rapidly developed a campaigning role encapsulating an ever deeper role in both planning and policy formulation. Subsequently, they have developed community inclusion at the core of their function. While the portents remain good, potential problems relate to economic resources, task allocation, impacts on labour markets, interactions with the statutory sector, operational independence and to relations with local democracy. Outlined in this paper are historic functions, operation and development of the sector and perceived issues for the future. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Climate change and eHealth: a promising strategy for health sector mitigation and adaptation

    Directory of Open Access Journals (Sweden)

    Åsa Holmner

    2012-06-01

    Full Text Available Climate change is one of today's most pressing global issues. Policies to guide mitigation and adaptation are needed to avoid the devastating impacts of climate change. The health sector is a significant contributor to greenhouse gas emissions in developed countries, and its climate impact in low-income countries is growing steadily. This paper reviews and discusses the literature regarding health sector mitigation potential, known and hypothetical co-benefits, and the potential of health information technology, such as eHealth, in climate change mitigation and adaptation. The promising role of eHealth as an adaptation strategy to reduce societal vulnerability to climate change, and the link's between mitigation and adaptation, are also discussed. The topic of environmental eHealth has gained little attention to date, despite its potential to contribute to more sustainable and green health care. A growing number of local and global initiatives on ‘green information and communication technology (ICT’ are now mentioning eHealth as a promising technology with the potential to reduce emission rates from ICT use. However, the embracing of eHealth is slow because of limitations in technological infrastructure, capacity and political will. Further research on potential emissions reductions and co-benefits with green ICT, in terms of health outcomes and economic effectiveness, would be valuable to guide development and implementation of eHealth in health sector mitigation and adaptation policies.

  19. Climate change and eHealth: a promising strategy for health sector mitigation and adaptation

    Science.gov (United States)

    Holmner, Åsa; Rocklöv, Joacim; Ng, Nawi; Nilsson, Maria

    2012-01-01

    Climate change is one of today's most pressing global issues. Policies to guide mitigation and adaptation are needed to avoid the devastating impacts of climate change. The health sector is a significant contributor to greenhouse gas emissions in developed countries, and its climate impact in low-income countries is growing steadily. This paper reviews and discusses the literature regarding health sector mitigation potential, known and hypothetical co-benefits, and the potential of health information technology, such as eHealth, in climate change mitigation and adaptation. The promising role of eHealth as an adaptation strategy to reduce societal vulnerability to climate change, and the link's between mitigation and adaptation, are also discussed. The topic of environmental eHealth has gained little attention to date, despite its potential to contribute to more sustainable and green health care. A growing number of local and global initiatives on ‘green information and communication technology (ICT)’ are now mentioning eHealth as a promising technology with the potential to reduce emission rates from ICT use. However, the embracing of eHealth is slow because of limitations in technological infrastructure, capacity and political will. Further research on potential emissions reductions and co-benefits with green ICT, in terms of health outcomes and economic effectiveness, would be valuable to guide development and implementation of eHealth in health sector mitigation and adaptation policies. PMID:22679398

  20. Extending health insurance coverage to the informal sector: Lessons from a private micro health insurance scheme in Lagos, Nigeria.

    Science.gov (United States)

    Peterson, Lauren; Comfort, Alison; Hatt, Laurel; van Bastelaer, Thierry

    2018-04-15

    As a growing number of low- and middle-income countries commit to achieving universal health coverage, one key challenge is how to extend coverage to informal sector workers. Micro health insurance (MHI) provides a potential model to finance health services for this population. This study presents lessons from a pilot study of a mandatory MHI plan offered by a private insurance company and distributed through a microfinance bank to urban, informal sector workers in Lagos, Nigeria. Study methods included a survey of microfinance clients, key informant interviews, and a review of administrative records. Demographic, health care seeking, and willingness-to-pay data suggested that microfinance clients, particularly women, could benefit from a comprehensive MHI plan that improved access to health care and reduced out-of-pocket spending on health services. However, administrative data revealed declining enrollment, and key informant interviews further suggested low use of the health insurance plan. Key implementation challenges, including changes to mandatory enrollment requirements, insufficient client education and marketing, misaligned incentives, and weak back-office systems, undermined enrollment and use of the plan. Mandatory MHI plans, intended to mitigate adverse selection and facilitate private insurers' entry into new markets, present challenges for covering informal sector workers, including when distributed through agents such as a microfinance bank. Properly aligning the incentives of the insurer and the agent are critical to effectively distribute and service insurance. Further, an urban environment presents unique challenges for distributing MHI, addressing client perceptions of health insurance, and meeting their health care needs. Copyright © 2018 John Wiley & Sons, Ltd.

  1. Health-care sector and complementary medicine: practitioners' experiences of delivering acupuncture in the public and private sectors.

    Science.gov (United States)

    Bishop, Felicity L; Amos, Nicola; Yu, He; Lewith, George T

    2012-07-01

    The aim was to identify similarities and differences between private practice and the National Health Service (NHS) in practitioners' experiences of delivering acupuncture to treat pain. We wished to identify differences that could affect patients' experiences and inform our understanding of how trials conducted in private clinics relate to NHS clinical practice. Acupuncture is commonly used in primary care for lower back pain and is recommended in the National Institute for Health and Clinical Excellence's guidelines. Previous studies have identified differences in patients' accounts of receiving acupuncture in the NHS and in the private sector. The major recent UK trial of acupuncture for back pain was conducted in the private sector. Semi-structured qualitative interviews were conducted with 16 acupuncturists who had experience of working in the private sector (n = 7), in the NHS (n =3), and in both the sectors (n = 6). The interviews lasted between 24 and 77 min (median=49 min) and explored acupuncturists' experiences of treating patients in pain. Inductive thematic analysis was used to identify similarities and differences across private practice and the NHS. The perceived effectiveness of acupuncture was described consistently and participants felt they did (or would) deliver acupuncture similarly in NHS and in private practice. In both the sectors, patients sought acupuncture as a last resort and acupuncturist-patient relationships were deemed important. Acupuncture availability differed across sectors: in the NHS it was constrained by Trust policies and in the private sector by patients' financial resources. There were greater opportunities for autonomous practice in the private sector and regulation was important for different reasons in each sector. In general, NHS practitioners had Western-focussed training and also used conventional medical techniques, whereas private practitioners were more likely to have Traditional Chinese training and to practise

  2. Public health workforce employment in US public and private sectors.

    Science.gov (United States)

    Kennedy, Virginia C

    2009-01-01

    The purpose of this study was to describe the number and distribution of 26 administrative, professional, and technical public health occupations across the array of US governmental and nongovernmental industries. This study used data from the Occupational Employment Statistics program of the US Bureau of Labor Statistics. For each occupation of interest, the investigator determined the number of persons employed in 2006 in five industries and industry groups: government, nonprofit agencies, education, healthcare, and all other industries. Industry-specific employment profiles varied from one occupation to another. However, about three-fourths of all those engaged in these occupations worked in the private healthcare industry. Relatively few worked in nonprofit or educational settings, and less than 10 percent were employed in government agencies. The industry-specific distribution of public health personnel, particularly the proportion employed in the public sector, merits close monitoring. This study also highlights the need for a better understanding of the work performed by public health occupations in nongovernmental work settings. Finally, the Occupational Employment Statistics program has the potential to serve as an ongoing, national data collection system for public health workforce information. If this potential was realized, future workforce enumerations would not require primary data collection but rather could be accomplished using secondary data.

  3. Achieving value for money in health: a comparative analysis of OECD countries and regional countries.

    Science.gov (United States)

    Çelik, Yusuf; Khan, Mahmud; Hikmet, Neşet

    2017-10-01

    To measure efficiency gains in health sector over the years 1995 to 2013 in OECD, EU, non-member European countries. An output-oriented DEA model with variable return to scale, and residuals estimated by regression equations were used to estimate efficiencies of health systems. Slacks for health care outputs and inputs were calculated by using DEA multistage method of estimating country efficiency scores. Better health outcomes of countries were related with higher efficiency. Japan, France, or Sweden were found to be peer-efficient countries when compared to other developed countries like Germany and United States. Increasing life expectancy beyond a certain high level becomes very difficult to achieve. Despite declining marginal productivity of inputs on health outcomes, some developed countries and developing countries were found to have lowered their inefficiencies in the use of health inputs. Although there was no systematic relationship between political system of countries and health system efficiency, the objectives of countries on social and health policy and the way of achieving these objectives might be a factor increasing the efficiency of health systems. Economic and political stability might be as important as health expenditure in improving health system goals. A better understanding of the value created by health expenditures, especially in developed countries, will require analysis of specific health interventions that can increase value for money in health. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  4. Interventions to reduce corruption in the health sector

    Science.gov (United States)

    Gaitonde, Rakhal; Oxman, Andrew D; Okebukola, Peter O; Rada, Gabriel

    2016-01-01

    Background Corruption is the abuse or complicity in abuse, of public or private position, power or authority to benefit oneself, a group, an organisation or others close to oneself; where the benefits may be financial, material or non-material. It is wide-spread in the health sector and represents a major problem. Objectives Our primary objective was to systematically summarise empirical evidence of the effects of strategies to reduce corruption in the health sector. Our secondary objective was to describe the range of strategies that have been tried and to guide future evaluations of promising strategies for which there is insufficient evidence. Search methods We searched 14 electronic databases up to January 2014, including: CENTRAL; MEDLINE; EMBASE; sociological, economic, political and other health databases; Human Resources Abstracts up to November 2010; Euroethics up to August 2015; and PubMed alerts from January 2014 to June 2016. We searched another 23 websites and online databases for grey literature up to August 2015, including the World Bank, the International Monetary Fund, the U4 Anti-Corruption Resource Centre, Transparency International, healthcare anti-fraud association websites and trial registries. We conducted citation searches in Science Citation Index and Google Scholar, and searched PubMed for related articles up to August 2015. We contacted corruption researchers in December 2015, and screened reference lists of articles up to May 2016. Selection criteria For the primary analysis, we included randomised trials, non-randomised trials, interrupted time series studies and controlled before-after studies that evaluated the effects of an intervention to reduce corruption in the health sector. For the secondary analysis, we included case studies that clearly described an intervention to reduce corruption in the health sector, addressed either our primary or secondary objective, and stated the methods that the study authors used to collect and

  5. Diagnostic evaluation of dementia in the secondary health care sector

    DEFF Research Database (Denmark)

    Phung, Thien Kieu Thi; Andersen, Birgitte Bo; Kessing, Lars Vedel

    2009-01-01

    BACKGROUND: We conducted a nationwide registry-based study of the quality of diagnostic evaluation for dementia in the secondary health care sector. METHOD: Two hundred patients were randomly selected from the patient population (4,682 patients) registered for the first time with a dementia...... diagnosis in the nationwide hospital registries during the last 6 months of 2003. Through medical record review, we evaluated the completeness of the work-up on which the dementia diagnosis was based, using evidence-based dementia guidelines as reference standards. RESULTS: Satisfactory or acceptable...... completion of the basic dementia work-up was documented in 51.3% of the patients. Only 11.5% of those with unsatisfactory work-up were referred to follow-up investigations. Dementia syndrome was confirmed in 88.5% of the cases, but correct subtypes were diagnosed in only 35.1%. CONCLUSION: The adherence...

  6. Health Sector Evolution Plan in Iran; Equity and Sustainability Concerns.

    Science.gov (United States)

    Moradi-Lakeh, Maziar; Vosoogh-Moghaddam, Abbas

    2015-08-31

    In 2014, a series of reforms, called as the Health Sector Evolution Plan (HSEP), was launched in the health system of Iran in a stepwise process. HSEP was mainly based on the fifth 5-year health development national strategies (2011-2016). It included different interventions to: increase population coverage of basic health insurance, increase quality of care in the Ministry of Health and Medical Education (MoHME) affiliated hospitals, reduce out-of-pocket (OOP) payments for inpatient services, increase quality of primary healthcare, launch updated relative value units (RVUs) of clinical services, and update tariffs to more realistic values. The reforms resulted in extensive social reaction and different professional feedback. The official monitoring program shows general public satisfaction. However, there are some concerns for sustainability of the programs and equity of financing. Securing financial sources and fairness of the financial contribution to the new programs are the main concerns of policy-makers. Healthcare providers' concerns (as powerful and influential stakeholders) potentially threat the sustainability and efficiency of HSEP. Previous experiences on extending health insurance coverage show that they can lead to a regressive healthcare financing and threat financial equity. To secure financial sources and to increase fairness, the contributions of people to new interventions should be progressive by their income and wealth. A specific progressive tax would be the best source, however, since it is not immediately feasible, a stepwise increase in the progressivity of financing must be followed. Technical concerns of healthcare providers (such as nonplausible RVUs for specific procedures or nonefficient insurance-provider processes) should be addressed through proper revision(s) while nontechnical concerns (which are derived from conflicting interests) must be responded through clarification and providing transparent information. The requirements of

  7. Health Sector Evolution Plan in Iran; Equity and Sustainability Concerns

    Directory of Open Access Journals (Sweden)

    Maziar Moradi-Lakeh

    2015-10-01

    Full Text Available In 2014, a series of reforms, called as the Health Sector Evolution Plan (HSEP, was launched in the health system of Iran in a stepwise process. HSEP was mainly based on the fifth 5-year health development national strategies (2011-2016. It included different interventions to: increase population coverage of basic health insurance, increase quality of care in the Ministry of Health and Medical Education (MoHME affiliated hospitals, reduce out-of-pocket (OOP payments for inpatient services, increase quality of primary healthcare, launch updated relative value units (RVUs of clinical services, and update tariffs to more realistic values. The reforms resulted in extensive social reaction and different professional feedback. The official monitoring program shows general public satisfaction. However, there are some concerns for sustainability of the programs and equity of financing. Securing financial sources and fairness of the financial contribution to the new programs are the main concerns of policy-makers. Healthcare providers’ concerns (as powerful and influential stakeholders potentially threat the sustainability and efficiency of HSEP. Previous experiences on extending health insurance coverage show that they can lead to a regressive healthcare financing and threat financial equity. To secure financial sources and to increase fairness, the contributions of people to new interventions should be progressive by their income and wealth. A specific progressive tax would be the best source, however, since it is not immediately feasible, a stepwise increase in the progressivity of financing must be followed. Technical concerns of healthcare providers (such as nonplausible RVUs for specific procedures or nonefficient insurance-provider processes should be addressed through proper revision(s while nontechnical concerns (which are derived from conflicting interests must be responded through clarification and providing transparent information. The

  8. Assessment of the Technical Potential for Achieving Net Zero-Energy Buildings in the Commercial Sector

    Energy Technology Data Exchange (ETDEWEB)

    Griffith, B.; Long, N.; Torcellini, P.; Judkoff, R.; Crawley, D.; Ryan, J.

    2007-12-01

    This report summarizes the findings from research conducted at NREL to assess the technical potential for zero-energy building technologies and practices to reduce the impact of commercial buildings on the U.S. energy system. Commercial buildings currently account for 18% of annual U.S. energy consumption, and energy use is growing along with overall floor area. Reducing the energy use of this sector will require aggressive research goals and rapid implementation of the research results.

  9. Harnessing Private-Sector Innovation to Improve Health Insurance Exchanges.

    Science.gov (United States)

    Gresenz, Carole Roan; Hoch, Emily; Eibner, Christine; Rudin, Robert S; Mattke, Soeren

    2016-05-09

    Overhauling the individual health insurance market-including through the creation of health insurance exchanges-was a key component of the Patient Protection and Affordable Care Act's multidimensional approach to addressing the long-standing problem of the uninsured in the United States. Despite succeeding in enrolling millions of Americans, the exchanges still face several challenges, including poor consumer experience, high operational and development costs, and incomplete market penetration. In light of these challenges, analysts considered a different model for the exchanges-privately facilitated exchanges-which could address these challenges and deepen the Affordable Care Act's impact. In this model, the government retains control over sovereign exchange functions but allows the private sector to assume responsibility for more-peripheral exchange functions, such as developing and sustaining exchange websites. Although private-sector entities have already undertaken exchange-related functions on a limited basis, privately facilitated exchanges could conceivably relieve the government of its responsibility for front-end website operations and consumer decision-support functions entirely. A shift to privately facilitated exchanges could improve the consumer experience, increase enrollment, and lower costs for state and federal governments. A move to such a model requires, nonetheless, managing its risks, such as reduced consumer protection, increased consumer confusion, and the possible lack of a viable revenue base for privately facilitated exchanges, especially in less populous states. On net, the benefits are large enough and the risks sufficiently manageable to seriously consider such a shift. This paper provides background information and more detail on the analysts' assessment.

  10. Public sector reform and demand for human resources for health (HRH

    Directory of Open Access Journals (Sweden)

    Lethbridge Jane

    2004-11-01

    Full Text Available Abstract This article considers some of the effects of health sector reform on human resources for health (HRH in developing countries and countries in transition by examining the effect of fiscal reform and the introduction of decentralisation and market mechanisms to the health sector. Fiscal reform results in pressure to measure the staff outputs of the health sector. Financial decentralisation often leads to hospitals becoming "corporatised" institutions, operating with business principles but remaining in the public sector. The introduction of market mechanisms often involves the formation of an internal market within the health sector and market testing of different functions with the private sector. This has immediate implications for the employment of health workers in the public sector, because the public sector may reduce its workforce if services are purchased from other sectors or may introduce more short-term and temporary employment contracts. Decentralisation of budgets and administrative functions can affect the health sector, often in negative ways, by reducing resources available and confusing lines of accountability for health workers. Governance and regulation of health care, when delivered by both public and private providers, require new systems of regulation. The increase in private sector provision has led health workers to move to the private sector. For those remaining in the public sector, there are often worsening working conditions, a lack of employment security and dismantling of collective bargaining agreements. Human resource development is gradually being recognised as crucial to future reforms and the formulation of health policy. New information systems at local and regional level will be needed to collect data on human resources. New employment arrangements, strengthening organisational culture, training and continuing education will also be needed.

  11. Mobility and health sector development in China and India.

    Science.gov (United States)

    Holdaway, Jennifer; Levitt, Peggy; Fang, Jing; Rajaram, Narasimhan

    2015-04-01

    China and India are both attempting to create comprehensive healthcare systems in the context of rapid but uneven economic growth and rapidly changing burdens of disease. While in each country the referencing of international policies and work experience abroad have been part of this process, research has yet to examine the kind of knowledge that is exchanged or the various actors involved in knowledge circulation. Based on a study of two sub-national contexts, this article focuses on the role Chinese and Indian health professionals who have studied and worked overseas play in introducing ideas and practices about healthcare provision and health education. We found that experience abroad influenced individuals, institutions, and each society differently and with some contradictory effects. International experience clearly contributed to personal growth and led individuals to support the adoption of new institutional practices, such as more egalitarian relations between doctors and patients and between students and teachers. However, the content of what individuals learned overseas and the mechanisms through which this knowledge was introduced back into homeland settings often reinforced rather than ameliorated institutional hierarchies and social inequalities. While the scope of this research was limited, we suggest that more explicit analysis of the role professional migrants play in transferring ideas and practices within the health sector would be valuable for policymakers and funders seeking to support a more productive interaction between local and global knowledge. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Crisis Management in the Health Sector: Qualities and characteristics of health crisis managers

    Directory of Open Access Journals (Sweden)

    Manwlidou Zacharoula

    2009-01-01

    Full Text Available The rapidly evolving nature of today’s health systems and the need to adapt to modern demands,require that these systems are staffed with skilled health crisis managers. Based on that scenario, crisis managerswith good knowledge and training, adequate experience, as well as virtues of excellent organizational skills,operational planning, mental power and social sensitivity, can play a key role in dealing successfully with crisesin the health sector.

  13. Right place of human resource management in the reform of health sector.

    Science.gov (United States)

    Hassani, Seyed Abas; Mobaraki, Hossein; Bayat, Maboubeh; Mafimoradi, Shiva

    2013-01-01

    In this paper the real role and place of human resource (HR) in health system reform will be discussed and determined within the whole system through the comprehensive Human Resource Management (HRM) model. Delphi survey and a questionnaire were used to 1) collect HR manager ideas and comments and 2) identify the main challenges of HRM. Then the results were discussed in an expert panel after being analyzed by content analysis method. Also, a deep focus study of recorded documents related to Health Human Resource Management was done. Then based on all achieved results, a rich picture was drawn to illustrate the right place of HRM in health sector. Finally, the authors revitalize the missed function of HRM within the health sector by drawing a holistic conceptual model. The most percentage of frequency about HR belongs to "Lack of reliable HR information system" (91%) and the least percentage of frequency belongs to "Low responsibility of HR" (28%). The most percentage of frequency about HR manager belongs to "Inattention to HR managers as key managers and consider them in background" (80%) and the least percentage of frequency belongs to "Lack of coordination between universities' policies" (30%). According to the conceptual framework, human resources employed in health system are viewed from two comprehensive approaches: instrumental approach and institutional. Unlike the common belief that looks HRM through the supportive approach, it is discussed that HRM not only has an instrumental role, but also do have a driver role.

  14. Balancing health and industrial policy objectives in the pharmaceutical sector: lessons from Australia.

    Science.gov (United States)

    Morgan, Steve; McMahon, Meghan; Greyson, Devon

    2008-08-01

    Policy-makers worldwide struggle to balance health with industrial policy objectives in the pharmaceutical sector. Tensions arise over pricing and reimbursement in particular. What health plans view as necessary to maintain equitable access to medicines, industry views as inimical to R&D and innovation. Australia has grappled with this issue for years, even incorporating the goal of "maintaining a responsible and viable medicines industry" into its National Medicines Policy. This case study was conducted via a narrative review that examined Australia's experiences balancing health and industrial policy objectives in the pharmaceutical sector. The review included electronic databases, grey literature and government publications for reports on relevant Australian policy published over the period 1985-2007. While pharmaceutical companies claim that Australia's pricing and reimbursement policies suppress drug prices and reduce profits, national policy audits indicate these claims are misguided. Australia appears to have secured relatively low prices for generics and "me-too drugs" while paying internationally competitive prices for "breakthrough" medicines. Simultaneously, Australia has focused efforts on local pharmaceutical investment through a variety of industry-targeted R&D incentive policies. Despite the fact that policy reviews suggest that Australia has achieved balance between health and industrial policy objectives, the country continues to face criticism from industry that its health goals harm innovation and R&D. Recent reforms raise the question whether Australia can sustain the apparent balance.

  15. Government stewardship of the for-profit private health sector in Afghanistan.

    Science.gov (United States)

    Cross, Harry E; Sayedi, Omarzaman; Irani, Laili; Archer, Lauren C; Sears, Kathleen; Sharma, Suneeta

    2017-04-01

    Since 2003, Afghanistan's largely unregulated for-profit private health sector has grown at a rapid pace. In 2008, the Ministry of Public Health (MoPH) launched a long-term stewardship initiative to oversee and regulate private providers and align the sector with national health goals. We examine the progress the MoPH has made towards more effective stewardship, consider the challenges and assess the early impacts on for-profit performance. We reviewed publicly available documents, publications and the grey literature to analyse the development, adoption and implementation of strategies, policies and regulations. We carried out a series of key informant/participant interviews, organizational capacity assessments and analyses of hospital standards checklists. Using a literature review of health systems strengthening, we proposed an Afghan-specific definition of six key stewardship functions to assess progress towards MoPH stewardship objectives. The MoPH and its partners have achieved positive results in strengthening its private sector stewardship functions especially in generating actionable intelligence and establishing strategic policy directions, administrative structures and a legal and regulatory framework. Progress has also been made on improving accountability and transparency, building partnerships and applying minimum required standards to private hospitals. Procedural and operational issues still need resolution and the MoPH is establishing mechanisms for resolving them. The MoPH stewardship initiative is notable for its achievements to date under challenging circumstances. Its success is due to the focus on developing a solid policy framework and building institutions and systems aimed at ensuring higher quality private services, and a rational long-term and sustainable role for the private sector. Although the MoPH stewardship initiative is still at an early stage, the evidence suggests that enhanced stewardship functions in the MoPH are leading to a

  16. Health Information Management System for Elderly Health Sector: A Qualitative Study in Iran.

    Science.gov (United States)

    Sadoughi, Farahnaz; Shahi, Mehraban; Ahmadi, Maryam; Davaridolatabadi, Nasrin

    2016-02-01

    There are increasing change and development of information in healthcare systems. Given the increase in aging population, managers are in need of true and timely information when making decision. The aim of this study was to investigate the current status of the health information management system for the elderly health sector in Iran. This qualitative study was conducted in two steps. In the first step, required documents for administrative managers were collected using the data gathering form and observed and reviewed by the researcher. In the second step, using an interview guide, the required information was gathered through interviewing experts and faculty members. The convenience, purposeful and snowball sampling methods were applied to select interviewees and the sampling continued until reaching the data saturation point. Finally, notes and interviews were transcribed and content analysis was used to analyze them. The results of the study showed that there was a health information management system for the elderly health sector in Iran. However, in all primary health care centers the documentation of data was done manually; the data flow was not automated; and the analysis and reporting of data are also manually. Eventually, decision makers are provided with delayed information. It is suggested that the steward of health in Iran, the ministry of health, develops an appropriate infrastructure and finally puts a high priority on the implementation of the health information management system for elderly health sector in Iran.

  17. Capital dynamics and local health systems: searching for a comprehensive analysis of the health sector

    Directory of Open Access Journals (Sweden)

    Maria de Fátima Siliansky de Andreazzi

    2006-01-01

    Full Text Available The article presents a proposal of a methodology aimed to analyze the health care sector according to the dynamics of capital accumulation. That approach could be summed up to more traditional approaches founded in the Public Health field, based in a political perspective. The proposal departs from concepts and methods of Industrial Organization, already used for health care markets, in the European and Latin-American (CEPAL contexts. We aggregated economic and historical variables to these approaches, which delimitate possibilities and impose constraints to the strategies of the local agents. The objective of the paper is to give methodological support to public managers at state and local level, whose role as the single commander in their territories is prescribed by the present health policy in Brazil. That includes all the fields related to private sector regulation in health: from planning the supply to quality control of providers.

  18. Banking for health: the role of financial sector actors in investing in global health.

    Science.gov (United States)

    Krech, Rüdiger; Kickbusch, Ilona; Franz, Christian; Wells, Nadya

    2018-01-01

    The world faces multiple health financing challenges as the global health burden evolves. Countries have set an ambitious health policy agenda for the next 15 years with prioritisation of universal health coverage under the Sustainable Development Goals. The scale of investment needed for equitable access to health services means global health is one of the key economic opportunities for decades to come. New financing partnerships with the private sector are vital. The aim of this study is to unlock additional financing sources, acknowledging the imperative to link financial returns to the providers of capital, and create profitable, sustainable financing structures. This paper outlines the global health investment opportunity exploring intersections of financial and health sector interests, and the role investment in health can play in economic development. Considering increasing demand for impact investments, the paper explores responsible financing initiatives and expansion of the global movement for sustainable capital markets. Adding an explicit health component (H) to the Environmental, Social and Governance (ESG) investment criteria, creating the ESG+H initiative, could serve as catalyst for the inclusion of health criteria into mainstream financial actors' business practices and investment objectives. The conclusion finds that health considerations directly impact profitability of the firm and therefore should be incorporated into financial analysis. Positive assessment of health impact, at a broad societal or environmental level, as well as for a firm's employees can become a value enhancing competitive advantage. An ESG+H framework could incorporate this into mainstream financial decision-making and into scalable investment products.

  19. A multi-sector assessment of community organizational capacity for promotion of Chinese immigrant worker health.

    Science.gov (United States)

    Tsai, Jenny H-C; Thompson, Elaine A

    2017-12-01

    Community-based collaborative approaches have received increased attention as a means for addressing occupational health disparities. Organizational capacity, highly relevant to engaging and sustaining community partnerships, however, is rarely considered in occupational health research. To characterize community organizational capacity specifically relevant to Chinese immigrant worker health, we used a cross-sectional, descriptive design with 36 agencies from six community sectors in King County, Washington. Joint interviews, conducted with two representatives from each agency, addressed three dimensions of organizational capacity: organizational commitment, resources, and flexibility. Descriptive statistics were used to capture the patterning of these dimensions by community sector. Organizational capacity varied widely across and within sectors. Chinese and Pan-Asian service sectors indicated higher capacity for Chinese immigrant worker health than did Chinese faith-based, labor union, public, and Pan-ethnic nonprofit sectors. Variation in organizational capacity in community sectors can inform selection of collaborators for community-based, immigrant worker health interventions. © 2017 Wiley Periodicals, Inc.

  20. Interventions to reduce corruption in the health sector.

    Science.gov (United States)

    Gaitonde, Rakhal; Oxman, Andrew D; Okebukola, Peter O; Rada, Gabriel

    2016-08-16

    Corruption is the abuse or complicity in abuse, of public or private position, power or authority to benefit oneself, a group, an organisation or others close to oneself; where the benefits may be financial, material or non-material. It is wide-spread in the health sector and represents a major problem. Our primary objective was to systematically summarise empirical evidence of the effects of strategies to reduce corruption in the health sector. Our secondary objective was to describe the range of strategies that have been tried and to guide future evaluations of promising strategies for which there is insufficient evidence. We searched 14 electronic databases up to January 2014, including: CENTRAL; MEDLINE; EMBASE; sociological, economic, political and other health databases; Human Resources Abstracts up to November 2010; Euroethics up to August 2015; and PubMed alerts from January 2014 to June 2016. We searched another 23 websites and online databases for grey literature up to August 2015, including the World Bank, the International Monetary Fund, the U4 Anti-Corruption Resource Centre, Transparency International, healthcare anti-fraud association websites and trial registries. We conducted citation searches in Science Citation Index and Google Scholar, and searched PubMed for related articles up to August 2015. We contacted corruption researchers in December 2015, and screened reference lists of articles up to May 2016. For the primary analysis, we included randomised trials, non-randomised trials, interrupted time series studies and controlled before-after studies that evaluated the effects of an intervention to reduce corruption in the health sector. For the secondary analysis, we included case studies that clearly described an intervention to reduce corruption in the health sector, addressed either our primary or secondary objective, and stated the methods that the study authors used to collect and analyse data. One review author extracted data from the

  1. Exploring the impact of customer relational benefit on relationship commitment in health service sectors.

    Science.gov (United States)

    Weng, Rhay-Hung; Huang, Jin-An; Huang, Ching-Yuan; Huang, Shih-Chang

    2010-01-01

    An increasing number of health service sectors have begun to implement relationship marketing to try to establish long-term relationship with customers. Customer relational benefit has been an important subject for relationship marketing researchers. This study was conducted to investigate how customer relational benefit might influence relationship commitment in health service sectors. The research used a questionnaire survey that retrieved a total number of 403 valid questionnaires. The data were collected by way of personal visits and investigations of outpatients in three regional hospitals in Taiwan. After the reliability and the validity of the questionnaire sample were examined, the data were verified by using hierarchical regression analysis. Results showed that confidence benefit constituted the most pronounced factor for hospital customers. Confidence benefit, social benefit, and special treatment benefit were perceived by customers as the key factors that have a positive influence on relationship commitment. In particular, customers placing greater emphasis on confidence benefit tended to be less willing to establish relationship commitment. When health service managers develop marketing strategies using customer relational benefit, they will still need to enhance customer confidence benefit as one of the main ways of achieving future improvements. In the event where health service managers seek to install resources for establishing and maintaining a good relationship commitment with customers, the crucial factors of social and special treatment benefits should not be ignored when seeking to enhance the customers' perception of confidence benefit.

  2. A Blueprint for Innovation to Achieve Health System Transformation.

    Science.gov (United States)

    Snowdon, Anne W

    2017-01-01

    Global health systems are challenged by escalating costs and growing demands for care created by the demands of aging populations and rising rates of chronic illness which place unsustainable pressure on health systems to meet population health needs. To overcome these challenges, transformational change is needed to strengthen health system performance and sustainability. Innovation is widely viewed as the strategy to drive transformational change in health systems; yet to date, innovation has lacked a clearly defined focus or agenda to achieve transformation. An actionable innovation agenda is needed to achieve transformational change for health systems. The key conditions for success as an innovation strategy are examined, including clearly defined innovation objectives, key milestones, and actionable steps every system stakeholder must pursue in order to guide the innovation agenda and ultimately accelerate the transformational changes needed for a sustainable healthcare system that delivers value to populations.

  3. Educating the future public health workforce: do schools of public health teach students about the private sector?

    Science.gov (United States)

    Rutkow, Lainie; Traub, Arielle; Howard, Rachel; Frattaroli, Shannon

    2013-01-01

    Recent surveys indicate that approximately 40% of graduates from schools of public health are employed within the private sector or have an employer charged with regulating the private sector. These data suggest that schools of public health should provide curricular opportunities for their students--the future public health workforce--to learn about the relationship between the private sector and the public's health. To identify opportunities for graduate students in schools of public health to select course work that educates them about the relationship between the private sector and public health. We systematically identified and analyzed data gathered from publicly available course titles and descriptions on the Web sites of accredited schools of public health. Data were collected in the United States. The sample consisted of accredited schools of public health. Descriptions of the number and types of courses that schools of public health offer about the private sector and identification of how course descriptions frame the private sector relative to public health. We identified 104 unique courses with content about the private sector's relationship to public health. More than 75% of accredited schools of public health offered at least 1 such course. Nearly 25% of identified courses focused exclusively on the health insurance industry. Qualitative analysis of the data revealed 5 frames used to describe the private sector, including its role as a stakeholder in the policy process. Schools of public health face a curricular gap, with relatively few course offerings that teach students about the relationship between the private sector and the public's health. By developing new courses or revising existing ones, schools of public health can expose the future public health workforce to the varied ways public health professionals interact with the private sector, and potentially influence students' career paths.

  4. Improving Cross-Sector Comparisons: Going Beyond the Health-Related QALY.

    Science.gov (United States)

    Brazier, John; Tsuchiya, Aki

    2015-12-01

    The quality-adjusted life-year (QALY) has become a widely used measure of health outcomes for use in informing decision making in health technology assessment. However, there is growing recognition of outcomes beyond health within the health sector and in related sectors such as social care and public health. This paper presents the advantages and disadvantages of ten possible approaches covering extending the health-related QALY and using well-being and monetary-based methods, in order to address the problem of using multiple outcome measures to inform resource allocation within and between sectors.

  5. Health-financing reforms in southeast Asia: challenges in achieving universal coverage.

    Science.gov (United States)

    Tangcharoensathien, Viroj; Patcharanarumol, Walaiporn; Ir, Por; Aljunid, Syed Mohamed; Mukti, Ali Ghufron; Akkhavong, Kongsap; Banzon, Eduardo; Huong, Dang Boi; Thabrany, Hasbullah; Mills, Anne

    2011-03-05

    In this sixth paper of the Series, we review health-financing reforms in seven countries in southeast Asia that have sought to reduce dependence on out-of-pocket payments, increase pooled health finance, and expand service use as steps towards universal coverage. Laos and Cambodia, both resource-poor countries, have mostly relied on donor-supported health equity funds to reach the poor, and reliable funding and appropriate identification of the eligible poor are two major challenges for nationwide expansion. For Thailand, the Philippines, Indonesia, and Vietnam, social health insurance financed by payroll tax is commonly used for formal sector employees (excluding Malaysia), with varying outcomes in terms of financial protection. Alternative payment methods have different implications for provider behaviour and financial protection. Two alternative approaches for financial protection of the non-poor outside the formal sector have emerged-contributory arrangements and tax-financed schemes-with different abilities to achieve high population coverage rapidly. Fiscal space and mobilisation of payroll contributions are both important in accelerating financial protection. Expanding coverage of good-quality services and ensuring adequate human resources are also important to achieve universal coverage. As health-financing reform is complex, institutional capacity to generate evidence and inform policy is essential and should be strengthened. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. The System of Indicators for Monitoring the Achievement of the Goals of Sustainable Development in the Agrarian Sector

    Directory of Open Access Journals (Sweden)

    Chala Tеtyana G.

    2017-06-01

    Full Text Available The article describes the results of statistical evaluation of the system of indicators for monitoring the achievement of the goals of sustainable development (GSD in the agrarian sector. It has been determined that, in order to achieve sustainable development, the following three pillars need to be reconciled: economic growth, social integration, and environmental protection. The objectives and indicators of the GSD 2 «Overcoming hunger, achieving food security, improving nutrition, and facilitating sustainable development of agriculture» were considered in detail. It has been determined that the indicator, which illustrates vividly the status and perspective of development of the agrarian sector, is the indicator 2.a.1 «Index of orientation towards agriculture, defined by the public expenditure structure». Methods for calculation of the Agriculture Orientation Index (AOI were considered. The dynamics of the AOI for Ukraine and world-wide for 2004-2013 were analyzed. The values of the AOI index for Ukraine, the neighboring countries, and the EU Member States in 2013 have been provided. It has been determined that Ukraine has a low AOI among the EU countries and among the neighboring countries, which indicates a poor orientation towards agriculture.

  7. Health in All (Foreign) Policy: challenges in achieving coherence.

    Science.gov (United States)

    Labonté, Ronald

    2014-06-01

    Health in All Policies (HiAP) approach is generally perceived as an intersectoral approach to national or sub-national public policy development, such that health outcomes are given full consideration by non-health sectors. Globalization, however, has created numerous 'inherently global health issues' with cross-border causes and consequences, requiring new forms of global governance for health. Although such governance often includes both state and non-state (private, civil society) actors in agenda setting and influence, different actors have differing degrees of power and authority and, ultimately, it is states that ratify intergovernmental covenants or normative declarations that directly or indirectly affect health. This requires public health and health promotion practitioners working within countries to give increased attention to the foreign policies of their national governments. These foreign policies include those governing national security, foreign aid, trade and investment as well as the traditional forms of diplomacy. A new term has been coined to describe how health is coming to be positioned in governments' foreign policies: global health diplomacy. To become adept at this nuanced diplomatic practice requires familiarity with the different policy frames by which health might be inserted into the foreign policy deliberations, and thence intergovernmental/global governance negotiations. This article discusses six such frames (security, trade, development, global public goods, human rights, ethical/moral reasoning) that have been analytically useful in assessing the potential for greater and more health-promoting foreign policy coherence: a 'Health in All (Foreign) Policies' approach. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Cross-country analysis of strategies for achieving progress towards global goals for women's and children's health.

    Science.gov (United States)

    Ahmed, Syed Masud; Rawal, Lal B; Chowdhury, Sadia A; Murray, John; Arscott-Mills, Sharon; Jack, Susan; Hinton, Rachael; Alam, Prima M; Kuruvilla, Shyama

    2016-05-01

    To identify how 10 low- and middle-income countries achieved accelerated progress, ahead of comparable countries, towards meeting millennium development goals 4 and 5A to reduce child and maternal mortality. We synthesized findings from multistakeholder dialogues and country policy reports conducted previously for the Success Factors studies in 10 countries: Bangladesh, Cambodia, China, Egypt, Ethiopia, the Lao People's Democratic Republic, Nepal, Peru, Rwanda and Viet Nam. A framework approach was used to analyse and synthesize the data from the country reports, resulting in descriptive or explanatory conclusions by theme. Successful policy and programme approaches were categorized in four strategic areas: leadership and multistakeholder partnerships; health sector; sectors outside health; and accountability for resources and results. Consistent and coordinated inputs across sectors, based on high-impact interventions, were assessed. Within the health sector, key policy and programme strategies included defining standards, collecting and using data, improving financial protection, and improving the availability and quality of services. Outside the health sector, strategies included investing in girls' education, water, sanitation and hygiene, poverty reduction, nutrition and food security, and infrastructure development. Countries improved accountability by strengthening and using data systems for planning and evaluating progress. Reducing maternal and child mortality in the 10 fast-track countries can be linked to consistent and coordinated policy and programme inputs across health and other sectors. The approaches used by successful countries have relevance to other countries looking to scale-up or accelerate progress towards the sustainable development goals.

  9. The contracting round: achieving health gain or financial balance?

    Science.gov (United States)

    McCarthy, M

    1998-12-01

    In the 1991 National Health Service reforms, health authorities became responsible for the health of their resident population, and they contract for health services from NHS providers - trusts and primary care services. A case study in Camden and Islington, an inner London health district, during 1996-1997 shows that contracting was directed more towards achieving financial balance than health objectives. Reasons include the inflationary effect of competition within an internal market, the power of administrators in decision-making within the health authority, and lack of adequate financial accounting in the NHS to relate costs to health outcomes. The introduction of programme budgets for districts would provide more cost-effective use of the nation's resources.

  10. Entrepreneurs and Public-Sector Employees: The Role of Achievement Motivation and Risk in Occupational Choice.

    Science.gov (United States)

    Tucker, Irvin B., III

    1988-01-01

    Presents a study that investigated how achievement motivation and risk affect entrepreneurs and nonentrepreneurs in their selection of occupations. Concludes that the will to be independent and successful is more important to entrepreneurs than for others, while personal risk-taking preferences are not significant in explaining entrepreneurial…

  11. Economic planning and equilibrium growth of human resources and capital in health-care sector: Case study of Iran.

    Science.gov (United States)

    Mahboobi-Ardakan, Payman; Kazemian, Mahmood; Mehraban, Sattar

    2017-01-01

    During different planning periods, human resources factor has been considerably increased in the health-care sector. The main goal is to determine economic planning conditions and equilibrium growth for services level and specialized workforce resources in health-care sector and also to determine the gap between levels of health-care services and specialized workforce resources in the equilibrium growth conditions and their available levels during the periods of the first to fourth development plansin Iran. In the study after data collection, econometric methods and EViews version 8.0 were used for data processing. The used model was based on neoclassical economic growth model. The results indicated that during the former planning periods, although specialized workforce has been increased significantly in health-care sector, lack of attention to equilibrium growth conditions caused imbalance conditions for product level and specialized workforce in health-care sector. In the past development plans for health services, equilibrium conditions based on the full employment in the capital stock, and specialized labor are not considered. The government could act by choosing policies determined by the growth model to achieve equilibrium level in the field of human resources and services during the next planning periods.

  12. Economic planning and equilibrium growth of human resources and capital in health-care sector: Case study of Iran

    Science.gov (United States)

    Mahboobi-Ardakan, Payman; Kazemian, Mahmood; Mehraban, Sattar

    2017-01-01

    CONTEXT: During different planning periods, human resources factor has been considerably increased in the health-care sector. AIMS: The main goal is to determine economic planning conditions and equilibrium growth for services level and specialized workforce resources in health-care sector and also to determine the gap between levels of health-care services and specialized workforce resources in the equilibrium growth conditions and their available levels during the periods of the first to fourth development plansin Iran. MATERIALS AND METHODS: In the study after data collection, econometric methods and EViews version 8.0 were used for data processing. The used model was based on neoclassical economic growth model. RESULTS: The results indicated that during the former planning periods, although specialized workforce has been increased significantly in health-care sector, lack of attention to equilibrium growth conditions caused imbalance conditions for product level and specialized workforce in health-care sector. CONCLUSIONS: In the past development plans for health services, equilibrium conditions based on the full employment in the capital stock, and specialized labor are not considered. The government could act by choosing policies determined by the growth model to achieve equilibrium level in the field of human resources and services during the next planning periods. PMID:28616419

  13. in the health service sector – results of literature study

    Directory of Open Access Journals (Sweden)

    Irena Sobańska

    2015-12-01

    Full Text Available The aim of this paper is to provide a review of the existing literature related to the directions of change from thepoint of view of the influence that lean approach has for management and accounting in health care institutions.The article is an account of the content of the selected 19 papers (from more than 200 analyzed published in thefield within the period 1995–2013. The investigation of the literature was conducted in two basic perspectives:theoretical considerations and results of empirical research (case study, questionnaire survey.The method of literature analysis was applied for the realization of the aim formulated in the paper. Twogroups of articles were the object of the analysis: theoretical and presenting explanatory results of empiricalinvestigations.The lean approach, which originated in the motor industry (production factories, is fully suitable for use inhealthcare organizations operating in various cultural contexts, and for reforming national healthcare systems toincrease their efficiency. The spreading and adoption of the lean concept in the medical services sector has anevolutionary character, similarly to the earlier spread of lean in manufacturing industries.

  14. Introducing payment for performance in the health sector of Tanzania- the policy process.

    Science.gov (United States)

    Chimhutu, Victor; Tjomsland, Marit; Songstad, Nils Gunnar; Mrisho, Mwifadhi; Moland, Karen Marie

    2015-09-02

    Prompted by the need to achieve progress in health outcomes, payment for performance (P4P) schemes are becoming popular policy options in the health systems in many low income countries. This paper describes the policy process behind the introduction of a payment for performance scheme in the health sector of Tanzania illuminating in particular the interests of and roles played by the Government of Norway, the Government of Tanzania and the other development partners. The study employed a qualitative research design using in-depth interviews (IDIs), observations and document reviews. Thirteen IDIs with key-informants representing the views of ten donor agencies and government departments influential in the process of introducing the P4P scheme in Tanzania were conducted in Dar es Salaam, Tanzania and Oslo, Norway. Data was collected on the main trends and thematic priorities in development aid policy, countries and actors perceived to be proponents and opponents to the P4P scheme, and P4P agenda setting in Tanzania. The initial introduction of P4P in the health sector of Tanzania was controversial. The actors involved including the bilateral donors in the Health Basket Fund, the World Bank, the Tanzanian Government and high level politicians outside the Health Basket Fund fought for their values and interests and formed alliances that shifted in the course of the process. The process was characterized by high political pressure, conflicts, changing alliances, and, as it evolved, consensus building. The P4P policy process was highly political with external actors playing a significant role in influencing the agenda in Tanzania, leaving less space for the Government of Tanzania to provide leadership in the process. Norway in particular, took a leading role in setting the agenda. The process of introducing P4P became long and frustrating causing mistrust among partners in the Health Basket Fund.

  15. Contracting private sector providers for public sector health services in Jalisco, Mexico: perspectives of system actors

    Directory of Open Access Journals (Sweden)

    González Luz

    2009-10-01

    Full Text Available Abstract Introduction Contracting out health services is a strategy that many health systems in the developing world are following, despite the lack of decisive evidence that this is the best way to improve quality, increase efficiency and expand coverage. A large body of literature has appeared in recent years focusing on the results of several contracting strategies, but very few papers have addressed aspects of the managerial process and how this can affect results. Case description This paper describes and analyses the perceptions and opinions of managers and workers about the benefits and challenges of the contracting model that has been in place for almost 10 years in the State of Jalisco, Mexico. Both qualitative and quantitative information was collected. An open-ended questionnaire was used to obtain information from a group of managers, while information provided by a self-selected group of workers was collected via a closed-ended questionnaire. The analysis contrasted the information obtained from each source. Discussion and Evaluation Findings show that perceptions of managers and workers vary for most of the items studied. For managers the model has been a success, as it has allowed for expansion of coverage based on a cost-effective strategy, while for workers the model also possesses positive elements but fails to provide fair labour relationships, which negatively affects their performance. Conclusion Perspectives of the two main groups of actors in Jalisco's contracting model are important in the design and adjustment of an adequate contracting model that includes managerial elements to give incentives to worker performance, a key element necessary to achieve the model's ultimate objectives. Lessons learnt from this study could be relevant for the experience of contracting models in other developing countries.

  16. Investment in intellectual capital and achievement of the competitive advantage in hotel sector

    Directory of Open Access Journals (Sweden)

    Qasim Mohammed Dahash

    2018-07-01

    Full Text Available The primary objective of the research paper is to provide some insights on the concepts of intellec-tual capital and its important dimensions alongside to investigate the possible association between intellectual capital and attainment of competitive advantage. This study focuses on Iraqi hotel industry which is an under-research area in the context of intellectual capital and its relationship with competitive advantage. An adapted questionnaire was utilized to collect the responses from top and middle level managers of four and five-star hotels in Iraq. The reliability and validity of data collec-tion instrument were measured through Cronbach’s alpha, Composite Reliability and Average Var-iance Extracted respectively. The competitive advantage was then regressed against Human, Rela-tional and Structural capital by application of Partial Least Square methodology. Results of the study showed a positive and strong connotation among intellectual capital and attainment of competitive advantage. The human capital had the highest contribution for competitive advantage in hotel sector of Iraq. The top management of hotels should take interest to develop, maintain and retain human capital to attain competitive advantage over competitors.

  17. Achieving excellence in community health centers: implications for health reform.

    Science.gov (United States)

    Gurewich, Deborah; Capitman, John; Sirkin, Jenna; Traje, Diana

    2012-02-01

    Existing studies tell us little about care quality variation within the community health center (CHC) delivery system. They also tell us little about the organizational conditions associated with CHCs that deliver especially high quality care. The purpose of this study was to examine the operational practices associated with a sample of high performing CHCs. Qualitative case studies of eight CHCs identified as delivering high-quality care relative to other CHCs were used to examine operational practices, including systems to facilitate care access, manage patient care, and monitor performance. Four common themes emerged that may contribute to high performance. At the same time, important differences across health centers were observed, reflecting differences in local environments and CHC capacity. In the development of effective, community-based models of care, adapting care standards to meet the needs of local conditions may be important.

  18. Morbidity and Health Risk Factors Among New Mexico Miners: A Comparison Across Mining Sectors.

    Science.gov (United States)

    Shumate, Alice M; Yeoman, Kristin; Victoroff, Tristan; Evans, Kandace; Karr, Roger; Sanchez, Tami; Sood, Akshay; Laney, Anthony Scott

    2017-08-01

    This study examines differences in chronic health outcomes between coal, uranium, metal, and nonmetal miners. In a cross-sectional study using data from a health screening program for current and former New Mexico miners, log-binomial logistic regression models were used to estimate relative risks of respiratory and heart disease, cancer, osteoarthritis, and back pain associated with mining in each sector as compared with coal, adjusting for other relevant risk factors. Differential risks in angina, pulmonary symptoms, asthma, cancer, osteoarthritis, and back pain between mining sectors were found. New Mexico miners experience different chronic health challenges across sectors. These results demonstrate the importance of using comparable data to understand how health risks differ across mining sectors. Further investigation among a broader geographic population of miners will help identify the health priorities and needs in each sector.

  19. The Public Health Innovation Model: Merging Private Sector Processes with Public Health Strengths.

    Science.gov (United States)

    Lister, Cameron; Payne, Hannah; Hanson, Carl L; Barnes, Michael D; Davis, Siena F; Manwaring, Todd

    2017-01-01

    Public health enjoyed a number of successes over the twentieth century. However, public health agencies have arguably been ill equipped to sustain these successes and address the complex threats we face today, including morbidity and mortality associated with persistent chronic diseases and emerging infectious diseases, in the context of flat funding and new and changing health care legislation. Transformational leaders, who are not afraid of taking risks to develop innovative approaches to combat present-day threats, are needed within public health agencies. We propose the Public Health Innovation Model (PHIM) as a tool for public health leaders who wish to integrate innovation into public health practice. This model merges traditional public health program planning models with innovation principles adapted from the private sector, including design thinking, seeking funding from private sector entities, and more strongly emphasizing program outcomes. We also discuss principles that leaders should consider adopting when transitioning to the PHIM, including cross-collaboration, community buy-in, human-centered assessment, autonomy and creativity, rapid experimentation and prototyping, and accountability to outcomes.

  20. The Public Health Innovation Model: Merging Private Sector Processes with Public Health Strengths

    Directory of Open Access Journals (Sweden)

    Cameron Lister

    2017-08-01

    Full Text Available Public health enjoyed a number of successes over the twentieth century. However, public health agencies have arguably been ill equipped to sustain these successes and address the complex threats we face today, including morbidity and mortality associated with persistent chronic diseases and emerging infectious diseases, in the context of flat funding and new and changing health care legislation. Transformational leaders, who are not afraid of taking risks to develop innovative approaches to combat present-day threats, are needed within public health agencies. We propose the Public Health Innovation Model (PHIM as a tool for public health leaders who wish to integrate innovation into public health practice. This model merges traditional public health program planning models with innovation principles adapted from the private sector, including design thinking, seeking funding from private sector entities, and more strongly emphasizing program outcomes. We also discuss principles that leaders should consider adopting when transitioning to the PHIM, including cross-collaboration, community buy-in, human-centered assessment, autonomy and creativity, rapid experimentation and prototyping, and accountability to outcomes.

  1. Banking for health: the role of financial sector actors in investing in global health

    Science.gov (United States)

    Kickbusch, Ilona; Franz, Christian; Wells, Nadya

    2018-01-01

    The world faces multiple health financing challenges as the global health burden evolves. Countries have set an ambitious health policy agenda for the next 15 years with prioritisation of universal health coverage under the Sustainable Development Goals. The scale of investment needed for equitable access to health services means global health is one of the key economic opportunities for decades to come. New financing partnerships with the private sector are vital. The aim of this study is to unlock additional financing sources, acknowledging the imperative to link financial returns to the providers of capital, and create profitable, sustainable financing structures. This paper outlines the global health investment opportunity exploring intersections of financial and health sector interests, and the role investment in health can play in economic development. Considering increasing demand for impact investments, the paper explores responsible financing initiatives and expansion of the global movement for sustainable capital markets. Adding an explicit health component (H) to the Environmental, Social and Governance (ESG) investment criteria, creating the ESG+H initiative, could serve as catalyst for the inclusion of health criteria into mainstream financial actors’ business practices and investment objectives. The conclusion finds that health considerations directly impact profitability of the firm and therefore should be incorporated into financial analysis. Positive assessment of health impact, at a broad societal or environmental level, as well as for a firm’s employees can become a value enhancing competitive advantage. An ESG+H framework could incorporate this into mainstream financial decision-making and into scalable investment products. PMID:29736278

  2. The Bangladesh paradox: exceptional health achievement despite economic poverty.

    Science.gov (United States)

    Chowdhury, A Mushtaque R; Bhuiya, Abbas; Chowdhury, Mahbub Elahi; Rasheed, Sabrina; Hussain, Zakir; Chen, Lincoln C

    2013-11-23

    Bangladesh, the eighth most populous country in the world with about 153 million people, has recently been applauded as an exceptional health performer. In the first paper in this Series, we present evidence to show that Bangladesh has achieved substantial health advances, but the country's success cannot be captured simplistically because health in Bangladesh has the paradox of steep and sustained reductions in birth rate and mortality alongside continued burdens of morbidity. Exceptional performance might be attributed to a pluralistic health system that has many stakeholders pursuing women-centred, gender-equity-oriented, highly focused health programmes in family planning, immunisation, oral rehydration therapy, maternal and child health, tuberculosis, vitamin A supplementation, and other activities, through the work of widely deployed community health workers reaching all households. Government and non-governmental organisations have pioneered many innovations that have been scaled up nationally. However, these remarkable achievements in equity and coverage are counterbalanced by the persistence of child and maternal malnutrition and the low use of maternity-related services. The Bangladesh paradox shows the net outcome of successful direct health action in both positive and negative social determinants of health--ie, positives such as women's empowerment, widespread education, and mitigation of the effect of natural disasters; and negatives such as low gross domestic product, pervasive poverty, and the persistence of income inequality. Bangladesh offers lessons such as how gender equity can improve health outcomes, how health innovations can be scaled up, and how direct health interventions can partly overcome socioeconomic constraints. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Public-Private health sector mix- way forward

    African Journals Online (AJOL)

    Bank.1. The World Bank articulated its position in two reports,2,3 basically recommending ... lution in public sector management thinking, termed “new public management” The new public man- ..... Buso DL, Hausler H, Jinabhai N. Knowledge,.

  4. Catastrophic Health Expenditure After the Implementation of Health Sector Evolution Plan: A Case Study in the West of Iran

    Directory of Open Access Journals (Sweden)

    Bakhtiar Piroozi

    2016-07-01

    Full Text Available Background: One of the main objectives of health systems is the financial protection against out-of-pocket (OOP health expenditures. OOP health expenditures can lead to catastrophic payments, impoverishment or poverty among households. In Iran, health sector evolution plan (HSEP has been implemented since 2014 in order to achieve universal health coverage and reduce the OOP health expenditures as a percentage of total health expenditures. This study aimed to explore the percentage of households facing catastrophic health expenditures (CHE after the implementation of HSEP and the factors that determine CHE. Methods: A total of 663 households were selected through a cluster sampling based on the census framework of Sanandaj Health Center in July 2015. Data were gathered using face-to-face interviews based on the household section of the World Health Survey questionnaire. In this study, according to the World Health Organization (WHO definition, if household health expenditures were equal to or more than 40% of the household capacity to pay, household was considered to be facing CHE. The determinants of CHE were analyzed using logistic regression model. Results: The rates of households facing CHE were 4.8%. The key determinants of CHE were household economic status, presence of elderly or disabled members in the household and utilization of inpatient or rehabilitation services. Conclusion: The comparison of our findings and those of other studies carried out using a methodology comparable with ours in different parts of Iran before the implementation of HSEP suggests that the implementation of recent reforms has reduced CHE at the household level. Utilization of inpatient and rehabilitation services, the presence of elderly or disabled members in the household and the low economic status of the household would increase the likelihood of facing CHE. These variables should be considered by health policy-makers in order to review and revise content of

  5. The roles of the health sector and health workers before, during and after violent conflict

    DEFF Research Database (Denmark)

    Buhmann, Caecilie; Barbara, Joanna Santa; Arya, Neil

    2010-01-01

    Starting with a view of war as a significant population health problem, this article explores the roles of health workers in relation to violent conflict. Four different roles are identified, defined by goals and values--military, development, humanitarian and peace. In addition, four dimensions...... of health work are seen as cross-cutting factors influencing health work in violent conflict-- whether the health worker is an insider or outsider to the conflict, whether they are oriented to primary, secondary or tertiary prevention of the mortality and morbidity of war, whether they take an individual...... clinical or a population health approach, and whether they are oriented to policy and whole-sector change or not. This article explores the nature of these roles, the influence of these cross-cutting dimensions, the challenges of each role and finally commonalities and possibilities for cooperation between...

  6. Private sector participation and health system performance in sub-saharan Africa.

    Science.gov (United States)

    Yoong, Joanne; Burger, Nicholas; Spreng, Connor; Sood, Neeraj

    2010-10-07

    The role of the private health sector in developing countries remains a much-debated and contentious issue. Critics argue that the high prices charged in the private sector limits the use of health care among the poorest, consequently reducing access and equity in the use of health care. Supporters argue that increased private sector participation might improve access and equity by bringing in much needed resources for health care and by allowing governments to increase focus on underserved populations. However, little empirical exists for or against either side of this debate. We examine the association between private sector participation and self-reported measures of utilization and equity in deliveries and treatment of childhood respiratory disease using regression analysis, across a sample of nationally-representative Demographic and Health Surveys from 34 SSA economies. We also examine the correlation between private sector participation and key background factors (socioeconomic development, business environment and governance) and use multivariate regression to control for potential confounders. Private sector participation is positively associated with greater overall access and reduced disparities between rich and poor as well as urban and rural populations. The positive association between private sector participation and improved health system performance is robust to controlling for confounders including per capita income and maternal education. Private sector participation is positively correlated with measures of socio-economic development and favorable business environment. Greater participation is associated with favorable intermediate outcomes in terms of access and equity. While these results do not establish a causal link between private sector participation and health system performance, they suggest that there is no deleterious link between private sector participation and health system performance in SSA.

  7. Assessing Private Sector Involvement in Health Care and Universal Health Coverage in Light of the Right to Health

    Science.gov (United States)

    2016-01-01

    Abstract The goal of universal health coverage is to “ensure that all people obtain the health services they need without suffering financial hardship when paying for them.” There are many connections between this goal and the state’s legal obligation to realize the human right to health. In the context of this goal, it is important to assess private actors’ involvement in the health sector. For example, private actors may not always have the incentives to deal with externalities that affect the availability, accessibility, acceptability, and quality of health care services; they may not be in a position to provide “public goods”; or they may operate under imperfect information. This paper sets out to answer the question, what legal human rights obligations do states have in terms of regulating private sector involvement in health care? PMID:28559678

  8. Assessing Private Sector Involvement in Health Care and Universal Health Coverage in Light of the Right to Health.

    Science.gov (United States)

    Hallo De Wolf, Antenor; Toebes, Brigit

    2016-12-01

    The goal of universal health coverage is to "ensure that all people obtain the health services they need without suffering financial hardship when paying for them." There are many connections between this goal and the state's legal obligation to realize the human right to health. In the context of this goal, it is important to assess private actors' involvement in the health sector. For example, private actors may not always have the incentives to deal with externalities that affect the availability, accessibility, acceptability, and quality of health care services; they may not be in a position to provide "public goods"; or they may operate under imperfect information. This paper sets out to answer the question, what legal human rights obligations do states have in terms of regulating private sector involvement in health care?

  9. Evaluation of health promotion training for the Western Australian Aboriginal maternal and child health sector.

    Science.gov (United States)

    Wilkins, Alexa; Lobo, Roanna C; Griffin, Denese M; Woods, Heather A

    2015-04-01

    The evaluation of health promotion training for the Western Australian (WA) Aboriginal maternal and child health (MCH) sector. Fifty-one MCH professionals from five regions in WA who attended one of three health promotion short courses in 2012-2013 were invited to complete an online survey or a telephone interview, between 4 to 17 months post-course. Respondents were asked how they had utilised the information and resources from the training and to identify the enabling factors or barriers to integrating health promotion into their work practices subsequently. Overall response rate was 33% (n=17); 94% of respondents reported they had utilised the information and resources from the course and 76% had undertaken health promotion activities since attending the course. Building contacts with other MCH providers and access to planning tools were identified as valuable components of the course. Barriers to translating knowledge into practice included financial constraints and lack of organisational support for health promotion activity. Health promotion training provides participants with the skills and confidence to deliver health promotion strategies in their communities. The training presents an opportunity to build health professionals' capacity to address some determinants of poor health outcomes among pregnant Aboriginal women and their babies. SO WHAT?: Training would be enhanced if accompanied by ongoing support for participants to integrate health promotion into their work practice, organisational development including health promotion training for senior management, establishing stronger referral pathways among partner organisations to support continuity of care and embedding training into MCH workforce curricula.

  10. Millennium Development Goals: how public health professionals perceive the achievement of MDGs

    Directory of Open Access Journals (Sweden)

    Marta Lomazzi

    2014-09-01

    Full Text Available Background: There have been various consultations on the Millennium Development Goals (MDGs by different groups. However, even if it is clear that the health sector has led the development success of the MDGs, only a few MDG reports consider public health experts’ points of view and these are mainly government driven. Designs: The World Federation of Public Health Associations (WFPHA has executed a global survey to consult public health professionals worldwide concerning the implementation and achievements of the MDGs.The survey was conceived by WFPHA health professionals and promulgated online. Public health professionals and organisations dealing with MDGs responded to the survey. Content analysis was conducted to analyse the data. Results: Survey participants attributed the highest importance worldwide to MDGs dealing with women, poverty and hunger reduction, and disease prevention and management. Moreover, they underlined the role of education, referring both to school children and professionals. In high and upper-middle income countries, environmental challenges also received considerable attention.Notably, respondents underlined that weak governance and unstable political situations, as well as the gap between professionals and politicians, were among the main causes that detracted from MDG achievements. Conclusion: The public health workforce felt it would be imperative to be included from the outset in the design and implementation of further goals. This implies that those professionals have to take an active part in the political process leading to a new and accountable framework.

  11. Social Media for e-Government in the Public Health Sector: Protocol for a Systematic Review

    Science.gov (United States)

    Franco, Massimo; Tursunbayeva, Aizhan

    2016-01-01

    Background Public sector organizations worldwide are engaging with social media as part of a growing e-government agenda. These include government departments of health, public health agencies, and state-funded health care and research organizations. Although examples of social media in health have been described in the literature, little is known about their overall scope or how they are achieving the objectives of e-government. A systematic literature review is underway to capture and synthesize existing evidence on the adoption, use, and impacts of social media in the public health sector. A series of parallel scoping exercises has taken place to examine (1) relevant existing systematic reviews, to assess their focus, breadth, and fit with our review topic, (2) existing concepts related to e-government, public health, and the public health sector, to assess how semantic complexity might influence the review process, and (3) the results of pilot searches, to examine the fit of social media within the e-government and health literatures. The methods and observations of the scoping exercises are reported in this protocol, alongside the methods and interim results for the systematic review itself. Objective The systematic review has three main objectives: To capture the corpus of published studies on the uses of social media by public health organizations; to classify the objectives for which social media have been deployed in these contexts and the methods used; and to analyze and synthesize evidence of the uptake, use, and impacts of social media on various outcomes. Methods A set of scoping exercises were undertaken, to inform the search strategy and analytic framework. Searches have been carried out in MEDLINE, the Cochrane Library, Web of Science, and the Scopus international electronic databases, and appropriate gray literature sources. Articles published between January 1, 2004, and July 12, 2015, were included. There was no restriction by language. One

  12. Social Media for e-Government in the Public Health Sector: Protocol for a Systematic Review.

    Science.gov (United States)

    Franco, Massimo; Tursunbayeva, Aizhan; Pagliari, Claudia

    2016-03-11

    Public sector organizations worldwide are engaging with social media as part of a growing e-government agenda. These include government departments of health, public health agencies, and state-funded health care and research organizations. Although examples of social media in health have been described in the literature, little is known about their overall scope or how they are achieving the objectives of e-government. A systematic literature review is underway to capture and synthesize existing evidence on the adoption, use, and impacts of social media in the public health sector. A series of parallel scoping exercises has taken place to examine (1) relevant existing systematic reviews, to assess their focus, breadth, and fit with our review topic, (2) existing concepts related to e-government, public health, and the public health sector, to assess how semantic complexity might influence the review process, and (3) the results of pilot searches, to examine the fit of social media within the e-government and health literatures. The methods and observations of the scoping exercises are reported in this protocol, alongside the methods and interim results for the systematic review itself. The systematic review has three main objectives: To capture the corpus of published studies on the uses of social media by public health organizations; to classify the objectives for which social media have been deployed in these contexts and the methods used; and to analyze and synthesize evidence of the uptake, use, and impacts of social media on various outcomes. A set of scoping exercises were undertaken, to inform the search strategy and analytic framework. Searches have been carried out in MEDLINE, the Cochrane Library, Web of Science, and the Scopus international electronic databases, and appropriate gray literature sources. Articles published between January 1, 2004, and July 12, 2015, were included. There was no restriction by language. One reviewer (AT) has independently

  13. A Big Data Revolution in Health Care Sector: Opportunities, Challenges and Technological Advancements

    OpenAIRE

    Sanskruti Patel; Atul Patel

    2016-01-01

    Health care sector grows tremendously in last few decades. The health care sector has generated huge amounts of data that has huge volume, enormous velocity and vast variety. Also it comes from a variety of new sources as hospitals are now tend to implemented electronic health record (EHR) systems. These sources have strained the existing capabilities of existing conventional relational database management systems. In such scenario, Big data solutions offer to harness these massive, heterogen...

  14. A Community Checklist for Health Sector Resilience Informed by Hurricane Sandy.

    Science.gov (United States)

    Toner, Eric S; McGinty, Meghan; Schoch-Spana, Monica; Rose, Dale A; Watson, Matthew; Echols, Erin; Carbone, Eric G

    This is a checklist of actions for healthcare, public health, nongovernmental organizations, and private entities to use to strengthen the resilience of their community's health sector to disasters. It is informed by the experience of Hurricane Sandy in New York and New Jersey and analyzed in the context of findings from other recent natural disasters in the United States. The health sector is defined very broadly, including-in addition to hospitals, emergency medical services (EMS), and public health agencies-healthcare providers, outpatient clinics, long-term care facilities, home health providers, behavioral health providers, and correctional health services. It also includes community-based organizations that support these entities and represent patients. We define health sector resilience very broadly, including all factors that preserve public health and healthcare delivery under extreme stress and contribute to the rapid restoration of normal or improved health sector functioning after a disaster. We present the key findings organized into 8 themes. We then describe a conceptual map of health sector resilience that ties these themes together. Lastly, we provide a series of recommended actions for improving health sector resilience at the local level. The recommended actions emphasize those items that individuals who experienced Hurricane Sandy deemed to be most important. The recommendations are presented as a checklist that can be used by a variety of interested parties who have some role to play in disaster preparedness, response, and recovery in their own communities. Following a general checklist are supplemental checklists that apply to specific parts of the larger health sector.

  15. Exploration of priority actions for strengthening the role of nurses in achieving universal health coverage

    Directory of Open Access Journals (Sweden)

    Rowaida Al Maaitah

    Full Text Available ABSTRACT Objective: to explore priority actions for strengthening the role of Advanced Practice Nurses (APNs towards the achievement of Universal Health Converge (UHC as perceived by health key informants in Jordan. Methods: an exploratory qualitative design, using a semi-structured survey, was utilized. A purposive sample of seventeen key informants from various nursing and health care sectors was recruited for the purpose of the study. Content analysis utilizing the five-stage framework approach was used for data analysis. Results: the findings revealed that policy and regulation, nursing education, research, and workforce were identified as the main elements that influence the role of APNs in contributing to the achievement of UHC. Priority actions were identified by the participants for the main four elements. Conclusion: study findings confirm the need to strengthen the role of APNs to achieve UHC through a major transformation in nursing education, practice, research, leadership, and regulatory system. Nurses should unite to come up with solid nursing competencies related to APNs, PHC, UHC, leadership and policy making to strengthen their position as main actors in influencing the health care system and evidence creation.

  16. Engaging the private sector in public health challenges in Namibia

    NARCIS (Netherlands)

    de Beer, I.H.

    2017-01-01

    Engaging the private sector in healthcare is a central theme in the work of PharmAccess Foundation, a Dutch not-for-profit organization, based in Amsterdam, with offices in several African countries, including Namibia. This thesis describes interventions developed and applied in Namibia to engage

  17. The creation of the health consumer: challenges on health sector regulation after managed care era.

    Science.gov (United States)

    Iriart, Celia; Franco, Tulio; Merhy, Emerson E

    2011-02-24

    We utilized our previous studies analyzing the reforms affecting the health sector developed in the 1990s by financial groups to frame the strategies implemented by the pharmaceutical industry to regain market positions and to understand the challenges that regulatory agencies are confronting. We followed an analytical approach for analyzing the process generated by the disputes between the financial groups and the pharmaceutical corporations and the challenges created to governmental regulation. We analyzed primary and secondary sources using situational and discourse analyses. We introduced the concepts of biomedicalization and biopedagogy, which allowed us to analyze how medicalization was radicalized. In the 1990s, structural adjustment policies facilitated health reforms that allowed the entrance of multinational financial capital into publicly-financed and employer-based insurance. This model operated in contraposition to the interests of the medical industrial complex, which since the middle of the 1990s had developed silent reforms to regain authority in defining the health-ill-care model. These silent reforms radicalized the medicalization. Some reforms took place through deregulatory processes, such as allowing direct-to-consumer advertisements of prescription drugs in the United States. In other countries different strategies were facilitated by the lack of regulation of other media such as the internet. The pharmaceutical industry also has had a role in changing disease definitions, rebranding others, creating new ones, and pressuring for approval of treatments to be paid by public, employer, and private plans. In recent years in Brazil there has been a substantial increase in the number of judicial claims demanding that public administrations pay for new treatments. We found that the dispute for the hegemony of the health sector between financial and pharmaceutical companies has deeply transformed the sector. Patients converted into consumers are

  18. The creation of the health consumer: challenges on health sector regulation after managed care era

    Directory of Open Access Journals (Sweden)

    Merhy Emerson E

    2011-02-01

    Full Text Available Abstract Background We utilized our previous studies analyzing the reforms affecting the health sector developed in the 1990s by financial groups to frame the strategies implemented by the pharmaceutical industry to regain market positions and to understand the challenges that regulatory agencies are confronting. Methods We followed an analytical approach for analyzing the process generated by the disputes between the financial groups and the pharmaceutical corporations and the challenges created to governmental regulation. We analyzed primary and secondary sources using situational and discourse analyses. We introduced the concepts of biomedicalization and biopedagogy, which allowed us to analyze how medicalization was radicalized. Results In the 1990s, structural adjustment policies facilitated health reforms that allowed the entrance of multinational financial capital into publicly-financed and employer-based insurance. This model operated in contraposition to the interests of the medical industrial complex, which since the middle of the 1990s had developed silent reforms to regain authority in defining the health-ill-care model. These silent reforms radicalized the medicalization. Some reforms took place through deregulatory processes, such as allowing direct-to-consumer advertisements of prescription drugs in the United States. In other countries different strategies were facilitated by the lack of regulation of other media such as the internet. The pharmaceutical industry also has had a role in changing disease definitions, rebranding others, creating new ones, and pressuring for approval of treatments to be paid by public, employer, and private plans. In recent years in Brazil there has been a substantial increase in the number of judicial claims demanding that public administrations pay for new treatments. Conclusions We found that the dispute for the hegemony of the health sector between financial and pharmaceutical companies has deeply

  19. Health 2020 – Achieving Health and Development in Today’s Europe

    Directory of Open Access Journals (Sweden)

    Zsuzsanna Jakab

    2014-09-01

    CONCLUSION: This article presents the development process of Health 2020 and its main strategic goals, objectives and content. Further, it describes what is needed to successfully implement Health 2020 in countries and how WHO can provide technical assistance to countries that embark on developing health policy aligned with the Health 2020 policy framework. The development and implementation of Health 2020 is a powerful vehicle for concerted inter-sectoral action across the WHO European Region for improving health and well-being of present and future generations. Successful implementation of Health 2020 needs providing technical assistance by WHO to the countries to embark on developing health policy aligned with the Health 2020 policy framework.

  20. Scaling up the health workforce in the public sector: the role of government fiscal policy.

    Science.gov (United States)

    Vujicic, Marko

    2010-01-01

    Health workers play a key role in increasing access to health care services. Global and country-level estimates show that staffing in many developing countries - particularly in Sub-Saharan Africa - is far leaner than needed to deliver essential health services to the population. One factor that can limit scaling up the health workforce in developing countries is the government's overall wage policy which sometimes creates restrictions on hiring in the health sector. But while there is considerable debate, the information base in this important area has been quite limited. This paper summarizes the process that determines the budget for health wages in the public sector, how it is linked to overall wage policies, and how this affects staffing in the health sector. The author draws mainly from a recent World Bank report.

  1. Leveraging the private sector for child health: a qualitative examination of caregiver and provider perspectives on private sector care for childhood pneumonia in Uttar Pradesh, India.

    Science.gov (United States)

    Brunie, Aurélie; Lenzi, Rachel; Lahiri, Anamika; Izadnegahdar, Rasa

    2017-02-22

    The private health sector is a primary source of curative care for childhood illnesses in many low- and middle-income countries. Therefore ensuring appropriate private sector care is an important step towards improving outcomes from illnesses like pneumonia, which is the leading infectious cause of childhood mortality worldwide. This study aimed to provide evidence on private sector care for childhood pneumonia in Uttar Pradesh, India, by simultaneously exploring providers' knowledge and practices and caregivers' experiences. We conducted in-depth interviews with a purposive sample of 36 practitioners and 34 caregivers in two districts. Practitioners included allopathic doctors, AYUSH providers, and drug sellers. Caregivers were mothers of children under the age of five with symptoms consistent with pneumonia who had seen one of those practitioners. Interview transcripts were analyzed thematically. Caregivers were generally prompt in seeking care outside the home, but many initially favored local informal providers based on access and cost. Drug sellers were not commonly consulted for treatment. Formal providers had imperfect, but reasonable, knowledge of pneumonia and followed appropriate steps for diagnosis, though some gaps were noticed that were primarily related to lack of (or failure to use) diagnostic tools. Most practitioners prescribed antibiotics and supportive symptomatic treatment. Relational and structural factors encouraged overuse of antibiotics and treatment interruption. Caregivers often had a limited understanding of treatment but wanted rapid symptomatic improvements, frequently leading to sequentially consulting multiple providers and interrupting treatment when symptoms improved. Providers were confronted with these expectations and care-seeking patterns. This study contributes in-depth evidence on private sector care for childhood pneumonia in UP. Achieving appropriate care requires an enriched perspective that simultaneously considers the

  2. Why do health workers in rural Tanzania prefer public sector employment?

    Science.gov (United States)

    Songstad, Nils Gunnar; Moland, Karen Marie; Massay, Deodatus Amadeus; Blystad, Astrid

    2012-04-05

    Severe shortages of qualified health workers and geographical imbalances in the workforce in many low-income countries require the national health sector management to closely monitor and address issues related to the distribution of health workers across various types of health facilities. This article discusses health workers' preferences for workplace and their perceptions and experiences of the differences in working conditions in the public health sector versus the church-run health facilities in Tanzania. The broader aim is to generate knowledge that can add to debates on health sector management in low-income contexts. The study has a qualitative study design to elicit in-depth information on health workers' preferences for workplace. The data comprise ten focus group discussions (FGDs) and 29 in-depth interviews (IDIs) with auxiliary staff, nursing staff, clinicians and administrators in the public health sector and in a large church-run hospital in a rural district in Tanzania. The study has an ethnographic backdrop based on earlier long-term fieldwork in Tanzania. The study found a clear preference for public sector employment. This was associated with health worker rights and access to various benefits offered to health workers in government service, particularly the favourable pension schemes providing economic security in old age. Health workers acknowledged that church-run hospitals generally were better equipped and provided better quality patient care, but these concerns tended to be outweighed by the financial assets of public sector employment. In addition to the sector specific differences, family concerns emerged as important in decisions on workplace. The preference for public sector employment among health workers shown in this study seems to be associated primarily with the favourable pension scheme. The overall shortage of health workers and the distribution between health facilities is a challenge in a resource constrained health system

  3. The Social Environment and the Health Care sector

    OpenAIRE

    da Rocha Fernandes, Joao Diogo

    2012-01-01

    The objective of this thesis was to defend an alternative approach by health policy makers for improving health outcomes through investing on social factors of peoples' lives, rather than by increasing health expenditures. In order to defend this theory, this master thesis addresses two research questions: Which are the social determinants of health with largest impact on health status of individuals? And what is the statistical correlation between those social determinants of health and self...

  4. What is the Meaning of Public Sector Health?

    DEFF Research Database (Denmark)

    Waldorff, Susanne Boch

    2013-01-01

    This study explores the dynamics involved in establishing discourses necessary for constructing organizational change within the public sector. Drawing upon critical discourse analysis, the study identifies two competing discourses – a ‘patient’ and a ‘healthy citizen’ discourse, which exist...... in the context of public sector change. First, the study shows that discourses not only provide different senses of meaning and warrant particular social actors a louder voice than others, but that these actors also develop discursive legitimizing strategies and translate particular meanings...... into the organization and organizational practices. Second, when the strategies make a discourse resonate with the local context, in this case a highly political context, then specific organizational practices become more legitimate than others, and the discourse is more inclined to become manifest. Finally...

  5. Development of health biotechnology in developing countries: can private-sector players be the prime movers?

    Science.gov (United States)

    Abuduxike, Gulifeiya; Aljunid, Syed Mohamed

    2012-01-01

    Health biotechnology has rapidly become vital in helping healthcare systems meet the needs of the poor in developing countries. This key industry also generates revenue and creates employment opportunities in these countries. To successfully develop biotechnology industries in developing nations, it is critical to understand and improve the system of health innovation, as well as the role of each innovative sector and the linkages between the sectors. Countries' science and technology capacities can be strengthened only if there are non-linear linkages and strong interrelations among players throughout the innovation process; these relationships generate and transfer knowledge related to commercialization of the innovative health products. The private sector is one of the main actors in healthcare innovation, contributing significantly to the development of health biotechnology via knowledge, expertise, resources and relationships to translate basic research and development into new commercial products and innovative processes. The role of the private sector has been increasingly recognized and emphasized by governments, agencies and international organizations. Many partnerships between the public and private sector have been established to leverage the potential of the private sector to produce more affordable healthcare products. Several developing countries that have been actively involved in health biotechnology are becoming the main players in this industry. The aim of this paper is to discuss the role of the private sector in health biotechnology development and to study its impact on health and economic growth through case studies in South Korea, India and Brazil. The paper also discussed the approaches by which the private sector can improve the health and economic status of the poor. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. Modeling transitions in the California light-duty vehicles sector to achieve deep reductions in transportation greenhouse gas emissions

    International Nuclear Information System (INIS)

    Leighty, Wayne; Ogden, Joan M.; Yang, Christopher

    2012-01-01

    California’s target for reducing economy-wide greenhouse gas (GHG) emissions is 80% below 1990 levels by 2050. We develop transition scenarios for meeting this goal in California’s transportation sector, with focus on light-duty vehicles (LDVs). We explore four questions: (1) what options are available to reduce transportation sector GHG emissions 80% below 1990 levels by 2050; (2) how rapidly would transitions in LDV markets, fuels, and travel behaviors need to occur over the next 40 years; (3) how do intermediate policy goals relate to different transition pathways; (4) how would rates of technological change and market adoption between 2010 and 2050 impact cumulative GHG emissions? We develop four LDV transition scenarios to meet the 80in50 target through a combination of travel demand reduction, fuel economy improvements, and low-carbon fuel supply, subject to restrictions on trajectories of technological change, potential market adoption of new vehicles and fuels, and resource availability. These scenarios exhibit several common themes: electrification of LDVs, rapid improvements in vehicle efficiency, and future fuels with less than half the carbon intensity of current gasoline and diesel. Availability of low-carbon biofuels and the level of travel demand reduction are “swing factors” that influence the degree of LDV electrification required. - Highlights: ► We model change in California LDVs for deep reduction in transportation GHG emissions. ► Reduced travel demand, improved fuel economy, and low-carbon fuels are all needed. ► Transitions must begin soon and occur quickly in order to achieve the 80in50 goal. ► Low-C biofuel supply and travel demand influence the need for rapid LDV electrification. ► Cumulative GHG emissions from LDVs can differ between strategies by up to 40%.

  7. Use of communities of practice in business and health care sectors: a systematic review.

    Science.gov (United States)

    Li, Linda C; Grimshaw, Jeremy M; Nielsen, Camilla; Judd, Maria; Coyte, Peter C; Graham, Ian D

    2009-05-17

    Since being identified as a concept for understanding knowledge sharing, management, and creation, communities of practice (CoPs) have become increasingly popular within the health sector. The CoP concept has been used in the business sector for over 20 years, but the use of CoPs in the health sector has been limited in comparison. First, we examined how CoPs were defined and used in these two sectors. Second, we evaluated the evidence of effectiveness on the health sector CoPs for improving the uptake of best practices and mentoring new practitioners. We conducted a search of electronic databases in the business, health, and education sectors, and a hand search of key journals for primary studies on CoP groups. Our research synthesis for the first objective focused on three areas: the authors' interpretations of the CoP concept, the key characteristics of CoP groups, and the common elements of CoP groups. To examine the evidence on the effectiveness of CoPs in the health sector, we identified articles that evaluated CoPs for improving health professional performance, health care organizational performance, professional mentoring, and/or patient outcome; and used experimental, quasi-experimental, or observational designs. The structure of CoP groups varied greatly, ranging from voluntary informal networks to work-supported formal education sessions, and from apprentice training to multidisciplinary, multi-site project teams. Four characteristics were identified from CoP groups: social interaction among members, knowledge sharing, knowledge creation, and identity building; however, these were not consistently present in all CoPs. There was also a lack of clarity in the responsibilities of CoP facilitators and how power dynamics should be handled within a CoP group. We did not find any paper in the health sector that met the eligibility criteria for the quantitative analysis, and so the effectiveness of CoP in this sector remained unclear. There is no dominant trend

  8. Health transformation plan: Goals achievement in Nemazee hospital

    Directory of Open Access Journals (Sweden)

    Ali Akbar Ahmadi

    2016-01-01

    Full Text Available Introduction: The main purpose of this study was to assess fulfillment of goals about “Health Transformation Plan (HTP of Ministry of Health, Treatment and Medical Education” from the perspective of managers, which is as one of the most important management challenges in the Health System Reform Plan. These goals included six packages determined by the Ministry of Health, Treatment and Medical Education, the fulfillment of each of which one was evaluated separately as sub-goals in the current study. Finally, the rank of each package in comparison to other packages was determined and presented, using means rank test (Friedman test. Method: This study was conducted using a questionnaire in which comments of the senior and middle managers of Nemazee hospital were collected as the research data. Due to the fact that about one year has passed since the beginning of implementation of HTP and since there were no documented methods or questionnaires, the researcher designed a self-made questionnaire. The basis of designing the questionnaire was the set of guidelines developed for Health System Reform Plan. These guidelines include goals that a hospital should achieve during implementation of Health System Reform Plan. After sharing these goals with senior and middle managers of Nemazee hospital (as the place of research, they were converted to a questionnaire including 20 questions. The questionnaire included the goals that must be achieved in Nemazee hospital of Shiraz during the implementation of the plan. After designing the questionnaire, a preliminary test was taken to assess the reliability. Results: Cronbach’s alpha coefficient (0.88 showed a high rate of reliability in the above questionnaire. After the final data collection, the questionnaire was tested in a sample of 100 senior and middle managers; the results showed that about six packages were specified by the Ministry of Health, Treatment and Medical Education. The majority of

  9. Occupational class inequalities in health across employment sectors: the contribution of working conditions.

    Science.gov (United States)

    Lahelma, Eero; Laaksonen, Mikko; Aittomäki, Akseli

    2009-01-01

    While health inequalities among employees are well documented, their variation and determinants among employee subpopulations are poorly understood. We examined variations in occupational class inequalities in health within four employment sectors and the contribution of working conditions to these inequalities. Cross-sectional data from the Helsinki Health Study in 2000-2002 were used. Each year, employees of the City of Helsinki, aged 40-60 years, received a mailed questionnaire (n = 8,960, 80% women, overall response rate for 3 years 67%). The outcome was physical health functioning measured by the overall physical component summary of SF-36. The socioeconomic indicator was occupational social class. Employment sectors studied were health care, education, social welfare and administration (n = 6,557). Physical and mental workload, and job demands and job control were explanatory factors. Inequality indices from logistic regression analysis were calculated. Occupational class inequalities in physical health functioning were slightly larger in education (1.47) than in the other sectors (1.43-1.40). Physical workload explained 95% of inequalities in social welfare and 32-36% in the other sectors. Job control also partly explained health inequalities. However, adjusting for mental workload and job demands resulted in larger health inequalities. Inequalities in physical health functioning were found within each employment sector, with minor variation in their magnitude. Physical workload was the main explanation for these inequalities, but its contribution varied between the sectors. In contrast, considering psychosocial working conditions led to wider inequalities. Improving physical working conditions among the lower occupational classes would help reduce health inequalities within different employment sectors.

  10. Commitment among state health officials & its implications for health sector reform: lessons from Gujarat.

    Science.gov (United States)

    Maheshwari, Sunil; Bhat, Ramesh; Saha, Somen

    2008-02-01

    Commitment, competencies and skills of people working in the health sector can significantly impact the performance and its reform process. In this study we attempted to analyse the commitment of state health officials and its implications for human resource practices in Gujarat. A self-administered questionnaire was used to measure commitment and its relationship with human resource (HR) variables. Employee's organizational commitment (OC) and professional commitment (PC) were measured using OC and PC scale. Fifty five medical officers from Gujarat participated in the study. Professional commitment of doctors (3.21 to 4.01) was found to be higher than their commitment to the organization (3.01 to 3.61). Doctors did not perceive greater fairness in the system on promotion (on the scale of 5, score: 2.55) and were of the view that the system still followed seniority based promotion (score: 3.42). Medical officers were upset about low autonomy in the department with regard to reward and recognition, accounting procedure, prioritization and synchronization of health programme and other administrative activities. Our study provided some support for positive effects of progressive HR practices on OC, specifically on affective and normative OC. Following initiatives were identified to foster a development climate among the health officials: providing opportunities for training, professional competency development, developing healthy relationship between superiors and subordinates, providing useful performance feedback, and recognising and rewarding performance. For reform process in the health sector to succeed, there is a need to promote high involvement of medical officers. There is a need to invest in developing leadership quality, supervision skills and developing autonomy in its public health institutions.

  11. Challenges towards Realization of Health Care Sector Goals of ...

    African Journals Online (AJOL)

    Background: Human resource for health (HRH) is an essential building block for effective and efficient health care system. In Tanzania this component is faced by many challenges which in synergy with others make the health care system inefficient. In vision 2025 the country recognizes the importance of the health care ...

  12. The economy, the health sector and child health in Zimbabwe since independence.

    Science.gov (United States)

    Sanders, D; Davies, R

    1988-01-01

    This paper examines the changes in the economic environment which have taken place in Zimbabwe since independence in April 1980, concentrating on those which are relevant to health. It also describes the post-independence restructuring of the health sector itself. Finally, it considers some changes which have taken place in the health status of children. Despite a prolonged drought, economic recession and the imposition of economic stabilisation measures, there is evidence of a sharp improvement in infant and young child mortality. This has resulted almost certainly from an energetic expansion and reorientation of health care provision, and particularly from greatly improved access to immunisation and oral rehydration therapy. The adverse effects of drought and stabilisation measures have been partially offset by aid-supported relief feeding and particular health programmes. However, the economic crisis has resulted in a decline in real incomes for a large number of households since the immediate post-independence boom. This is reflected in high levels of childhood undernutrition which seem to have remained static despite the health care drive. This emerging divergence between death rates and quality of life as reflected by nutrition levels is reflective on the one hand of rapid expansion in effective health care provision, and on the other of little change in socio-economic conditions for the majority of the population.

  13. Contemporary specificities of labour in the health care sector: introductory notes for discussion.

    Science.gov (United States)

    Campos, Francisco Eduardo; Albuquerque, Eduardo da Motta e

    2005-08-18

    This paper combines the literature on public health, on economics of health and on economics of technological innovation to discuss the peculiarities of labour in the health care sector. METHOD AND FRAMEWORK: The starting point is the investigation of the economic peculiarities of medical care. This investigation leads to the identification of the prevalence of non-market forms of medical care in the countries of the Organisation for Economic Co-operation and Development (OECD). Furthermore, the health care system has a distinctive characteristic from other economic sectors: it is the intersection between social welfare and innovation systems. The relationship between technological innovation and cost in the health care sector is surveyed. Finally, the Brazilian case is discussed as an example of a developing country. The peculiarities of labour in the health care sector suggest the need to recognize the worth of sectoral labour and to cease to treat it separately. This process should take into account the rapid development of the health innovation system and one important consequence: the obsolescence of the acquired knowledge. One way to dignify labour is to implement continued education and training of health professions personnel.

  14. Contemporary specificities of labour in the health care sector: introductory notes for discussion

    Directory of Open Access Journals (Sweden)

    Albuquerque Eduardo

    2005-08-01

    Full Text Available Abstract Background This paper combines the literature on public health, on economics of health and on economics of technological innovation to discuss the peculiarities of labour in the health care sector. Method and framework The starting point is the investigation of the economic peculiarities of medical care. Results and discussions This investigation leads to the identification of the prevalence of non-market forms of medical care in the countries of the Organisation for Economic Co-operation and Development (OECD. Furthermore, the health care system has a distinctive characteristic from other economic sectors: it is the intersection between social welfare and innovation systems. The relationship between technological innovation and cost in the health care sector is surveyed. Finally, the Brazilian case is discussed as an example of a developing country. Conclusion The peculiarities of labour in the health care sector suggest the need to recognize the worth of sectoral labour and to cease to treat it separately. This process should take into account the rapid development of the health innovation system and one important consequence: the obsolescence of the acquired knowledge. One way to dignify labour is to implement continued education and training of health professions personnel.

  15. Contemporary specificities of labour in the health care sector: introductory notes for discussion

    Science.gov (United States)

    Campos, Francisco Eduardo; Albuquerque, Eduardo da Motta e

    2005-01-01

    Background This paper combines the literature on public health, on economics of health and on economics of technological innovation to discuss the peculiarities of labour in the health care sector. Method and framework The starting point is the investigation of the economic peculiarities of medical care. Results and discussions This investigation leads to the identification of the prevalence of non-market forms of medical care in the countries of the Organisation for Economic Co-operation and Development (OECD). Furthermore, the health care system has a distinctive characteristic from other economic sectors: it is the intersection between social welfare and innovation systems. The relationship between technological innovation and cost in the health care sector is surveyed. Finally, the Brazilian case is discussed as an example of a developing country. Conclusion The peculiarities of labour in the health care sector suggest the need to recognize the worth of sectoral labour and to cease to treat it separately. This process should take into account the rapid development of the health innovation system and one important consequence: the obsolescence of the acquired knowledge. One way to dignify labour is to implement continued education and training of health professions personnel. PMID:16109174

  16. A qualitative assessment of health extension workers' relationships with the community and health sector in Ethiopia : opportunities for enhancing maternal health performance

    NARCIS (Netherlands)

    Kok, Maryse C; Kea, Aschenaki Z.; Datiko, Daniel G; Broerse, Jacqueline E W; Dieleman, Marjolein; Taegtmeyer, Miriam; Tulloch, Olivia

    2015-01-01

    BACKGROUND: Health extension workers (HEWs) in Ethiopia have a unique position, connecting communities to the health sector. This intermediary position requires strong interpersonal relationships with actors in both the community and health sector, in order to enhance HEW performance. This study

  17. Creating an integrated public sector? Labour's plans for the modernisation of the English health care system

    Directory of Open Access Journals (Sweden)

    Nick Goodwin

    2002-03-01

    Full Text Available The current Labour Government has embarked on radical public sector reform in England. A so-called ‘Modernisation Agenda’ has been developed that is encapsulated in the NHS Plan—a document that details a long-term vision for health care. This plan involves a five-fold strategy: investment through greater public funding; quality assurance; improving access; service integration and inter-professional working; and providing a public health focus. The principles of Labour's vision have been broadly supported. However, achieving its aims appears reliant on two key factors. First, appropriate resources are required to create capacity, particularly management capacity, to enable new functions to develop. Second, promoting access and service integration requires the development of significant co-ordination, collaboration and networking between agencies and individuals. This is particularly important for health and social care professionals. Their historically separate professions suggest that a significant period of change management is required to allow new roles and partnerships to evolve. In an attempt to secure delivery of its goals, however, the Government has placed the emphasis on further organisational restructuring. In doing so, the Government may have missed the key challenges faced in delivering its NHS Plan. As this paper argues, cultural and behavioural change is probably a far more appropriate and important requirement for success than a centrally directed approach that emphasises the rearrangement of structural furniture.

  18. The role of institutions on the effectiveness of malaria treatment in the Ghanaian health sector

    OpenAIRE

    Amporfu, Eugenia; Nonvignon, Justice

    2015-01-01

    Background The Ghanaian health sector has undertaken several policies to help improve the quality of care received by patients. This includes the construction of several health facilities, the increase in the training of health workers, especially nurses, and the introduction of incentive packages (such as salary increase) to motivate health workers. The important question is to what extent does the institutional arrangement between the health facilities and the government as well as between ...

  19. [Constraints and opportunities for inter-sector health promotion initiatives: a case study].

    Science.gov (United States)

    Magalhães, Rosana

    2015-07-01

    This article analyzes the implementation of inter-sector initiatives linked to the Family Grant, Family Health, and School Health Programs in the Manguinhos neighborhood in the North Zone of Rio de Janeiro, Brazil. The study was conducted in 2010 and 2011 and included document review, local observation, and 25 interviews with program managers, professionals, and staff. This was an exploratory case study using a qualitative approach that identified constraints and opportunities for inter-sector health experiences, contributing to the debate on the effectiveness of health promotion and poverty relief programs.

  20. Safeguarding the Health Sector in Times of Macroeconomic Instability

    International Development Research Centre (IDRC) Digital Library (Canada)

    2008-01-01

    Jan 1, 2008 ... ... financing, quality, accessibility, and utilization), rather than on health status. ... and access to care, health-care reform, and tuberculosis control. ... 2017 call for proposals to establish Cyber Policy Centres in the Global South.

  1. General Satisfaction Among Healthcare Workers: Differences Between Employees in Medical and Mental Health Sector

    Science.gov (United States)

    Papathanasiou, Ioanna V.; Kleisiaris, Christos F.; Tsaras, Konstantinos; Fradelos, Evangelos C.; Kourkouta, Lambrini

    2015-01-01

    Background: General satisfaction is a personal experience and sources of satisfaction or dissatisfaction vary between professional groups. General satisfaction is usually related with work settings, work performance and mental health status. Aim: The purpose of this research study was to investigate the level of general satisfaction of health care workers and to examine whether there were any differences among employees of medical and mental health sector. Methods: The sample consisted of employees from the medical and mental health sector, who were all randomly selected. A two-part questionnaire was used to collect data. The first section involved demographic information and the second part was a General Satisfaction Questionnaire (GSQ). The statistical analysis of data was performed using the software package 19.0 for Windows. Descriptive statistics were initially generated for sample characteristics. All data exhibited normal distributions and thus the parametric t-test was used to compare mean scores between the two health sectors. P values satisfaction for the employees in medical sector was 4.5 (5=very satisfied) and for the employees in mental health sector is 4.8. T-test showed that these results are statistical different (t=4.55, psatisfaction. Conclusions: Mental health employees appear to experience higher levels of general satisfaction and mainly they experience higher satisfaction from family roles, life and sexual life, emotional state and relations with patients. PMID:26543410

  2. General Satisfaction Among Healthcare Workers: Differences Between Employees in Medical and Mental Health Sector.

    Science.gov (United States)

    Papathanasiou, Ioanna V; Kleisiaris, Christos F; Tsaras, Konstantinos; Fradelos, Evangelos C; Kourkouta, Lambrini

    2015-08-01

    General satisfaction is a personal experience and sources of satisfaction or dissatisfaction vary between professional groups. General satisfaction is usually related with work settings, work performance and mental health status. The purpose of this research study was to investigate the level of general satisfaction of health care workers and to examine whether there were any differences among employees of medical and mental health sector. The sample consisted of employees from the medical and mental health sector, who were all randomly selected. A two-part questionnaire was used to collect data. The first section involved demographic information and the second part was a General Satisfaction Questionnaire (GSQ). The statistical analysis of data was performed using the software package 19.0 for Windows. Descriptive statistics were initially generated for sample characteristics. All data exhibited normal distributions and thus the parametric t-test was used to compare mean scores between the two health sectors. P values satisfaction for the employees in medical sector was 4.5 (5=very satisfied) and for the employees in mental health sector is 4.8. T-test showed that these results are statistical different (t=4.55, psatisfaction. Mental health employees appear to experience higher levels of general satisfaction and mainly they experience higher satisfaction from family roles, life and sexual life, emotional state and relations with patients.

  3. PRIVATE SECTOR IN HEALTH CARE DELIVERY: A REALITY AND A CHALLENGE IN PAKISTAN.

    Science.gov (United States)

    Shaikh, Babar Tasneem

    2015-01-01

    Under performance of the public sector health care system in Pakistan has created a room for private sector to grow and become popular in health service delivery, despite its questionable quality, high cost and dubious ethics of medical practice. Private sector is no doubt a reality; and is functioning to plug many weaknesses and gaps in health care delivery to the poor people of Pakistan. Yet, it is largely unregulated and unchecked due to the absence of writ of the state. In spite of its inherent trait of profit making, the private sector has played a significant and innovative role both in preventive and curative service provision. Private sector has demonstrated great deal of responsiveness, hence creating a relation of trust with the consumers of health in Pakistan, majority of who spend out of their pocket to buy 'health'. There is definitely a potential to engage and involve private and non-state entities in the health care system building their capacities and instituting regulatory frameworks, to protect the poor's access to health care system.

  4. Evasion of "mandatory" social health insurance for the formal sector: evidence from Lao PDR.

    Science.gov (United States)

    Alkenbrack, Sarah; Hanson, Kara; Lindelow, Magnus

    2015-10-19

    In the last decade, almost every low- or middle-income country in the world has expressed support for universal health coverage (UHC). While at the beginning of the UHC movement, country strategies focused on increasing access to the formal sector as the first step of UHC, there is now consensus that countries should cover the entire population, with particular attention to covering the poor. However, it is often assumed that mandatory schemes will automatically cover their target populations, and consequently little is known about why firms comply or do not comply with enrolment requirements. Using the experience of Lao PDR, where the enrolment rate in the mandatory social security scheme is low and the capacity for regulation is weak, we conducted this study to better understand the determinants of enrolment of private sector firms in mandatory social security. We used a cross-sectional case-comparison design, surveying 130 firms. We applied a structured questionnaire to explore determinants of enrolment, specifically looking at firm characteristics (e.g., industry category, ownership); sociodemographic characteristics of company heads; firms' risk perceptions; details of employment contracts; employee benefits; and exposure to social security. Closed ended questions were analysed quantitatively, while content analysis was applied to open-ended questions. Logistic regression was used to examine the determinants of enrolment. Smaller privately owned firms in the services industry were the least likely to enrol in social security, while firms in the trade industry were more likely to enrol than firms in manufacturing, construction, or services. The main reason for not enrolling was that firms offered a better package of benefits to their employees, although further investigation of company benefits showed that this was not the case in practice. Additional reasons for non-compliance were lack of knowledge and poor quality of care at government hospitals. The study

  5. A spatial national health facility database for public health sector planning in Kenya in 2008

    Directory of Open Access Journals (Sweden)

    Gething Peter W

    2009-03-01

    improving planning. Expansion in public health care in Kenya has resulted in significant increases in geographic access although several areas of the country need further improvements. This information is key to future planning and with this paper we have released the digital spatial database in the public domain to assist the Kenyan Government and its partners in the health sector.

  6. A spatial national health facility database for public health sector planning in Kenya in 2008.

    Science.gov (United States)

    Noor, Abdisalan M; Alegana, Victor A; Gething, Peter W; Snow, Robert W

    2009-03-06

    resulted in significant increases in geographic access although several areas of the country need further improvements. This information is key to future planning and with this paper we have released the digital spatial database in the public domain to assist the Kenyan Government and its partners in the health sector.

  7. FUNCTIONAL ANALYSIS OF THE HEALTH SECTOR IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Bogdan Tatiana

    2015-07-01

    Full Text Available This paper comprises an assessment of the Romanian health financing policy and a detailed analysis of income and expenditure trends over the past seven years. The current situation of the health system is evaluated by reviewing the existing health legislation and documents on public health policies from Romania and from abroad, by analyzing the official statistics (the Romanian Yearbook of Health Statistics, Who database and by performing a healthcare system financial analysis. Although the financial efforts of the Romanian state to support the health system have increased, almost all the incomes and expenditures of the health care system having recorded significant increases, the population perception on health services worsened. Financing the health system continues to be inadequate and used in an ineffective way. Health is an essential component of well-being with major socio-economic implications. The organization and functioning of the health system depends on ensuring adequate funding. Romania must develop its health strategy in the context of European Union policies. These policies are based on values and principles such as promoting universal protection against financial risk, promoting a more equitable distribution of the financing burden, promoting equitable provision and use of services relative to need, improving the transparency and accountability of the system to the public, promoting quality and efficiency in service delivery, improving administrative efficiency, while ensuring the financial sustainability of the health system. In this context, in order to support a financially sustainable and high performing health system, the paper includes recommendations for increasing the public incomes in the health insurance system and options to streamline the healthcare services and expenses in the future.

  8. The role of retiree health insurance in the early retirement of public sector employees.

    Science.gov (United States)

    Shoven, John B; Slavov, Sita Nataraj

    2014-12-01

    Most government employees have access to retiree health coverage, which provides them with group health coverage even if they retire before Medicare eligibility. We study the impact of retiree health coverage on the labor supply of public sector workers between the ages of 55 and 64. We find that retiree health coverage raises the probability of stopping full time work by 4.3 percentage points (around 38 percent) over two years among public sector workers aged 55-59, and by 6.7 percentage points (around 26 percent) over two years among public sector workers aged 60-64. In the younger age group, retiree health insurance mostly seems to facilitate transitions to part-time work rather than full retirement. However, in the older age group, it increases the probability of stopping work entirely by 4.3 percentage points (around 22 percent). Copyright © 2014 Elsevier B.V. All rights reserved.

  9. General budget support: has it benefited the health sector?

    Science.gov (United States)

    Fernandes Antunes, Adelio; Xu, Ke; James, Chris D; Saksena, Priyanka; Van de Maele, Nathalie; Carrin, Guy; Evans, David B

    2013-12-01

    There has been recent controversy about whether aid directed specifically to health has caused recipient governments to reallocate their own funds to non-health areas. At the same time, general budget support (GBS) has been increasing. GBS allows governments to set their own priorities, but little is known about how these additional resources are subsequently used. This paper uses cross-country panel data to assess the impact of GBS programmes on health spending in low-income and middle-income countries, using dynamic panel techniques to estimate unbiased coefficients in the presence of serial correlation. We found no clear evidence that GBS had any impact, positive or negative, on government health spending derived from domestic sources. GBS also had no observed impact on total government health spending from all sources (external as well as domestic). In contrast, health-specific aid was associated with a decline in health expenditures from domestic sources, but there was not a full substitution effect. That is, despite this observed fungibility, health-specific aid still increases total government health spending from all sources. Finally, increases in total government expenditure led to substantial increases in domestic government health expenditures. Copyright © 2012 John Wiley & Sons, Ltd.

  10. Cross-sector Service Provision in Health and Social Care: An Umbrella Review

    Directory of Open Access Journals (Sweden)

    Shannon Winters

    2016-04-01

    Full Text Available Introduction: Meeting the complex health needs of people often requires interaction among numerous different sectors. No one service can adequately respond to the diverse care needs of consumers. Providers working more effectively together is frequently touted as the solution. Cross-sector service provision is defined as independent, yet interconnected sectors working together to better meet the needs of consumers and improve the quality and effectiveness of service provision. Cross-sector service provision is expected, yet much remains unknown about how it is conceptualised or its impact on health status. This umbrella review aims to clarify the critical attributes that shape cross-sector service provision by presenting the current state of the literature and building on the findings of the 2004 review by Sloper. Methods: Literature related to cross-sector service provision is immense, which poses a challenge for decision makers wishing to make evidence-informed decisions. An umbrella review was conducted to articulate the overall state of cross-sector service provision literature and examine the evidence to allow for the discovery of consistencies and discrepancies across the published knowledge base. Findings: Sixteen reviews met the inclusion criteria. Seven themes emerged: Focusing on the consumer, developing a shared vision of care, leadership involvement, service provision across the boundaries, adequately resourcing the arrangement, developing novel arrangements or aligning with existing relationships, and strengthening connections between sectors. Future research from a cross-organisational, rather than individual provider, perspective is needed to better understand what shapes cross-sector service provision at the boundaries. Conclusion: Findings aligned closely with the work done by Sloper and raise red flags related to reinventing what is already known. Future researchers should look to explore novel areas rather than looking into

  11. Cross-sector Service Provision in Health and Social Care: An Umbrella Review.

    Science.gov (United States)

    Winters, Shannon; Magalhaes, Lilian; Anne Kinsella, Elizabeth; Kothari, Anita

    2016-04-08

    Meeting the complex health needs of people often requires interaction among numerous different sectors. No one service can adequately respond to the diverse care needs of consumers. Providers working more effectively together is frequently touted as the solution. Cross-sector service provision is defined as independent, yet interconnected sectors working together to better meet the needs of consumers and improve the quality and effectiveness of service provision. Cross-sector service provision is expected, yet much remains unknown about how it is conceptualised or its impact on health status. This umbrella review aims to clarify the critical attributes that shape cross-sector service provision by presenting the current state of the literature and building on the findings of the 2004 review by Sloper. Literature related to cross-sector service provision is immense, which poses a challenge for decision makers wishing to make evidence-informed decisions. An umbrella review was conducted to articulate the overall state of cross-sector service provision literature and examine the evidence to allow for the discovery of consistencies and discrepancies across the published knowledge base. Sixteen reviews met the inclusion criteria. Seven themes emerged: Focusing on the consumer, developing a shared vision of care, leadership involvement, service provision across the boundaries, adequately resourcing the arrangement, developing novel arrangements or aligning with existing relationships, and strengthening connections between sectors. Future research from a cross-organisational, rather than individual provider, perspective is needed to better understand what shapes cross-sector service provision at the boundaries. Findings aligned closely with the work done by Sloper and raise red flags related to reinventing what is already known. Future researchers should look to explore novel areas rather than looking into areas that have been explored at length. Evaluations of out

  12. The "aid contract" and its compensation scheme: a case study of the performance of the Ugandan health sector.

    Science.gov (United States)

    Oliveira Cruz, Valeria; McPake, Barbara

    2010-10-01

    Current literature on aid effectiveness describes increasing use of a more contractual approach to the relationship between donor and recipient government in which a system of rewards and penalties for good and bad performance operates. The purpose of this case study of the Ugandan health sector was to understand the extent to which this approach is influencing processes and effectiveness. This qualitative study used a conceptual framework based on agency theory and 'realistic evaluation'. Our results showed that the main official mechanism to assess and reward performance established through the Sector Wide Approach lacked objective criteria and was based on an unstructured system of discussions and agreements among donors. The achievement of a satisfactory performance rating was facilitated by the agreeing to undertakings that were under-demanding, vaguely formulated and lacking quantitative benchmarks against which progress could be measured. However, even when poor performance was readily observable, penalties failed to be applied by donors. This was always the case in relation to health sector performance and mostly so in relation to general governance and accountability. Funds continued to be disbursed despite the lack of progress made in achieving targets and undertakings and other evident performance problems (e.g. in the area of governance). A series of explanations of the failure to penalise were put forward by donor representatives in relation to this behaviour including the need to maintain long-term relationships based on trust and not to undermine health sector performance by withdrawing aid. Thus there are likely to be incentives to disburse funds and report success, irrespective of the realities of aid programmes in the context of large foreign aid volumes associated with increased political visibility of aid in donor countries.

  13. [Facing the HIV/AIDS epidemic in Mexico: the response of the health sector].

    Science.gov (United States)

    Gutiérrez, Juan Pablo; López-Zaragoza, José Luis; Valencia-Mendoza, Atanacio; Pesqueira, Eduardo; Ponce-de-León, Samuel; Bertozzi, Stefano M

    2004-01-01

    To analyze the challenges and accomplishments of the Mexican health system as it faced the HIV/AIDS epidemic over the 20 years since discovery of the virus. A review of the relevant literature was done. The topics revised were: HIV/AIDS epidemiology, the early response of the health system and civil society, prevention and risk behaviors, care and treatment, and financing and resources allocation. In Mexico a rapid initial public response surely contributed to containing any early spread of the epidemic to select populations; whether that spread will continue to be contained is an open question. Sexual risk practices remain high not only among traditional risk populations but also among youth. Even though the epidemic remains concentrated in Mexico, principally among MSM and IDU, only 13% of public HIV prevention funds are directed to key populations at especially high risk of becoming infected or infecting others. In recent years antiretroviral coverage has increased rapidly with funding increasing from 30 to 367 million pesos from 2001 to 2003 and coverage now approaching 100%. Of all health spending on HIV/AIDS in the public sector, 82.4% is spent by the social security institutes and 17.6% by the Ministry of Health. The former provides medical care to about half of PLHA while the latter, in addition to caring for the other half, supports the large majority of prevention expenses. One of the challenges faced by the health system which has largely achieved universal antiretroviral coverage is how to provide quality care with appropriate monitoring, promotion of adherence and recognition and treatment of resistance and adverse effects--without dramatically increasing costs.

  14. How Does Retiree Health Insurance Influence Public Sector Employee Saving?

    OpenAIRE

    Robert Clark; Olivia S. Mitchell

    2013-01-01

    Economic theory predicts that employer-provided retiree health insurance (RHI) benefits have a crowd-out effect on household wealth accumulation, not dissimilar to the effects reported elsewhere for employer pensions, Social Security, and Medicare. Nevertheless, we are unaware of any similar research on the impacts of retiree health insurance per se. Accordingly, the present paper utilizes a unique data file on respondents to the Health and Retirement Study, to explore how employer-provided r...

  15. Health sector reforms in Central and Eastern Europe

    Directory of Open Access Journals (Sweden)

    2004-04-01

    Full Text Available The political and economic transition of the 1990s in the countries of central and eastern Europe has been accompanied by wide ranging health care reform. The initial Soviet model has given way to a variety of forms of health insurance. Yet, as this paper argues, reform has too often been preoccupied with ideological imperatives, such as provider autonomy and the creation of funds separate from government, and has given much less thought to the contribution that health care can make to population health. The paper begins by examining the changing nature of health care. It recalls how the Soviet model was able to provide basic care to dispersed populations at low cost but notes how this is no longer sufficient in the face of an increasingly complex health care environment. This complexity reflects several factors, such as the growth in chronic disease, the emergence of new forms of infectious disease, and the introduction of new treatments requiring integrated delivery systems. It reviews evidence on how the former communist countries failed to keep up with developments in the west from the 1970s onwards, at a time when the complexity of health care was becoming apparent. It continues by setting out a framework for the organisation of health care based on the goal of health gain. This involves a series of activities that can be summarised as active purchasing, and which include assessment of health needs, designing effective packages of care, and monitoring outcomes. It concludes by arguing that a new relationship is needed between the state and the organisations involved in funding and delivering health care, to design a system that will tackle the considerable health needs of the people who live in this region.

  16. What do They Know? Guidelines and Knowledge Translation for Foreign Health Sector Workers Following Natural Disasters.

    Science.gov (United States)

    Dunin-Bell, Ola

    2018-04-01

    Introduction The incidence of natural disasters is increasing worldwide, with countries the least well-equipped to mitigate or manage them suffering the greatest losses. Following natural disasters, ill-prepared foreign responders may become a burden to the affected population, or cause harm to those needing help. Problem The study was performed to determine if international guidelines for foreign workers in the health sector exist, and evidence of their implementation. A structured literature search was used to identify guidelines for foreign health workers (FHWs) responding to natural disasters. Analysis of semi-structured interviews of health sector responders to the 2015 Nepal earthquake was then performed, looking at preparation and field activities. No guidelines were identified to address the appropriate qualifications of, and preparations for, international individuals participating in disaster response in the health sector. Interviews indicated individuals choosing to work with experienced organizations received training prior to disaster deployment and described activities in the field consistent with general humanitarian principles. Participants in an ad hoc team (AHT) did not. In spite of need, there is a lack of published guidelines for potential international health sector responders to natural disasters. Learning about disaster response may occur only after joining a team. Dunin-Bell O . What do they know? Guidelines and knowledge translation for foreign health sector workers following natural disasters. Prehosp Disaster Med. 2018;33(2):139-146.

  17. Private sector, human resources and health franchising in Africa.

    Science.gov (United States)

    Prata, Ndola; Montagu, Dominic; Jefferys, Emma

    2005-04-01

    In much of the developing world, private health care providers and pharmacies are the most important sources of medicine and medical care and yet these providers are frequently not considered in planning for public health. This paper presents the available evidence, by socioeconomic status, on which strata of society benefit from publicly provided care and which strata use private health care. Using data from The World Bank's Health Nutrition and Population Poverty Thematic Reports on 22 countries in Africa, an assessment was made of the use of public and private health services, by asset quintile groups, for treatment of diarrhoea and acute respiratory infections, proxies for publicly subsidized services. The evidence and theory on using franchise networks to supplement government programmes in the delivery of public health services was assessed. Examples from health franchises in Africa and Asia are provided to illustrate the potential for franchise systems to leverage private providers and so increase delivery-point availability for public-benefit services. We argue that based on the established demand for private medical services in Africa, these providers should be included in future planning on human resources for public health. Having explored the range of systems that have been tested for working with private providers, from contracting to vouchers to behavioural change and provider education, we conclude that franchising has the greatest potential for integration into large-scale programmes in Africa to address critical illnesses of public health importance.

  18. Private sector, human resources and health franchising in Africa.

    Science.gov (United States)

    Prata, Ndola; Montagu, Dominic; Jefferys, Emma

    2005-01-01

    In much of the developing world, private health care providers and pharmacies are the most important sources of medicine and medical care and yet these providers are frequently not considered in planning for public health. This paper presents the available evidence, by socioeconomic status, on which strata of society benefit from publicly provided care and which strata use private health care. Using data from The World Bank's Health Nutrition and Population Poverty Thematic Reports on 22 countries in Africa, an assessment was made of the use of public and private health services, by asset quintile groups, for treatment of diarrhoea and acute respiratory infections, proxies for publicly subsidized services. The evidence and theory on using franchise networks to supplement government programmes in the delivery of public health services was assessed. Examples from health franchises in Africa and Asia are provided to illustrate the potential for franchise systems to leverage private providers and so increase delivery-point availability for public-benefit services. We argue that based on the established demand for private medical services in Africa, these providers should be included in future planning on human resources for public health. Having explored the range of systems that have been tested for working with private providers, from contracting to vouchers to behavioural change and provider education, we conclude that franchising has the greatest potential for integration into large-scale programmes in Africa to address critical illnesses of public health importance. PMID:15868018

  19. Accreditation and Participatory Design in the Health-Care Sector

    DEFF Research Database (Denmark)

    Simonsen, Jesper; Scheuer, John Damm; Hertzum, Morten

    2015-01-01

    We reconsider the role of participatory design approaches emphasizing the current context of the accreditation regime imposed on the Danish healthcare sector. We describe effects-driven IT development as an instrument supporting sustained participatory design. Effects-driven IT development includes...... specifying, realizing, and measuring effects from using an information technology. This approach aligns with much of the logic inherent in accreditation and it supports challenging parts of the accreditation process. Effects-driven IT development furthermore might support effects related to clinical evidence......-based thinking. We describe and compare effects- driven IT development with accreditation and discuss the prospects and challenges for this approach to participatory design within the healthcare domain....

  20. Public-private partnerships in the Potuguese health sector.

    Science.gov (United States)

    Simões, Jorge; Barros, Pedro Pita; Temido, Marta

    2010-01-01

    In Portugal, the PPP in the healthcare sector appeared only at the dawn of the new century, with the central feature of including clinical activities within its scope. Currently--except for one hospital--the Portuguese PPP experience can only be assessed in terms of conceptual model and tender processes. The analysis showed that, based on arguments associated with non-contractible investment and ex-post renegotiation opportunities, hospitals with higher technological complexity should exclude clinical activities from the PPP contract, and also that, despite the time-consuming process, the PPP can be considered a success in price competition dimension. The analysis also showed that, assessing the performance of the single PPP hospital in Portugal with two comparable units, there is no evidence that the best or worst results are correlated with the legal status and with the established management model.

  1. Mental health promotion competencies in the health sector in Finland: a qualitative study of the views of professionals.

    Science.gov (United States)

    Tamminen, Nina; Solin, Pia; Stengård, Eija; Kannas, Lasse; Kettunen, Tarja

    2017-07-01

    In this study, we aimed to investigate what competencies are needed for mental health promotion in health sector practice in Finland. A qualitative study was carried out to seek the views of mental health professionals regarding mental health promotion-related competencies. The data were collected via two focus groups and a questionnaire survey of professionals working in the health sector in Finland. The focus groups consisted of a total of 13 professionals. Further, 20 questionnaires were received from the questionnaire survey. The data were analysed using the qualitative data analysis software ATLAS.ti Scientific Software Development GmbH, Berlin. A content analysis was carried out. In total, 23 competencies were identified and clustered under the categories of theoretical knowledge, practical skills, and personal attitudes and values. In order to promote mental health, it is necessary to have a knowledge of the principles and concepts of mental health promotion, including methods and tools for effective practices. Furthermore, a variety of skills-based competencies such as communication and collaboration skills were described. Personal attitudes and values included a holistic approach and respect for human rights, among others. The study provides new information on what competencies are needed to plan, implement and evaluate mental health promotion in health sector practice, with the aim of contributing to a more effective workforce. The competencies provide aid in planning training programmes and qualifications, as well as job descriptions and roles in health sector workplaces related to mental health promotion.

  2. Vertical funding, non-governmental organizations, and health system strengthening: perspectives of public sector health workers in Mozambique.

    Science.gov (United States)

    Mussa, Abdul H; Pfeiffer, James; Gloyd, Stephen S; Sherr, Kenneth

    2013-06-14

    In the rapid scale-up of human immunodeficiency virus (HIV) care and acquired immunodeficiency syndrome (AIDS) treatment, many donors have chosen to channel their funds to non-governmental organizations and other private partners rather than public sector systems. This approach has reinforced a private sector, vertical approach to addressing the HIV epidemic. As progress on stemming the epidemic has stalled in some areas, there is a growing recognition that overall health system strengthening, including health workforce development, will be essential to meet AIDS treatment goals. Mozambique has experienced an especially dramatic increase in disease-specific support over the last eight years. We explored the perspectives and experiences of key Mozambican public sector health managers who coordinate, implement, and manage the myriad donor-driven projects and agencies. Over a four-month period, we conducted 41 individual qualitative interviews with key Ministry workers at three levels in the Mozambique national health system, using open-ended semi-structured interview guides. We also reviewed planning documents. All respondents emphasized the value and importance of international aid and vertical funding to the health sector and each highlighted program successes that were made possible by recent increased aid flows. However, three serious concerns emerged: 1) difficulties coordinating external resources and challenges to local control over the use of resources channeled to international private organizations; 2) inequalities created within the health system produced by vertical funds channeled to specific services while other sectors remain under-resourced; and 3) the exodus of health workers from the public sector health system provoked by large disparities in salaries and work. The Ministry of Health attempted to coordinate aid by implementing a "sector-wide approach" to bring the partners together in setting priorities, harmonizing planning, and coordinating

  3. Health-Sector Performance in Post-Independent Nigeria: A ...

    African Journals Online (AJOL)

    A lot of studies had been carried out to ascertain the reasons for this poor performance, the findings from these studies are contradictory. Most of the studies in this area have treated health output or performance and health expenditure in Nigeria, without considering its link with governance. Therefore, this study examined ...

  4. Ebola and other issues in the health sector in Africa

    African Journals Online (AJOL)

    In this September issue of African Health Sciences we bring you diverse articles with wide ranging themes. In general, they encompass infectious disease, glucose me- tabolism, newborn care, non communicable diseases and health systems. We have added a special article[1] on viral hemorrhagic fevers especially Ebola ...

  5. STD care in the South African private health sector | Schneider ...

    African Journals Online (AJOL)

    Objectives. To establish the accessibility and quality of sexually transmitted disease (SID) care provided by private general practitioners (GPs) and workplace health services in South Africa. Design. Structured telephone interviews were conducted with a random national sample of 120 GPs and 244 occupational health ...

  6. The development of methodological tools to assess the health sector with the resulting standardized index

    Directory of Open Access Journals (Sweden)

    Hansuvarova Evgenia Adolfovna

    2016-10-01

    The proposed assessment methodology resulting standardized health index in the various countries of the world allows you to define the country implementing an effective management strategy in the health sector. The leading positions belong to the countries where the state health policy has shown its greatest efficiency. This technique can be used not only for point scoring result of a standardized health index in the world, but also to assess in a particular country.

  7. Health sector reforms and human resources for health in Uganda and Bangladesh: mechanisms of effect

    Directory of Open Access Journals (Sweden)

    Kielmann Tara

    2007-02-01

    Full Text Available Abstract Background Despite the expanding literature on how reforms may affect health workers and which reactions they may provoke, little research has been conducted on the mechanisms of effect through which health sector reforms either promote or discourage health worker performance. This paper seeks to trace these mechanisms and examines the contextual framework of reform objectives in Uganda and Bangladesh, and health workers' responses to the changes in their working environments by taking a 'realistic evaluation' approach. Methods The study findings were generated by triangulating both qualitative and quantitative methods of data collection and analysis among policy technocrats, health managers and groups of health providers. Quantitative surveys were conducted with over 700 individual health workers in both Bangladesh and Uganda and supplemented with qualitative data obtained from focus group discussions and key interviews with professional cadres, health managers and key institutions involved in the design, implementation and evaluation of the reforms of interest. Results The reforms in both countries affected the workforce through various mechanisms. In Bangladesh, the effects of the unification efforts resulted in a power struggle and general mistrust between the two former workforce tracts, family planning and health. However positive effects of the reforms were felt regarding the changes in payment schemes. Ugandan findings show how the workforce responded to a strong and rapidly implemented system of decentralisation where the power of new local authorities was influenced by resource constraints and nepotism in recruitment. On the other hand, closer ties to local authorities provided the opportunity to gain insight into the operational constraints originating from higher levels that health staff were dealing with. Conclusion Findings from the study suggest that a reform planners should use the proposed dynamic responses model to

  8. Implementation and quality monitoring of e-communication across Health care sectors

    DEFF Research Database (Denmark)

    Nicolaisen, Anne; Qvist, Peter

    will identify challenges in e-communication across health care sectors and provide knowledge of the implementation and quality of the Sam:Bo e-communication. Points for discussion: How to improve quality of care using e-communication in general practice in the handover of patients and how to measure it? What......Background: There has been an increased focus on how to improve the quality of care for patients that receives services from more than one sector in the health care system. Continuity in and coordination of patient pathways in the health care system are included in accreditation standards both...... for general practice and hospitals. An important factor for patient-perceived quality of care is the cooperation between the health care sectors that provides services for the patient. In 2009 the Region of Southern Denmark launched a collaboration agreement called Sam:Bo between general practice, hospitals...

  9. Evaluating digital libraries in the health sector. Part 1: measuring inputs and outputs.

    Science.gov (United States)

    Cullen, Rowena

    2003-12-01

    This is the first part of a two-part paper which explores methods that can be used to evaluate digital libraries in the health sector. In this first part, some approaches to evaluation that have been proposed for mainstream digital information services are examined for their suitability to provide models for the health sector. The paper summarizes some major national and collaborative initiatives to develop measures for digital libraries, and analyses these approaches in terms of their relationship to traditional measures of library performance, which are focused on inputs and outputs, and their relevance to current debates among health information specialists. The second part* looks more specifically at evaluative models based on outcomes, and models being developed in the health sector.

  10. Individual and organizational impact of enterprises resources planning system in health care sector

    International Nuclear Information System (INIS)

    Ilyas, A.; Fiaz, M.; Tayyaba, A.

    2016-01-01

    Use of ERPS (Enterprise Resource Planning System) in health care sector has positive impacts. The purpose of this research is to find out the individual and organizational impact in health care sector. Hypotheses were postulated that the use of ERPS has positive individual and organizational impacts. A research questionnaire was used to test these hypotheses which have twelve dimensions for both impacts. This instrument was adopted from literature and self-administrated to 504 individuals with response rate of 60 percentage and only 56 percentage of questionnaires were used. The results of this study revealed that the use of ERPS has positive individual and organizational impacts. This study will help the health care organizations to find out impacts of ERPS in health care sector and also to better understand the individual and organizational impacts. (author)

  11. The benefits divide: health care purchasing in retail versus other sectors.

    Science.gov (United States)

    Maxwell, James; Temin, Peter; Zaman, Saminaz

    2002-01-01

    This paper is the first to compare health care purchasing in the retail versus other sectors of the Fortune 500. Employing millions of low-wage workers, the retail sector is the largest employer of uninsured workers in the economy. We found that retail companies are using the same competitive bidding process that other companies use to obtain a given level of coverage for the lowest possible cost. However, they are more price oriented than other Fortune 500 companies are. The most striking disparity lies in the nearly fivefold difference in offer rates for health care coverage. This shows that the economy's bifurcation in health benefits extends even to the nation's largest companies.

  12. Sources of satisfaction and dissatisfaction among specialists within the public and private health sectors

    DEFF Research Database (Denmark)

    Ashton, Toni; Brown, Paul M.; Sopina, Elizaveta (Liza)

    2013-01-01

    and professional development, key sources of dissatisfaction are workload pressures, mentally demanding work and managerial interference. In the private sector specialists value the opportunity to work independently and apply their own ideas in the workplace. Conclusion Sources of job satisfaction...... and dissatisfaction amongst specialists are different for the public and private sectors. Allowing specialists more freedom to work independently and to apply their own ideas in the workplace may enhance recruitment and retention of specialists in the public health system....

  13. Benefits of implementation of ISO 9001 Quality System in the health sector

    OpenAIRE

    Petkovska, Sofija; Gjorgjeska, Biljana

    2012-01-01

    Quality Standard ISO 9001 helps and enables organizations, regardless of the sector they exist in, to implement the quality management properly. Recent years have attracted attention to the possibilities of implementing this standard in the health sector and the economic viability of that long-term investment. Healthcare organizations are recognizing the value system that combines all the criteria for managing quality, including management of business, compliance and management of procedural ...

  14. Cross-sector partnerships and public health: challenges and opportunities for addressing obesity and noncommunicable diseases through engagement with the private sector.

    Science.gov (United States)

    Johnston, Lee M; Finegood, Diane T

    2015-03-18

    Over the past few decades, cross-sector partnerships with the private sector have become an increasingly accepted practice in public health, particularly in efforts to address infectious diseases in low- and middle-income countries. Now these partnerships are becoming a popular tool in efforts to reduce and prevent obesity and the epidemic of noncommunicable diseases. Partnering with businesses presents a means to acquire resources, as well as opportunities to influence the private sector toward more healthful practices. Yet even though collaboration is a core principle of public health practice, public-private or nonprofit-private partnerships present risks and challenges that warrant specific consideration. In this article, we review the role of public health partnerships with the private sector, with a focus on efforts to address obesity and noncommunicable diseases in high-income settings. We identify key challenges-including goal alignment and conflict of interest-and consider how changes to partnership practice might address these.

  15. Towards international strategic partnership management between the ICT and health care sectors: seven pillars of effectiveness.

    Science.gov (United States)

    Caro, Denis H J

    2002-01-01

    This study identifies seven key characteristics of effective strategic partnership management issues between the Information and Communication (ICT) and health care sectors. It underscores the implications for international health community, based on experiences in Canada, Germany, Sweden and the United Kingdom.

  16. Staff and bed distribution in public sector mental health services in ...

    African Journals Online (AJOL)

    Background. The Eastern Cape Province of South Africa is a resource-limited province with a fragmented mental health service. Objective. To determine the current context of public sector mental health services in terms of staff and bed distribution, and how this corresponds to the population distribution in the province.

  17. Integration: the firm and the health care sector.

    Science.gov (United States)

    Laugesen, Miriam J; France, George

    2014-07-01

    Integration in health care is a key goal of health reform in United States and England. Yet past efforts in the 1990s to better integrate the delivery system were of limited success. Building on work by Bevan and Janus on delivery integration, this article explores integration through the lens of economic theories of integration. Firms generally integrate to increase efficiency through economies of scale, to improve their market power, and resolve the transaction costs involved with multiple external suppliers. Using the United States and England as laboratories, we apply concepts of economic integration to understand why integration does or does not occur in health care, and whether expectations of integrating different kinds of providers (hospital, primary care) and health and social services are realistic. Current enthusiasm for a more integrated health care system expands the scope of integration to include social services in England, but retains the focus on health care in the United States. We find mixed applicability of economic theories of integration. Economies of scale have not played a significant role in stimulating integration in both countries. Managerial incentives for monopoly or oligopoly may be more compelling in the United States, since hospitals seek higher prices and more leverage over payers. In both countries the concept of transaction costs could explain the success of new payment and budgeting methods, since health care integration ultimately requires resolving transaction costs across different delivery organizations.

  18. Results of a workplace health campaign: what can be achieved?

    Science.gov (United States)

    Leyk, Dieter; Rohde, Ulrich; Hartmann, Nadine D; Preuß, Philipp A; Sievert, Alexander; Witzki, Alexander

    2014-05-02

    Effective health promotion in the workplace is now essential because of the rising health-related costs for businesses, the increasing pressure arising from international competition, prolonged working lives, and the aging of the work force. The basic problem of prevention campaigns is that the target groups are too rarely reached and sustainable benefits too rarely achieved. In 2011, we carried out a broad-based health and fitness campaign to assess how many personnel could be motivated to participate in a model study under nearly ideal conditions. 1010 personnel were given the opportunity to participate in various kinds of sports, undergo sports-medicine examinations, attend monthly expert lectures, and benefit from nutritional offerings and Intranet information during work hours. Pseudonymized questionnaires were used to classify the participants according to their exercise behavior as non-active, not very active, and very active. The participants' subjective responses (regarding, e.g., health, exercise, nutrition, and the factors that motivated them to participate in sports or discouraged them from doing so) were recorded, as were their objective data (measures of body size and strength). The duration of the study was one year. 490 of the 1010 personnel (48.5%, among whom 27.2% were nonactive, 44.1% not very active, and 28.7% very active) participated in the initial questionnaire and testing. By the end of the study, this figure had dropped to 17.8%; diminished participation affected all three groups to a comparable extent. A comparison of dropouts and non-dropouts revealed that older age was a stable predictor for drop-out (bivariate odds ratio [OR] 1.028, p = 0.006; multivariate OR 1.049, p = 0.009). The study participants reported beneficial effects on their health and health awareness, performance ability, psychological balance, stress perception, exercise and dietary behavior. Even under optimal conditions and with high use of staff resources, this model

  19. Electronic records management in the public health sector of the ...

    African Journals Online (AJOL)

    Ngulup

    records) ... cally related administrative decision-making and problem-solving. ... This implies that a successful e-health system needs maximum support from proper ...... disaster backup for recovery in case it is affected by disaster like fire and water.

  20. Medicare and Medicaid Trends in Health Care Sectors

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) provides monthly and fiscal-year-to-date income and expenditure trends for Medicare Hospital Insurance (HI) and...

  1. Local communities and health disaster management in the mining sector

    Directory of Open Access Journals (Sweden)

    Freek Cronjé

    2013-03-01

    Full Text Available Mining activities throughout the Southern African Development Community (SADC have impacted on the health and safety of mining communities for many decades. Despite the economic contribution of mining to surrounding communities, a huge amount of social and environmental harm is associated with the industry. In this regard, mining companies have, on the one hand, contributed toward improved social development by providing jobs, paying taxes and earning foreign exchange. On the other hand, they have been linked publicly to poor labour conditions, corruption, pollution incidents, health and safety failings, as well as disrespect of human rights. The objectives of this study are to give an overview of social and natural factors relating to health disasters in selected communities in the mining environment. Regarding the findings, this paper focuses on the social and natural factors involved in the creation of health disasters. The social factors include poverty, unemployment, poor housing and infrastructure, prostitution and a high influx of unaccompanied migrant labour. Major health issues in this regard, which will be highlighted, are the extraordinary high incidence rate of HIV and STIs (sexually transmitted infections, addiction and mental illness. The environmental (natural threats to health that will be discussed in the study are harmful particles in the air and water, excessive noise and overcrowded and unhygienic living conditions. In conclusion, the paper also finds that communities need to be ‘fenced in’ in terms of health disaster management instead of being excluded. Specific recommendations to mining companies to reduce health and safety disasters will be made to conclude the paper.

  2. Health care costs: saving in the private sector.

    Science.gov (United States)

    Robeson, F E

    1979-01-01

    Robeson offers a number of options to employers to help reduce the impact of increasing health care costs. He points out that large organizations which employ hundreds of people have considerable market power which can be exerted to contain costs. It is suggested that the risk management departments assume the responsibility for managing the effort to reduce the costs of medical care and of the health insurance programs of these organizations since that staff is experienced at evaluating premiums and negotiating with third-party payors. The article examines a number of short-run strategies for firms to pursue to contain health care costs: (1) use alternative delivery systems such as health maintenance organizations (HMOs) which have cost-cutting potential but require marketing efforts to persuade employees of their desirability; (2) contracts with third-party payors which require a second opinion (peer review), a practice which saved one labor union over $2 million from 1972 to 1976; (3) implementation of insurance coverage for less expensive outpatient care; and (4) the use of claims review. These strategies are compared in terms of four criteria: supply of demand for health services; management effort; cost; and time necessary for realized savings. Robeson concludes that development of a management plan for containing health care costs requires an extensive analysis of alternatives, organizational objectives, existing policies, and resources, and offers a table summarizing the cost-containment strategies that a firm should consider.

  3. Public Health Achievements and Challenges: Symposium of the University of Mostar Faculty of Health Studies.

    Science.gov (United States)

    Ravlija, Jelena; Vasilj, Ivan; Babic, Dragan; Marijanovic, Inga

    2017-05-01

    Public health is an important area of health care that reflects the readiness of the state and society to provide the welfare of all citizens through the promotion of health and the preservation of a healthy environment - factors that directly affect the health of the population. The field of public health is very broad and its concept is changing over time, being defined in a narrower and wider sense. In short, public health is a science and practice that aims at ensuring the conditions in which people can preserve and improve their health and prevent health damage. The third millennium brings its specifics, needs and priorities according to challenges public health is faced by in the twenty-first century: the economic crisis, rising inequality, population aging, rising rates of chronic diseases, migration, urbanization, ecosystem change, climate change, etc. The role of public health is to protect, improve health, prevent diseases and injuries. Such a public health approach implies a multisectoral work focusing on "wider health determinants", and within this activity experts from various medical and non-medical profiles, whose field of public health is concerned, can be found. The development of inter-departmental co-operation skills contributes to a better understanding of health professionals and professionals of other profiles, and facilitates common, synergistic actions in addressing public health problems in the community. Symposium on Public Health Achievements and Challenges organized by the University of Mostar Faculty of Health Studies is just another indication of the obligation, the need and the desire for professional and scientific contribution to the fight for better health. Our faculty has so far organized other numerous symposia, and the aim of this symposium is to present public health achievements and challenges in our surrounding in order to protect, improve health, prevent diseases and injuries in a modern way.

  4. Taking stock of monitoring and evaluation systems in the health sector: findings from Rwanda and Uganda.

    Science.gov (United States)

    Holvoet, Nathalie; Inberg, Liesbeth

    2014-07-01

    In the context of sector-wide approaches and the considerable funding being put into the health sectors of low-income countries, the need to invest in well-functioning national health sector monitoring and evaluation (M&E) systems is widely acknowledged. Regardless of the approach adopted, an important first step in any strategy for capacity development is to diagnose the quality of existing systems or arrangements, taking into account both the supply and demand sides of M&E. As no standardized M&E diagnostic instrument currently exists, we first invested in the development of an assessment tool for sector M&E systems. To counter the criticism that M&E is often narrowed down to a focus on technicalities, our diagnostic tool assesses the quality of M&E systems according to six dimensions: (i) policy; (ii) quality of indicators and data (collection) and methodology; (iii) organization (further divided into iiia: structure and iiib: linkages); (iv) capacity; (v) participation of non-government actors and (vi) M&E outputs: quality and use. We subsequently applied the assessment tool to the health sector M&E systems of Rwanda and Uganda, and this article provides a comparative overview of the main research findings. Our research may have important implications for policy, as both countries receive health sector (budget) support in relation to which M&E system diagnosis and improvement are expected to be high on the agenda. The findings of our assessments indicate that, thus far, the health sector M&E systems in Rwanda and Uganda can at best be diagnosed as 'fragmentary', with some stronger and weaker elements. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  5. Harmony in health sector: a requirement for effective healthcare delivery in Nigeria.

    Science.gov (United States)

    Osaro, Erhabor; Charles, Adias Teddy

    2014-09-01

    Harmony is defined as the pleasing combination of elements of a system to form an all-inclusive, all involving and more productive team. The aim of this present review was to investigate the factors militating against harmony among healthcare professional in the Nigerian healthcare delivery system. This review was carried out by searching through literature on the topic that bother on harmony among health professions in the health sector. Literature search and reports from previous studies indicates that harmony among health workers is pivotal to improving the health indices. However, available evidence suggests that unlike in the developed world, health care professionals do not collaborate well together in Nigeria because of the claim of superiority of a particular health professional over others. This has often resulted in inter-professional conflict which is threatening to tear the health sector apart to the detriment of the patients. The Nigeria health system should be based on team work. Health professionals from a variety of disciplines should work together to deliver the best possible healthcare services to all Nigerians. All members of the team are equally valuable and essential to the smooth running of hospitals. Hospitals should ideally be headed by health administrators or by a qualified member of any of the professions in the health sector. Copyright © 2014 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

  6. Regulating the for-profit private health sector: lessons from East and Southern Africa.

    Science.gov (United States)

    Doherty, Jane E

    2015-03-01

    International evidence shows that, if poorly regulated, the private health sector may lead to distortions in the type, quantity, distribution, quality and price of health services, as well as anti-competitive behaviour. This article provides an overview of legislation governing the for-profit private health sector in East and Southern Africa. It identifies major implementation problems and suggests strategies Ministries of Health could adopt to regulate the private sector more effectively and in line with key public health objectives. This qualitative study was based on a document review of existing legislation in the region, and seven semi-structured interviews with individuals selected purposively on the basis of their experience in policymaking and legislation. Legislation was categorized according to its objectives and the level at which it operates. A thematic content analysis was conducted on interview transcripts. Most legislation focuses on controlling the entry of health professionals and organizations into the market. Most countries have not developed adequate legislation around behaviour following entry. Generally the type and quality of services provided by private practitioners and facilities are not well-regulated or monitored. Even where there is specific health insurance regulation, provisions seldom address open enrolment, community rating and comprehensive benefit packages (except in South Africa). There is minimal control of prices. Several countries are updating and improving legislation although, in most cases, this is without the benefit of an overarching policy on the private sector, or reference to wider public health objectives. Policymakers in the East and Southern African region need to embark on a programme of action to strengthen regulatory frameworks and instruments in relation to private health care provision and insurance. They should not underestimate the power of the private health sector to undermine efforts for increased

  7. Developing and testing an instrument for identifying performance incentives in the Greek health care sector

    Directory of Open Access Journals (Sweden)

    Paleologou Victoria

    2006-09-01

    Full Text Available Abstract Background In the era of cost containment, managers are constantly pursuing increased organizational performance and productivity by aiming at the obvious target, i.e. the workforce. The health care sector, in which production processes are more complicated compared to other industries, is not an exception. In light of recent legislation in Greece in which efficiency improvement and achievement of specific performance targets are identified as undisputable health system goals, the purpose of this study was to develop a reliable and valid instrument for investigating the attitudes of Greek physicians, nurses and administrative personnel towards job-related aspects, and the extent to which these motivate them to improve performance and increase productivity. Methods A methodological exploratory design was employed in three phases: a content development and assessment, which resulted in a 28-item instrument, b pilot testing (N = 74 and c field testing (N = 353. Internal consistency reliability was tested via Cronbach's alpha coefficient and factor analysis was used to identify the underlying constructs. Tests of scaling assumptions, according to the Multitrait-Multimethod Matrix, were used to confirm the hypothesized component structure. Results Four components, referring to intrinsic individual needs and external job-related aspects, were revealed and explain 59.61% of the variability. They were subsequently labeled: job attributes, remuneration, co-workers and achievement. Nine items not meeting item-scale criteria were removed, resulting in a 19-item instrument. Scale reliability ranged from 0.782 to 0.901 and internal item consistency and discriminant validity criteria were satisfied. Conclusion Overall, the instrument appears to be a promising tool for hospital administrations in their attempt to identify job-related factors, which motivate their employees. The psychometric properties were good and warrant administration to a larger

  8. Developing and testing an instrument for identifying performance incentives in the Greek health care sector.

    Science.gov (United States)

    Paleologou, Victoria; Kontodimopoulos, Nick; Stamouli, Aggeliki; Aletras, Vassilis; Niakas, Dimitris

    2006-09-13

    In the era of cost containment, managers are constantly pursuing increased organizational performance and productivity by aiming at the obvious target, i.e. the workforce. The health care sector, in which production processes are more complicated compared to other industries, is not an exception. In light of recent legislation in Greece in which efficiency improvement and achievement of specific performance targets are identified as undisputable health system goals, the purpose of this study was to develop a reliable and valid instrument for investigating the attitudes of Greek physicians, nurses and administrative personnel towards job-related aspects, and the extent to which these motivate them to improve performance and increase productivity. A methodological exploratory design was employed in three phases: a) content development and assessment, which resulted in a 28-item instrument, b) pilot testing (N = 74) and c) field testing (N = 353). Internal consistency reliability was tested via Cronbach's alpha coefficient and factor analysis was used to identify the underlying constructs. Tests of scaling assumptions, according to the Multitrait-Multimethod Matrix, were used to confirm the hypothesized component structure. Four components, referring to intrinsic individual needs and external job-related aspects, were revealed and explain 59.61% of the variability. They were subsequently labeled: job attributes, remuneration, co-workers and achievement. Nine items not meeting item-scale criteria were removed, resulting in a 19-item instrument. Scale reliability ranged from 0.782 to 0.901 and internal item consistency and discriminant validity criteria were satisfied. Overall, the instrument appears to be a promising tool for hospital administrations in their attempt to identify job-related factors, which motivate their employees. The psychometric properties were good and warrant administration to a larger sample of employees in the Greek healthcare system.

  9. The Role of Private Health Sector for Tuberculosis Control in Debre Markos Town, Northwest Ethiopia.

    Science.gov (United States)

    Reta, Alemayehu; Simachew, Addis

    2018-01-01

    Tuberculosis has been declared to be a global epidemic. Despite all the effort, only less than half the annual estimated cases are reported by health authorities to the WHO. This could be due to poor reporting from the private sector. In Ethiopia, tuberculosis has also been a major public health problem. The aim of this study was to assess the role of the private health sector in tuberculosis control in Debre Markos. An institution based cross-sectional descriptive study was carried out in private health facilities. A total of 260 tuberculosis suspects attending the private clinics were interviewed. Focus group discussion, checklist, and structured questionnaire were used. Majority of the private clinics were less equipped, poorly regulated, and owned by health workers who were self-employed on a part-time basis. Provider delay of 4 and more months was significantly associated higher likelihood of turning to a private provider (OR = 2.70, 95% CI = (1.20, 6.08)). There is significant delay among tuberculosis patients. Moreover, there is poor regulation of the private health sector by public health authorities. The involvement of the private sector in tuberculosis control should be limited to identification and refer to tuberculosis cases and suspects.

  10. Health reform and cesarean sections in the private sector: The experience of Peru.

    Science.gov (United States)

    Arrieta, Alejandro

    2011-02-01

    To test the hypothesis that the health reform enacted in Peru in 1997 increased the rate of cesarean sections in the private sector due to non-clinical factors. Different rounds of the Demographic and Health Survey are used to estimate determinants of c-section rates in private and public facilities before and after the healthcare reform. Estimations are based on a pooled linear regression controlling by obstetric and socioeconomic characteristics. C-section rates in the private sector grew from 28 to 53% after the health reform. Compared to the Ministry of Health (MOH), giving birth in a private hospital in the post-reform period adds 19% to the probability of c-section. The health reform implemented in the private sector increased physician incentives to over-utilize c-sections. The reform consolidated and raised the market power of private health insurers, but at the same time did not provide mechanisms to enlarge, regulate and disclose information of private providers. All these factors created the conditions for fee-for-service paid providers to perform more c-sections. Comparable trends in c-section rates have been observed in Latin American countries who implemented similar reforms in their private sector, suggesting a need to rethink the role of private health providers in developing countries. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  11. What research impacts do Australian primary health care researchers expect and achieve?

    Directory of Open Access Journals (Sweden)

    Reed Richard L

    2011-11-01

    Full Text Available Abstract Background Funding for research is under pressure to be accountable in terms of benefits and translation of research findings into practice and policy. Primary health care research has considerable potential to improve health care in a wide range of settings, but little is known about the extent to which these impacts actually occur. This study examines the impact of individual primary health care research projects on policy and practice from the perspective of Chief Investigators (CIs. Methods The project used an online survey adapted from the Buxton and Hanney Payback Framework to collect information about the impacts that CIs expected and achieved from primary health care research projects funded by Australian national competitive grants. Results and Discussion Chief Investigators (CIs provided information about seventeen completed projects. While no CI expected their project to have an impact in every domain of the framework used in the survey, 76% achieved at least half the impacts they expected. Sixteen projects had published and/or presented their work, 10 projects included 11 doctorate awards in their research capacity domain. All CIs expected their research to lead to further research opportunities with 11 achieving this. Ten CIs achieved their expectation of providing information for policy making but only four reported their research had influenced policy making. However 11 CIs achieved their expectation of providing information for organizational decision making and eight reported their research had influenced organizational decision making. Conclusion CIs reported that nationally funded primary health care research projects made an impact on knowledge production, staff development and further research, areas within the realm of influence of the research team and within the scope of awareness of the CIs. Some also made an impact on policy and organizational decision-making, and on localized clinical practice and service

  12. The Contribution of Civil Society Organizations in Achieving Health ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Global gaps in health care The World Health Organization's Health for All ... Making the invisible visible: gender, data, and evidence for development ... Strengthening Governance in Health Systems for Reproductive Health and Rights in ...

  13. [Organizational wellbeing in the health sector: the Piemonte Region experience].

    Science.gov (United States)

    Converso, Daniela; Baratti, Alberto

    2010-01-01

    In 2007, the Health Councillorship of the Piedmont region announced, in convention with the Psychology Department of the University of Turin, of the creation of "Workgroup for Safeguard of Organizational Wellbeing" composed by psychologists, occupational doctors, and superintendents for Prevention and Protection services. This group is aimed at promoting pilot experiences in the Health Units in order to prevent and combat psychosocial discomfort and to sustain workers' wellbeing. A complex intervention started in January 2009 and involved the personnel from Services for the Organization and Development of Human Resources, Personnel Services, Services for Occupational Medicine, Services of Communication, Quality Services, belonging to all of the Health Units from Piedmont, and of some structures operating within the national health service, for a total of 23 work groups. Based on the results produced and/or from the shared reflections in the classroom between the 23 groups, four main themes were singled out, corresponding to different levels and fields of interventions, in order to favour the contrast of psychosocial distress and to promote a culture of wellbeing, were adopted taking into account needs and cultural specificity of different Units' realities. The activities embarked on, inside every main theme represent, in the expectations of all the participants, good practices that could be spread to the different Local Health Units.

  14. Health Services in Denmark: Co-operation between different sectors?

    DEFF Research Database (Denmark)

    Singla, Rashmi

    minorities, constituting about 9 % of the total population of 5.5 millions.    The Danish Welfare State can be characterised as ‘universal’, providing high quality social care and benefits to all members of the society. Overall, the Danish healthcare system is based on a free access system with equity...... interventions and individual activities by the few health workers with a special interest in the migrant health. TTT is an illustration of providing psychosocial services to ethnic minority youth and their families based on combination of citizen volunteer work with partly state funding. This mental health NGO......, marked by systematic, stratified and hierarchical organisation and on the other end “Bottom up” approach in the United Kingdom,  marked by grassroots orientation and rather chaotic situation organising programmes for dispersed groups (Watters and Ingleby, 2004).  ...

  15. Coordination and health sector adaptation to climate change in the Vietnamese Mekong Delta

    Directory of Open Access Journals (Sweden)

    Daniel Gilfillan

    2017-09-01

    Full Text Available This research examines the impact of three coordination dimensions on health sector adaptation to climate change in the Vietnamese Mekong Delta: cross-scale, cross-sectoral, and cross-boundary. While tasks are divided up between government ministries and departments in Vietnam, there is little collaboration on issues that span mandates. Similarly, while water flows in the Vietnamese Mekong Delta take resource management and health concerns across provincial boundaries, formal mechanisms for interprovincial collaboration are lacking. While decentralization efforts have sought to devolve authority and decision making to lower levels, there is continued state-centered top-down policy making, and this limits collaborative coordination across scales. All three of these issues inhibit health sector adaptation to climate change in the Vietnamese Mekong Delta, and though these coordination issues are recognized by the Vietnamese government, to date there has been little success in addressing them. The authors hope to stimulate further debate and discussion of coordination problems, and conclude that despite some significant challenges, the South West Steering Committee could play a facilitating role coordinating climate change responses in health and other sectors across the Vietnamese Mekong Delta. As an analysis of governance, this research is applicable to other areas and sectors in Vietnam, as well as to other parts of South East Asia.

  16. Reforming Victoria's primary health and community service sector: rural implications.

    Science.gov (United States)

    Alford, K

    2000-01-01

    In 1999 the Victorian primary care and community support system began a process of substantial reform, involving purchasing reforms and a contested selection process between providers in large catchment areas across the State. The Liberal Government's electoral defeat in September 1999 led to a review of these reforms. This paper questions the reforms from a rural perspective. They were based on a generic template that did not consider rural-urban differences in health needs or other differences including socio-economic status, and may have reinforced if not aggravated rural-urban differences in the quality of and access to primary health care in Victoria.

  17. Safety and health practice among laboratory staff in Malaysian education sector

    Science.gov (United States)

    Husna Che Hassan, Nurul; Rasdan Ismail, Ahmad; Kamilah Makhtar, Nor; Azwadi Sulaiman, Muhammad; Syuhadah Subki, Noor; Adilah Hamzah, Noor

    2017-10-01

    Safety is the most important issue in industrial sector such as construction and manufacturing. Recently, the increasing number of accident cases reported involving school environment shows the important of safety issues in education sector. Safety awareness among staff in this sector is crucial in order to find out the method to prevent the accident occurred in future. This study was conducted to analyze the knowledge of laboratory staff in term of safety and health practice in laboratory. Survey questionnaires were distributing among 255 of staff laboratory from ten District Education Offices in Kelantan. Descriptive analysis shows that the understanding of safety and health practice are low while doing some job activities in laboratory. Furthermore, some of the staff also did not implemented safety practice that may contribute to unplanned event occur in laboratory. Suggestion that the staff at laboratory need to undergo on Occupational Safety and Health training to maintain and create safe environment in workplaces.

  18. Treatment and prevention of malaria in pregnancy in the private health sector in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus

    2016-01-01

    BACKGROUND: Malaria in pregnancy is a major public health problem in Uganda; and it is the leading cause of anaemia among pregnant women and low birth weight in infants. Previous studies have noted poor quality of care in the private sector. Thus there is need to explore ways of improving quality...... of care in the private sector that provides almost a half of health services in Uganda. METHODS: A survey was conducted from August to October 2014 within 57 parishes in Mukono district, central Uganda. The selected parishes had a minimum of 200 households and at least one registered drug shop, pharmacy...... the factors that most influenced correct treatment of fever in pregnancy. CONCLUSION: Treatment of fever during pregnancy was poor in this study setting. These data highlight the need to develop interventions to improve patient safety and quality of care for pregnant women in the private health sector...

  19. Corporate governance of public health services: lessons from New Zealand for the state sector.

    Science.gov (United States)

    Perkins, R; Barnett, P; Powell, M

    2000-01-01

    New Zealand public hospitals and related services were grouped into 23 Crown Health Enterprises and registered as companies in 1993. Integral to this change was the introduction of corporate governance. New directors, largely from the business sector, were appointed to govern these organisations as efficient and effective businesses. This article presents the results of a survey of directors of New Zealand publicly-owned health provider organisations. Although directors thought they performed well in business systems development, they acknowledged their shortcomings in meeting government expectations in respect to financial performance and social responsibility. Changes in public health sector provider performance indicators have resulted in a mixed report card for the sector six years after corporate governance was instituted.

  20. Corporate Social Responsibility and Employee Health in the Nigerian Banking Sector

    Directory of Open Access Journals (Sweden)

    Dr. Chukwuemeka Anene MBBS

    2013-07-01

    Full Text Available It is often said that the most important entity in any organisation is its human capital. With this is in mind, it has been recommended that an organisation which seeks to do well must pay particular attention to the welfare of its employees. This paper considers the issue of employer health insurance as it operates in the Nigerian banking sector. It argues that employee welfare, being a corporate social responsibility, banks must do more to ensure that the healthcare of their employees are better taken care of, bearing in mind the relative youth of most bank employees and the sensitive nature of work in the banking sector. The paper begins with an overview of corporate social responsibility, the nature of employee healthcare available in Nigeria and managed healthcare in the private sector. The paper also considers the typical health challenges of bank employees and healthcare options available to them, making a case for better structured health care for bank employees.

  1. Safeguarding the Health Sector in Times of Macroeconomic Instability

    International Development Research Centre (IDRC) Digital Library (Canada)

    At one end are medium-income countries like Mexico, Colombia, and Thailand ... However, these two areas of study—the effects of MAPs on health outcomes and the ...... practices in the management and treatment of tuberculosis (TB) in India. ...... in the southern state of Chiapas initially raised doubts about political stability.

  2. Increased fairness in priority setting processes within the health sector

    DEFF Research Database (Denmark)

    Zulu, Joseph M.; Michelo, Charles; Msoni, Carol

    2014-01-01

    administration, in non-governmental organizations (NGO) and in health facilities. RESULTS: During the baseline study, concepts of legitimacy and fairness in PS processes were found to be grounded in local values of equity and impartiality. Government and other organizational strategies strongly supported...

  3. Waiting Time Policies in the Health Care Sector. What Works?

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Bech, Mickael

    2013-01-01

    times. In addition, a range of other measures may indirectly have affected waiting times, such as a general increase in spending on health care, the general practitioners’ role as gate-keepers, increased use of activity-based hospital reimbursement, increasing use of private heath insurance and private...

  4. Occupational Health and Safety in the Nigerian Public Sector ...

    African Journals Online (AJOL)

    The focus of this paper is to explore the issue of occupational health and safety ... this paper seeks to examine major causes of occupational hazards in the public ... not report to the management for fear of negative effect that may result from it.

  5. Health surveillance assistants as intermediates between the community and health sector in Malawi : exploring how relationships influence performance

    NARCIS (Netherlands)

    Kok, Maryse C.; Namakhoma, Ireen; Nyirenda, Lot; Chikaphupha, Kingsley; Broerse, Jacqueline E W; Dieleman, Marjolein; Taegtmeyer, Miriam; Theobald, Sally

    2016-01-01

    Background: There is increasing global interest in how best to support the role of community health workers (CHWs) in building bridges between communities and the health sector. CHWs' intermediary position means that interpersonal relationships are an important factor shaping CHW performance. This

  6. Achieving and Sustaining Universal Health Coverage: Fiscal Reform of the National Health Insurance in Taiwan.

    Science.gov (United States)

    Lan, Jesse Yu-Chen

    2017-12-01

    The paper discusses the expansion of the universal health coverage (UHC) in Taiwan through the establishment of National Health Insurance (NHI), and the fiscal crisis it caused. Two key questions are addressed: How did the NHI gradually achieve universal coverage, and yet cause Taiwanese health spending to escalate to fiscal crisis? What measures have been taken to reform the NHI finance and achieve moderate success to date? The main argument of this paper is that the Taiwanese Government did try to implement various reforms to save costs and had moderate success, but the path-dependent process of reform does not allow increasing contribution rates significantly and thereby makes sustainability challenging.

  7. Employment-based health benefits and public-sector coverage: opportunity for leadership.

    Science.gov (United States)

    Darling, Helen

    2006-01-01

    In this commentary, Helen Darling, speaking from the large-employer perspective, responds to James Robinson's paper on the mature health insurance industry, which faces declining opportunities with employer-based health benefits and growing but less appealing public-sector opportunities for management and other services. The similar needs of public and private employers and payers provide an opportunity for leadership, accelerating innovation and using value-added services to improve safety, quality, and efficiency of health care for all.

  8. How do countries regulate the health sector? Evidence from Tanzania and Zimbabwe.

    Science.gov (United States)

    Kumaranayake, L; Mujinja, P; Hongoro, C; Mpembeni, R

    2000-12-01

    The health sectors in many low- and middle-income countries have been characterized in recent years by extensive private sector activity. This has been complemented by increasing public-private linkages, such as the contracting-out of selected services or facilities, development of new purchasing arrangements, franchising and the introduction of vouchers. Increasingly, however, experience with the private sector has indicated a number of problems with the quality, price and distribution of private health services, and thus led to a growing focus on the role of government in regulation. This paper presents the existing network of regulations governing private activity in the health sectors of Tanzania and Zimbabwe, and their appropriateness in the context of emerging market realities. It draws on a comparative mapping exercise reviewing the complexity of the variables currently being regulated, the level of the health system at which they apply, and the specific instruments being used. Findings indicate that much of the existing regulation occurs through legislation. There is still very much a focus on the 'social' rather than 'economic' aspects of regulation within the health sector. Recent changes have attempted to address aspects of private health provision, but some very key gaps remain. In particular, current regulations in Tanzania and Zimbabwe: (1) focus on individual inputs rather than health system organizations; (2) aim to control entry and quality rather than explicitly quantity, price or distribution; and (3) fail to address the market-level problems of anti-competitive practices and lack of patient rights. This highlights the need for additional measures to promote consumer protection and address the development of new private markets such as for health insurance or laboratory and other ancillary services.

  9. Crisis in the health sector: Impact on nurses' working conditions.

    Science.gov (United States)

    Granero-Lázaro, Alberto; Blanch-Ribas, Josep M; Roldán-Merino, Juan Francisco; Torralbas-Ortega, Jordi; Escayola-Maranges, Ana María

    In a context of economic crisis and policies to reduce the public deficit, the budgets of the Catalan Health Institute (CHI) were cut by 15.33% between 2010 and 2014. To assess the perceived impact on nurses' work conditions of measures to contain health spending. The study design was descriptive and transversal. A sample of 1,760 nurses from the province of Barcelona answered a questionnaire on the perceived impact of health spending containment measures implemented in their workplace during the early years of the crisis. Among the main aspects of the perceived impact of these measures, 86.6% of the nurses identified a pay cut and an increase in the following relevant parameters of their working conditions: number of hours worked (66.7%), final ratio of treated patients (35.2%), task complexity and workload (75.3%), rotation through various departments (31.5%), work shifts (21.4%) or work areas (23.4%), job insecurity (58.4%) and loss of employment by dismissal (6.6%) or non-renewal of contract (9%). The perceived impact of the crisis showed a triple negative component: Pay cut, work overload and job insecurity. As a combined effect of this multiple trend, the nurses acknowledged a deterioration in their working conditions and quality of working life. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  10. The Impact of Robotics on Employment and Motivation of Employees in the Service Sector, with Special Reference to Health Care

    Directory of Open Access Journals (Sweden)

    Mohammed Owais Qureshi

    2014-12-01

    Conclusion: Replacing employees with robots is an inevitable choice for organizations in the service sector, more so in the health care sector because of the challenging and sometimes unhealthy working environments, but, at the same time, the researchers propose that it should be done in a manner that helps in improving the employment and motivation of employees in this sector.

  11. Great expectations for the World Health Organization: a Framework Convention on Global Health to achieve universal health coverage.

    Science.gov (United States)

    Ooms, G; Marten, R; Waris, A; Hammonds, R; Mulumba, M; Friedman, E A

    2014-02-01

    Establishing a reform agenda for the World Health Organization (WHO) requires understanding its role within the wider global health system and the purposes of that wider global health system. In this paper, the focus is on one particular purpose: achieving universal health coverage (UHC). The intention is to describe why achieving UHC requires something like a Framework Convention on Global Health (FCGH) that have been proposed elsewhere,(1) why WHO is in a unique position to usher in an FCGH, and what specific reforms would help enable WHO to assume this role. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  12. Lessons from the business sector for successful knowledge management in health care: a systematic review.

    Science.gov (United States)

    Kothari, Anita; Hovanec, Nina; Hastie, Robyn; Sibbald, Shannon

    2011-07-25

    The concept of knowledge management has been prevalent in the business sector for decades. Only recently has knowledge management been receiving attention by the health care sector, in part due to the ever growing amount of information that health care practitioners must handle. It has become essential to develop a way to manage the information coming in to and going out of a health care organization. The purpose of this paper was to summarize previous studies from the business literature that explored specific knowledge management tools, with the aim of extracting lessons that could be applied in the health domain. We searched seven databases using keywords such as "knowledge management", "organizational knowledge", and "business performance". We included articles published between 2000-2009; we excluded non-English articles. 83 articles were reviewed and data were extracted to: (1) uncover reasons for initiating knowledge management strategies, (2) identify potential knowledge management strategies/solutions, and (3) describe facilitators and barriers to knowledge management. KM strategies include such things as training sessions, communication technologies, process mapping and communities of practice. Common facilitators and barriers to implementing these strategies are discussed in the business literature, but rigorous studies about the effectiveness of such initiatives are lacking. The health care sector is at a pinnacle place, with incredible opportunities to design, implement (and evaluate) knowledge management systems. While more research needs to be done on how best to do this in healthcare, the lessons learned from the business sector can provide a foundation on which to build.

  13. A qualitative assessment of health extension workers' relationships with the community and health sector in Ethiopia: opportunities for enhancing maternal health performance.

    Science.gov (United States)

    Kok, Maryse C; Kea, Aschenaki Z; Datiko, Daniel G; Broerse, Jacqueline E W; Dieleman, Marjolein; Taegtmeyer, Miriam; Tulloch, Olivia

    2015-09-30

    Health extension workers (HEWs) in Ethiopia have a unique position, connecting communities to the health sector. This intermediary position requires strong interpersonal relationships with actors in both the community and health sector, in order to enhance HEW performance. This study aimed to understand how relationships between HEWs, the community and health sector were shaped, in order to inform policy on optimizing HEW performance in providing maternal health services. We conducted a qualitative study in six districts in the Sidama zone, which included focus group discussions (FGDs) with HEWs, women and men from the community and semi-structured interviews with HEWs; key informants working in programme management, health service delivery and supervision of HEWs; mothers; and traditional birth attendants. Respondents were asked about facilitators and barriers regarding HEWs' relationships with the community and health sector. Interviews and FGDs were recorded, transcribed, translated, coded and thematically analysed. HEWs were selected by their communities, which enhanced trust and engagement between them. Relationships were facilitated by programme design elements related to support, referral, supervision, training, monitoring and accountability. Trust, communication and dialogue and expectations influenced the strength of relationships. From the community side, the health development army supported HEWs in liaising with community members. From the health sector side, top-down supervision and inadequate training possibilities hampered relationships and demotivated HEWs. Health professionals, administrators, HEWs and communities occasionally met to monitor HEW and programme performance. Expectations from the community and health sector regarding HEWs' tasks sometimes differed, negatively affecting motivation and satisfaction of HEWs. HEWs' relationships with the community and health sector can be constrained as a result of inadequate support systems, lack of

  14. Health care policy and community pharmacy: implications for the New Zealand primary health care sector.

    Science.gov (United States)

    Scahill, Shane; Harrison, Jeff; Carswell, Peter; Shaw, John

    2010-06-25

    and other primary care providers. There are significant barriers to change. Some of these are financial but many are professional and organisational and require a genuine commitment from the whole primary health care sector.

  15. Achieving Health Equity Through Community Engagement in Translating Evidence to Policy: The San Francisco Health Improvement Partnership, 2010?2016

    OpenAIRE

    Grumbach, Kevin; Vargas, Roberto A.; Fleisher, Paula; Arag?n, Tom?s J.; Chung, Lisa; Chawla, Colleen; Yant, Abbie; Garcia, Estela R.; Santiago, Amor; Lang, Perry L.; Jones, Paula; Liu, Wylie; Schmidt, Laura A.

    2017-01-01

    Background The San Francisco Health Improvement Partnership (SFHIP) promotes health equity by using a novel collective impact model that blends community engagement with evidence-to-policy translational science. The model involves diverse stakeholders, including ethnic-based community health equity coalitions, the local public health department, hospitals and health systems, a health sciences university, a school district, the faith community, and others sectors. Community Context We report o...

  16. Health-sector responses to address the impacts of climate change in Nepal.

    Science.gov (United States)

    Dhimal, Meghnath; Dhimal, Mandira Lamichhane; Pote-Shrestha, Raja Ram; Groneberg, David A; Kuch, Ulrich

    2017-09-01

    Nepal is highly vulnerable to global climate change, despite its negligible emission of global greenhouse gases. The vulnerable climate-sensitive sectors identified in Nepal's National Adaptation Programme of Action (NAPA) to Climate Change 2010 include agriculture, forestry, water, energy, public health, urbanization and infrastructure, and climate-induced disasters. In addition, analyses carried out as part of the NAPA process have indicated that the impacts of climate change in Nepal are not gender neutral. Vector-borne diseases, diarrhoeal diseases including cholera, malnutrition, cardiorespiratory diseases, psychological stress, and health effects and injuries related to extreme weather are major climate-sensitive health risks in the country. In recent years, research has been done in Nepal in order to understand the changing epidemiology of diseases and generate evidence for decision-making. Based on this evidence, the experience of programme managers, and regular surveillance data, the Government of Nepal has mainstreamed issues related to climate change in development plans, policies and programmes. In particular, the Government of Nepal has addressed climate-sensitive health risks. In addition to the NAPA report, several policy documents have been launched, including the Climate Change Policy 2011; the Nepal Health Sector Programme - Implementation Plan II (NHSP-IP 2) 2010-2015; the National Health Policy 2014; the National Health Sector Strategy 2015-2020 and its implementation plan (2016-2021); and the Health National Adaptation Plan (H-NAP): climate change and health strategy and action plan (2016-2020). However, the translation of these policies and plans of action into tangible action on the ground is still in its infancy in Nepal. Despite this, the health sector's response to addressing the impact of climate change in Nepal may be taken as a good example for other low- and middle-income countries.

  17. Legal gaps relating to labour safety and health in the maritime transport sector in Spain.

    Science.gov (United States)

    Rodríguez, Julio Louro; Portela, Rosa Mary de la Campa; Carrera, Paula Vazquez

    2011-01-01

    Nowadays the labour sector is experiencing an important increase in the application of risk prevention policies. Although these policies are very significant due to their repercussions in the health of workers, we noticed important legal gaps in maritime sector regulations. Frequently sea workers are legally abandoned, by exclusion or omission, at the moment of claiming for the improvement of their working environment and the reduction of the negative consequences derived from this negligence over their safety and health. In the present paper we try to shed some light on this topic by analysing and examining minutely the Spanish applicable risk prevention legislation for this sector. Moreover, the recommendations of the International Maritime Organization are compared with the current application of the law. At the same time, we present some possible solutions to such problems from an objective point of view.

  18. Use of communities of practice in business and health care sectors: A systematic review

    Directory of Open Access Journals (Sweden)

    Coyte Peter C

    2009-05-01

    Full Text Available Abstract Background Since being identified as a concept for understanding knowledge sharing, management, and creation, communities of practice (CoPs have become increasingly popular within the health sector. The CoP concept has been used in the business sector for over 20 years, but the use of CoPs in the health sector has been limited in comparison. Objectives First, we examined how CoPs were defined and used in these two sectors. Second, we evaluated the evidence of effectiveness on the health sector CoPs for improving the uptake of best practices and mentoring new practitioners. Methods We conducted a search of electronic databases in the business, health, and education sectors, and a hand search of key journals for primary studies on CoP groups. Our research synthesis for the first objective focused on three areas: the authors' interpretations of the CoP concept, the key characteristics of CoP groups, and the common elements of CoP groups. To examine the evidence on the effectiveness of CoPs in the health sector, we identified articles that evaluated CoPs for improving health professional performance, health care organizational performance, professional mentoring, and/or patient outcome; and used experimental, quasi-experimental, or observational designs. Results The structure of CoP groups varied greatly, ranging from voluntary informal networks to work-supported formal education sessions, and from apprentice training to multidisciplinary, multi-site project teams. Four characteristics were identified from CoP groups: social interaction among members, knowledge sharing, knowledge creation, and identity building; however, these were not consistently present in all CoPs. There was also a lack of clarity in the responsibilities of CoP facilitators and how power dynamics should be handled within a CoP group. We did not find any paper in the health sector that met the eligibility criteria for the quantitative analysis, and so the effectiveness

  19. The Impact of Electricity Sector Privatization on Public Health

    DEFF Research Database (Denmark)

    Gonzalez-Eiras, Martin; Rossi, Martín

    2008-01-01

    We use province-level data for Argentina to test for the causal relation between electricity distribution and health. We are interested in the impact of privatization on two output measures, incidence of low birth weight and child mortality rates caused by food poisoning. Privatization improves...... service coverage which, through the use of refrigerators, may improve nutritional intake. Privatization also results in a reduction in the frequency of interruptions, and thus may reduce the likelihood of food poisoning. We find some evidence that privatization reduced the frequency of low birth weight...... and child mortality rates caused by food poisoning. Results are not strong enough to inform the policy debate with respect to the benefits that privatizations have on the welfare of the poor....

  20. Sensitivity of health sector indicators' response to climate change in Ghana.

    Science.gov (United States)

    Dovie, Delali B K; Dzodzomenyo, Mawuli; Ogunseitan, Oladele A

    2017-01-01

    There is accumulating evidence that the emerging burden of global climate change threatens the fidelity of routine indicators for disease detection and management of risks to public health. The threat partially reflects the conservative character of the health sector and the reluctance to adopt new indicators, despite the growing awareness that existing environmental health indicators were developed to respond to risks that may no longer be relevant, and are too simplistic to also act as indicators for newer global-scale risk factors. This study sought to understand the scope of existing health indicators, while aiming to discover new indicators for building resilience against three climate sensitive diseases (cerebro spinal meningitis, malaria and diarrhea). Therefore, new potential indicators derived from human and biophysical origins were developed to complement existing health indicators, thereby creating climate-sensitive battery of robust composite indices of resilience in health planning. Using Ghana's health sector as a case study systematic international literature review, national expert consultation, and focus group outcomes yielded insights into the relevance, sensitivity and impacts of 45 indicators in 11 categories in responding to climate change. In total, 65% of the indicators were sensitive to health impacts of climate change; 24% acted directly; 31% synergistically; and 45% indirectly, with indicator relevance strongly associated with type of health response. Epidemiological indicators (e.g. morbidity) and health demographic indicators (e.g. population structure) require adjustments with external indicators (e.g. biophysical, policy) to be resilient to climate change. Therefore, selective integration of social and ecological indicators with existing public health indicators improves the fidelity of the health sector to adopt more robust planning of interdependent systems to build resilience. The study highlights growing uncertainties in

  1. Achieving growth within the UK's Domestic Energy Efficiency Retrofitting Services sector, practitioner experiences and strategies moving forward

    International Nuclear Information System (INIS)

    Gooding, Luke; Gul, Mehreen S.

    2017-01-01

    The adoption of the UK Green Deal policy provided an unprecedented change within the policy arena of domestic retrofit. Government financial support present within previous policy regimes was reduced and private industry was enlisted to provide finance, delivery mechanisms and management schemes for national domestic low carbon retrofit. Consequently, the Energy Efficiency Retrofit Services (EERS) sector needed to grow capacity and deliver retrofit at a larger scale. This research focuses on assessing the present EERS sector industry and its strategy to increase retrofit activity. This paper provides findings from on the ground interviews with UK EERS sector practitioners with relation to their experience of working with the Green Deal, and also their suggested strategies progressing forward now the Green Deal is no longer operational. Key findings suggest that UK EERS sector practitioners were unprepared to professionally deal with the expectation of the Green Deal, in terms of business administration and also dealing with the policy itself. Moving forward an emphasis is suggested which focused on training, to enable an increase in EERS sector capabilities, and to also enable an improvement of the quality and variety of work completed. Additionally, findings detail the requirement for enhanced communication between clients and policy administrators, to increase clarity in policy implementation and stakeholder expectation. - Highlights: • Assessment of Green Deal from supply chain perspective. • Highlighting of strategies utilised by retrofit practitioners to implement policy. • Indication of possible routes forward for domestic retrofit policy.

  2. Climate change and its effect on agriculture, water resources and human health sectors in Poland

    Directory of Open Access Journals (Sweden)

    M. Szwed

    2010-08-01

    Full Text Available Multi-model ensemble climate projections in the ENSEMBLES Project of the EU allowed the authors to quantify selected extreme-weather indices for Poland, of importance to climate impacts on systems and sectors. Among indices were: number of days in a year with high value of the heat index; with high maximum and minimum temperatures; length of vegetation period; and number of consecutive dry days. Agricultural, hydrological, and human health indices were applied to evaluate the changing risk of weather extremes in Poland in three sectors. To achieve this, model-based simulations were compared for two time horizons, a century apart, i.e., 1961–1990 and 2061–2090. Climate changes, and in particular increases in temperature and changes in rainfall, have strong impacts on agriculture via weather extremes – droughts and heat waves. The crop yield depends particularly on water availability in the plant development phase. To estimate the changes in present and future yield of two crops important for Polish agriculture i.e., potatoes and wheat, some simple empirical models were used. For these crops, decrease of yield is projected for most of the country, with national means of yield change being: –2.175 t/ha for potatoes and –0.539 t/ha for wheat. Already now, in most of Poland, evapotranspiration exceeds precipitation during summer, hence the water storage (in surface water bodies, soil and ground decreases. Summer precipitation deficit is projected to increase considerably in the future. The additional water supplies (above precipitation needed to use the agro-potential of the environment would increase by half. Analysis of water balance components (now and in the projected future can corroborate such conclusions. As regards climate and health, a composite index, proposed in this paper, is a product of the number of senior discomfort days and the number of seniors (aged 65+. The value of this index is projected to increase over 8-fold during

  3. An Innovative School Health Education Model Designed for Student Achievement.

    Science.gov (United States)

    Rohwer, John; Wandberg, Bob

    New threats to the health of American children, often psychosocial in nature due to societal changes, must be addressed. The Minnesota School Health Education Model is based on the integration of four primary components: (1) school health education goals aimed at health promotion, disease prevention, and long-term positive health effects on…

  4. Cross-country analysis of strategies for achieving progress towards global goals for women’s and children’s health

    Science.gov (United States)

    Ahmed, Syed Masud; Rawal, Lal B; Chowdhury, Sadia A; Murray, John; Arscott-Mills, Sharon; Jack, Susan; Hinton, Rachael; Alam, Prima M

    2016-01-01

    Abstract Objective To identify how 10 low- and middle-income countries achieved accelerated progress, ahead of comparable countries, towards meeting millennium development goals 4 and 5A to reduce child and maternal mortality. Methods We synthesized findings from multistakeholder dialogues and country policy reports conducted previously for the Success Factors studies in 10 countries: Bangladesh, Cambodia, China, Egypt, Ethiopia, the Lao People's Democratic Republic, Nepal, Peru, Rwanda and Viet Nam. A framework approach was used to analyse and synthesize the data from the country reports, resulting in descriptive or explanatory conclusions by theme. Findings Successful policy and programme approaches were categorized in four strategic areas: leadership and multistakeholder partnerships; health sector; sectors outside health; and accountability for resources and results. Consistent and coordinated inputs across sectors, based on high-impact interventions, were assessed. Within the health sector, key policy and programme strategies included defining standards, collecting and using data, improving financial protection, and improving the availability and quality of services. Outside the health sector, strategies included investing in girls’ education, water, sanitation and hygiene, poverty reduction, nutrition and food security, and infrastructure development. Countries improved accountability by strengthening and using data systems for planning and evaluating progress. Conclusion Reducing maternal and child mortality in the 10 fast-track countries can be linked to consistent and coordinated policy and programme inputs across health and other sectors. The approaches used by successful countries have relevance to other countries looking to scale-up or accelerate progress towards the sustainable development goals. PMID:27147765

  5. [Actively promote nutrition and health surveillance, achieve the national nutrition and health goals].

    Science.gov (United States)

    Ding, Gangqiang; Zhao, Wenhua; Chen, Junshi

    2016-03-01

    The results of Chinese Nutrition and Health Surveillance (2010-2012) showed that the anemia prevalence in China reduced significantly compared with 2002, and people's nutrition and health status have improved. Unbalanced diet still exist, such as low intake of vegetables and fruits, and high intake of salt. The serum total cholesterol level and the prevalence of hypercholesterolemia and borderline high cholesterolemia were high among urban adults, and more attention should be paid for high serum total cholesterol level among older adults. These results are significant to the development of nutrition and health intervention strategy, carry out nutrition intervention and the achievement of national nutrition and health goals.

  6. Slavery in New Zealand: What is the role of the health sector?

    Science.gov (United States)

    King, Paula; Blaiklock, Alison; Stringer, Christina; Amaranathan, Jay; McLean, Margot

    2017-10-06

    Contemporary forms of slavery and associated adverse health effects are a serious, complex and often neglected issue within the New Zealand health sector. Slavery in New Zealand has most recently been associated with the fishing and horticulture industries. However, victims may be found in a number of other industry sectors, including the health and aged-care sectors, or outside of the labour market such as in forced, early (underage) and servile forms of marriage. Victims of slavery are at increased risk of acute and chronic health problems, injuries from dangerous working and living conditions, and physical and sexual abuse. These issues are compounded by restricted access to high-quality healthcare. Slavery is a violation of many human rights, including the right to health. New Zealand has obligations under international law to ensure that all victims of slavery have access to adequate physical and psychological care. The health sector has opportunities to identify, intervene and protect victims. This requires doctors and other health practitioners to demonstrate their leadership, knowledge and commitment towards addressing slavery and its health consequences in ways that are effective and do not cause further harm. Key recommendations for a safe approach towards identifying and managing people in situations of slavery include building rapport, and culturally competent practice with an empathetic non-judgmental approach. We also recommend that health organisations and regulatory and professional bodies develop culturally competent guidelines to respond safely to those identified in situations of slavery. These responses should be based on the respect, promotion and protection of human rights, and occur within a robust person-centric coordinated government response to addressing slavery in New Zealand.

  7. The challenges of good governance in the aquatic animal health sector.

    Science.gov (United States)

    Kahn, S; Mylrea, G; Yaacov, K Bar

    2012-08-01

    Animal health is fundamental to efficient animal production and, therefore, to food security and human health. This holds true for both terrestrial and aquatic animals. Although partnership between producers and governmental services is vital for effective animal health programmes, many key activities are directly carried out by governmental services. Noting the need to improve the governance of such services in many developing countries, the World Organisation for Animal Health (OIE), using the OIE Tool for the Evaluation of Performance of Veterinary Services, conducts assessments of Veterinary Services and Aquatic Animal Health Services (AAHS) to help strengthen governance and support more effective delivery of animal health programmes. While good governance and the tools to improve governance in the aquatic animal sector are largely based on the same principles as those that apply in the terrestrial animal sector, there are some specific challenges in the aquatic sector that have a bearing on the governance of services in this area. For example, the aquaculture industry has experienced rapid growth and the use of novel species is increasing; there are important gaps in scientific knowledge on diseases of aquatic animals; there is a need for more information on sustainable production; the level of participation of the veterinary profession in aquatic animal health is low; and there is a lack of standardisation in the training of aquatic animal health professionals. Aquaculture development can be a means of alleviating poverty and hunger in developing countries. However, animal diseases, adverse environmental impacts and food safety risks threaten to limit this development. Strengthening AAHS governance and, in consequence, aquatic animal health programmes, is the best way to ensure a dynamic and sustainable aquaculture sector in future. This paper discusses the specific challenges to AAHS governance and some OIE initiatives to help Member Countries to address

  8. The World Health Organization's mechanisms for increasing the health sector budget: The South African context.

    Science.gov (United States)

    Venter, Fouche Hendrik Johannes; Wolfaardt, Jaqueline Elizabeth

    2016-07-04

    South Africa (SA) has limited scope for raising income taxes, and the proposed National Health Insurance (NHI) scheme will necessitate growth in the health sector budget. The NHI White Paper suggests five funding scenarios to meet the expected shortfall. These scenarios are a mixture of a surcharge on taxable income, an increase in value-added tax and a payroll tax. Five alternative options, suggested by the World Health Organization, are interrogated as ways to decrease the general taxation proposed in the White Paper. The five mechanisms (corporate tax, financial transaction levy, and taxes on tobacco, alcohol and unhealthy foods) were chosen based on their fund-raising potential and their mandatory element. A literature review provides the information for a discussion of the potential costs of each mechanism. Within specific assumptions, potential budgetary contribution is compared with the requirement. First, raising corporate tax rates could raise enough funds, but the losses due to capital flight might be too much for the local economy to bear. Second, a levy on currency transactions is unlikely to raise the required resources, even without a probable decrease in the number of transactions. Third, the increase in the tax on tobacco and alcohol would need to be very large, even assuming that consumption patterns would remain unchanged. Lastly, a tax on unhealthy food products is a new idea and could be explored as an option - especially as the SA Treasury has announced its future implementation. Implementing only one of the mechanisms is unlikely to increase available funding sufficiently, but if they are implemented together the welfare-maximising tax rate for each mechanism may be high enough to fulfil the NHI scheme's budgetary requirement, moderating the increases in the tax burden of the SA population.

  9. Sources of satisfaction and dissatisfaction among specialists within the public and private health sectors.

    Science.gov (United States)

    Ashton, Toni; Brown, Paul; Sopina, Elizaveta; Cameron, Linda; Tenbensel, Timothy; Windsor, John

    2013-09-27

    As in many countries, medical and surgical specialists in New Zealand have the opportunity of working in the public sector, the private sector or both. This study aimed to explore the level and sources of satisfaction and dissatisfaction of specialists in New Zealand with working in the two sectors. Such information can assist workforce planning, management and policy and may inform the wider debate about the relationship between the two sectors. A postal survey was conducted of 1983 registered specialists throughout New Zealand. Respondents were asked to assess 14 sources of satisfaction and 9 sources of dissatisfaction according to a 5-point Likert scale. Means and standard deviations were calculated for the total sample, and for procedural and non-procedural specialties. Differences between the means of each source of satisfaction and dissatisfaction were also calculated. Completed surveys were received from 943 specialists (47% response rate). Overall mean levels of satisfaction were higher in the private sector than the public sector while levels of dissatisfaction were lower. While the public system is valued for its opportunities for further education and professional development, key sources of dissatisfaction are workload pressures, mentally demanding work and managerial interference. In the private sector specialists value the opportunity to work independently and apply their own ideas in the workplace. Sources of job satisfaction and dissatisfaction amongst specialists are different for the public and private sectors. Allowing specialists more freedom to work independently and to apply their own ideas in the workplace may enhance recruitment and retention of specialists in the public health system.

  10. Lumbar spinal fusion patients' demands to the primary health sector: evaluation of three rehabilitation protocols

    DEFF Research Database (Denmark)

    Soegaard, Rikke; Christensen, Finn B; Lauerberg, Ida

    2006-01-01

    Very few studies have investigated the effects or costs of rehabilitation regimens following lumbar spinal fusion. The effectiveness of in-hospital rehabilitation regimens has substantial impact on patients' demands in the primary health care sector. The aim of this study was to investigate patie...... service utilization in the primary health care sector as compared to the usual regimen and a training exercise regimen. The results stress the importance of a cognitive element of coping in a rehabilitation program.......Very few studies have investigated the effects or costs of rehabilitation regimens following lumbar spinal fusion. The effectiveness of in-hospital rehabilitation regimens has substantial impact on patients' demands in the primary health care sector. The aim of this study was to investigate patient......-articulated demands to the primary health care sector following lumbar spinal fusion and three different in-hospital rehabilitation regimens in a prospective, randomized study with a 2-year follow-up. Ninety patients were randomized 3 months post lumbar spinal fusion to either a 'video' group (one-time oral...

  11. The progressive spread of ADR: The example of the health sector

    Directory of Open Access Journals (Sweden)

    De Angelis, M.

    2011-01-01

    Full Text Available The instrument of mediation is a growing phenomenon. The EU legislation leaves the individual states the definition, articulation and differentiation of the various types of alternative dispute resolution. In Italy the mediation procedure in the health sector has still to be invented since at the moment.

  12. Three methods of interfacing with the private sector by mental health agencies.

    Science.gov (United States)

    McRae, J A

    1989-01-01

    This article outlines three methods of mental health marketing--formal, intermediary, and interactive. It discusses advantages and disadvantages of each method. These approaches are particularly good for public, non-profit agencies and individuals in contacting the private sector. The need for flexibility and marketing mix is emphasized.

  13. High performance work practices in the health care sector: A dutch case study

    NARCIS (Netherlands)

    Boselie, J.P.P.E.F.

    2010-01-01

    Purpose – This paper aims to present an empirical study of the effect of high performance work practices on commitment and citizenship behaviour in the health care sector. The theory suggests that individual employees are willing “to go the extra mile” when they are given the opportunity to develop

  14. The private health sector in South Africa - current trends and future ...

    African Journals Online (AJOL)

    The private health sector is experiencing a crisis of spiralling costs, with average annual cost increases of between 13% and 32% over the decade 1978 - 1988. This trend is partly explained by the high utilisation rates that result from the combination of the 'fee-for-service' system and the 'third-party' payment structure of the ...

  15. Staff/population ratios in South African public sector mental health ...

    African Journals Online (AJOL)

    To document existing staff/population ratios per 100 000 population in South African public sector mental health services. Design. Cross-sectional survey. ... The staff/population ratios per 100 000 population for selected personnel categories (with the interprovincial ranges in brackets) were as follows: total nursing staff 15.6 ...

  16. The root causes of ineffective and inefficient healthcare technology management in Benin public health sector

    NARCIS (Netherlands)

    Houngbo, T.; Zweekhorst, M.B.M.; Bunders- Aelen, J.G.F.; Coleman, H.L.S.; Medenou, D.; Dakpanon, L.Y.; de Cock Buning, Tjard

    2017-01-01

    This study aims to identify the root causes and solutions of main problems facing Healthcare Technology Management in Benin׳s public health sector. Conducted in Benin from 2008 to 2010, two surveys were used with key actors in Healthcare Technology Management. The first survey was based on 377

  17. Foreign direct investment in the health care sector and most-favoured locations in developing countries.

    Science.gov (United States)

    Outreville, J François

    2007-12-01

    Given the growing importance of the health care sector and the significant development of trade in health services, foreign direct investment (FDI) in this sector has gathered momentum with the General Agreement on Trade in Services. Despite extensive case based research and publications in recent years on health care markets and the rise of private sectors, it is surprisingly difficult to find evidence on the relative importance of the largest multinational corporations (MNCs) operating in the health care sector. The objective of the paper is to identify some of the determinants of foreign investment of the largest MNCs operating in this industry. The list of the largest MNCs has been compiled using company websites and data is available for 41 developing economies for which at least two MNCs have an office (branch and/or affiliate). The results of this study have some important implications. They indicate that location-specific advantages of host countries, including good governance, do provide an explication of the internationalization of firms in some developing countries rather than others.

  18. Public-Private health sector mix- way forward | Buso | South African ...

    African Journals Online (AJOL)

    The debate on Public-Private mix has been around in South Africa (SA) for the past ten years. The debate arose out of a realisation of the weaknesses in the public health parallel with the ever-increasing private sector worldwide. The concept has been referred to in different terminologies, public-private mix, public private ...

  19. Cross-sector cooperation in health-enhancing physical activity policymaking

    DEFF Research Database (Denmark)

    Hämäläinen, Riitta-Maija; Aro, Arja R.; Juel Lau, Cathrine

    2016-01-01

    in health-enhancing physical activity (HEPA) policies in six European Union (EU) member states. METHODS: Qualitative content analysis of HEPA policies and semi-structured interviews with key policymakers in six European countries. RESULTS: Cross-sector cooperation varied between EU member states within HEPA...

  20. The skills gap in nursing management in the South African public health sector.

    Science.gov (United States)

    Pillay, Rubin

    2011-01-01

    Nurse managers are central to health delivery in South Africa. However, there is a paucity of research that analyzes their competence to successfully discharge their managerial role. To identify the competencies perceived to be important for effective nursing management in the South African public sector and the managers' self-assessed proficiency in these. A cross-sectional survey using a self-administered questionnaire. 215 senior nursing managers at South African public sector hospitals. Respondents rated the level of importance that 51 proposed competencies had in their job and indicated their proficiency in each. Public sector managers ranked controlling as the most important competency, followed by leading, organizing, and self-management. Health/clinical skills, planning, and legal/ethical competencies were ranked as being relatively less important. They assessed themselves as being most competent in self-management, followed by planning, controlling, leading, and specific health skills. The competency gap was the largest for legal/ethical issues, organizing, and controlling. The competency gap for planning and self-management was relatively smaller. This research confirms that there is a lack of management capacity within the public health sector and also identifies the areas in which the lack of knowledge or skills is most significant. © 2011 Wiley Periodicals, Inc.

  1. Lighting in the health care sector; Verlichting in de zorg

    Energy Technology Data Exchange (ETDEWEB)

    Visser, R. [Grontmij, Amersfoort (Netherlands)

    2009-02-15

    The importance of light for people's health and welfare attracts frequent attention, not only the professional press but also in countless articles in newspapers and news magazines. Insufficient illumination can upset the biological clock and may even cause depression. In principle this applies to anyone who has to stay indoors all day or nearly all day; in the case of care homes it affects residents who have no regular opportunity to sit at a window, for example those who are bedridden. Research indicates that we need a minimum daily portion of daylight or of artificial light with similar qualities as daylight. This is also of great importance to night workers. [Dutch] Niet alleen in de vakpers, maar ook in tal van dag- en weekbladen, wordt regelmatig het belang van licht voor het welzijn en de gezondheid van de mens aan de orde gesteld. Gebrek aan voldoende licht kan het bioritme verstoren en zelfs leiden tot depressie. Dat geldt in principe voor alle mensen die om wat voor redenen dan ook de hele dag of nagenoeg de hele dag binnen moeten blijven. In zorginstellingen is dit vooral van toepassing voor degenen die zich niet regelmatig direct achter het ream kunnen bevinden, zoals mensen die bedlegering zijn. Want door onderzoek is gebleken dat we elke dag een voldoende portie daglicht nodig hebben of licht met overeenkomstige kwaliteiten als daglicht. Voor mensen die 's nachts moeten werken is het laatstgenoemde ook van groot belang.

  2. Challenges in Preparing Veterinarians for Global Animal Health: Understanding the Public Sector.

    Science.gov (United States)

    Hollier, Paul J; Quinn, Kaylee A; Brown, Corrie C

    Understanding of global systems is essential for veterinarians seeking to work in realms outside of their national domain. In the global system, emphasis remains on the public sector, and the current curricular emphasis in developed countries is on private clinical practice for the domestic employment market. There is a resulting lack of competency at graduation for effective engagement internationally. The World Organisation for Animal Health (OIE) has created standards for public sector operations in animal health, which must be functional to allow for sustainable development. This public sector, known as the Veterinary Services, or VS, serves to control public good diseases, and once effectively built and fully operational, allows for the evolution of a functional private sector, focused on private good diseases. Until the VS is fully functional, support of private good services is non-sustainable and any efforts delivered are not long lasting. As new graduates opt for careers working in the international development sector, it is essential that they understand the OIE guidelines to help support continuing improvement. Developing global veterinarians by inserting content into the veterinary curriculum on how public systems can operate effectively could markedly increase the potential of our professional contributions globally, and particularly in the areas most in need.

  3. Accelerators/decelerators of achieving universal access to sexual and reproductive health services: a case study of Iranian health system.

    Science.gov (United States)

    Akbari, Nahid; Ramezankhani, Ali; Pazargadi, Mehrnoosh

    2013-07-01

    At the 1994 International Conference on Population and Development (ICPD), held in Cairo, the global community agreed to the goal of achieving universal access to sexual and reproductive health (SRH) and rights by 2015. This research explores the accelerators and decelerators of achieving universal access to the sexual and reproductive health targets and accordingly makes some suggestions. We have critically reviewed the latest national reports and extracted the background data on each SRH indicator. The key stakeholders, both national and international, were visited and interviewed at two sites. A total of 55 in-depth interviews were conducted with religious leaders, policy-makers, senior managers, senior academics, and health care managers. Six focus-group discussions were also held among health care providers. The study was qualitative in nature. Obstacles on the road to achieving universal access to SRH can be viewed from two perspectives. One gap exists between current achievements and the targets. The other gap arises due to age, marital status, and residency status. The most recently observed trends in the indicators of the universal access to SRH shows that the achievements in the "unmet need for family planning" have been poor. Unmet need for family planning could directly be translated to unwanted pregnancies and unwanted childbirths; the former calls for sexual education to underserved people, including adolescents; and the latter calls for access to safe abortion. Local religious leaders have not actively attended international goal-setting programs. Therefore, they usually do not presume a positive attitude towards these goals. Such negative attitudes seem to be the most important factors hindering the progress towards universal access to SRH. Lack of international donors to fund for SRH programs is also another barrier. In national levels both state and the society are interactively playing their roles. We have used a cascade model for presenting the

  4. Analysis of health sector gender equality and social inclusion strategy 2009 of Nepal.

    Science.gov (United States)

    Mahara, G B; Dhital, S R

    2014-01-01

    The policy on gender equality and social inclusion (GESI) in health sector of Nepal is formulated in 2009 targeting toward poor, vulnerable, marginalized social and ethnic groups. Gender inequality and social discrimination are a social problem that affect on individual health finally. The main objective of this paper is to critically analysis and evaluates the Government's strategy on health sector gender equality and social inclusion in Nepal. We collected published and unpublished information assessing the public health, policy analysis and research needs from different sources. A different policy approaches for the analysis and evaluation of GESI strategies is applied in this paper. Universal education, community participation, individual, group and mass communication approaches, and social capital are the key aspects of effective implementation of policy at target levels.

  5. Implementation status of accrual accounting system in health sector.

    Science.gov (United States)

    Mehrolhassani, Mohammad Hossien; Khayatzadeh-Mahani, Akram; Emami, Mozhgan

    2014-07-29

    Management of financial resources in health systems is one of the major issues of concern for policy makers globally. As a sub-set of financial management, accounting system is of paramount importance. In this paper, which presents part of the results of a wider research project on transition process from a cash accounting system to an accrual accounting system, we look at the impact of components of change on implementation of the new system. Implementing changes is fraught with many obstacles and surveying these challenges will help policy makers to better overcome them. The study applied a quantitative manner in 2012 at Kerman University of Medical Science in Iran. For the evaluation, a teacher made valid questionnaire with Likert scale was used (Cranach's alpha of 0.89) which included 7 change components in accounting system. The study population was 32 subordinate units of Kerman University of Medical Sciences and for data analysis, descriptive and inferential statistics and correlation coefficient in SPSS version 19 were used. Level of effect of all components on the implementation was average downward (5.06±1.86), except for the component "management & leadership (3.46±2.25)" (undesirable from external evaluators' viewpoint) and "technology (6.61±1.92) and work processes (6.35±2.19)" (middle to high from internal evaluators' viewpoint). Results showed that the establishment of accrual accounting system faces infrastructural challenges, especially the components of leadership and management and followers. As such, developing effective measures to overcome implementation obstacles should target these components.

  6. Implementation Status of Accrual Accounting System in Health Sector

    Science.gov (United States)

    Mehrolhassani, Mohammad Hossien; Khayatzadeh-Mahani, Akram; Emami, Mozhgan

    2015-01-01

    Introduction: Management of financial resources in health systems is one of the major issues of concern for policy makers globally. As a sub-set of financial management, accounting system is of paramount importance. In this paper, which presents part of the results of a wider research project on transition process from a cash accounting system to an accrual accounting system, we look at the impact of components of change on implementation of the new system. Implementing changes is fraught with many obstacles and surveying these challenges will help policy makers to better overcome them. Methods: The study applied a quantitative manner in 2012 at Kerman University of Medical Science in Iran. For the evaluation, a teacher made valid questionnaire with Likert scale was used (Cranach’s alpha of 0.89) which included 7 change components in accounting system. The study population was 32 subordinate units of Kerman University of Medical Sciences and for data analysis, descriptive and inferential statistics and correlation coefficient in SPSS version 19 were used. Results: Level of effect of all components on the implementation was average downward (5.06±1.86), except for the component “management & leadership (3.46±2.25)” (undesirable from external evaluators’ viewpoint) and “technology (6.61±1.92) and work processes (6.35±2.19)” (middle to high from internal evaluators’ viewpoint). Conclusions: Results showed that the establishment of accrual accounting system faces infrastructural challenges, especially the components of leadership and management and followers. As such, developing effective measures to overcome implementation obstacles should target these components. PMID:25560337

  7. Determinants of enrollment of informal sector workers in cooperative based health scheme in Bangladesh

    Science.gov (United States)

    Sarker, Abdur Razzaque; Sultana, Marufa; Mahumud, Rashidul Alam; Ahmed, Sayem; Islam, Ziaul; Morton, Alec; Khan, Jahangir A. M.

    2017-01-01

    Background Providing access to affordable health care for the informal sector remains a considerable challenge for low income countries striving to make progress towards universal health coverage. The objective of the study is to identify the factors shaping the decision to enroll in a cooperative based health scheme for informal workers in Bangladesh and also help to identify the features of informal workers without health schemes and their likelihood of being insured. Methods Data were derived from a cross-sectional in-house survey within the catchment area of a cooperative based health scheme in Bangladesh during April–June 2014, covering a total of 784 households (458 members and 326 non-members). Multivariate logistic regression model was used to identify factors associated with cooperative based health scheme and explanatory variables. Findings This study found that a number of factors were significant determinants of health scheme participation including sex of household head, household composition, occupational category as well as involvement social financial safety net programs. Conclusion Findings from this study can be suggestive for policy-makers interested in scaling up health insurance for informal workers in Bangladesh. Shared funding from this large informal sector can generate new resources for healthcare, which is in line with the healthcare financing strategy of Bangladesh as well as the recommendation of the World Health Organization for developing social health insurance as part of the path to Universal Health Coverage. PMID:28750052

  8. Determinants of enrollment of informal sector workers in cooperative based health scheme in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Abdur Razzaque Sarker

    Full Text Available Providing access to affordable health care for the informal sector remains a considerable challenge for low income countries striving to make progress towards universal health coverage. The objective of the study is to identify the factors shaping the decision to enroll in a cooperative based health scheme for informal workers in Bangladesh and also help to identify the features of informal workers without health schemes and their likelihood of being insured.Data were derived from a cross-sectional in-house survey within the catchment area of a cooperative based health scheme in Bangladesh during April-June 2014, covering a total of 784 households (458 members and 326 non-members. Multivariate logistic regression model was used to identify factors associated with cooperative based health scheme and explanatory variables.This study found that a number of factors were significant determinants of health scheme participation including sex of household head, household composition, occupational category as well as involvement social financial safety net programs.Findings from this study can be suggestive for policy-makers interested in scaling up health insurance for informal workers in Bangladesh. Shared funding from this large informal sector can generate new resources for healthcare, which is in line with the healthcare financing strategy of Bangladesh as well as the recommendation of the World Health Organization for developing social health insurance as part of the path to Universal Health Coverage.

  9. The impact of slow economic growth on health sector reform: a cross-national perspective.

    Science.gov (United States)

    Saltman, Richard B

    2018-01-24

    This paper assesses recent health sector reform strategies across Europe adopted since the onset of the 2008 financial crisis. It begins with a brief overview of the continued economic pressure on public funding for health care services, particularly in tax-funded Northern European health care systems. While economic growth rates across Europe have risen a bit in the last year, they remain below the level necessary to provide the needed expansion of public health sector revenues. This continued public revenue shortage has become the central challenge that policymakers in these health systems confront, and increasingly constrains their potential range of policy options. The paper then examines the types of targeted reforms that various European governments have introduced in response to this increased fiscal stringency. Particularly in tax-funded health systems, these efforts have been focused on two types of changes on the production side of their health systems: consolidating and/or centralizing administrative authority over public hospitals, and revamping secondary and primary health services as well as social services to reduce the volume, cost and less-than-optimal outcomes of existing public elderly care programs. While revamping elderly care services also was pursued in the social health insurance (SHI) system in the Netherlands, both the Dutch and the German health systems also made important changes on the financing side of their health systems. Both types of targeted reforms are illustrated through short country case studies. Each of these country assessments flags up new mechanisms that have been introduced and which potentially could be reshaped and applied in other national health sector contexts. Reflecting the tax-funded structure of the Canadian health system, the preponderance of cases discussed focus on tax-funded countries (Norway, Denmark, Sweden, Finland, England, Ireland), with additional brief assessments of recent changes in the SHI

  10. The Barriers to Achieve Financial Protection in Iranian Health System: A Qualitative Study in a Developing Country.

    Science.gov (United States)

    Naghdi, Seyran; Moradi, Tayebeh; Tavangar, Fateh; Bahrami, Giti; Shahboulaghi, Mohammadi; Ghiasvand, Hesam

    2017-09-01

    The move to universal health coverage and consequently health promotion is influenced by political, socio-economic and other contextual factors in a country. Iran, as a developing country with an upper-middle national income, has developed policies to achieve universal health coverage through financial protection. This study aims to investigate barriers to develop financial protection as a requirement to achieve universal health coverage. This qualitative study was conducted using 20 in-depth interviews with experts in social welfare, health insurance and financing. The framework analysis method was used to analyze the data. The results have been categorized in three major themes that were extracted from ten sub-themes. The major themes included the political, social and economic context of the country, the context and structure of healthcare system and dimensions of UHC. Achieving financial protection as a long-term objective should be considered as a priority among Iranian policy makers that requires an inter-sectoral collaboration with a defined in-charge body. Health policy makers in Iran should develop a more comprehensive benefits package for diseases and health conditions with catastrophic consequences. They also should develop a plan to cover the poor people.

  11. Occupational health profile of workers employed in the manufacturing sector of India.

    Science.gov (United States)

    Suri, Shivali; Das, Ranjan

    2016-01-01

    The occupational health scenario of workers engaged in the manufacturing sector in India deserves attention for their safety and increasing productivity. We reviewed the status of the manufacturing sector, identified hazards faced by workers, and assessed the existing legislations and healthcare delivery mechanisms. From October 2014 to March 2015, we did a literature review by manual search of pre-identified journals, general electronic search, electronic search of dedicated websites/databases and personal communication with experts of occupational health. An estimated 115 million workers are engaged in the manufacturing sector, though the Labour Bureau takes into account only one-tenth of them who work in factories registered with the government. Most reports do not mention the human capital employed neither their quality of life, nor occupational health services available. The incidence of accidents were documented till 2011, and industry-wise break up of data is not available. Occupational hazards reported include hypertension, stress, liver disease, diabetes, tuberculosis, eye/ hearing problems, cancers, etc. We found no studies for manufacturing industries in glass, tobacco, computer and allied products, etc. The incidence of accidents is decreasing but the proportion of fatalities is increasing. Multiple legislations exist which cover occupational health, but most of these are old and have not been amended adequately to reflect the present situation. There is a shortage of manpower and occupational health statistics for dealing with surveillance, prevention and regulation in this sector. There is an urgent need of a modern occupational health legislation and an effective machinery to enforce it, preferably through intersectoral coordination between the Employees' State Insurance Corporation, factories and state governments. Occupational health should be integrated with the general health services.

  12. Adoption of Free Open Source Geographic Information System Solution for Health Sector in Zanzibar Tanzania

    OpenAIRE

    BAKAR, Abubakar D.; KIMARO, Honest C.; SULTAN, Abu Bakar MD; HAMIAR, S.

    2014-01-01

    The study aims at developing in-depth understanding on how Open Source Geographic Information System technology is used to provide solutions for data visualization in the health sector of Zanzibar, Tanzania. The study focuses on implementing the health visualization solutions for the purpose of bridging the gap during the transition period from proprietary software to the Free Open-Source Software using Key Indicator Data System. The developed tool facilitates data integration between the two...

  13. Report of the 6th Tanzania Joint Annual Health Sector Review

    OpenAIRE

    Smithson, Paul

    2005-01-01

    The 6th Annual Joint Health Sector Review was concluded successfully at Kunduchi Beach hotel, between 4th and 6th April 2005. It was preceded by a Technical preparatory meeting, held at Belinda Hotel. This year’s was the largest Review yet, with over 200 participants. As well as government and donor representatives, the meeting was attended by a variety of civil society and NGO representatives. The Honourable Minister of Health opened the meeting. Judged by the milestones, performance over th...

  14. Strategies for engaging the private sector in sexual and reproductive health: how effective are they?

    Science.gov (United States)

    Peters, David H; Mirchandani, Gita G; Hansen, Peter M

    2004-10-01

    The private health sector provides a significant portion of sexual and reproductive health (SRH) services in developing countries. Yet little is known about which strategies for intervening with private providers can improve quality or coverage of services. We conducted a systematic review of the literature through PubMed from 1980 to 2003 to assess the effectiveness of private sector strategies for SRH services in developing countries. The strategies examined were regulating, contracting, financing, franchising, social marketing, training and collaborating. Over 700 studies were examined, though most were descriptive papers, with only 71 meeting our inclusion criteria of having a private sector strategy for one or more SRH services and the measurement of an outcome in the provider or the beneficiary. Nearly all studies (96%) had at least one positive association between SRH and the private sector strategy. About three-quarters of the studies involved training private providers, though combinations of strategies tended to give better results. Maternity services were most commonly addressed (55% of studies), followed by prevention and treatment of sexually transmitted diseases (32%). Using study design to rate the strength of evidence, we found that the evidence about effectiveness of private sector strategies on SRH services is weak. Most studies did not use comparison groups, or they relied on cross-sectional designs. Nearly all studies examined short-term effects, largely measuring changes in providers rather than changes in health status or other effects on beneficiaries. Five studies with more robust designs (randomized controlled trials) demonstrated that contraceptive use could be increased through supporting private providers, and showed cases where the knowledge and practices of private providers could be improved through training, regulation and incentives. Although tools to work with the private sector offer considerable promise, without stronger research

  15. Health surveillance assistants as intermediates between the community and health sector in Malawi: exploring how relationships influence performance.

    Science.gov (United States)

    Kok, Maryse C; Namakhoma, Ireen; Nyirenda, Lot; Chikaphupha, Kingsley; Broerse, Jacqueline E W; Dieleman, Marjolein; Taegtmeyer, Miriam; Theobald, Sally

    2016-05-03

    There is increasing global interest in how best to support the role of community health workers (CHWs) in building bridges between communities and the health sector. CHWs' intermediary position means that interpersonal relationships are an important factor shaping CHW performance. This study aimed to obtain in-depth insight into the facilitators of and barriers to interpersonal relationships between health surveillance assistants (HSAs) and actors in the community and health sector in hard-to-reach settings in two districts in Malawi, in order to inform policy and practice on optimizing HSA performance. The study followed a qualitative design. Forty-four semi-structured interviews and 16 focus group discussions were conducted with HSAs, different community members and managers in Mchinji and Salima districts. Data were recorded, transcribed, translated, coded and thematically analysed. HSAs had relatively strong interpersonal relationships with traditional leaders and volunteers, who were generally supportive of their work. From the health sector side, HSAs linked to health professionals and managers, but found them less supportive. Accountability structures at the community level were not well-established and those within the health sector were executed irregularly. Mistrust from the community, volunteers or HSAs regarding incentives and expectations that could not be met by "higher levels" undermined support structures and led to demotivation and hampered performance. Supervision and training were sometimes a source of mistrust and demotivation for HSAs, because of the perceived disinterest of supervisors, uncoordinated supervision and favouritism in selection of training participants. Rural HSAs were seen as more disadvantaged than HSAs in urban areas. HSAs' intermediary position necessitates trusting relationships between them and all actors within the community and the health sector. There is a need to improve support and accountability structures that

  16. Psychosocial safety climate: a multilevel theory of work stress in the health and community service sector.

    Science.gov (United States)

    Dollard, M F; McTernan, W

    2011-12-01

    Work stress is widely thought to be a significant problem in the health and community services sector. We reviewed evidence from a range of different data sources that confirms this belief. High levels of psychosocial risk factors, psychological health problems and workers compensation claims for stress are found in the sector. We propose a multilevel theoretical model of work stress to account for the results. Psychosocial safety climate (PSC) refers to a climate for psychological health and safety. It reflects the balance of concern by management about psychological health v. productivity. By extending the health erosion and motivational paths of the Job Demands-Resources model we propose that PSC within work organisations predicts work conditions and in turn psychological health and engagement. Over and above this, however, we expect that the external environment of the sector particularly government policies, driven by economic rationalist ideology, is increasing work pressure and exhaustion. These conditions are likely to lead to a reduced quality of service, errors and mistakes.

  17. Isomorphic pressures, institutional strategies, and knowledge creation in the health care sector.

    Science.gov (United States)

    Yang, Chen-Wei; Fang, Shih-Chieh; Huang, Wei-Min

    2007-01-01

    Health care organizations are facing surprisingly complex challenges, including new treatment and diagnostic technologies, ongoing pressures for health care institutional reform, the emergence of new organizational governance structures, and knowledge creation for the health care system. To maintain legitimacy in demanding environments, organizations tend to copy practices of similar organizations, which lead to isomorphism, and to use internal strategies to accommodate changes. A concern is that a poor fit between isomorphic pressures and internal strategies can interfere with developmental processes, such as knowledge creation. The purposes of this article are to, first, develop a set of propositions, based on institutional theory, as a theoretical framework that might explain the influence of isomorphic pressures on institutional processes through which knowledge is created within the health care sector and, second, propose that a good fit between isomorphic pressures factors and health care organizations' institutional strategic choices will enhance the health care organizations' ability to create knowledge. To develop a theoretical framework, we developed a set of propositions based on literature pertaining to the institutional theory perspective of isomorphic pressures and the response of health care organizations to isomorphic pressures. Institutional theory perspectives of isomorphic pressures and institutional strategies may provide a new understanding for health care organizations seeking effective knowledge creation strategies within institutional environment of health care sector. First, the ability to identify three forces for isomorphic change is critical for managers. Second, the importance of a contingency approach by health care managers can lead to strategies tailoring to cope with uncertainties facing their organizations.

  18. Role of GIS in social sector planning: can developing countries benefit from the examples of primary health care (PHC) planning in Britain?

    Science.gov (United States)

    Ishfaq, Mohammad; Lodhi, Bilal Khan

    2012-04-01

    Social sector planning requires rational approaches where community needs are identified by referring to relative deprivation among localities and resources are allocated to address inequalities. Geographical information system (GIS) has been widely argued and used as a base for rational planning for equal resource allocation in social sectors around the globe. Devolution of primary health care is global strategy that needs pains taking efforts to implement it. GIS is one of the most important tools used around the world in decentralization process of primary health care. This paper examines the scope of GIS in social sector planning by concentration on primary health care delivery system in Pakistan. The work is based on example of the UK's decentralization process and further evidence from US. This paper argues that to achieve benefits of well informed decision making to meet the communities' needs GIS is an essential tool to support social sector planning and can be used without any difficulty in any environment. There is increasing trend in the use of Health Management Information System (HMIS) in Pakistan with ample internet connectivity which provides well established infrastructure in Pakistan to implement GIS for health care, however there is need for change in attitude towards empowering localities especially with reference to decentralization of decision making. This paper provides GIS as a tool for primary health care planning in Pakistan as a starting point in defining localities and preparing locality profiles for need identification that could help developing countries in implementing the change.

  19. Consensus and contention in the priority setting process: examining the health sector in Uganda.

    Science.gov (United States)

    Colenbrander, Sarah; Birungi, Charles; Mbonye, Anthony K

    2015-06-01

    Health priority setting is a critical and contentious issue in low-income countries because of the high burden of disease relative to the limited resource envelope. Many sophisticated quantitative tools and policy frameworks have been developed to promote transparent priority setting processes and allocative efficiency. However, low-income countries frequently lack effective governance systems or implementation capacity, so high-level priorities are not determined through evidence-based decision-making processes. This study uses qualitative research methods to explore how key actors' priorities differ in low-income countries, using Uganda as a case study. Human resources for health, disease prevention and family planning emerge as the common priorities among actors in the health sector (although the last of these is particularly emphasized by international agencies) because of their contribution to the long-term sustainability of health-care provision. Financing health-care services is the most disputed issue. Participants from the Ugandan Ministry of Health preferentially sought to increase net health expenditure and government ownership of the health sector, while non-state actors prioritized improving the efficiency of resource use. Ultimately it is apparent that the power to influence national health outcomes lies with only a handful of decision-makers within key institutions in the health sector, such as the Ministries of Health, the largest bilateral donors and the multilateral development agencies. These power relations reinforce the need for ongoing research into the paradigms and strategic interests of these actors. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  20. Digital Transformation and Disruption of the Health Care Sector: Internet-Based Observational Study.

    Science.gov (United States)

    Herrmann, Maximilian; Boehme, Philip; Mondritzki, Thomas; Ehlers, Jan P; Kavadias, Stylianos; Truebel, Hubert

    2018-03-27

    Digital innovation, introduced across many industries, is a strong force of transformation. Some industries have seen faster transformation, whereas the health care sector only recently came into focus. A context where digital corporations move into health care, payers strive to keep rising costs at bay, and longer-living patients desire continuously improved quality of care points to a digital and value-based transformation with drastic implications for the health care sector. We tried to operationalize the discussion within the health care sector around digital and disruptive innovation to identify what type of technological enablers, business models, and value networks seem to be emerging from different groups of innovators with respect to their digital transformational efforts. From the Forbes 2000 and CBinsights databases, we identified 100 leading technology, life science, and start-up companies active in the health care sector. Further analysis identified projects from these companies within a digital context that were subsequently evaluated using the following criteria: delivery of patient value, presence of a comprehensive and distinctive underlying business model, solutions provided, and customer needs addressed. Our methodological approach recorded more than 400 projects and collaborations. We identified patterns that show established corporations rely more on incremental innovation that supports their current business models, while start-ups engage their flexibility to explore new market segments with notable transformations of established business models. Thereby, start-ups offer higher promises of disruptive innovation. Additionally, start-ups offer more diversified value propositions addressing broader areas of the health care sector. Digital transformation is an opportunity to accelerate health care performance by lowering cost and improving quality of care. At an economic scale, business models can be strengthened and disruptive innovation models

  1. Infection prevention and control in health facilities in post-Ebola Liberia: don't forget the private sector!

    Science.gov (United States)

    Tremblay, N; Musa, E; Cooper, C; Van den Bergh, R; Owiti, P; Baller, A; Siafa, T; Woldeyohannes, D; Shringarpure, K; Gasasira, A

    2017-06-21

    Setting: Recognising the importance of infection prevention and control (IPC), a minimum standards tool (MST) was developed in Liberia to guide the safe (re-) opening and provision of care in health facilities. Objectives: To analyse the implementation of specific IPC measures after the 2014 Ebola virus outbreak between June 2015 and May 2016, and to compare the relative improvements in IPC between the public and private sectors. Design: A retrospective comparative cohort study. Results: We evaluated 723 (94%) of the 769 health facilities in Liberia. Of these, 437 (60%) were public and 286 (40%) were private. There was an overall improvement in the MST scores from a median of 13 to 14 out of a maximum possible score of 16. While improvements were observed in all aspects of IPC in both public and private health facilities, IPC implementation was systematically higher in public facilities. Conclusions: We demonstrate the feasibility of monitoring IPC implementation using the MST checklist in post-Ebola Liberia. Our study shows that improvements were made in key aspects of IPC after 1 year of evaluations and tailored recommendations. We also highlight the need to increase the focus on the private sector to achieve further improvements in IPC.

  2. Stimulation of Efficient Employee Performance through Human Resource Management Practices: A Study on the Health Care Sector of Bangladesh

    Directory of Open Access Journals (Sweden)

    Fatema Nusrat

    2018-01-01

    Full Text Available As the world is becoming more competitive and unstable than ever before; health care sector, especially in a developing country like Bangladesh, is seeking to gain competitive advantage through the performance of its employees and is turning to be more innovative in this perspective through human resource management (HRM practices. Experts view HRM practices as a set of internally consistent policies and practices designed and implemented to ensure that the human capital of the organization contributes to the achievement of its objectives. This paper examined the effects of human resource management (HRM practices on stimulating or enhancing efficient employee performance in the health care sector of Bangladesh. Ten dimensions and 43 item statements of human resource management (HRM practices and efficient employee performance have been adopted to undertake this study. Data have been gathered following a quantitative survey by a structured questionnaire conducted among a diverse group of employees (N = 240 working in 20 different health care service providing organizations of Bangladesh following simple random sampling method. Several statistical techniques consisting of descriptive analysis, Pearson correlations, ANOVA, Coefficient and regression analysis have been applied using SPSS software to analyze the collected data for taking decisions regarding the hypotheses. The results of the statistical analysis reveal that human resource management (HRM practices positively stimulates efficient employee performance. This study therefore recommends among others: enhancement of motivation among employees, improvement in the reward system, establishment of strong organizational culture, training and re-training of employees,  and employees participation in decision making.

  3. Good governance and corruption in the health sector: lessons from the Karnataka experience.

    Science.gov (United States)

    Huss, R; Green, A; Sudarshan, H; Karpagam, Ss; Ramani, Kv; Tomson, G; Gerein, N

    2011-11-01

    Strengthening good governance and preventing corruption in health care are universal challenges. The Karnataka Lokayukta (KLA), a public complaints agency in Karnataka state (India), was created in 1986 but played a prominent role controlling systemic corruption only after a change of leadership in 2001 with a new Lokayukta (ombudsman) and Vigilance Director for Health (VDH). This case study of the KLA (2001-06) analysed the:Scope and level of poor governance in the health sector; KLA objectives and its strategy; Factors which affected public health sector governance and the operation of the KLA. We used a participatory and opportunistic evaluation design, examined documents about KLA activities, conducted three site visits, two key informant and 44 semi-structured interviews and used a force field model to analyse the governance findings. The Lokayukta and his VDH were both proactive and economically independent with an extended social network, technical expertise in both jurisdiction and health care, and were widely perceived to be acting for the common good. They mobilized media and the public about governance issues which were affected by factors at the individual, organizational and societal levels. Their investigations revealed systemic corruption within the public health sector at all levels as well as in public/private collaborations and the political and justice systems. However, wider contextual issues limited their effectiveness in intervening. The departure of the Lokayukta, upon completing his term, was due to a lack of continued political support for controlling corruption. Governance in the health sector is affected by positive and negative forces. A key positive factor was the combined social, cultural and symbolic capital of the two leaders which empowered them to challenge corrupt behaviour and promote good governance. Although change was possible, it was precarious and requires continuous political support to be sustained.

  4. Achieving universal health coverage in small island states: could importing health services provide a solution?

    Science.gov (United States)

    Walls, Helen; Smith, Richard

    2018-01-01

    Background Universal health coverage (UHC) is difficult to achieve in settings short of medicines, health workers and health facilities. These characteristics define the majority of the small island developing states (SIDS), where population size negates the benefits of economies of scale. One option to alleviate this constraint is to import health services, rather than focus on domestic production. This paper provides empirical analysis of the potential impact of this option. Methods Analysis was based on publicly accessible data for 14 SIDS, covering health-related travel and health indicators for the period 2003–2013, together with in-depth review of medical travel schemes for the two highest importing SIDS—the Maldives and Tuvalu. Findings Medical travel from SIDS is accelerating. The SIDS studied generally lacked health infrastructure and technologies, and the majority of them had lower than the recommended number of physicians in a country, which limits their capacity for achieving UHC. Tuvalu and the Maldives were the highest importers of healthcare and notably have public schemes that facilitate medical travel and help lower the out-of-pocket expenditure on medical travel. Although different in approach, design and performance, the medical travel schemes in Tuvalu and the Maldives are both examples of measures used to increase access to health services that cannot feasibly be provided in SIDS. Interpretation Our findings suggest that importing health services (through schemes to facilitate medical travel) is a potential mechanism to help achieve universal healthcare for SIDS but requires due diligence over cost, equity and quality control. PMID:29527349

  5. A participatory model for improving occupational health and safety: improving informal sector working conditions in Thailand.

    Science.gov (United States)

    Manothum, Aniruth; Rukijkanpanich, Jittra; Thawesaengskulthai, Damrong; Thampitakkul, Boonwa; Chaikittiporn, Chalermchai; Arphorn, Sara

    2009-01-01

    The purpose of this study was to evaluate the implementation of an Occupational Health and Safety Management Model for informal sector workers in Thailand. The studied model was characterized by participatory approaches to preliminary assessment, observation of informal business practices, group discussion and participation, and the use of environmental measurements and samples. This model consisted of four processes: capacity building, risk analysis, problem solving, and monitoring and control. The participants consisted of four local labor groups from different regions, including wood carving, hand-weaving, artificial flower making, and batik processing workers. The results demonstrated that, as a result of applying the model, the working conditions of the informal sector workers had improved to meet necessary standards. This model encouraged the use of local networks, which led to cooperation within the groups to create appropriate technologies to solve their problems. The authors suggest that this model could effectively be applied elsewhere to improve informal sector working conditions on a broader scale.

  6. The role of the health care sector in the U.S. economy.

    Science.gov (United States)

    Foley, J

    1993-10-01

    This Issue Brief discusses factors that contribute to the growth of health care expenditures and the reasons that many individuals, employers, and policymakers consider health expenditures too high. In addition, it describes various industries that make up the health care delivery system and their role in the U.S. economy as employers, producers, exporters, and suppliers of research and development. The report also discusses the economic implications of rising health care expenditures for individuals, employers, and the federal government and the potential impact of proposed health care reform on the health care sector and the U.S. economy as a whole. Health care delivery industries such as pharmaceuticals and medical equipment suppliers have higher than average research and development levels, in addition to a positive balance of trade. Moreover, while the total number of jobs in the private sector declined between 1990 and 1993, the number of jobs in the relatively high paid health services sector continued to grow. In aggregate, employer spending on health care represents only 6.6 percent of total labor costs. In comparison, wages and salaries represent 83 percent of total labor costs. Consequently, the growth rate of health care expenditures has a smaller impact on the growth rate of total compensation than does the growth rate in wages and salaries. Using job multipliers developed by the U.S. Department of Commerce, it is estimated that the 18,600 health care services jobs in Rochester, Minnesota in 1993 created another 32,000 jobs in the area. Any contraction of the health care sector in cities that have a large concentration of employment in health services would result in reduced employment in restaurants, retail stores, janitorial services, and other local businesses. EBRI's simulations estimated that between 200,000 and 1.2 million workers could become unemployed as a direct result of a mandate that employers provide health benefits to their employees

  7. Evaluating digital libraries in the health sector. Part 2: measuring impacts and outcomes.

    Science.gov (United States)

    Cullen, Rowena

    2004-03-01

    This is the second part of a two-part paper which explores methods that can be used to evaluate digital libraries in the health sector. Part 1 focuses on approaches to evaluation that have been proposed for mainstream digital information services. This paper investigates evaluative models developed for some innovative digital library projects, and some major national and international electronic health information projects. The value of ethnographic methods to provide qualitative data to explore outcomes, adding to quantitative approaches based on inputs and outputs is discussed. The paper concludes that new 'post-positivist' models of evaluation are needed to cover all the dimensions of the digital library in the health sector, and some ways of doing this are outlined.

  8. Occupational Health and Role of Gender: A Study in Informal Sector Fisheries of Udupi, India.

    Science.gov (United States)

    Tripathi, Pooja; Kamath, Ramachandra; Tiwari, Rajnarayan

    2017-01-01

    Fisherwomen are informal sector workers involved in post-harvest operations and are mostly engaged in peeling, trading, and processing of fish. High degree of wage disparity and gender inequalities results in different socioeconomic status of fisherwomen and fishermen. This study aimed to identify gender issues and their effect on the health status of fisherwomen. The present cross-sectional included 171 fishermen and fisherwomen. Interview technique was used to collect information using a predesigned proforma. Data was analyzed using SPSS Version 15.0. Fifty-five percent of the participants complained of work-related health problems. A total of 63.9% of women had occupational health problems compared to 48.5% of the men ( P workplace. A total of 53.8% were paid on piece-rate basis. This study identified many occupational and gender issues in the informal sector.

  9. Job satisfaction of primary health-care providers (public sector in urban setting

    Directory of Open Access Journals (Sweden)

    Pawan Kumar

    2013-01-01

    Full Text Available Introduction: Job satisfaction is determined by a discrepancy between what one wants in a job and what one has in a job. The core components of information necessary for what satisfies and motivates the health work force in our country are missing at policy level. Therefore present study will help us to know the factors for job satisfaction among primary health care providers in public sector. Materials and Methods: Present study is descriptive in nature conducted in public sector dispensaries/primary urban health centers in Delhi among health care providers. Pretested structured questionnaire was administered to 227 health care providers. Data was analyzed using SPSS and relevant statistical test were applied. Results: Analysis of study reveals that ANMs are more satisfied than MOs, Pharmacist and Lab assistants/Lab technicians; and the difference is significant (P < 0.01. Age and education level of health care providers don′t show any significant difference in job satisfaction. All the health care providers are dissatisfied from the training policies and practices, salaries and opportunities for career growth in the organization. Majority of variables studied for job satisfaction have low scores. Five factor were identified concerned with job satisfaction in factor analysis. Conclusion: Job satisfaction is poor for all the four groups of health care providers in dispensaries/primary urban health centers and it is not possible to assign a single factor as a sole determinant of dissatisfaction in the job. Therefore it is recommended that appropriate changes are required at the policy as well as at the dispensary/PUHC level to keep the health work force motivated under public sector in Delhi.

  10. Resource allocation in Pakistan's health sector: a critical appraisal and a path toward the Millennium Development Goals.

    Science.gov (United States)

    Shaikh, Babar Tasneem; Ejaz, Irum; Mazhar, Arslan; Hafeez, Assad

    2013-01-01

    Pakistan is trying hard to sustain its progress toward the Millennium Development Goals. However, because of a lack of political commitment to innovative solutions to improve its financing mechanism, the health system is unable to provide even essential and basic services to the people. The country, with more than 70% of the population living on less than two US dollars a day, largely depends on direct taxes for its revenue. Because of inadequate financing, the quality of government services is inexcusably poor; therefore, a majority of people seek healthcare in the private sector. This has led to a horde of issues pertaining to equity, accessibility and fairness. High out-of-pocket expenses on health jeopardize a family's livelihood, pushing it into a vicious circle of poverty. In the wake of recent devolution, this paper presents options for future health financing that enables the provinces to exert their autonomy to safeguard the health of the most vulnerable in the country. Our recommendations follow the vision of the World Health Organization and the Commission on Macroeconomics and Health, to achieve universal health coverage and social protection for the poor. Copyright © 2013 Longwoods Publishing.

  11. Health care achievement and challenges in the Western Cape

    African Journals Online (AJOL)

    our citizens: (I) the introduction of free primary health care. (PHC) services has made ... Representatives, House of Delegates, House of Assembly. (which operated ... produce the Provincial Health Plan with its 26 task team reports, which have ...

  12. Health Risks Awareness of Electronic Waste Workers in the Informal Sector in Nigeria.

    Science.gov (United States)

    Ohajinwa, Chimere M; Van Bodegom, Peter M; Vijver, Martina G; Peijnenburg, Willie J G M

    2017-08-13

    Insight into the health risk awareness levels of e-waste workers is important as it may offer opportunities for better e-waste recycling management strategies to reduce the health effects of informal e-waste recycling. Therefore, this study assessed the knowledge, attitude, and practices associated with occupational health risk awareness of e-waste workers compared with a control group (butchers) in the informal sector in Nigeria. A cross-sectional study was used to assess health risk awareness of 279 e-waste workers (repairers and dismantlers) and 221 butchers from the informal sector in three locations in Nigeria in 2015. A questionnaire was used to obtain information on socio-demographic backgrounds, occupational history, knowledge, attitude, and work practices. The data was analysed using Analysis of Variance. The three job designations had significantly different knowledge, attitude, and practice mean scores ( p = 0.000), with butchers consistently having the highest mean scores. Only 43% of e-waste workers could mention one or more Personal Protective Equipment needed for their job compared with 70% of the butchers. The health risk awareness level of the e-waste workers was significantly lower compared with their counterparts in the same informal sector. A positive correlation existed between the workers' knowledge and their attitude and practice. Therefore, increasing the workers' knowledge may decrease risky practices.

  13. Health Sector Reform, Emotional Exhaustion, and Nursing Burnout: A Retrospective Panel Study in Iran.

    Science.gov (United States)

    Sadati, Ahmad Kalateh; Rahnavard, Farnaz; Heydari, Seyed Taghi; Hemmati, Soroor; Ebrahimzadeh, Najmeh; Lankarani, Kamran Bagheri

    2017-10-01

    Nursing burnout is affected by various factors, including work overload. Since the inauguration of the Health Sector Evolution Plan (HSEP) in Iran in 2014, government hospitals have been required to provide health services to the public at all levels. This decision, however, has increased the volume of patients admitted to government hospitals. Because nurses are on the front line of health services, they are faced with a greater load of care provision. This study aimed to evaluate nursing burnout before and after HSEP in Iran, with an emphasis on the differences between government and private hospitals. This retrospective panel study used Maslach's burnout inventory to evaluate nursing burnout in 371 nurses working in government and private hospitals in Shiraz, Iran, before and 7 months after the health sector reform. Chi-square test and paired t test were used to compare burnout scores. The results showed that nursing burnout had changed significantly after HSEP was launched (p = .030). A more detailed assessment found that burnout and emotional exhaustion had both increased significantly in the government-hospital group (ps = .014 and .001, respectively). However, no significant change in burnout was found in the private-hospital group over the same period. The findings of this study indicate an increase in nursing burnout in government hospitals. An important issue in every health sector reform is nursing resource management, with a focus on burnout. Accordingly, policymakers should consider the work overload situation of nurses and work to prevent increased burnout, especially emotional exhaustion.

  14. Job satisfaction and motivation of health workers in public and private sectors: cross-sectional analysis from two Indian states.

    Science.gov (United States)

    Peters, David H; Chakraborty, Subrata; Mahapatra, Prasanta; Steinhardt, Laura

    2010-11-25

    Ensuring health worker job satisfaction and motivation are important if health workers are to be retained and effectively deliver health services in many developing countries, whether they work in the public or private sector. The objectives of the paper are to identify important aspects of health worker satisfaction and motivation in two Indian states working in public and private sectors. Cross-sectional surveys of 1916 public and private sector health workers in Andhra Pradesh and Uttar Pradesh, India, were conducted using a standardized instrument to identify health workers' satisfaction with key work factors related to motivation. Ratings were compared with how important health workers consider these factors. There was high variability in the ratings for areas of satisfaction and motivation across the different practice settings, but there were also commonalities. Four groups of factors were identified, with those relating to job content and work environment viewed as the most important characteristics of the ideal job, and rated higher than a good income. In both states, public sector health workers rated "good employment benefits" as significantly more important than private sector workers, as well as a "superior who recognizes work". There were large differences in whether these factors were considered present on the job, particularly between public and private sector health workers in Uttar Pradesh, where the public sector fared consistently lower (P public sector, where all 17 items had greater discordance for public sector workers than for workers in the private sector (P < 0.001). There are common areas of health worker motivation that should be considered by managers and policy makers, particularly the importance of non-financial motivators such as working environment and skill development opportunities. But managers also need to focus on the importance of locally assessing conditions and managing incentives to ensure health workers are motivated in

  15. Latin America and the Caribbean: Assessment of the Advances in Public Health for the Achievement of the Millennium Development Goals

    Directory of Open Access Journals (Sweden)

    Amal K. Mitra

    2010-05-01

    Full Text Available To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs, that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1 eradicating extreme poverty and hunger; (2 achieving universal primary education; (3 promoting gender equality; (4 reducing child mortality; (5 improving maternal health; (6 combating HIV/AIDS, malaria and other diseases; (7 ensuring environmental sustainability; and (8 developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN Secretary-General urges countries to engage constructively to review progress towards the MDGs. This paper aims to evaluate advances in public health, with special reference to gender inequalities in health, health sector reform, global burden of disease, neglected tropical diseases, vaccination, antibiotic use, sanitation and safe water, nutrition, tobacco and alcohol use, indicators of health, and disease prevention in Latin America and the Caribbean region (LAC. The paper also identifies areas of deficits for the achievement of MDGs in LAC.

  16. Latin America and the Caribbean: assessment of the advances in public health for the achievement of the Millennium Development Goals.

    Science.gov (United States)

    Mitra, Amal K; Rodriguez-Fernandez, Gisela

    2010-05-01

    To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs), that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) promoting gender equality; (4) reducing child mortality; (5) improving maternal health; (6) combating HIV/AIDS, malaria and other diseases; (7) ensuring environmental sustainability; and (8) developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN Secretary-General urges countries to engage constructively to review progress towards the MDGs. This paper aims to evaluate advances in public health, with special reference to gender inequalities in health, health sector reform, global burden of disease, neglected tropical diseases, vaccination, antibiotic use, sanitation and safe water, nutrition, tobacco and alcohol use, indicators of health, and disease prevention in Latin America and the Caribbean region (LAC). The paper also identifies areas of deficits for the achievement of MDGs in LAC.

  17. Curing a meagre health care system by lean methods--translating 'chains of care' in the Swedish health care sector.

    Science.gov (United States)

    Trägårdh, Björn; Lindberg, Kajsa

    2004-01-01

    The purpose of this article is to discuss what happens when work embedded in a 'meagre' organizational context is changed by lean production-related methods. The article is based on studies of seven lean production-inspired projects in the Swedish health care sector, a sector already poor due to organizational slack. The projects were directed to develop 'health care chains', an organizational concept regarded as a way to rationalize health care organizations as well as to develop them, i.e. increase productivity, quality from a customer perspective and quality of working conditions. The article analyses the projects from an interpretative perspective and discusses how modem management models with ambitions to concurrently rationalize and develop organizations--e.g. lean production and health care chains--are used in a 'meagre' organizational field. As an outcome, a model is presented that explores what is beyond simple imitations and unique translations of ideas when a new concept is implemented in local organizations.

  18. A practical and systematic approach to organisational capacity strengthening for research in the health sector in Africa.

    Science.gov (United States)

    Bates, Imelda; Boyd, Alan; Smith, Helen; Cole, Donald C

    2014-03-03

    Despite increasing investment in health research capacity strengthening efforts in low and middle income countries, published evidence to guide the systematic design and monitoring of such interventions is very limited. Systematic processes are important to underpin capacity strengthening interventions because they provide stepwise guidance and allow for continual improvement. Our objective here was to use evidence to inform the design of a replicable but flexible process to guide health research capacity strengthening that could be customized for different contexts, and to provide a framework for planning, collecting information, making decisions, and improving performance. We used peer-reviewed and grey literature to develop a five-step pathway for designing and evaluating health research capacity strengthening programmes, tested in a variety of contexts in Africa. The five steps are: i) defining the goal of the capacity strengthening effort, ii) describing the optimal capacity needed to achieve the goal, iii) determining the existing capacity gaps compared to the optimum, iv) devising an action plan to fill the gaps and associated indicators of change, and v) adapting the plan and indicators as the programme matures. Our paper describes three contrasting case studies of organisational research capacity strengthening to illustrate how our five-step approach works in practice. Our five-step pathway starts with a clear goal and objectives, making explicit the capacity required to achieve the goal. Strategies for promoting sustainability are agreed with partners and incorporated from the outset. Our pathway for designing capacity strengthening programmes focuses not only on technical, managerial, and financial processes within organisations, but also on the individuals within organisations and the wider system within which organisations are coordinated, financed, and managed. Our five-step approach is flexible enough to generate and utilise ongoing learning. We have

  19. Public-private sector interactions and the demand for supplementary health insurance in the United Kingdom.

    Science.gov (United States)

    Bíró, Anikó; Hellowell, Mark

    2016-07-01

    We examine the demand for private health insurance (PHI) in the United Kingdom and relate this to changes in the supply of public and private healthcare. Using a novel collection of administrative, private sector and survey data, we re-assess the relationships between the quality and availability of public and private sector inpatient care, and the demand for PHI. We find that PHI coverage in the United Kingdom is positively related to the median of the region- and year-specific public sector waiting times. We find that PHI prevalence ceteris paribus increases with being self-employed and employed, while it decreases with having financial difficulties. In addition, we highlight the complexities of inter-sectoral relations and their impact on PHI demand. Within a region, we find that an increase in private healthcare supply is associated with a decrease in public sector waiting times, implying lower PHI demand. This may be explained by the usage of private facilities by NHS commissioners. These results have important implications for policymakers interested in the role of private healthcare supply in enhancing the availability of and equitable access to acute inpatient care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Achieving universal health coverage in South Africa through a district health system approach: conflicting ideologies of health care provision.

    Science.gov (United States)

    Fusheini, Adam; Eyles, John

    2016-10-07

    Universal Health Coverage (UHC) has emerged as a major goal for health care delivery in the post-2015 development agenda. It is viewed as a solution to health care needs in low and middle countries with growing enthusiasm at both national and global levels. Throughout the world, however, the paths of countries to UHC have differed. South Africa is currently reforming its health system with UHC through developing a national health insurance (NHI) program. This will be practically achieved through a decentralized approach, the district health system, the main vehicle for delivering services since democracy. We utilize a review of relevant documents, conducted between September 2014 and December 2015 of district health systems (DHS) and UHC and their ideological underpinnings, to explore the opportunities and challenges, of the district health system in achieving UHC in South Africa. Review of data from the NHI pilot districts suggests that as South Africa embarks on reforms toward UHC, there is a need for a minimal universal coverage and emphasis on district particularity and positive discrimination so as to bridge health inequities. The disparities across districts in relation to health profiles/demographics, health delivery performance, management of health institutions or district management capacity, income levels/socio-economic status and social determinants of health, compliance with quality standards and above all the burden of disease can only be minimised through positive discrimination by paying more attention to underserved and disadavantaged communities. We conclude that in South Africa the DHS is pivotal to health reform and UHC may be best achieved through minimal universal coverage with positive discrimination to ensure disparities across districts in relation to disease burden, human resources, financing and investment, administration and management capacity, service readiness and availability and the health access inequalities are consciously

  1. Achieving health equity: from root causes to fair outcomes.

    Science.gov (United States)

    Marmot, Michael

    2007-09-29

    Health is a universal human aspiration and a basic human need. The development of society, rich or poor, can be judged by the quality of its population's health, how fairly health is distributed across the social spectrum, and the degree of protection provided from disadvantage due to ill-health. Health equity is central to this premise and to the work of the Commission on Social Determinants of Health. Strengthening health equity--globally and within countries--means going beyond contemporary concentration on the immediate causes of disease. More than any other global health endeavour, the Commission focuses on the "causes of the causes"--the fundamental structures of social hierarchy and the socially determined conditions these create in which people grow, live, work, and age. The time for action is now, not just because better health makes economic sense, but because it is right and just. The outcry against inequity has been intensifying for many years from country to country around the world. These cries are forming a global movement. The Commission on Social Determinants of Health places action to ensure fair health at the head and the heart of that movement.

  2. Prohibit, constrain, encourage, or purchase: how should we engage with the private health-care sector?

    Science.gov (United States)

    Montagu, Dominic; Goodman, Catherine

    2016-08-06

    The private for-profit sector's prominence in health-care delivery, and concern about its failures to deliver social benefit, has driven a search for interventions to improve the sector's functioning. We review evidence for the effectiveness and limitations of such private sector interventions in low-income and middle-income countries. Few robust assessments are available, but some conclusions are possible. Prohibiting the private sector is very unlikely to succeed, and regulatory approaches face persistent challenges in many low-income and middle-income countries. Attention is therefore turning to interventions that encourage private providers to improve quality and coverage (while advancing their financial interests) such as social marketing, social franchising, vouchers, and contracting. However, evidence about the effect on clinical quality, coverage, equity, and cost-effectiveness is inadequate. Other challenges concern scalability and scope, indicating the limitations of such interventions as a basis for universal health coverage, though interventions can address focused problems on a restricted scale. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. [Managment system in safety and health at work organization. An Italian example in public sector: Inps].

    Science.gov (United States)

    Di Loreto, G; Felicioli, G

    2010-01-01

    The Istituto Nazionale della Previdenza Sociale (Inps) is one of the biggest Public Sector organizations in Italy; about 30.000 people work in his structures. Fifteen years ago, Inps launched a long term project with the objective to create a complex and efficient safety and health at work organization. Italian law contemplates a specific kind of physician working on safety and health at work, called "Medico competente", and 85 Inps's physicians work also as "Medico competente". This work describes how IT improved coordination and efficiency in this occupational health's management system.

  4. Is the Water Sector Lagging behind Education and Health on Aid Effectiveness? Lessons from Bangladesh, Ethiopia and Uganda

    Directory of Open Access Journals (Sweden)

    Katharina Welle

    2009-10-01

    Full Text Available A study in three countries (Bangladesh, Ethiopia and Uganda assessed progress against the Paris Principles for Aid Effectiveness (AE in three sectors – water, health and education – to test the assumption that the water sector is lagging behind. The findings show that it is too simplistic to say that the water sector is lagging, although this may well be the case in some countries. The study found that wider governance issues are more important for AE than having in place sector-specific mechanics such as Sector-Wide Approaches alone. National political leadership and governance are central drivers of sector AE, while national financial and procurement systems and the behaviour of actors who have not signed up to the Paris Principles – at both national and global levels – have implications for progress that cut across sectors. Sectors and sub-sectors do nonetheless have distinct features that must be considered in attempting to improve sector-level AE. In light of these findings, using political economy approaches to better understand and address governance and strengthening sector-level monitoring is recommended as part of efforts to improve AE and development results in the water sector.

  5. Private health purchasing practices in the public sector: a comparison of state employers and the Fortune 500.

    Science.gov (United States)

    Maxwell, James; Temin, Peter; Petigara, Tanaz

    2004-01-01

    State governments are influential purchasers of health benefits but have not been studied extensively. In a recent survey of senior benefit managers, we examine the extent to which states have followed the private-sector approach to purchasing health care. We found that states have adopted "industrial purchasing" practices similar to those of large private employers but offer greater choice of carriers and pay a higher percentage of premiums. Unions continue to influence health care purchasing in both the public and private sectors. Double-digit increases in health costs and the current budget crisis may force states to align their purchasing practices with the private sector to cut costs.

  6. Access to safe legal abortion in Malaysia: women's insights and health sector response.

    Science.gov (United States)

    Low, Wah-Yun; Tong, Wen-Ting; Wong, Yut-Lin; Jegasothy, Ravindran; Choong, Sim-Poey

    2015-01-01

    Malaysia has an abortion law, which permits termination of pregnancy to save a woman's life and to preserve her physical and mental health (Penal Code Section 312, amended in 1989). However, lack of clear interpretation and understanding of the law results in women facing difficulties in accessing abortion information and services. Some health care providers were unaware of the legalities of abortion in Malaysia and influenced by their personal beliefs with regard to provision of abortion services. Accessibility to safer abortion techniques is also an issue. The development of the 2012 Guidelines on Termination of Pregnancy and Guidelines for Management of Sexual and Reproductive Health among Adolescents in Health Clinics by the Ministry of Health, Malaysia, is a step forward toward increasing women's accessibility to safe abortion services in Malaysia. This article provides an account of women's accessibility to abortion in Malaysia and the health sector response in addressing the barriers. © 2014 APJPH.

  7. Research priorities for the health sector for the 8th Malaysia Plan

    International Nuclear Information System (INIS)

    Narimah Awin

    2000-01-01

    At the inter-institutional meeting to identify, the research priorities for the sector for the 7MP (7 th Malaysian Plan), held in mid-1994, priorities were determined according to the hierarchy of socioeconomic groups, target areas, programmes and scopes. The more detailed projects under these were to be determined by the researchers they embark on the projects themselves. The most useful level for reference is the target area. There were 7 target areas identified at the deliberations, and an eighth one (medical biotechnology) was added later on by the IRPA Secretariat in the Ministry of Science Technology and Environment. These 8 target areas are: 1)Health problems associated with lifestyles 2) Health problems related to demographic changes, 3) Vector borne and other communicable diseases, 4 ) Epidemiological databases, 5) Technologies in health, 6)The health system and health care industry, 7) Environmental and occupational health, 8) Medical biotechnology. (author)

  8. Research priorities for the health sector for the 8{sup th} Malaysia Plan

    Energy Technology Data Exchange (ETDEWEB)

    Awin, Narimah [Inst. of Medical Research, Kuala Lumpur (Malaysia)

    2000-07-01

    At the inter-institutional meeting to identify, the research priorities for the sector for the 7MP (7{sup th} Malaysian Plan), held in mid-1994, priorities were determined according to the hierarchy of socioeconomic groups, target areas, programmes and scopes. The more detailed projects under these were to be determined by the researchers they embark on the projects themselves. The most useful level for reference is the target area. There were 7 target areas identified at the deliberations, and an eighth one (medical biotechnology) was added later on by the IRPA Secretariat in the Ministry of Science Technology and Environment. These 8 target areas are: 1)Health problems associated with lifestyles 2) Health problems related to demographic changes, 3) Vector borne and other communicable diseases, 4 ) Epidemiological databases, 5) Technologies in health, 6)The health system and health care industry, 7) Environmental and occupational health, 8) Medical biotechnology. (author)

  9. Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services

    OpenAIRE

    Larson, S; Chapman, S; Spetz, J; Brindis, CD

    2017-01-01

    Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers (SBHCs) may be one strategy to decrease health disparities.Empirical studies between 2003 and 2013 of US pediatric populations and of US SBHCs were included if rese...

  10. [Health promotion and prevention in the economic crisis: the role of the health sector. SESPAS report 2014].

    Science.gov (United States)

    Márquez-Calderón, Soledad; Villegas-Portero, Román; Gosalbes Soler, Victoria; Martínez-Pecino, Flora

    2014-06-01

    This article reviews trends in lifestyle factors and identifies priorities in the fields of prevention and health promotion in the current economic recession. Several information sources were used, including a survey of 30 public health and primary care experts. Between 2006 and 2012, no significant changes in lifestyle factors were detected except for a decrease in habitual alcohol drinking. There was a slight decrease in the use of illegal drugs and a significant increase in the use of psychoactive drugs. Most experts believe that decision-making about new mass screening programs and changes in vaccination schedules needs to be improved by including opportunity cost analysis and increasing the transparency and independence of the professionals involved. Preventive health services are contributing to medicalization, but experts' opinions are divided on the need for some preventive activities. Priorities in preventive services are mental health and HIV infection in vulnerable populations. Most experts trust in the potential of health promotion to mitigate the health effects of the economic crisis. Priority groups are children, unemployed people and other vulnerable groups. Priority interventions are community health activities (working in partnership with local governments and other sectors), advocacy, and mental health promotion. Effective tools for health promotion that are currently underused are legislation and mass media. There is a need to clarify the role of the healthcare sector in intersectorial activities, as well as to acknowledge that social determinants of health depend on other sectors. Experts also warn of the consequences of austerity and of policies that negatively impact on living conditions. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  11. Morocco's policy choices to achieve Universal health coverage ...

    African Journals Online (AJOL)

    Morocco's health system remains weak in spite of the improvement of other development indicators in the last ten years. Health remains one of the major challenges to lower the social disparities that are the priority for the authorities. Despite the goodwill of all stakeholders, significant reforms implemented respond only ...

  12. Opinion: Achieving real gender equality for adolescent health | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-11-14

    Nov 14, 2016 ... The world is now home to the greatest number of youth (aged 10–24) in history. ... Read the post about adolescent health by IDRC's Program ... project was recognized for its efforts to improve health service provision and the ...

  13. Advantages of Coordinated School Health Portfolios: Documenting and Showcasing Achievements

    Science.gov (United States)

    Shipley, Meagan; Lohrmann, David; Barnes, Priscilla; O'Neill, Jim

    2013-01-01

    Background: Thirteen school district teams from Michigan and Indiana participated in the Michiana Coordinated School Health Leadership Institute with the intent of Coordinated School Health Program (CSHP) implementation. The purpose of this study was to determine if portfolios served as an effective approach for documenting teams' accomplishments…

  14. Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services

    Science.gov (United States)

    Larson, Satu; Chapman, Susan; Spetz, Joanne; Brindis, Claire D.

    2017-01-01

    Background: Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers…

  15. Involving diaspora and expatriates as human resources in the health sector in Nepal.

    Science.gov (United States)

    Devkota, A; Devkota, B; Ghimire, J; Mahato, R K; Gupta, R P; Hada, A

    2013-05-01

    Health professional mobility has increased in the recent years and is one of the public health concerns in the developing countries including Nepal. On the other hand, we can't ignore a positive shift of Nepali diaspora coming back to Nepal for some work related projects. The objective of this study was thus to estimate the number of Nepalese Diaspora and foreign expatriate those are coming to Nepal and explore the ways and process of their engagement in the health sector of Nepal. Mixed method was used. In total, 13 Key Informant Interviews were conducted at the central level along with record review from professional councils. Nepalese Diasporas mainly come through Diaspora Volunteering Organizations, Non Resident Nepali Association and personal connections to the place of their origin. Nepalese Diasporas have supported as health specialists, health camps and project organizers, trainer and hospital promoters, supplier of equipment including ambulances etc. The Nepalese Diasporas are unrecorded with professional organizations such as NMC and NHPC. As such the real status and results of support from Nepalese Diaspora are not known. Overall, 5,120 foreign medical professionals have served to Nepal through NMC followed by 739 nursing professionals through NNC and 189 paramedical staff through NHPC as of 2012. Systematic information on number and characteristics of the Nepalese Diaspora and their role in the health sector of Nepal is limited. The health professional bodies have some record systems but they lack uniformity and systematic process.

  16. The Implementation of Minimum Service Standards (MMS on Public Service for Health Services Sector in Bondowoso, Indonesia

    Directory of Open Access Journals (Sweden)

    Untung Kuzairi

    2018-04-01

    Full Text Available One of heatlh policies implemented by the hospital is the minimum service standards (MSS. MSS is a benchmark of hospital service quality in providing services to the public. Talking about health service quality problem, it was found out as the field fact that the achievement of MSS indicator in General Hospital of Dr. H. Koesnadi Bondowoso, Indonesia in 2016 still did not fulfill target of standard hospital service (type B and  minimum service standard (MSS of hospital. This fact shows that the quality of health services in general hospital of  dr. H. Koesnadi Bondowoso is still low. So, this research aims to describe the policy implementation of minimum service standard and to analyze the obstacles in the implementation of MSS policy at general hospital of  dr. H. Koesnadi Bondowoso. So, this research would discuss the policy implementation of minimum service standards by using Edward III concept as a tool to analyze it. This research employed qualitative research with phenomenological approach. The results showed that the implementation of MSS policy of dr. H. Koesnadi Bondowoso general hospital still did not run well. This was due to several factors  such as communication, bureaucratic structure, sources, dispositions (attitude and leadership in sectoral ego control. Sectoral ego can be shaped from educational background of specialist doctors who still adhered seniority and lack of individual role of implementor in building interpersonal communication and conflict management.

  17. Extending voluntary health insurance to the informal sector: experiences and expectations of the informal sector in Kenya [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Edwine W. Barasa

    2017-09-01

    Full Text Available Background: Kenya has made a policy decision to use contributory health insurance as one of its key pre-payment health financing mechanisms. The National Hospital Insurance Fund (NHIF is the main health insurer in Kenya. While the NHIF has hitherto focused its efforts on providing health insurance coverage to individuals in the formal sector, it has recently broadened its focus to include individuals in the informal sector. This paper provides an analysis of the perceptions, and experiences of informal sector individuals in Kenya with regard to enrolment with the NHIF.  Methods: We collected data through key informant interviews (39 in two purposefully selected counties. Study participants were drawn from healthcare facilities contracted by the NHIF, and current, former, and prospective informal sector members. We analyzed data using a grounded approach.  Results: Participants felt that the NHIF provided inadequate information about the registration and membership processes as well as benefit entitlements. There was variable and inconsistent communication by the NHIF. There was also variance between the official benefit package and the actual benefits received by members. The NHIF registration requirements and processes presented an administrative barrier to obtaining membership. The NHIF premium level and contribution mechanism presents a financial barrier to current and prospective members. Healthcare providers discriminated against NHIF members compared to cash-payers or private insurance holders.  Conclusions: The NHIF could improve enrolment and retention of informal sector individuals by; 1 using communication strategies that are effective at reaching the informal sector, 2 improving the affordability of the premium rates, 3 simplifying the enrolment requirements and process, and 4 strengthening accountability mechanisms between itself and healthcare facilities to ensure that enrolled members receive the benefits that they are

  18. Persistence as the path from motivation to performance in the Papua New Guinea health sector.

    Science.gov (United States)

    Elich, Luke

    2009-01-01

    This paper considers how the individual capacity states of motivation, confidence, skill and ability relate to performance, and identifies a crucial role for the discretionary behaviour of individuals: specifically, employee persistence and innovation. The study Understanding the people and performance link: unlocking the black box undertaken by Purcell and colleagues is relied upon in constructing a theoretical framework for the conceptual interrelationships between performance and the human-resource-mediating variables, which is then applied within the Papua New Guinea (PNG) health sector context. The study by Purcell and colleagues, which was informed by organizations with well-developed and functioning human resource policies and practices, is distinguished from the PNG health sector, where human resource frameworks are largely ineffective--yet it is determined that the importance of 'discretionary behaviour' relative to performance, whilst varied, is undiminished.

  19. Organization and Finance of China's Health Sector: Historical Antecedents for Macroeconomic Structural Adjustment.

    Science.gov (United States)

    Li, Hui; Hilsenrath, Peter

    2016-01-01

    China has exploded onto the world economy over the past few decades and is undergoing rapid transformation toward relatively more services. The health sector is an important part of this transition. This article provides a historical account of the development of health care in China since 1949. It also focuses on health insurance and macroeconomic structural adjustment to less saving and more consumption. In particular, the question of how health insurance impacts precautionary savings is considered. Multivariate analysis using data from 1990 to 2012 is employed. The household savings rate is the dependent variable in 3 models segmented for rural and urban populations. Independent variables include out-of-pocket health expenditures, health insurance payouts, housing expenditure, education expenditure, and consumption as a share of gross domestic product (GDP). Out-of-pocket health expenditures were positively correlated with household savings rates. But health insurance remains weak, and increased payouts by health insurers have not been associated with lower levels of household savings so far. Housing was positively correlated, whereas education had a negative association with savings rates. This latter finding was unexpected. Perhaps education is perceived as investment and a substitute for savings. China's shift toward a more service-oriented economy includes growing dependence on the health sector. Better health insurance is an important part of this evolution. The organization and finance of health care is integrally linked with macroeconomic policy in an environment constrained by prevailing institutional convention. Problems of agency relationships, professional hegemony, and special interest politics feature prominently, as they do elsewhere. China also has a dual approach to medicine relying heavily on providers of traditional Chinese medicine. Both of these segments will take part in China's evolution, adding another layer of complexity to policy. © The

  20. Achieving the American dream: facilitators and barriers to health and mental health for Latino immigrants.

    Science.gov (United States)

    Shobe, Marcia A; Coffman, Maren J; Dmochowski, Jacek

    2009-01-01

    Latinos are the largest minority group in the U.S. For Latino immigrants, a shift in migration from larger to smaller cities has recently occurred; the Latino immigrant population in Charlotte, North Carolina, has increased by 634% since 1990. The extent to which immigrants can achieve health and well-being is often related to employment, healthcare access, and social support. This study explored the human, social, and financial capital circumstances of Latino immigrants new to Charlotte and examined the effects of different aspects of capital on health outcomes. Findings indicate that capital is significantly associated with functional status and depression. Implications for social work are discussed.

  1. The relationship between the growth in the health sector and inbound health tourism: the case of Turkey.

    Science.gov (United States)

    Uçak, Harun

    2016-01-01

    One of the consequences of globalisation for Turkey, as well as in other emerging countries, has been an increasing trend in health tourism. Households have been considered choice the best option in terms of price and alternative possibilities while they have been solved their health problems. Previous studies have argued that the main drivers of the growth of inbound health tourism to developing countries are lower costs, shorter waiting periods, and better quality of care. This study aimed to test the effect of health and social service sector growth on the flow of inbound health tourism between 2004:Q1 and 2015:Q4 by employing Granger causality and Johansen cointegration approaches. Our findings suggested that there is a long-run Granger causality from domestic health and social work expenditures to health tourism income whereas this is non-existence in the opposite direction.

  2. Investigation of Relationship between Organizational Climate and Organizational Citizenship Behavior: A Research on Health Sector

    OpenAIRE

    Serdar Öge; Pınar Erdogan

    2015-01-01

    The main objective of this research is to describe the relationship between organizational climate and organizational citizenship behavior. In order to examine this relationship, a research is intended to be carried out in relevant institutions and organizations operating in the health sector in Turkey. It will be researched that whether there is a statistically significant relationship between organizational climate and organizational citizenship behavior through elated ...

  3. [Monkeypox: second human case observed in Ivory Coast (rural health sector of Daloa].

    Science.gov (United States)

    Merouze, F; Lesoin, J J

    1983-01-01

    A second case of human monkeypox (world fifty-forth case) has been observed in Ivory Coast (rural health sector of Daloa). A three years old girl presented a major pox-like eruption which evolved to recovery. The authors describe the eruption, the evolution of the sickness, and the scars observed at the fourth month after recovery. It has not been possible to prove neither animal-human nor interhuman contagion.

  4. Corporate social responsibility in health sector: a case study in the government hospitals in Medan, Indonesia

    Directory of Open Access Journals (Sweden)

    Arlina Nurbaity Lubis

    2018-03-01

    Full Text Available Contemporary society demands that every organization operate with a sense of social responsibility. Many organizations now include corporate social responsibility (CSR activities in their work programs. In the health sector, however, the role of CSR has not been studied as intensively as in private corporations because the services provided by the health sector are already valued as directly serving humanity. This research aims to evaluate the impact of CSR on the health sector, specifically on government hospitals. This model was developed by analyzing the influence of CSR on hospital reputation, customer loyalty, and hospital values. By answering questionnaires, a total of 200 hospital patients from four government hospitals participated in the study. The proposed model was evaluated using path analysis with AMOS tools. The results of this study provide empirical evidence that overall, CSR positively affects the reputation of the hospital, patient loyalty, and hospital value. Although there is a direct negative effect of CSR on hospital value, the larger influence of indirect effect that occurs through the mediating role of reputation and patient loyalty variables shows that CSR is able to increase the hospital value. Practically, these results imply that CSR should be applied as a strategic tool in improving the value of the hospital.

  5. Carbon footprint of telemedicine solutions--unexplored opportunity for reducing carbon emissions in the health sector.

    Science.gov (United States)

    Holmner, Asa; Ebi, Kristie L; Lazuardi, Lutfan; Nilsson, Maria

    2014-01-01

    The healthcare sector is a significant contributor to global carbon emissions, in part due to extensive travelling by patients and health workers. To evaluate the potential of telemedicine services based on videoconferencing technology to reduce travelling and thus carbon emissions in the healthcare sector. A life cycle inventory was performed to evaluate the carbon reduction potential of telemedicine activities beyond a reduction in travel related emissions. The study included two rehabilitation units at Umeå University Hospital in Sweden. Carbon emissions generated during telemedicine appointments were compared with care-as-usual scenarios. Upper and lower bound emissions scenarios were created based on different teleconferencing solutions and thresholds for when telemedicine becomes favorable were estimated. Sensitivity analyses were performed to pinpoint the most important contributors to emissions for different set-ups and use cases. Replacing physical visits with telemedicine appointments resulted in a significant 40-70 times decrease in carbon emissions. Factors such as meeting duration, bandwidth and use rates influence emissions to various extents. According to the lower bound scenario, telemedicine becomes a greener choice at a distance of a few kilometers when the alternative is transport by car. Telemedicine is a potent carbon reduction strategy in the health sector. But to contribute significantly to climate change mitigation, a paradigm shift might be required where telemedicine is regarded as an essential component of ordinary health care activities and not only considered to be a service to the few who lack access to care due to geography, isolation or other constraints.

  6. Worksite health and wellness programs: Canadian achievements & prospects.

    Science.gov (United States)

    Després, Jean-Pierre; Alméras, Natalie; Gauvin, Lise

    2014-01-01

    Canada has experienced a substantial reduction in mortality related to cardiovascular disease (CVD). There is a general consensus that more effective and widespread health promotion interventions may lead to further reductions in CVD risk factors and actual disease states. In this paper, we briefly outline the prevalence of selected risk factors for CVD in Canada, describe characteristics of the Canadian labor market and workforce, and depict what is known about health and wellness program delivery systems in Canadian workplaces. Our review indicates that there have been numerous and diverse relevant legislative and policy initiatives to create a context conducive to improve the healthfulness of Canadian workplaces. However, there is still a dearth of evidence on the effectiveness of the delivery system and the actual impact of workplace health and wellness programs in reducing CVD risk in Canada. Thus, while a promising model, more research is needed in this area. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. The challenge of achieving health equity in Africa | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2011-02-01

    Feb 1, 2011 ... Global health professionals have struggled with a definition for some time. ... That group, which became EQUINET, has grown today to a steering committee ... portrays a burgeoning youth-owned business landscape in Africa, ...

  8. Safety and Health Division achievements during 40 years

    International Nuclear Information System (INIS)

    Noriah Mod Ali

    2012-01-01

    During her speech, presenter outlined several issues regarding on establishment of Safety and Health Division since 40 years. This division contain of 3 sub unit; Physical Safety Group, Medical Physic Group and Non-ionizing Radiation group (NIR). The objectives of this division to implement R and D activities and services regarding safety and radiological health also non-radiological to ensure public safety, environment and asset suit with obligations established by authorities, IAEA standards and regulations.(author)

  9. Intra Sector Policy Interventions for Improvement of Iranian Health Financing System

    Directory of Open Access Journals (Sweden)

    Peivand Bastani

    2013-09-01

    Full Text Available Background and purpose: To determine an appropriate financial model for the health system of Iran, several studies have been conducted. But it seems that these studies were not comprehensive and further investigation is required. So to design a valid and enforceable mechanism, the study of policy interventions will be considered through consensus of all stakeholders. This investigation was done to determine the necessary policies and internal interventions for health care system financial improvement in Iran. Materials and methods: The present work was carried out through investigating all key stakeholders in the medical system and the related sectors in Iran, along with the analysis of internal and external communication by using SWOT and STEEP.V methods. Results: Strategic management of health-care costs, the development of a new financial system, clarity of costs, benefiting from health national accounts, the regulation of budget based on operations, preparing the credit of per capita from prepayment and risk accumulation, the development of referral systems and mechanisms, the establishment of public fund for services purchase, preventing the involvement of insurances in non-insurance cases, competing services with the private sector and increasing resources for the promotion of equality level have been determined as the key proposed interventions. Conclusion: It seems that the interventions based to the development of improving health financial system including the deployment of full accrual basis instead of cash basis, preparing and using services cost and operational budgeting and finally, cost management and productivity are the prerequisites of reforming health financial system.

  10. Process Evaluation of Communitisation Programme in Public Sector Health Facilities, Mokokchung District, Nagaland, 2015.

    Science.gov (United States)

    Tushi, Aonungdok; Kaur, Prabhdeep

    2017-01-01

    Public sector health facilities were poorly managed due to a history of conflict in Nagaland, India. Government of Nagaland introduced "Nagaland Communitisation of Public Institutions and Services Act" in 2002. Main objectives of the evaluation were to review the functioning of Health Center Managing Committees (HCMCs), deliver health services in the institutions managed by HCMC, identify strengths as well as challenges perceived by HCMC members in the rural areas of Mokokchung district, Nagaland. The evaluation was made using input, process and output indicators. A doctor, the HCMC Chairman and one member from each of the three community health centers (CHC) and four primary health centers (PHC) were surveyed using a semi-structured questionnaire and an in-depth interview guide. Proportions for quantitative data were computed and key themes from the same were identified. Overall; the infrastructure, equipment and outpatient/inpatient service availability was satisfactory. There was a lack of funds and shortage of doctors, drugs as well as laboratory facilities. HCMCs were in place and carried out administrative activities. HCMCs felt ownership, mobilized community contributions and managed human resources. HCMC members had inadequate funds for their transport and training. They faced challenges in service delivery due to political interference and lack of adequate human, material, financial resources. Communitisation program was operational in the district. HCMC members felt the ownership of health facilities. Administrative, political support and adequate funds from the government are needed for effective functioning of HCMCs and optimal service delivery in public sector facilities.

  11. Job satisfaction among public health professionals working in public sector: a cross sectional study from Pakistan.

    Science.gov (United States)

    Kumar, Ramesh; Ahmed, Jamil; Shaikh, Babar Tasneem; Hafeez, Rehan; Hafeez, Assad

    2013-01-09

    Job satisfaction largely determines the productivity and efficiency of human resource for health. It literally depicts the extent to which professionals like or dislike their jobs. Job satisfaction is said to be linked with the employee's work environment, job responsibilities and powers and time pressure; the determinants which affect employee's organizational commitment and consequently the quality of services. The objective of the study was to determine the level of and factors influencing job satisfaction among public health professionals in the public sector. This was a cross sectional study conducted in Islamabad, Pakistan. Sample size was universal including 73 public health professionals, with postgraduate qualifications and working in government departments of Islamabad. A validated structured questionnaire was used to collect data from April to October 2011. Overall satisfaction rate was 41% only, while 45% were somewhat satisfied and 14% of professionals highly dissatisfied with their jobs. For those who were not satisfied, working environment, job description and time pressure were the major causes. Other factors influencing the level of satisfaction were low salaries, lack of training opportunities, improper supervision and inadequate financial rewards. Our study documented a relatively low level of overall satisfaction among workers in public sector health care organizations. Considering the factors responsible for this state of affairs, urgent and concrete strategies must be developed to address the concerns of public health professionals as they represent a highly sensitive domain of health system of Pakistan. Improving the overall work environment, review of job descriptions and better remuneration might bring about a positive change.

  12. Equity of the premium of the Ghanaian National Health Insurance Scheme and the implications for achieving universal coverage.

    Science.gov (United States)

    Amporfu, Eugenia

    2013-01-07

    The Ghanaian National Health Insurance Scheme (NHIS) was introduced to provide access to adequate health care regardless of ability to pay. By law the NHIS is mandatory but because the informal sector has to make premium payment before they are enrolled, the authorities are unable to enforce mandatory nature of the scheme. The ultimate goal of the Scheme then is to provide all residents with access to adequate health care at affordable cost. In other words, the Scheme intends to achieve universal coverage. An important factor for the achievement of universal coverage is that revenue collection be equitable. The purpose of this study is to examine the vertical and horizontal equity of the premium collection of the Scheme. The Kakwani index method as well as graphical analysis was used to study the vertical equity. Horizontal inequity was measured through the effect of the premium on redistribution of ability to pay of members. The extent to which the premium could cause catastrophic expenditure was also examined. The results showed that revenue collection was both vertically and horizontally inequitable. The horizontal inequity had a greater effect on redistribution of ability to pay than vertical inequity. The computation of catastrophic expenditure showed that a small minority of the poor were likely to incur catastrophic expenditure from paying the premium a situation that could impede the achievement of universal coverage. The study provides recommendations to improve the inequitable system of premium payment to help achieve universal coverage.

  13. Equity of the premium of the Ghanaian national health insurance scheme and the implications for achieving universal coverage

    Directory of Open Access Journals (Sweden)

    Amporfu Eugenia

    2013-01-01

    Full Text Available Abstract The Ghanaian National Health Insurance Scheme (NHIS was introduced to provide access to adequate health care regardless of ability to pay. By law the NHIS is mandatory but because the informal sector has to make premium payment before they are enrolled, the authorities are unable to enforce mandatory nature of the scheme. The ultimate goal of the Scheme then is to provide all residents with access to adequate health care at affordable cost. In other words, the Scheme intends to achieve universal coverage. An important factor for the achievement of universal coverage is that revenue collection be equitable. The purpose of this study is to examine the vertical and horizontal equity of the premium collection of the Scheme. The Kakwani index method as well as graphical analysis was used to study the vertical equity. Horizontal inequity was measured through the effect of the premium on redistribution of ability to pay of members. The extent to which the premium could cause catastrophic expenditure was also examined. The results showed that revenue collection was both vertically and horizontally inequitable. The horizontal inequity had a greater effect on redistribution of ability to pay than vertical inequity. The computation of catastrophic expenditure showed that a small minority of the poor were likely to incur catastrophic expenditure from paying the premium a situation that could impede the achievement of universal coverage. The study provides recommendations to improve the inequitable system of premium payment to help achieve universal coverage.

  14. The relationship of school performance and mental health: Educational achievement as indicator of psychopathology

    NARCIS (Netherlands)

    Tempelaar, W.M.

    2017-01-01

    In this thesis we explored the relationship between poor educational achievement and psychopathology. Examining the association between educational achievement and mental health problems and development of psychiatric disorders is important to investigate the potential value of educational

  15. Basing care reforms on evidence: the Kenya health sector costing model.

    Science.gov (United States)

    Flessa, Steffen; Moeller, Michael; Ensor, Tim; Hornetz, Klaus

    2011-05-27

    The Government of the Republic of Kenya is in the process of implementing health care reforms. However, poor knowledge about costs of health care services is perceived as a major obstacle towards evidence-based, effective and efficient health care reforms. Against this background, the Ministry of Health of Kenya in cooperation with its development partners conducted a comprehensive costing exercise and subsequently developed the Kenya Health Sector Costing Model in order to fill this data gap. Based on standard methodology of costing of health care services in developing countries, standard questionnaires and analyses were employed in 207 health care facilities representing different trustees (e.g. Government, Faith Based/Nongovernmental, private-for-profit organisations), levels of care and regions (urban, rural). In addition, a total of 1369 patients were randomly selected and asked about their demand-sided costs. A standard step-down costing methodology was applied to calculate the costs per service unit and per diagnosis of the financial year 2006/2007. The total costs of essential health care services in Kenya were calculated as 690 million Euros or 18.65 Euro per capita. 54% were incurred by public sector facilities, 17% by Faith Based and other Nongovernmental facilities and 23% in the private sector. Some 6% of the total cost is due to the overall administration provided directly by the Ministry and its decentralised organs. Around 37% of this cost is absorbed by salaries and 22% by drugs and medical supplies. Generally, costs of lower levels of care are lower than of higher levels, but health centres are an exemption. They have higher costs per service unit than district hospitals. The results of this study signify that the costs of health care services are quite high compared with the Kenyan domestic product, but a major share are fixed costs so that an increasing coverage does not necessarily increase the health care costs proportionally. Instead

  16. Basing care reforms on evidence: The Kenya health sector costing model

    Science.gov (United States)

    2011-01-01

    Background The Government of the Republic of Kenya is in the process of implementing health care reforms. However, poor knowledge about costs of health care services is perceived as a major obstacle towards evidence-based, effective and efficient health care reforms. Against this background, the Ministry of Health of Kenya in cooperation with its development partners conducted a comprehensive costing exercise and subsequently developed the Kenya Health Sector Costing Model in order to fill this data gap. Methods Based on standard methodology of costing of health care services in developing countries, standard questionnaires and analyses were employed in 207 health care facilities representing different trustees (e.g. Government, Faith Based/Nongovernmental, private-for-profit organisations), levels of care and regions (urban, rural). In addition, a total of 1369 patients were randomly selected and asked about their demand-sided costs. A standard step-down costing methodology was applied to calculate the costs per service unit and per diagnosis of the financial year 2006/2007. Results The total costs of essential health care services in Kenya were calculated as 690 million Euros or 18.65 Euro per capita. 54% were incurred by public sector facilities, 17% by Faith Based and other Nongovernmental facilities and 23% in the private sector. Some 6% of the total cost is due to the overall administration provided directly by the Ministry and its decentralised organs. Around 37% of this cost is absorbed by salaries and 22% by drugs and medical supplies. Generally, costs of lower levels of care are lower than of higher levels, but health centres are an exemption. They have higher costs per service unit than district hospitals. Conclusions The results of this study signify that the costs of health care services are quite high compared with the Kenyan domestic product, but a major share are fixed costs so that an increasing coverage does not necessarily increase the health

  17. Assessing the impact of a new health sector pay system upon NHS staff in England

    Directory of Open Access Journals (Sweden)

    Buchan James

    2008-06-01

    Full Text Available Abstract Background Pay and pay systems are a critical element in any health sector human resource strategy. Changing a pay system can be one strategy to achieve or sustain organizational change. This paper reports on the design and implementation of a completely new pay system in the National Health Service (NHS in England. 'Agenda for Change' constituted the largest-ever attempt to introduce a new pay system in the UK public services, covering more than one million staff. Its objectives were to improve the delivery of patient care as well as enhance staff recruitment, retention and motivation, and to facilitate new ways of working. Methods This study was the first independent assessment of the impact of Agenda for Change at a local and national level. The methods used in the research were a literature review; review of 'grey' unpublished documentation provided by key stakeholders in the process; analysis of available data; interviews with key national informants (representing government, employers and trade unions, and case studies conducted with senior human resource managers in ten NHS hospitals in England Results Most of the NHS trust managers interviewed were in favour of Agenda for Change, believing it would assist in delivering improvements in patient care and staff experience. The main benefits highlighted were: 'fairness', moving different staff groups on to harmonized conditions; equal pay claim 'protection'; and scope to introduce new roles and working practices. Conclusion Agenda for Change took several years to design, and has only recently been implemented. Its very scale and central importance to NHS costs and delivery of care argues for a full assessment at an early stage so that lessons can be learned and any necessary changes made. This paper highlights weaknesses in evaluation and limitations in progress. The absence of systematically derived and applied impact indicators makes it difficult to assess impact and impact

  18. Violencia contra las mujeres: el papel del sector salud en la legislación internacional Violence against women: the role of the health sector in international legislation

    Directory of Open Access Journals (Sweden)

    Gaby Ortiz-Barreda

    2012-10-01

    Full Text Available Objetivos: Identificar y describir las responsabilidades que se atribuyen a las administraciones sanitarias en materia de prevención y atención de la violencia contra las mujeres en la legislación internacional sobre este tema. Métodos: Análisis de contenido de las leyes de violencia contra las mujeres recopiladas en The Annual Review of Law of Harvard University, UN Secretary-General's database on Violence against Women, International Digest of Health Legislation y Stop Violence against Women. Se identificaron y seleccionaron las leyes que hacían mención explícita a la participación del sector salud en intervenciones de violencia contra las mujeres. Se clasificaron las intervenciones según los niveles de prevención primaria, secundaria y terciaria definidos por la Organización Mundial de la Salud en su Informe Mundial sobre Violencia y Salud (2002. Resultados: De 115 países analizados, 55 disponen de leyes sobre la violencia contra las mujeres que contemplan la participación del sector salud en sus intervenciones. En la mayoría, esta participación se centra en la denuncia de casos detectados y la atención de casos derivados de servicios policiales. Se identificaron 24 leyes que hacían mención a intervenciones específicamente desarrolladas por el sector salud, sobre todo de prevención terciaria. Las leyes de México, Colombia, Argentina, El Salvador, España y Filipinas integran intervenciones relacionadas con los tres niveles de prevención. Conclusiones: Una cuarta parte de las leyes sobre la violencia contra las mujeres estudiadas incorporan intervenciones específicas del sector salud. Esto sugiere que todavía es incipiente el abordaje integral del problema. Se requiere un mayor aprovechamiento de las potencialidades de este sector en intervenciones previas a las consecuencias de la violencia contra las mujeres.Objectives: To identify and describe the responsibilities attributed to health administrations in preventing

  19. Health Sector Inflation Rate and its Determinants in Iran: A Longitudinal Study (1995–2008)

    Science.gov (United States)

    TEIMOURIZAD, Abedin; HADIAN, Mohamad; REZAEI, Satar; HOMAIE RAD, Enayatollah

    2014-01-01

    Abstract Background Health price inflation rate is different from increasing in health expenditures. Health expenditures contain both quantity and prices but inflation rate contains prices. This study aimed to determine the factors that affect the Inflation Rate for Health Care Services (IRCPIHC) in Iran. Methods We used Central Bank of Iran data. We estimated the relationship between the inflation rate and its determinants using dynamic factor variable approach. For this purpose, we used STATA software. Results The study results revealed a positive relationship between the overall inflation as well as the number of dentists and health inflation. However, number of beds and physicians per 1000 people had a negative relationship with health inflation. Conclusion When the number of hospital beds and doctors increased, the competition between them increased, as well, thereby decreasing the inflation rate. Moreover, dentists and drug stores had the conditions of monopoly markets; therefore, they could change the prices easier compared to other health sectors. Health inflation is the subset of growth in health expenditures and the determinants of health expenditures are not similar to health inflation. PMID:26060721

  20. Health Sector Inflation Rate and its Determinants in Iran: A Longitudinal Study (1995-2008).

    Science.gov (United States)

    Teimourizad, Abedin; Hadian, Mohamad; Rezaei, Satar; Homaie Rad, Enayatollah

    2014-11-01

    Health price inflation rate is different from increasing in health expenditures. Health expenditures contain both quantity and prices but inflation rate contains prices. This study aimed to determine the factors that affect the Inflation Rate for Health Care Services (IRCPIHC) in Iran. We used Central Bank of Iran data. We estimated the relationship between the inflation rate and its determinants using dynamic factor variable approach. For this purpose, we used STATA software. The study results revealed a positive relationship between the overall inflation as well as the number of dentists and health inflation. However, number of beds and physicians per 1000 people had a negative relationship with health inflation. When the number of hospital beds and doctors increased, the competition between them increased, as well, thereby decreasing the inflation rate. Moreover, dentists and drug stores had the conditions of monopoly markets; therefore, they could change the prices easier compared to other health sectors. Health inflation is the subset of growth in health expenditures and the determinants of health expenditures are not similar to health inflation.

  1. Older lesbians and work in the Australian health and aged care sector.

    Science.gov (United States)

    Hughes, Mark; Kentlyn, Sujay

    2015-01-01

    While research has identified challenges lesbians face in the workplace, there is limited understanding of the particular experiences of older lesbians, especially those working in the health and aged care sector. This article draws on the stories of four women who participated in a narrative research project on lesbian and gay people's experiences of health and aged care. It highlights the need for future research to examine the complexity of identity expression and community affiliation, how people negotiate "coming out" in the workplace, the impact of discrimination, and the resources (such as friends) available to lesbians in the workplace.

  2. Psychosocial Work Hazards, Self-Rated Health and Burnout: A Comparison Study of Public and Private Sector Employees.

    Science.gov (United States)

    Liu, Hsi-Chen; Cheng, Yawen

    2018-04-01

    To compare psychosocial work conditions and health status between public and private sector employees and to examine if psychosocial work conditions explained the health differences. Two thousand four hundred fourty one public and 15,589 private sector employees participated in a cross-sectional survey. Psychosocial work hazards, self-rated health (SRH), and burnout status were assessed by questionnaire. As compared with private sector employees, public sector employees reported better psychosocial work conditions and better SRH, but higher risk of workplace violence (WPV) and higher levels of client-related burnout. Regression analyses indicated that higher psychosocial job demands, lower workplace justice, and WPV experience were associated with poor SRH and higher burnout. The public-private difference in client-related burnout remained even with adjustment of psychosocial work factors. Greater risks of WPV and client-related burnout observed in public sector employees warrant further investigation.

  3. Achieving Workplace Health through Application of Wellness Strategies

    Science.gov (United States)

    Robinson, Judith L.

    2008-01-01

    Purpose: 1) Understand and measure JSC workplace health: a) levels, sources, indicators & effects of negative, work-related stress; b) define leading indicators of emerging issues. 2 Provide linkage to outcomes: a) Focus application of wellness strategies & HR tools; b) Increase quality of work life and productivity. 3) Current effort will result in: a) Online assessment tool; b) Assessment of total JSC population (civil service & contractors); c) Application of mitigation tools and strategies. 4) Product of the JSC Employee Wellness Program. 5) Collaboration with Corporate Health Improvement Program/University of Arizona.

  4. Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores among Urban Youth in the United States

    Science.gov (United States)

    Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

    2014-01-01

    Background: The Institute of Medicine (2012) concluded that we must "strengthen schools as the heart of health." To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement,…

  5. Ebola Preparedness in the Netherlands: The Need for Coordination Between the Public Health and the Curative Sector.

    NARCIS (Netherlands)

    Swaan, Corien M; Öry, Alexander V; Schol, Lianne G C; Jacobi, André; Richardus, Jan Hendrik; Timen, Aura

    2018-01-01

    During the Ebola outbreak in West Africa in 2014-2015, close cooperation between the curative sector and the public health sector in the Netherlands was necessary for timely identification, referral, and investigation of patients with suspected Ebola virus disease (EVD).

  6. Ebola Preparedness in the Netherlands: The Need for Coordination Between the Public Health and the Curative Sector

    NARCIS (Netherlands)

    C. Swaan (Corien); Öry, A.V. (Alexander V.); Schol, L.G.C. (Lianne G. C.); A. Jacobi (Andre); J.H. Richardus (Jan Hendrik); A. Timen (Aura)

    2017-01-01

    markdownabstractContext: During the Ebola outbreak in West Africa in 2014-2015, close cooperation between the curative sector and the public health sector in the Netherlands was necessary for timely identification, referral, and investigation of patients with suspected Ebola virus disease (EVD).

  7. Financial Health of the Higher Education Sector: Financial Results and TRAC Outcomes 2013-14. Issues Paper 2015/07

    Science.gov (United States)

    Higher Education Funding Council for England, 2015

    2015-01-01

    This report provides an overview of the financial health of the Higher Education Funding Council for England (HEFCE)-funded higher education sector in England. The analysis covers financial results for the academic year 2013-14, as submitted to HEFCE in December 2014, as well as the outcomes from the sector's Transparent Approach to Costing (TRAC)…

  8. How to achieve a collaborative approach in health promotion

    DEFF Research Database (Denmark)

    Pals, Regitze Anne Saurbrey; Hempler, Nana Folmann

    2018-01-01

    (n = 15), professionals (n = 21) and users' family members (n = 12). Data were analysed using systematic text condensation. RESULTS: Users provided three recommendations for establishing a collaborative approach in communication about health: (1) involving users in deciding the agenda and setting...

  9. Achieving Health SDG 3 in Africa through NGO Capacity Building ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    2016-09-01

    Sep 1, 2016 ... Résumé. Comme les investisseurs mondiaux d'impact se préparent à soutenir le ... Sustainable Development Goals (SDGs) and ... innovative financing plans. .... agencies with the support of consultants. ... Centre for Health Science Training, Research and .... place consistent project management systems.

  10. Empowering Health Care Decision-makers to Achieve Regional ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This project builds on earlier work on the development and validation of an economic model to estimate the social, economic, and health burden of tobacco, together with the expected impact of tax increases in Argentina, Bolivia, Brazil, Chile, Colombia, Mexico, and Peru. Researchers will develop and evaluate the ...

  11. Private sector opportunities and threats to achieving malaria elimination in the Greater Mekong Subregion: results from malaria outlet surveys in Cambodia, the Lao PDR, Myanmar, and Thailand.

    Science.gov (United States)

    Phok, Sochea; Phanalasy, Saysana; Thein, Si Thu; Likhitsup, Asawin

    2017-05-02

    available. Over half of all anti-malarial distribution was by outlets that did not have confirmatory testing available in the Lao PDR (54%) and Myanmar (59%). Availability of quality-assured rapid diagnostic tests (RDT) amongst the RDT-stocking public sector ranged from 99.3% in the Lao PDR to 80.1% in Cambodia. In Cambodia, the Lao PDR, and Myanmar, less than 50% of the private sector reportedly received engagement (access to subsidized commodities, supervision, training or caseload reporting), which was most common among private health facilities and pharmacies. Findings from this multi-country study suggest that Cambodia, the Lao PDR, Myanmar, and Thailand are generally in alignment with national regulations, treatment guidelines, and quality-assurance standards. However, important gaps persist in the private sector which pose a threat to national malaria control and elimination goals. Several options are discussed to help align the private sector anti-malarial market with national elimination strategies.

  12. Healthy firms: constraints to growth among private health sector facilities in Ghana and Kenya.

    Science.gov (United States)

    Burger, Nicholas E; Kopf, Daniel; Spreng, Connor P; Yoong, Joanne; Sood, Neeraj

    2012-01-01

    Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa), but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent) report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent). Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent), accounting (Ghana: 45 percent; Kenya: 27 percent), and inventory control (Ghana: 41 percent; Kenya: 24 percent). A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to finance when they have the business processes in place for operating a successful business

  13. Healthy firms: constraints to growth among private health sector facilities in Ghana and Kenya.

    Directory of Open Access Journals (Sweden)

    Nicholas E Burger

    Full Text Available BACKGROUND: Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa, but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. METHODOLOGY/PRINCIPAL FINDINGS: We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent. Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent, accounting (Ghana: 45 percent; Kenya: 27 percent, and inventory control (Ghana: 41 percent; Kenya: 24 percent. A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. CONCLUSIONS/SIGNIFICANCE: The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to

  14. The fiscal crisis in the health sector: Patterns of cutback management across Europe.

    Science.gov (United States)

    Ongaro, Edoardo; Ferré, Francesca; Fattore, Giovanni

    2015-07-01

    The article investigates trends in health sector cutback management strategies occurred during the ongoing financial and fiscal crisis across Europe. A European-wide survey to top public healthcare managers was conducted in ten different countries to understand their perception about public sector policy reactions to the financial and economic crisis; answers from 760 respondents from the healthcare sector (30.7% response rate) were analyzed. A multinomial logistic regression was used to assess the characteristics of respondents, countries' institutional healthcare models and the trend in public health resources availability during the crisis associated to the decision to introduce unselective cuts, targeted cuts or efficiency savings measures. Differentiated responses to the fiscal crisis that buffeted public finances were reported both across and within countries. Organizational position of respondents is significant in explaining the perceived cutback management approach introduced, where decentralized positions detect a higher use of linear cuts compared to their colleagues working in central level organizations. Compared to Bismark-like systems Beveridge-like ones favour the introduction of targeted cuts. Postponing the implementation of new programmes and containing expenses through instruments like pay freezes are some of the most popular responses adopted, while outright staff layoffs or reduction of frontline services have been more selectively employed. To cope with the effects of the fiscal crisis healthcare systems are undergoing important changes, possibly also affecting the scope of universal coverage. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Ontario's changing electrical sector : implications for air quality and human health

    International Nuclear Information System (INIS)

    Perrota, K.; De Leon, F.

    1999-03-01

    Concerns regarding the changes to Ontario's electricity sector and the impacts that these changes may have on the environment and public health are discussed. Two of the major changes include the implementation of the Nuclear Asset Optimization Plan, and the introduction of competition to Ontario's electrical market. Both changes could have profound impacts on air quality in Toronto and the rest of Ontario. This report recommends that the Ontario Minister of Environment and the Ontario Minister of Energy, Science and Technology establish: a regulatory framework to ensure that competition in Ontario's electrical sector does not lead to greater reliance on coal-fired generating stations and further degradation of air quality, human health and the environment in Toronto and the rest of southern Ontario; annual air emission caps for the entire electrical sector to limit the volume of air pollutants released each year; a renewable energy standard which defines the percentage of electricity that must be generated with renewable energies by electrical suppliers serving Ontario consumers; and a public benefit fund to support the promotion of energy conservation and the development of renewable energies with a surcharge on the transmission of electricity. 35 refs., 5 tabs

  16. Critical success factors for achieving superior m-health success.

    Science.gov (United States)

    Dwivedi, A; Wickramasinghe, N; Bali, R K; Naguib, R N G

    2007-01-01

    Recent healthcare trends clearly show significant investment by healthcare institutions into various types of wired and wireless technologies to facilitate and support superior healthcare delivery. This trend has been spurred by the shift in the concept and growing importance of the role of health information and the influence of fields such as bio-informatics, biomedical and genetic engineering. The demand is currently for integrated healthcare information systems; however for such initiatives to be successful it is necessary to adopt a macro model and appropriate methodology with respect to wireless initiatives. The key contribution of this paper is the presentation of one such integrative model for mobile health (m-health) known as the Wi-INET Business Model, along with a detailed Adaptive Mapping to Realisation (AMR) methodology. The AMR methodology details how the Wi-INET Business Model can be implemented. Further validation on the concepts detailed in the Wi-INET Business Model and the AMR methodology is offered via a short vignette on a toolkit based on a leading UK-based healthcare information technology solution.

  17. Integrating human health into environmental impact assessment: case studies of Canada's Northern mining resource sector

    International Nuclear Information System (INIS)

    Noble, B.F.; Bronson, J.E.

    2005-01-01

    This paper examines the integration of human health considerations into environmental impact assessment (EIA) in the Canadian North. Emphasis is placed on the northern mining sector, where more land has been staked in the past decade than in the previous 50 years combined. Using information from interviews with northern EIA and health practitioners and reviews of selected project documents, we examined three principal mining case studies, northern Saskatchewan uranium mining operations, the Ekati diamond project, and the Voisey's Bay mine/mill project, to determine whether and how health considerations in EIA have evolved and the current nature and scope of health integration. Results suggest that despite the recognized link between environment and health and the number of high-profile megaprojects in Canada's North, human health, particularly social health, has not been given adequate treatment in northern EIA. Health considerations in EIA have typically been limited to physical health impacts triggered directly by project-induced environmental change, while social and other health determinants have been either not considered at all, or limited to those aspects of health and well-being that the project proponent directly controlled, namely employment opportunities and worker health and safety. In recent years, we have been seeing improvements in the scope of health in EIA to reflect a broader range of health determinants, including traditional land use and culture. However, there is still a need to adopt impact mitigation and enhancement measures that are sensitive to northern society, to monitor and follow up actual health impacts after project approval, and to ensure that mitigation and enhancement measures are effective. (author)

  18. Availability of medicines in public sector health facilities of two North Indian States.

    Science.gov (United States)

    Prinja, Shankar; Bahuguna, Pankaj; Tripathy, Jaya Prasad; Kumar, Rajesh

    2015-12-23

    Access to free essential medicines is a critical component of universal health coverage. However availability of essential medicines is poor in India with more than two-third of the people having limited or no access. This has pushed up private out-of-pocket expenditure due to medicines. The states of Punjab and Haryana are in the process of institutionalizing drug procurement models to provide uninterrupted access to essential medicines free of cost in all public hospitals and health centres. We undertook this study to assess the availability of medicines in public sector health facilities in the 2 states. Secondly, we also ascertained the quality of storage and inventory management systems in health facilities. The present study was carried out in 80 public health facilities across 12 districts in Haryana and Punjab states. Overall, within each state 1 MC, 6 DHs, 11 CHCs and 22 PHCs were selected for the study. Drug procurement mechanisms in both the states were studied through document reviews and in-depth interviews with key stakeholders. Stock registers were reviewed to collect data on availability of a basket of essential medicines -92 at Primary Health Centre (PHC) level, 132 at Community Health Centre (CHC) level and 160 at tertiary care (District Hospital/Medical College) level. These essential medicines were selected based on the Essential Medicine List (EML) of the Department of Health (DOH). Overall availability of medicines was 45.2% and 51.1% in Punjab and Haryana respectively. Availability of anti-hypertensives was around 60% in both the states whereas for anti-diabetics it was 44% and 47% in Punjab and Haryana respectively. Atleast one drug in each of the categories including analgesic/antipyretic, anti-helminthic, anti-spasmodic, anti-emetic, anti-hypertensive and uterotonics were nearly universally available in public sector facilities. On the contrary, medicines such as thrombolytics, anti-cancer and endocrine medicines were available in less

  19. Cost-effectiveness analysis for sector-wide priority setting in health

    NARCIS (Netherlands)

    R.C.W. Hutubessy (Raymond)

    2003-01-01

    textabstractCost-effectiveness analysis (CEA) provides one means by which decision-makers may assess and potentially improve the performance of health systems. The process can help to ensure that resources devoted to health systems are achieving the maximum possible benefit in terms of outcomes

  20. Medicaid Waivers and Public Sector Mental Health Service Penetration Rates for Youth.

    Science.gov (United States)

    Graaf, Genevieve; Snowden, Lonnie

    2018-01-22

    To assist families of youth with serious emotional disturbance in financing youth's comprehensive care, some states have sought and received Medicaid waivers. Medicaid waivers waive or relax the Medicaid means test for eligibility to provide insurance coverage to nonpoor families for expensive, otherwise out-of-reach treatment for youth with Serious Emotional Disturbance (SED). Waivers promote treatment access for the most troubled youth, and the present study investigated whether any of several Medicaid waiver options-and those that completely omit the means test in particular-are associated with higher state-wide public sector treatment penetration rates. The investigators obtained data from the U.S. Census, SAMHSA's Uniform Reporting System, and the Centers for Medicare and Medicaid Services. Analysis employed random intercept and random slope linear regression models, controlling for a variety of state demographic and fiscal variables, to determine whether a relationship between Medicaid waiver policies and state-level public sector penetration rates could be observed. Findings indicate that, whether relaxing or completely waiving Medicaid's qualifying income limits, waivers increase public sector penetration rates, particularly for youth under age 17. However, completely waiving Medicaid income limits did not uniquely contribute to penetration rate increases. States offering Medicaid waivers that either relax or completely waive Medicaid's means test to qualify for health coverage present higher public sector treatment rates for youth with behavioral health care needs. There is no evidence that restricting the program to waiving the means test for accessing Medicaid would increase treatment access. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  1. Setting research priorities across science, technology, and health sectors: the Tanzania experience.

    Science.gov (United States)

    de Haan, Sylvia; Kingamkono, Rose; Tindamanyire, Neema; Mshinda, Hassan; Makandi, Harun; Tibazarwa, Flora; Kubata, Bruno; Montorzi, Gabriela

    2015-03-12

    Identifying research priorities is key to innovation and economic growth, since it informs decision makers on effectively targeting issues that have the greatest potential public benefit. As such, the process of setting research priorities is of pivotal importance for favouring the science, technology, and innovation (STI)-driven development of low- and middle-income countries. We report herein on a major cross-sectoral nationwide research priority setting effort recently carried out in Tanzania by the Tanzania Commission for Science and Technology (COSTECH) in partnership with the Council on Health Research for Development (COHRED) and the NEPAD Agency. The first of its type in the country, the process brought together stakeholders from 42 sub-sectors in science, technology, and health. The cross-sectoral research priority setting process consisted of a 'training-of-trainers' workshop, a demonstration workshop, and seven priority setting workshops delivered to representatives from public and private research and development institutions, universities, non-governmental organizations, and other agencies affiliated to COSTECH. The workshops resulted in ranked listings of research priorities for each sub-sector, totalling approximately 800 priorities. This large number was significantly reduced by an expert panel in order to build a manageable instrument aligned to national development plans that could be used to guide research investments. The Tanzania experience is an instructive example of the challenges and issues to be faced in when attempting to identify research priority areas and setting an STI research agenda in low- and middle-income countries. As countries increase their investment in research, it is essential to increase investment in research management and governance as well, a key and much needed capacity for countries to make proper use of research investments.

  2. Gender equity and health sector reform in Colombia: mixed state-market model yields mixed results.

    Science.gov (United States)

    Ewig, Christina; Bello, Amparo Hernández

    2009-03-01

    In 1993, Colombia carried out a sweeping health reform that sought to dramatically increase health insurance coverage and reduce state involvement in health provision by creating a unitary state-supervised health system in which private entities are the main insurers and health service providers. Using a quantitative comparison of household survey data and an analysis of the content of the reforms, we evaluate the effects of Colombia's health reforms on gender equity. We find that several aspects of these reforms hold promise for greater gender equity, such as the resulting increase in women's health insurance coverage. However, the reforms have not achieved gender equity due to the persistence of fees which discriminate against women and the introduction of a two-tier health system in which women heads of household and the poor are concentrated in a lower quality health system.

  3. Comparison of Quality And Content of Violence Guidelines For The Health Care Sector

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    Rabia Kahveci

    2018-03-01

    Full Text Available More than 50% of the employees in health sector are exposed to violence at any time. This study investigated international workplace violence guidelines for the health care sector to compare their quality and content and explore whether these guidelines could be used in different settings. We ran a broad review to identify international guidelines for violence in health care. After identification of the guidelines, the quality of the guidelines was assessed by personal experience and views of the authors, also taking AGREE domains into consideration as a guidance. The identified guidelines were later qualitatively analyzed for the content by two researchers and compared to each other. Canada, New Zealand, USA, UK and Turkey’s guidelines were involved in the study. Definitions of workplace violence, risk factors, objectives of the guideline, legal requirements, responsible stakeholders, target population, strategies recommended, physical environment, training and staffing were assessed in the content of the violence guidelines. It was found that current guidelines need improvement in both quality and content, but it is possible to have an international guidance that could be applicable in different settings. The development of violence guidelines should be the first and most strategic step for better protection of the health care workers. We expect our results to be useful in preparation of new guidelines for different settings.

  4. Health worker (internal customer) satisfaction and motivation in the public sector in Ghana.

    Science.gov (United States)

    Agyepong, Irene Akua; Anafi, Patricia; Asiamah, Ebenezer; Ansah, Evelyn K; Ashon, Daniel A; Narh-Dometey, Christiana

    2004-01-01

    This paper describes factors affecting health worker motivation and satisfaction in the public sector in Ghana. The data are from a survey of public sector health care providers carried out in January 2002 and repeated in August 2003 using an interviewer administered structured questionnaire. It is part of a continuous quality improvement (CQI) effort in the health sector in the Greater Accra region of Ghana. Workplace obstacles identified that caused dissatisfaction and de-motivated staff in order of the most frequently mentioned were low salaries such that obtaining basic necessities of daily living becomes a problem; lack of essential equipment, tools and supplies to work with; delayed promotions; difficulties and inconveniences with transportation to work; staff shortages; housing, additional duty allowances and in-service (continuous) training. Others included children's education, vehicles to work with such as ambulances and pickups, staff transfer procedures, staff pre-service education inadequate for job requirements, and the effect of the job on family and other social factors. There were some differences in the percentages of staff selecting a given workplace obstacle between the purely rural districts, the highly urbanized Accra metropolis and the districts that were a mixture of urbanized and rural. It is unlikely that the Ghana Health Service can provide high quality of care to its end users (external customers) if workplace obstacles that de-motivate staff (internal customers) and negatively influence their performance are not properly recognized and addressed as a complex of inter-related problems producing a common result--dissatisfied poorly motivated staff and resulting poor quality services.

  5. Structural integration and performance of inter-sectoral public health-related policy networks: An analysis across policy phases

    NARCIS (Netherlands)

    Peters, D. T. J. M.; Raab, J.; Grêaux, K. M.; Stronks, K.; Harting, J.

    2017-01-01

    Background: Inter-sectoral policy networks may be effective in addressing environmental determinants of health with interventions. However, contradictory results are reported on relations between structural network characteristics (i.e., composition and integration) and network performance, such as

  6. Structural integration and performance of inter-sectoral public health-related policy networks : An analysis across policy phases

    NARCIS (Netherlands)

    Peters, Dorothee; Raab, J.; Grêaux, Kimberley M.; Stronks, Karien; Harting, Janneke

    2017-01-01

    Background: Inter-sectoral policy networks may be effective in addressing environmental determinants of health with interventions. However, contradictory results are reported on relations between structure and network characteristics (i.e., composition and integration) and network performance, such

  7. Job satisfaction and motivation of health workers in public and private sectors: cross-sectional analysis from two Indian states

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    Mahapatra Prasanta

    2010-11-01

    Full Text Available Abstract Background Ensuring health worker job satisfaction and motivation are important if health workers are to be retained and effectively deliver health services in many developing countries, whether they work in the public or private sector. The objectives of the paper are to identify important aspects of health worker satisfaction and motivation in two Indian states working in public and private sectors. Methods Cross-sectional surveys of 1916 public and private sector health workers in Andhra Pradesh and Uttar Pradesh, India, were conducted using a standardized instrument to identify health workers' satisfaction with key work factors related to motivation. Ratings were compared with how important health workers consider these factors. Results There was high variability in the ratings for areas of satisfaction and motivation across the different practice settings, but there were also commonalities. Four groups of factors were identified, with those relating to job content and work environment viewed as the most important characteristics of the ideal job, and rated higher than a good income. In both states, public sector health workers rated "good employment benefits" as significantly more important than private sector workers, as well as a "superior who recognizes work". There were large differences in whether these factors were considered present on the job, particularly between public and private sector health workers in Uttar Pradesh, where the public sector fared consistently lower (P P Conclusion There are common areas of health worker motivation that should be considered by managers and policy makers, particularly the importance of non-financial motivators such as working environment and skill development opportunities. But managers also need to focus on the importance of locally assessing conditions and managing incentives to ensure health workers are motivated in their work.

  8. Ebola Preparedness in the Netherlands: The Need for Coordination Between the Public Health and the Curative Sector.

    Science.gov (United States)

    Swaan, Corien M; Öry, Alexander V; Schol, Lianne G C; Jacobi, André; Richardus, Jan Hendrik; Timen, Aura

    During the Ebola outbreak in West Africa in 2014-2015, close cooperation between the curative sector and the public health sector in the Netherlands was necessary for timely identification, referral, and investigation of patients with suspected Ebola virus disease (EVD). In this study, we evaluated experiences in preparedness among stakeholders of both curative and public health sectors to formulate recommendations for optimizing preparedness protocols. Timeliness of referred patients with suspected EVD was used as indicator for preparedness. In focus group sessions and semistructured interviews, experiences of curative and public health stakeholders about the regional and national process of preparedness and response were listed. Timeliness recordings of all referred patients with suspected EVD (13) were collected from first date of illness until arrival in the referral academic hospital. Ebola preparedness was considered extensive compared with the risk of an actual patient, however necessary. Regional coordination varied between regions. More standardization of regional preparation and operational guidelines was requested, as well as nationally standardized contingency criteria, and the National Centre for Infectious Disease Control was expected to coordinate the development of these guidelines. For the timeliness of referred patients with suspected EVD, the median delay between first date of illness until triage was 2.0 days (range: 0-10 days), and between triage and arrival in the referral hospital, it was 5.0 hours (range: 2-7.5 hours). In none of these patients Ebola infection was confirmed. Coordination between the public health sector and the curative sector needs improvement to reduce delay in patient management in emerging infectious diseases. Standardization of preparedness and response practices, through guidelines for institutional preparedness and blueprints for regional and national coordination, is necessary, as preparedness for emerging infectious

  9. [Notes for understanding the problem of "public" health in the health sector].

    Science.gov (United States)

    Guimarães, Cristian Fabiano; da Silva, Rosane Azevedo Neves

    2015-03-01

    This paper presents a theoretical review of how the public health concept has been perceived in health practices, based on the problematic field introduced in Italian and Brazilian health reforms, in order to understand the construction of public health and the meanings that this term acquires in the health arena. The main goal is to understand how public health appears in the context of health movements in Italy and Brazil, as well as its movement of variation. In this sense, an attempt is made to identify elements that contribute to the composition of a genealogy of public health. From the investigation of public health practices, the tensions produced by this concept are analyzed, giving visibility to those practices that demonstrate the public health experience as a force in the world of health.

  10. Private sector delivery of health services in developing countries: a mixed-methods study on quality assurance in social franchises

    OpenAIRE

    Schlein, Karen; De La Cruz, Anna York; Gopalakrishnan, Tisha; Montagu, Dominic

    2013-01-01

    Abstract Background Across the developing world health care services are most often delivered in the private sector and social franchising has emerged, over the past decade, as an increasingly popular method of private sector health care delivery. Social franchising aims to strengthen business practices through economies of scale: branding clinics and purchasing drugs in bulk at wholesale prices. While quality is one of the established goals of social...

  11. Do we have the right models for scaling up health services to achieve the Millennium Development Goals?

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    Subramanian Savitha

    2011-12-01

    Full Text Available Abstract Background There is widespread agreement on the need for scaling up in the health sector to achieve the Millennium Development Goals (MDGs. But many countries are not on track to reach the MDG targets. The dominant approach used by global health initiatives promotes uniform interventions and targets, assuming that specific technical interventions tested in one country can be replicated across countries to rapidly expand coverage. Yet countries scale up health services and progress against the MDGs at very different rates. Global health initiatives need to take advantage of what has been learned about scaling up. Methods A systematic literature review was conducted to identify conceptual models for scaling up health in developing countries, with the articles assessed according to the practical concerns of how to scale up, including the planning, monitoring and implementation approaches. Results We identified six conceptual models for scaling up in health based on experience with expanding pilot projects and diffusion of innovations. They place importance on paying attention to enhancing organizational, functional, and political capabilities through experimentation and adaptation of strategies in addition to increasing the coverage and range of health services. These scaling up approaches focus on fostering sustainable institutions and the constructive engagement between end users and the provider and financing organizations. Conclusions The current approaches to scaling up health services to reach the MDGs are overly simplistic and not working adequately. Rather than relying on blueprint planning and raising funds, an approach characteristic of current global health efforts, experience with alternative models suggests that more promising pathways involve "learning by doing" in ways that engage key stakeholders, uses data to address constraints, and incorporates results from pilot projects. Such approaches should be applied to current

  12. Do we have the right models for scaling up health services to achieve the Millennium Development Goals?

    Science.gov (United States)

    Subramanian, Savitha; Naimoli, Joseph; Matsubayashi, Toru; Peters, David H

    2011-12-14

    There is widespread agreement on the need for scaling up in the health sector to achieve the Millennium Development Goals (MDGs). But many countries are not on track to reach the MDG targets. The dominant approach used by global health initiatives promotes uniform interventions and targets, assuming that specific technical interventions tested in one country can be replicated across countries to rapidly expand coverage. Yet countries scale up health services and progress against the MDGs at very different rates. Global health initiatives need to take advantage of what has been learned about scaling up. A systematic literature review was conducted to identify conceptual models for scaling up health in developing countries, with the articles assessed according to the practical concerns of how to scale up, including the planning, monitoring and implementation approaches. We identified six conceptual models for scaling up in health based on experience with expanding pilot projects and diffusion of innovations. They place importance on paying attention to enhancing organizational, functional, and political capabilities through experimentation and adaptation of strategies in addition to increasing the coverage and range of health services. These scaling up approaches focus on fostering sustainable institutions and the constructive engagement between end users and the provider and financing organizations. The current approaches to scaling up health services to reach the MDGs are overly simplistic and not working adequately. Rather than relying on blueprint planning and raising funds, an approach characteristic of current global health efforts, experience with alternative models suggests that more promising pathways involve "learning by doing" in ways that engage key stakeholders, uses data to address constraints, and incorporates results from pilot projects. Such approaches should be applied to current strategies to achieve the MDGs.

  13. Comprehensive sector-wide strategies to prevent and control obesity: what are the potential health and broader societal benefits? A case study from Australia.

    Science.gov (United States)

    Kite, James; Hector, Debra J; St George, Alexis; Pedisic, Zeljko; Phongsavan, Philayrath; Bauman, Adrian; Mitchell, Jo; Bellew, Bill

    2015-09-30

    Several countries have recently established multistakeholder strategies to prevent or control overweight and obesity; however, studies have not yet been done on their effectiveness and likely impact. This study's objectives were to (i) explore sector-wide benefits and impacts likely to accrue from implementing an obesity prevention strategy in the Australian state of New South Wales; (ii) discuss the wider implications of the findings for research and practice; and (iii) strengthen the case for sustained implementation of a comprehensive, intersectoral approach. A case study approach, including evidence reviews and illustrative epidemiological models, was used to show potential benefits from meeting selected targets and objectives specified in the strategy. For adults, improved health outcomes potentially include reductions in all-cause mortality, cardiovascular disease, type 2 diabetes, various cancers, osteoarthritis, infant mortality and healthcare costs. Potential benefits beyond the health sector involve disability payments, absenteeism, worker productivity, workplace injuries and insurance claims. For children and adolescents, improved health outcomes potentially include metabolic risk factors, dental health, prehypertension/hypertension, cardiovascular disease risk factors, depression, rates of mortality in hospitalised children, bullying and otitis media. Sector-wide health, social and economic benefits from successful implementation of multisector obesity prevention strategies are likely to be substantial if specified targets are achieved. Epidemiological modelling described in this paper for selected examples provides illustrative rather than comprehensive evidence for potential benefits. Process evaluation of the extent of implementation of these multisectoral strategies, together with the accumulated data on intervention effectiveness, will determine their potential population health benefit. Quantifying the health and social benefits that are likely to

  14. Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores Among Urban Youth in the United States*

    Science.gov (United States)

    Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

    2014-01-01

    Background The Institute of Medicine (2012) concluded that we must “strengthen schools as the heart of health.” To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement, and (2) examine cumulative effects of these assets on academic achievement. Methods Participants include 940 students (grades 5 and 6) from 12 schools randomly selected from an urban district. Data include physical assessments, fitness testing, surveys, and district records. Fourteen health indicators were gathered including physical health (eg, body mass index [BMI]), health behaviors (eg, meeting recommendations for fruit/vegetable consumption), family environment (eg, family meals), and psychological well-being (eg, sleep quality). Data were collected 3-6 months prior to standardized testing. Results On average, students reported 7.1 health assets out of 14. Those with more health assets were more likely to be at goal for standardized tests (reading/writing/mathematics), and students with the most health assets were 2.2 times more likely to achieve goal compared with students with the fewest health assets (both p student health may also improve academic achievement, closing equity gaps in both health and academic achievement. PMID:24320151

  15. Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN)

    Science.gov (United States)

    2012-01-01

    Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN) has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services. PMID:22640939

  16. Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN

    Directory of Open Access Journals (Sweden)

    Burgess Philip

    2012-05-01

    Full Text Available Abstract Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services.

  17. [Anachronic health care models for the elderly: challenges for the private sector].

    Science.gov (United States)

    Veras, Renato; Parahyba, Maria Isabel

    2007-10-01

    Brazil's population is aging rapidly. The average life expectancy is increasing such that a large proportion of the current population will reach old age. However, the large Brazilian cities still lack the kind of health services infrastructure needed to meet the demands resulting from present demographic changes. This article examines access to and utilization of health care among the elderly, with particular emphasis on the private sector, drawing on data from the National Household Sample Survey (PNAD, 1998 and 2003). Socio-demographic variables included gender, age, region of residence, and family income. According to the PNAD data presented in the current study, from 1998 to 2003, health conditions improved among Brazilians aged 60 years or older.

  18. Using social determinants of health to link health workforce diversity, care quality and access, and health disparities to achieve health equity in nursing.

    Science.gov (United States)

    Williams, Shanita D; Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis

    2014-01-01

    It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators-health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work-both within and outside the nursing field-that is necessary to answer these important but largely unanswered questions.

  19. Politics, class actors, and health sector reform in Brazil and Venezuela.

    Science.gov (United States)

    Mahmood, Qamar; Muntaner, Carles

    2013-03-01

    Universal access to healthcare has assumed renewed importance in global health discourse, along with a focus on strengthening health systems. These developments are taking place in the backdrop of concerted efforts to advocate moving away from vertical, disease-based approaches to tackling health problems. While this approach to addressing public health problems is a step in the right direction, there is still insufficient emphasis on understanding the socio-political context of health systems. Reforms to strengthen health systems and achieve universal access to healthcare should be cognizant of the importance of the socio-political context, especially state-society relations. That context determines the nature and trajectory of reforms promoting universality or any pro-equity change. Brazil and Venezuela in recent years have made progress in developing healthcare systems that aim to achieve universal access. These achievements are noteworthy given that, historically, both countries had a long tradition of healthcare systems which were highly privatized and geared towards access to healthcare for a small segment of the population while the majority was excluded. These achievements are also remarkable since they took place in an era of neoliberalism when many states, even those with universally-based healthcare systems, were moving in the opposite direction. We analyze the socio-political context in each of these countries and look specifically at how the changing state-society relations resulted in health being constitutionally recognized as a social right. We describe the challenges that each faced in developing and implementing healthcare systems embracing universality. Our contention is that achieving the principle of universality in healthcare systems is less of a technical matter and more a political project. It involves opposition from the socially conservative elements in the society. Navigation to achieve this goal requires a political strategy that

  20. Health Status of the Female Workers in the Garment Sector of Bangladesh

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    Shaheen AHMED

    2014-06-01

    Full Text Available Readymade Garment (RMG Sector in Bangladesh has been playing a vital role in creating employment opportunity for the rural marginal people for the last two decades. At present 5,100 garment factories are operating in this country and 3.6 million workers are working there in which more than 80 percent of them are female. From the beginning it is largely apparent that the health status of the female garment workers is not well enough to do their work properly. Keeping this in mind, the study was conducted to find out the health status of the female workers. In this study, 200 female workers of Bangladesh were interviewed to identify the major diseases they experienced. The study reveals that the majority of the female workers in the garment sector suffer from the diseases like problems in bones, abortion complexity, dermatitis, back pain, eye stain, pruritus, malnutrition, respiratory problems, hepatitis (Jandice, gastric pain, fatigue, fever, abdomen pain, common cold, and helminthiasis. The policy makers and other concern bodies should take necessary measures to ensure good health of the garment workers. It will help female workers to be more productive and their contribution to the country will be enhanced.

  1. Cost of delivering secondary-level health care services through public sector district hospitals in India

    Science.gov (United States)

    Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

    2017-01-01

    Background & objectives: Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Methods: Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. Results: The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was 844 (USD 15.5), i; 3481 (USD 64) and 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was 139 (USD 2.5). Interpretation & conclusions: The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India. PMID:29355142

  2. Process evaluation of communitisation programme in public sector health facilities, Mokokchung district, Nagaland, 2015

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    Aonungdok Tushi

    2017-01-01

    Full Text Available Background: Public sector health facilities were poorly managed due to a history of conflict in Nagaland, India. Government of Nagaland introduced “Nagaland Communitisation of Public Institutions and Services Act” in 2002. Main objectives of the evaluation were to review the functioning of Health Center Managing Committees (HCMCs, deliver health services in the institutions managed by HCMC, identify strengths as well as challenges perceived by HCMC members in the rural areas of Mokokchung district, Nagaland. Materials and Methods: The evaluation was made using input, process and output indicators. A doctor, the HCMC Chairman and one member from each of the three community health centers (CHC and four primary health centers (PHC were surveyed using a semi-structured questionnaire and an in-depth interview guide. Proportions for quantitative data were computed and key themes from the same were identified. Results: Overall; the infrastructure, equipment and outpatient/inpatient service availability was satisfactory. There was a lack of funds and shortage of doctors, drugs as well as laboratory facilities. HCMCs were in place and carried out administrative activities. HCMCs felt ownership, mobilized community contributions and managed human resources. HCMC members had inadequate funds for their transport and training. They faced challenges in service delivery due to political interference and lack of adequate human, material, financial resources. Conclusions: Communitisation program was operational in the district. HCMC members felt the ownership of health facilities. Administrative, political support and adequate funds from the government are needed for effective functioning of HCMCs and optimal service delivery in public sector facilities.

  3. Job satisfaction among public health professionals working in public sector: a cross sectional study from Pakistan

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    Kumar Ramesh

    2013-01-01

    Full Text Available Abstract Background Job satisfaction largely determines the productivity and efficiency of human resource for health. It literally depicts the extent to which professionals like or dislike their jobs. Job satisfaction is said to be linked with the employee’s work environment, job responsibilities and powers and time pressure; the determinants which affect employee’s organizational commitment and consequently the quality of services. The objective of the study was to determine the level of and factors influencing job satisfaction among public health professionals in the public sector. Methods This was a cross sectional study conducted in Islamabad, Pakistan. Sample size was universal including 73 public health professionals, with postgraduate qualifications and working in government departments of Islamabad. A validated structured questionnaire was used to collect data from April to October 2011. Results Overall satisfaction rate was 41% only, while 45% were somewhat satisfied and 14% of professionals highly dissatisfied with their jobs. For those who were not satisfied, working environment, job description and time pressure were the major causes. Other factors influencing the level of satisfaction were low salaries, lack of training opportunities, improper supervision and inadequate financial rewards. Conclusion Our study documented a relatively low level of overall satisfaction among workers in public sector health care organizations. Considering the factors responsible for this state of affairs, urgent and concrete strategies must be developed to address the concerns of public health professionals as they represent a highly sensitive domain of health system of Pakistan. Improving the overall work environment, review of job descriptions and better remuneration might bring about a positive change.

  4. Cost of delivering secondary-level health care services through public sector district hospitals in India.

    Science.gov (United States)

    Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

    2017-09-01

    Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was ' 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was ' 844 (USD 15.5), ' 3481 (USD 64) and ' 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was ' 139 (USD 2.5). The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India.

  5. [Facing the challenges of ubiquitous computing in the health care sector].

    Science.gov (United States)

    Georgieff, Peter; Friedewald, Michael

    2010-01-01

    The steady progress of microelectronics, communications and information technology will enable the realisation of the vision for "ubiquitous computing" where the Internet extends into the real world embracing everyday objects. The necessary technical basis is already in place. Due to their diminishing size, constantly falling price and declining energy consumption, processors, communications modules and sensors are being increasingly integrated into everyday objects today. This development is opening up huge opportunities for both the economy and individuals. In the present paper we discuss possible applications, but also technical, social and economic barriers to a wide-spread use of ubiquitous computing in the health care sector. .

  6. The role of institutions on the effectiveness of malaria treatment in the Ghanaian health sector.

    Science.gov (United States)

    Amporfu, Eugenia; Nonvignon, Justice

    2015-04-19

    The Ghanaian health sector has undertaken several policies to help improve the quality of care received by patients. This includes the construction of several health facilities, the increase in the training of health workers, especially nurses, and the introduction of incentive packages (such as salary increase) to motivate health workers. The important question is to what extent does the institutional arrangement between the health facilities and the government as well as between health workers and public health facility administration affect the quality of care? The objective of this study is to find the effect of institutional factors on the quality of care. The institutional factors examined were mainly the extent of decentralization between government and health facilities, as well as between health workers and facility administration, the hiring procedure, and job satisfaction. The study used primary data on former patients from sixty six health facilities in three administrative regions of Ghana: the Northern, the Ashanti and the Greater Accra regions. The quality indicator used was effectiveness of treatment as determined by the patient. Ordered logit regression was run for the indicator with patient and health facility characteristics as well as institutional factors as independent variables. The sample size was 2248. The results showed that the patient's level of formal education had a strong influence on the effectiveness of treatment. In addition, effectiveness of treatment differed according to the administrative region in which the facility was located, and according to the extent of decentralization between health facility and government. The quality of instruments used for treatment, the working conditions for health workers, and job satisfaction had no effect on the effectiveness of treatment. Decentralization, the flow of information from government to health facilities and from health facility administrators to health workers are important in

  7. The promotion of children's health and wellbeing: the contributions of England's charity sector

    Directory of Open Access Journals (Sweden)

    Persaud Albert

    2010-07-01

    Full Text Available Abstract Background Sports and arts based services for children have positive impacts on their mental and physical health. The charity sector provides such services, often set up in response to local communities expressing a need. The present study maps resilience promoting services provided by children's charities in England. Specifically, the prominence of sports and arts activities, and types of mental health provisions including telephone help-lines, are investigated. Findings The study was a cross-sectional web-based survey of chief executives, senior mangers, directors and chairs of charities providing services for children under the age of 16. The aims, objectives and activities of participating children's charities and those providing mental health services were described overall. In total 167 chief executives, senior managers, directors and chairs of charities in England agreed to complete the survey. From our sample of charities, arts activities were the most frequently provided services (58/167, 35%, followed by counselling (55/167, 33% and sports activities (36/167, 22%. Only 13% (22/167 of charities expected their work to contribute to the health legacy of the 2012 London Olympics. Telephone help lines were provided by 16% of the charities that promote mental health. Conclusions Counselling and arts activities were relatively common. Sports activities were limited despite the evidence base that sport and physical activity are effective interventions for well-being and health gain. Few of the charities we surveyed expected a health legacy from the 2012 London Olympics.

  8. The promotion of children's health and wellbeing: the contributions of England's charity sector.

    Science.gov (United States)

    Bhui, Kamaldeep S; Admasachew, Lul A; Persaud, Albert

    2010-07-13

    Sports and arts based services for children have positive impacts on their mental and physical health. The charity sector provides such services, often set up in response to local communities expressing a need. The present study maps resilience promoting services provided by children's charities in England. Specifically, the prominence of sports and arts activities, and types of mental health provisions including telephone help-lines, are investigated. The study was a cross-sectional web-based survey of chief executives, senior mangers, directors and chairs of charities providing services for children under the age of 16. The aims, objectives and activities of participating children's charities and those providing mental health services were described overall. In total 167 chief executives, senior managers, directors and chairs of charities in England agreed to complete the survey. From our sample of charities, arts activities were the most frequently provided services (58/167, 35%), followed by counselling (55/167, 33%) and sports activities (36/167, 22%). Only 13% (22/167) of charities expected their work to contribute to the health legacy of the 2012 London Olympics. Telephone help lines were provided by 16% of the charities that promote mental health. Counselling and arts activities were relatively common. Sports activities were limited despite the evidence base that sport and physical activity are effective interventions for well-being and health gain. Few of the charities we surveyed expected a health legacy from the 2012 London Olympics.

  9. Health factors in the everyday life and work of public sector employees in Sweden.

    Science.gov (United States)

    Erlandsson, Lena-Karin; Carlsson, Gunilla; Horstmann, Vibeke; Gard, Gunvor; Holmström, Eva

    2012-01-01

    The aim was to explore aspects of everyday life in addition to established risk factors and their relationship to subjective health and well-being among public sector employees in Sweden. Gainful employment impact on employees' health and well-being, but work is only one part of everyday life and a broader perspective is essential in order to identify health-related factors. Data were obtained from employees at six Social Insurance Offices in Sweden, 250 women and 50 men. A questionnaire based on established instruments and questions specifically designed for this study was used. Relationships between five factors of everyday life, subjective health and well-being were investigated by means of multivariate logistic regression analysis. The final model revealed a limited importance of certain work-related factors. A general satisfaction with everyday activities, a stress-free environment and general control in addition to not having monotonous movements at work were found to be factors explaining 46.3% of subjective good health and well-being. A person's entire activity pattern, including work, is important, and strategies for promoting health should take into account the person's situation as a whole. The interplay between risk and health factors is not clear and further research is warranted.

  10. Ideas, actors and institutions: lessons from South Australian Health in All Policies on what encourages other sectors' involvement.

    Science.gov (United States)

    Baum, Fran; Delany-Crowe, Toni; MacDougall, Colin; Lawless, Angela; van Eyk, Helen; Williams, Carmel

    2017-10-16

    This paper examines the extent to which actors from sectors other than health engaged with the South Australian Health in All Policies (HiAP) initiative, determines why they were prepared to do so and explains the mechanisms by which successful engagement happened. This examination applies theories of policy development and implementation. The paper draws on a five year study of the implementation of HiAP comprising document analysis, a log of key events, detailed interviews with 64 policy actors and two surveys of public servants. The findings are analysed within an institutional policy analysis framework and examine the extent to which ideas, institutional factors and actor agency influenced the willingness of actors from other sectors to work with Health sector staff under the HiAP initiative. In terms of ideas, there was wide acceptance of the role of social determinants in shaping health and the importance of action to promote health in all government agencies. The institutional environment was initially supportive, but support waned over the course of the study when the economy in South Australia became less buoyant and a health minister less supportive of health promotion took office. The existence of a HiAP Unit was very helpful for gaining support from other sectors. A new Public Health Act offered some promise of institutionalising the HiAP approach and ideas. The analysis concludes that a key factor was the operation of a supportive network of public servants who promoted HiAP, including some who were senior and influential. The South Australian case study demonstrates that despite institutional constraints and shifting political support within the health sector, HiAP gained traction in other sectors. The key factors that encouraged the commitment of others sectors to HiAP were the existence of a supportive, knowledgeable policy network, political support, institutionalisation of the ideas and approach, and balancing of the economic and social goals of

  11. Performance-based building codes: a call for injury prevention indicators that bridge health and building sectors.

    Science.gov (United States)

    Edwards, N

    2008-10-01

    The international introduction of performance-based building codes calls for a re-examination of indicators used to monitor their implementation. Indicators used in the building sector have a business orientation, target the life cycle of buildings, and guide asset management. In contrast, indicators used in the health sector focus on injury prevention, have a behavioural orientation, lack specificity with respect to features of the built environment, and do not take into account patterns of building use or building longevity. Suggestions for metrics that bridge the building and health sectors are discussed. The need for integrated surveillance systems in health and building sectors is outlined. It is time to reconsider commonly used epidemiological indicators in the field of injury prevention and determine their utility to address the accountability requirements of performance-based codes.

  12. Impatience versus achievement strivings in the Type A pattern: Differential effects on students' health and academic achievement

    Science.gov (United States)

    Spence, Janet T.; Helmreich, Robert L.; Pred, Robert S.

    1987-01-01

    Psychometric analyses of college students' responses to the Jenkins Activity Survey, a self-report measure of the Type A behavior pattern, revealed the presence of two relatively independent factors. Based on these analyses, two scales, labeled Achievement Strivings (AS) and Impatience and Irritability (II), were developed. In two samples of male and female college students, scores on AS but not on II were found to be significantly correlated with grade point average. Responses to a health survey, on the other hand, indicated that frequency of physical complaints was significantly correlated with II but not with AS. These results suggest that there are two relatively independent factors in the Type A pattern that have differential effects on performance and health. Future research on the personality factors related to coronary heart disease and other disorders might more profitably focus on the syndrome reflected in the II scale than on the Type A pattern.

  13. Utilisation and costs of nursing agencies in the South African public health sector, 2005-2010.

    Science.gov (United States)

    Rispel, Laetitia C; Angelides, George

    2014-01-01

    Globally, insufficient information exists on the costs of nursing agencies, which are temporary employment service providers that supply nurses to health establishments and/or private individuals. The aim of the study was to determine the utilisation and direct costs of nursing agencies in the South African public health sector. A survey of all nine provincial health departments was conducted to determine utilisation and management of nursing agencies. The costs of nursing agencies were assumed to be equivalent to expenditure. Provincial health expenditure was obtained for five financial years (2005/6-2009/10) from the national Basic Accounting System database, and analysed using Microsoft Excel. Each of the 166,466 expenditure line items was coded. The total personnel and nursing agency expenditure was calculated for each financial year and for each province. Nursing agency expenditure as a percentage of the total personnel expenditure was then calculated. The nursing agency expenditure for South Africa is the total of all provincial expenditure. The 2009/10 annual government salary scales for different categories of nurses were used to calculate the number of permanent nurses who could have been employed in lieu of agency expenditure. All expenditure is expressed in South African rands (R; US$1 ∼ R7, 2010 prices). Only five provinces reported utilisation of nursing agencies, but all provinces showed agency expenditure. In the 2009/10 financial year, R1.49 billion (US$212.64 million) was spent on nursing agencies in the public health sector. In the same year, agency expenditure ranged from a low of R36.45 million (US$5.20 million) in Mpumalanga Province (mixed urban-rural) to a high of R356.43 million (US$50.92 million) in the Eastern Cape Province (mixed urban-rural). Agency expenditure as a percentage of personnel expenditure ranged from 0.96% in KwaZulu-Natal Province (mixed urban-rural) to 11.96% in the Northern Cape Province (rural). In that financial year

  14. Do elections matter for private-sector healthcare management in Brazil? An analysis of municipal health policy.

    Science.gov (United States)

    McGregor, Alecia J; Siqueira, Carlos Eduardo; Zaslavsky, Alan M; Blendon, Robert J

    2017-07-12

    This study analyzed several political determinants of increased private-sector management in Brazilian health care. In Brazil, the poor depend almost exclusively on the public Unified Health System (the SUS), which remains severely underfunded. Given the overhead costs associated with privately contracted health services, increased private management is one driver of higher expenditures in the system. Although left parties campaign most vocally in support of greater public control of the SUS, the extent to which their stated positions translate into health care policy remains untested. Drawing on multiple publicly available data sources, we used linear regression to analyze how political party-in-power and existing private sector health care contracting affect the share of privately managed health care services and outsourcing in municipalities. Data from two election periods-2004 to 2008 and 2008 to 2012-were analyzed. Our findings showed that although private sector contracting varies greatly across municipalities, this variation is not systematically associated with political party in power. This suggests that electoral politics plays a relatively minor role in municipal-level health care administration. Existing levels of private sector management appear to have a greater effect on the public-private makeup of the Brazilian healthcare system, suggesting a strong role of path dependence in the evolution of Brazilian health care delivery. Despite campaign rhetoric asserting distinct positions on privatization in the SUS, factors other than political party in power have a greater effect on private-sector health system management at the municipal-level in Brazil. Given the limited effect of elections on this issue, strengthening participatory bodies such as municipal health councils may better enfranchise citizens in the fundamental debate over public and private roles in the health care sector.

  15. Multi-Sectoral Action for Addressing Social Determinants of Noncommunicable Diseases and Mainstreaming Health Promotion in National Health Programmes in India

    Directory of Open Access Journals (Sweden)

    Monika Arora

    2011-01-01

    Full Text Available Major noncommunicable diseases (NCDs share common behavioral risk factors and deep-rooted social determinants. India needs to address its growing NCD burden through health promoting partnerships, policies, and programs. High-level political commitment, inter-sectoral coordination, and community mobilization are important in developing a successful, national, multi-sectoral program for the prevention and control of NCDs. The World Health Organization′s "Action Plan for a Global Strategy for Prevention and Control of NCDs" calls for a comprehensive plan involving a whole-of-Government approach. Inter-sectoral coordination will need to start at the planning stage and continue to the implementation, evaluation of interventions, and enactment of public policies. An efficient multi-sectoral mechanism is also crucial at the stage of monitoring, evaluating enforcement of policies, and analyzing impact of multi-sectoral initiatives on reducing NCD burden in the country. This paper presents a critical appraisal of social determinants influencing NCDs, in the Indian context, and how multi-sectoral action can effectively address such challenges through mainstreaming health promotion into national health and development programs. India, with its wide socio-cultural, economic, and geographical diversities, poses several unique challenges in addressing NCDs. On the other hand, the jurisdiction States have over health, presents multiple opportunities to address health from the local perspective, while working on the national framework around multi-sectoral aspects of NCDs.

  16. A health app developer's guide to law and policy: a multi-sector policy analysis.

    Science.gov (United States)

    Parker, Lisa; Karliychuk, Tanya; Gillies, Donna; Mintzes, Barbara; Raven, Melissa; Grundy, Quinn

    2017-10-02

    Apps targeted at health and wellbeing sit in a rapidly growing industry associated with widespread optimism about their potential to deliver accessible and cost-effective healthcare. App developers might not be aware of all the regulatory requirements and best practice principles are emergent. Health apps are regulated in order to minimise their potential for harm due to, for example, loss of personal health privacy, financial costs, and health harms from delayed or unnecessary diagnosis, monitoring and treatment. We aimed to produce a comprehensive guide to assist app developers in producing health apps that are legally compliant and in keeping with high professional standards of user protection. We conducted a case study analysis of the Australian and related international policy environment for mental health apps to identify relevant sectors, policy actors, and policy solutions. We identified 29 policies produced by governments and non-government organisations that provide oversight of health apps. In consultation with stakeholders, we developed an interactive tool targeted at app developers, summarising key features of the policy environment and highlighting legislative, industry and professional standards around seven relevant domains: privacy, security, content, promotion and advertising, consumer finances, medical device efficacy and safety, and professional ethics. We annotated this developer guidance tool with information about: the relevance of each domain; existing legislative and non-legislative guidance; critiques of existing policy; recommendations for developers; and suggestions for other key stakeholders. We anticipate that mental health apps developed in accordance with this tool will be more likely to conform to regulatory requirements, protect consumer privacy, protect consumer finances, and deliver health benefit; and less likely to attract regulatory penalties, offend consumers and communities, mislead consumers, or deliver health harms. We

  17. Antipsychotics and dementia in Canada: a retrospective cross-sectional study of four health sectors.

    Science.gov (United States)

    Rios, Sebastian; Perlman, Christopher M; Costa, Andrew; Heckman, George; Hirdes, John P; Mitchell, Lori

    2017-10-23

    Antipsychotic medications are not recommended for the management of symptoms of dementia, particularly among persons with no behavioral or psychological symptoms. We examine patterns of antipsychotic medication use among persons with dementia across health sectors in Canada, with a focus on factors related to use among those without behavioral or psychotic symptoms. Using a retrospective cross-sectional design, this study examines antipsychotic use among adults aged 65 or older with dementia in home care (HC), complex continuing care (CCC), long-term care (LTC), and among alternate level care patients in acute hospitals (ALC). Using clinical data from January 1, 2009 to December 31, 2014, the prevalence of antipsychotic medication use was estimated by the presence of behavioral and psychotic symptoms. Logistic regression was used to identify sector specific factors associated with antipsychotic use in the absence of behavioral and psychotic symptoms. The total prevalence of antipsychotic use among older adults with dementia was 26% in HC, 54% in ALC, 41% in CCC, and 48% in LTC. This prevalence ranged from 38% (HC) to 73% (ALC) for those with both behavioral and psychotic symptoms and from 15% (HC) to 31% (ALC) among those with no symptoms. The regression models identified a number of variables were related to antipsychotic use in the absence of behavior or psychotic symptoms, such as bipolar disorder (OR = 6.63 in CCC; OR = 5.52 in LTC), anxious complaints (OR = 1.54 in LTC to 2.01 in CCC), and wandering (OR = 1.83 in ALC). Potentially inappropriate use of antipsychotic medications is prevalent among older adults with dementia across health sectors. The variations in prevalence observed from community to facility based care suggests that system issues may exist in appropriately managing persons with dementia.

  18. Sickness absence patterns and trends in the health care sector: 5-year monitoring of female municipal employees in the health and care sectors in Norway and Denmark.

    Science.gov (United States)

    Krane, Line; Johnsen, Roar; Fleten, Nils; Nielsen, Claus Vinther; Stapelfeldt, Christina M; Jensen, Chris; Braaten, Tonje

    2014-07-08

    Sickness absence is a growing public health problem in Norway and Denmark, with the highest absence rates being registered in Norway. We compared time trends in sickness absence patterns of municipal employees in the health and care sectors in Norway and Denmark. Data from 2004 to 2008 were extracted from the personnel registers of the municipalities of Kristiansand, Norway, and Aarhus, Denmark, for 3,181 and 8,545 female employees, respectively. Age-specific comparative statistics on sickness absence rates (number of calendar days of sickness absence/possible working days) and number of sick leave episodes were calculated for each year of the study period. There was an overall increasing trend in sickness absence rates in Denmark (P = 0.002), where rates were highest in the 20-29- (P = 0.01) and 50-59-year-old age groups (P = 0.03). Sickness absence rates in Norway were stable, except for an increase in the 20-29-year-old age group (P = 0.004). In both Norway and Denmark, the mean number of sick leave episodes increased (P sickness absence was higher in Norway than in Denmark. Both short-term and long-term absence increased in Denmark (P = 0.003 and P sickness absence rates in Denmark, while the largest overall increase in sick leave episodes was found in Norway. In both countries, the largest increases were observed among young employees. The results indicate that the two countries are converging in regard to sickness absence measured as rates and episodes.

  19. The politics of health sector reform in developing countries: three cases of pharmaceutical policy.

    Science.gov (United States)

    Reich, M R

    1995-01-01

    This paper examines the political dynamics of health sector reform in poor countries, through a comparative study of pharmaceutical policy reform in Sri Lanka, Bangladesh, and the Philippines. The paper first reviews five reasons why policy reform is political. It then presents three political economic models of the policy reform process: the political will, political factions, and political survival models. Next, the paper describes the three cases of national pharmaceutical policy reform, and identifies common conditions that made these reforms politically feasible. The paper's analysis suggests that health sector reform is feasible at certain definable, and perhaps predictable, political moments, especially in the early periods of new regimes. The most important and manipulable political factors are: political timing, which provides opportunities for policy entrepreneurs to introduce their ideas into public debate, and political management of group competition, which allows leaders to control the political effects of distributional consequences and protect the regime's stability. A strong and narrow political coalition improves the capacity of political leaders to resist the pressures of concentrated economic costs (both inside and outside national boundaries). The paper argues that for reform to succeed, policy-makers need effective methods to analyze relevant political conditions and shape key political factors in favor of policy reform. The method of Political Mapping is briefly introduced as a technique that can help policy-makers in analyzing and managing the political dimensions of policy reform and in improving the political feasibility of reform.

  20. A Survey of Job Satisfaction among Health Sector Staff of Tabriz Taleghani Educational Hospital

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    Leila Rastgar-Farajzadeh

    2016-03-01

    Full Text Available Background and Objectives : Job satisfaction is one of the most important variables in organizational behavior and the key variable in organizational researches and theories as well. The aim of present investigation was to determine the level of job satisfaction among health sector staff of Tabriz Taleghani Educational Hospital. Material and Methods : This cross-sectional study was performed in 2014. Health sector staffs of Taleghani Educational Hospital were studied through census method. Data collection tool was a questionnaire based on previous studies and consisted of 3 parts: demographic information (7 items, job satisfaction (21 questions and factors related to employee dissatisfaction (10 items. After collecting and entering data into IBM SPSS software, independent t tests, chi-square and ANOVA were applied. Results : The highest level of job satisfaction was in the field of relationship with colleagues and lowest level of job satisfaction was related to salary and benefits. The most common cause of employee dissatisfaction was pressure and stressful working environment and the least cause was the improper distribution of employees based on workload . Conclusion : According to the findings, the majority of job satisfaction among staff was at low and medium-level. Since job satisfaction is an important factor in the performance and quality of services provided by the hospital staff, it is recommended that managers and officials pay attention to defects and shortcomings and remove barriers.

  1. [The use of management contracts and professional incentives in the public health sector].

    Science.gov (United States)

    Ditterich, Rafael Gomes; Moysés, Simone Tetu; Moysés, Samuel Jorge

    2012-04-01

    Results-based management is a cornerstone of reform in public administration, including the health field, and has become the basis for other innovations such as the institutionalization of management contracts and the use of professional incentives. This review article aims to introduce and discuss the use of such management contracts in the public health sector. Management by results has developed means and tools that highlight the importance of shared responsibility and mutual commitment between workers and management-level directors. Thus, preset goals are negotiated among all the stakeholders and are evaluated periodically in order to grant professional incentives. It is necessary to improve the mechanisms for control and observation, to more precisely determine the healthcare and management indicators and their patterns, to train stakeholders in designing the plan, and to improve the use of professional incentives in order to effectively increase accountability vis-à-vis the desired results.

  2. Assistive technologies along supply chains in health care and in the social services sector.

    Science.gov (United States)

    Mayer, Peter; Hauer, Katharina; Schloffer, Evelyn; Leyrer, Barbara

    2015-01-01

    Health care systems in Austria and Slovenia are currently facing challenges due to scarce resources and demographic change which can be seen especially along the supply chains. The main objective of this paper is to present an option to improve the use of assistive technologies. An extensive literature research for the theoretic part as well as a qualitative survey for the empiric part focusing on short-term care were carried out. Results show that there is a lack of information and training on assistive technologies. As a consequence, their full potential cannot be exploited. Therefore a guideline for nursing consultations was developed. To conclude, both the literature research and the qualitative survey show that assistive technologies have high potentials to improve the supply chains in the health care and social services sector, but there is a lot of information and training on them needed.

  3. [Workplace Violence in the health sector: validation of the Italian version of the WHO questionnaire].

    Science.gov (United States)

    La Torre, G; Sestili, C; Iavazzo, E; Mannocci, A

    2017-01-01

    The phenomenon of violence and aggression in the workplace is frequent and constantly increasing. Healthcare professionals are most exposed to this phenomenon, especially those who work in urgent and psychiatric emergency departments. To validate the Italian version of the questionnaire "Workplace Violence in the Health Sector Case Study Research Instruments Survey Questionnaire", conducted by WHO. 55 randomly selected workers took part in the validation of the questionnaire among physicians, nurses and nursing trainees. The internal consistency analysis of the demand of 5 dichotomous variables on binary values ​​for violence levels suggests that Cronbach's alpha is 0.61, and Cronbach's alpha calculated on standardized elements is 0.69, which means that Reliability shows sufficient levels. The Italian translation carried out in this WHO questionnaire study shows good internal reliability and consistency and could be considered a useful tool in assessing and preventing aggression and violence against health professionals.

  4. The Flexible Care Service: a third-sector service for older people with mental health needs.

    Science.gov (United States)

    Ryder, Elaine

    2015-01-01

    Demographic patterns indicate that by 2030, one in five people in England will be over 65. Together with the fact that as people age they are more likely to suffer from comorbidities, it is of paramount importance that local services are designed to meet the needs of individual older people. The Flexible Care Service is a resource for older people with mental health problems. Through the use of client case studies, the Department of Health's 'six Cs' (care, compassion, competence, communication, courage and commitment) are used as a framework to demonstrate how a third-sector service such as Flexible Care can offer a person-centred approach in order to meet the diverse needs of individual clients. The framework is also used to demonstrate the high level of skills needed by flexible carers in order to provide this support.

  5. Explaining Quality Management in the Danish and Swedish Public Health Sectors

    DEFF Research Database (Denmark)

    Örnerheim, Mattias; Triantafillou, Peter

    2016-01-01

    was introduced in the Danish health services in 2009. Nationwide quality indicator projects are also found in Sweden, but there has been political attempt to introduce a compulsory system. This article seeks to explain this difference. It argues, first, that resistance from the medical professions blocked......This article examines the development of diverse quality systems in the otherwise quite similar Danish and Swedish public health sectors. After decades of numerous piecemeal medical and managerial quality development programs in both countries, a nationwide mandatory accreditation system...... the introduction of compulsory, nationwide quality systems in both countries for decades. Second, the implementation of the Danish accreditation system was triggered by a combination of unintended policy learning produced by local reforms in two counties and of the Ministry of Health’s carefully orchestrated...

  6. The Challenges and Issues Regarding E-Health and Health Information Technology Trends in the Healthcare Sector

    Science.gov (United States)

    Esmaeilzadeh, Pouyan; Sambasivan, Murali; Kumar, Naresh

    Like other industries, the utilization of the internet and Information Technology (IT) has increased in the health sector. Different applications attributed to the internet and IT in healthcare practice. It includes a range of services that intersect the edge of medicine, computer and information science. The presence of the internet helps healthcare practice with the use of electronic processes and communication. Also, health IT (HIT) deals with the devices, clinical guidelines and methods required to improve the management of information in healthcare. Although the internet and HIT has been considered as an influential means to enhance health care delivery, it is completely naive to imagine all new tools and mechanisms supported by the internet and HIT systems are simply adopted and used by all organizational members. As healthcare professionals play an important role in the healthcare sector, there is no doubt that mechanism of newly introduced HIT and new application of the internet in medical practice should be coupled with healthcare professionals' acceptance. Therefore, with great resistance by healthcare professionals new mechanism and tools supported by IT and the internet cannot be used properly and subsequently may not improve the quality of medical care services. However, factors affecting the healthcare professionals' adoption behavior concerning new e-health and HIT mechanism are still not conclusively identified. This research (as a theoretical study) tries to propose the source of resistance in order to handle the challenges over new e-technology in the health industry. This study uses the involved concepts and develops a conceptual framework to improve overall acceptance of e-health and HIT by healthcare professionals.

  7. The impact of robotics on employment and motivation of employees in the service sector, with special reference to health care.

    Science.gov (United States)

    Qureshi, Mohammed Owais; Syed, Rumaiya Sajjad

    2014-12-01

    The economy is being lifted by the new concept of robotics, but we cannot be sure of all the possible benefits. At this early stage, it therefore becomes important to find out the possible benefits/limitations associated with robotics, so that the positives can be capitalized, established, and developed further for the employment and motivation of employees in the health care sector, for overall economic development. The negatives should also be further studied and mitigated. This study is an exploratory research, based on secondary data, such as books on topics related to robotics, websites, public websites of concerned departments for data and statistics, journals, newspapers and magazines, websites of health care providers, and different printed materials (brochures, etc). The impact of robotics has both positive and negative impacts on the employment and motivation of employees in the retail sector. So far, there has been no substantial research done into robotics, especially in the health care sector. Replacing employees with robots is an inevitable choice for organizations in the service sector, more so in the health care sector because of the challenging and sometimes unhealthy working environments, but, at the same time, the researchers propose that it should be done in a manner that helps in improving the employment and motivation of employees in this sector.

  8. Improving social accountability processes in the health sector in sub-Saharan Africa: a systematic review.

    Science.gov (United States)

    Danhoundo, Georges; Nasiri, Khalidha; Wiktorowicz, Mary E

    2018-04-13

    Social accountability is a participatory process in which citizens are engaged to hold politicians, policy makers and public officials accountable for the services that they provide. In the Fifteenth Ordinary Session of the Assembly of the African Union, African leaders recognized the need for strong, decentralized health programs with linkages to civil society and private sector entities, full community participation in program design and implementation, and adaptive approaches to local political, socio-cultural and administrative environments. Despite the increasing use of social accountability, there is limited evidence on how it has been used in the health sector. The objective of this systematic review was to identify the conditions that facilitate effective social accountability in sub-Saharan Africa. Electronic databases (MEDLINE, PsycINFO, Sociological Abstracts, Social Sciences Abstracts) were searched for relevant articles published between 2000 and August 2017. Studies were eligible for inclusion if they were peer-reviewed English language publications describing a social accountability intervention in sub-Saharan Africa. Qualitative and quantitative study designs were eligible. Fourteen relevant studies were included in the review. The findings indicate that effective social accountability interventions involve leveraging partnerships and building coalitions; being context-appropriate; integrating data and information collection and analysis; clearly defined roles, standards, and responsibilities of leaders; and meaningful citizen engagement. Health system barriers, corruption, fear of reprisal, and limited funding appear to be major challenges to effective social accountability interventions. Although global accountability standards play an important guiding role, the successful implementation of global health initiatives depend on national contexts.

  9. Hospital utilization and out of pocket expenditure in public and private sectors under the universal government health insurance scheme in Chhattisgarh State, India: Lessons for universal health coverage.

    Science.gov (United States)

    Nandi, Sulakshana; Schneider, Helen; Dixit, Priyanka

    2017-01-01

    Research on impact of publicly financed health insurance has paid relatively little attention to the nature of healthcare provision the schemes engage. India's National Health Insurance Scheme or RSBY was made universal by Chhattisgarh State in 2012. In the State, public and private sectors provide hospital services in a context of extensive gender, social, economic and geographical inequities. This study examined enrolment, utilization (public and private) and out of pocket (OOP) expenditure for the insured and uninsured, in Chhattisgarh. The Chhattisgarh State Central sample (n = 6026 members) of the 2014 National Sample Survey (71st Round) on Health was extracted and analyzed. Variables of enrolment, hospitalization, out of pocket (OOP) expenditure and catastrophic expenditure were descriptively analyzed. Multivariate analyses of factors associated with enrolment, hospitalization (by sector) and OOP expenditure were conducted, taking into account gender, socio-economic status, residence, type of facility and ailment. Insurance coverage was 38.8%. Rates of hospitalization were 33/1000 population among the insured and 29/1000 among the uninsured. Of those insured and hospitalized, 67.2% utilized the public sector. Women, rural residents, Scheduled Tribes and poorer groups were more likely to utilize the public sector for hospitalizations. Although the insured were less likely to incur out of pocket (OOP) expenditure, 95.1% of insured private sector users and 66.0% of insured public sector users, still incurred costs. Median OOP payments in the private sector were eight times those in the public sector. Of households with at least one member hospitalized, 35.5% experienced catastrophic health expenditures (>10% monthly household consumption expenditure). The study finds that despite insurance coverage, the majority still incurred OOP expenditure. The public sector was nevertheless less expensive, and catered to the more vulnerable groups. It suggests the need to

  10. Hospital utilization and out of pocket expenditure in public and private sectors under the universal government health insurance scheme in Chhattisgarh State, India: Lessons for universal health coverage.

    Directory of Open Access Journals (Sweden)

    Sulakshana Nandi

    Full Text Available Research on impact of publicly financed health insurance has paid relatively little attention to the nature of healthcare provision the schemes engage. India's National Health Insurance Scheme or RSBY was made universal by Chhattisgarh State in 2012. In the State, public and private sectors provide hospital services in a context of extensive gender, social, economic and geographical inequities. This study examined enrolment, utilization (public and private and out of pocket (OOP expenditure for the insured and uninsured, in Chhattisgarh. The Chhattisgarh State Central sample (n = 6026 members of the 2014 National Sample Survey (71st Round on Health was extracted and analyzed. Variables of enrolment, hospitalization, out of pocket (OOP expenditure and catastrophic expenditure were descriptively analyzed. Multivariate analyses of factors associated with enrolment, hospitalization (by sector and OOP expenditure were conducted, taking into account gender, socio-economic status, residence, type of facility and ailment. Insurance coverage was 38.8%. Rates of hospitalization were 33/1000 population among the insured and 29/1000 among the uninsured. Of those insured and hospitalized, 67.2% utilized the public sector. Women, rural residents, Scheduled Tribes and poorer groups were more likely to utilize the public sector for hospitalizations. Although the insured were less likely to incur out of pocket (OOP expenditure, 95.1% of insured private sector users and 66.0% of insured public sector users, still incurred costs. Median OOP payments in the private sector were eight times those in the public sector. Of households with at least one member hospitalized, 35.5% experienced catastrophic health expenditures (>10% monthly household consumption expenditure. The study finds that despite insurance coverage, the majority still incurred OOP expenditure. The public sector was nevertheless less expensive, and catered to the more vulnerable groups. It suggests

  11. Health sector solidarity: a core European value but with broadly varying content.

    Science.gov (United States)

    Saltman, Richard B

    2015-01-01

    Although the concept of solidarity sits at the center of many European health sector debates, the specific groups eligible for coverage, the financing arrangements, and the range of services and benefits that, together, compose the operational content of solidarity have all changed considerably over time. In prior economic periods, solidarity covered considerably fewer services or groups of the population than it does today. As economic and political circumstances changed, the content of solidarity changed with them. Recent examples of these shifts are illustrated through a discussion of health reforms in Netherlands, Germany and also Israel (although not in Europe, the Israeli health system is similar in structure to European social health insurance systems). This article suggests that changed economic circumstances in Europe since the onset of the 2008 financial crisis may lead to re-configuring the scope and content of services covered by solidarity in many European health systems. A key issue for policymakers will be protecting vulnerable populations as this re-design occurs.

  12. A case for increased private sector involvement in Ireland's national animal health services.

    Science.gov (United States)

    More, Simon J

    2008-02-01

    Non-regulatory animal health issues, such as Johne's disease, infectious bovine rhinotracheitis (IBR) and mastitis will become increasing important, with ongoing globalisation of markets in animals and animal products. In response, Ireland may need to broaden the scope of its national animal health services. However, there have been concerns about the respective roles and responsibilities (both financial and otherwise) of government and industry in any such moves. This paper argues the case for increased private sector involvement in Ireland's national animal health services, based both on theoretical considerations and country case studies (the Netherlands and Australia). The Dutch and Australian case studies present examples of successful partnerships between government and industry, including systems and processes to address non-regulatory animal health issues. In each case, the roles and responsibilities of government are clear, as are the principles underpinning government involvement. Furthermore, the roles and responsibilities (financial and otherwise) of the Dutch and Australian industry are determined through enabling legislation, providing both legitimacy and accountability. There are constraints on the use of EU and national government funds to support non-regulatory animal health services in EU member states (such as Ireland and the Netherlands).

  13. A case for increased private sector involvement in ireland's national animal health services

    Directory of Open Access Journals (Sweden)

    More Simon J

    2008-02-01

    Full Text Available Abstract Non-regulatory animal health issues, such as Johne's disease, infectious bovine rhinotracheitis (IBR and mastitis will become increasing important, with ongoing globalisation of markets in animals and animal products. In response, Ireland may need to broaden the scope of its national animal health services. However, there have been concerns about the respective roles and responsibilities (both financial and otherwise of government and industry in any such moves. This paper argues the case for increased private sector involvement in Ireland's national animal health services, based both on theoretical considerations and country case studies (the Netherlands and Australia. The Dutch and Australian case studies present examples of successful partnerships between government and industry, including systems and processes to address non-regulatory animal health issues. In each case, the roles and responsibilities of government are clear, as are the principles underpinning government involvement. Furthermore, the roles and responsibilities (financial and otherwise of the Dutch and Australian industry are determined through enabling legislation, providing both legitimacy and accountability. There are constraints on the use of EU and national government funds to support non-regulatory animal health services in EU member states (such as Ireland and the Netherlands.

  14. Re-thinking global health sector efforts for HIV and tuberculosis epidemic control: promoting integration of programme activities within a strengthened health system.

    Science.gov (United States)

    Maher, Dermot

    2010-07-05

    The global financial crisis threatens global health, particularly exacerbating diseases of inequality, e.g. HIV/AIDS, and diseases of poverty, e.g. tuberculosis. The aim of this paper is to reconsider established practices and policies for HIV and tuberculosis epidemic control, aiming at delivering better results and value for money. This may be achieved by promoting greater integration of HIV and tuberculosis control programme activities within a strengthened health system. HIV and tuberculosis share many similarities in terms of their disease burden and the recommended stratagems for their control. HIV and tuberculosis programmes implement similar sorts of control activities, e.g. case finding and treatment, which depend for success on generic health system issues, including vital registration, drug procurement and supply, laboratory network, human resources, and financing. However, the current health system approach to HIV and tuberculosis control often involves separate specialised services. Despite some recent progress, collaboration between the programmes remains inadequate, progress in obtaining synergies has been slow, and results remain far below those needed to achieve universal access to key interventions. A fundamental re-think of the current strategic approach involves promoting integrated delivery of HIV and tuberculosis programme activities as part of strengthened general health services: epidemiological surveillance, programme monitoring and evaluation, community awareness of health-seeking behavior, risk behaviour modification, infection control, treatment scale-up (first-line treatment regimens), drug-resistance surveillance, containing and countering drug-resistance (second-line treatment regimens), research and development, global advocacy and global partnership. Health agencies should review policies and progress in HIV and tuberculosis epidemic control, learn mutual lessons for policy development and scaling up interventions, and identify ways

  15. Re-thinking global health sector efforts for HIV and tuberculosis epidemic control: promoting integration of programme activities within a strengthened health system

    Directory of Open Access Journals (Sweden)

    Maher Dermot

    2010-07-01

    Full Text Available Abstract Background The global financial crisis threatens global health, particularly exacerbating diseases of inequality, e.g. HIV/AIDS, and diseases of poverty, e.g. tuberculosis. The aim of this paper is to reconsider established practices and policies for HIV and tuberculosis epidemic control, aiming at delivering better results and value for money. This may be achieved by promoting greater integration of HIV and tuberculosis control programme activities within a strengthened health system. Discussion HIV and tuberculosis share many similarities in terms of their disease burden and the recommended stratagems for their control. HIV and tuberculosis programmes implement similar sorts of control activities, e.g. case finding and treatment, which depend for success on generic health system issues, including vital registration, drug procurement and supply, laboratory network, human resources, and financing. However, the current health system approach to HIV and tuberculosis control often involves separate specialised services. Despite some recent progress, collaboration between the programmes remains inadequate, progress in obtaining synergies has been slow, and results remain far below those needed to achieve universal access to key interventions. A fundamental re-think of the current strategic approach involves promoting integrated delivery of HIV and tuberculosis programme activities as part of strengthened general health services: epidemiological surveillance, programme monitoring and evaluation, community awareness of health-seeking behavior, risk behaviour modification, infection control, treatment scale-up (first-line treatment regimens, drug-resistance surveillance, containing and countering drug-resistance (second-line treatment regimens, research and development, global advocacy and global partnership. Health agencies should review policies and progress in HIV and tuberculosis epidemic control, learn mutual lessons for policy

  16. Prevalence of Hearing Loss Among Noise-Exposed Workers Within the Health Care and Social Assistance Sector, 2003 to 2012.

    Science.gov (United States)

    Masterson, Elizabeth A; Themann, Christa L; Calvert, Geoffrey M

    2018-04-01

    The purpose was to estimate the prevalence of hearing loss for noise-exposed U.S. workers within the Health Care and Social Assistance (HSA) sector. Audiograms for 1.4 million workers (8702 within HSA) from 2003 to 2012 were examined. Prevalences and adjusted risks for hearing loss as compared with a reference industry were estimated for the HSA sector and all industries combined. While the overall HSA sector prevalence for hearing loss was 19%, the prevalences in the Medical Laboratories subsector and the Offices of All Other Miscellaneous Health Practitioners subsector were 31% and 24%, respectively. The Child Day Care Services subsector had a 52% higher risk than the reference industry. High-risk industries for hearing loss exist within the HSA sector. Further work is needed to identify the sources of noise exposure and protect worker hearing.

  17. The comparative advantage of NGO (non-governmental organizations) in the health sector--a look at the evidence.

    Science.gov (United States)

    Matthias, A R; Green, A T

    1994-01-01

    Attention being given to the development of an appropriate public/private mix in health-care delivery should not exclude the role of non-governmental organizations (NGOs). There is a widely accepted thesis of NGO comparative advantage over government, but evidence to support this thesis is generally more anecdotal than analytical. This paper considers evidence available in the literature and from field research in southern Africa, especially with regard to efficiency, innovation and reaching grass-roots communities. The paper concludes that the comparative advantage of the NGO sector needs to be analysed in relation to both the private for-profit sector and the public sector.

  18. The importance of an integrating framework for achieving the Sustainable Development Goals: the example of health and well-being

    Science.gov (United States)

    Lee, Kelley; O'Riordan, Tim

    2016-01-01

    The 2030 Agenda for Sustainable Development came into force in January 2016 as the central United Nations (UN) platform for achieving ‘integrated and indivisible’ goals and targets across the three characteristic dimensions of sustainable development: the social, environmental and economic. We argue that, despite the UN adoption of the Sustainable Development Goals (SDGs), a framework for operationalising them in an integrated fashion is lacking. This article puts forth a framework for integrating health and well-being across the SDGs as both preconditions and outcomes of sustainable development. We present a rationale for this approach, and identify the challenges and opportunities for implementing and monitoring such a framework through a series of examples. We encourage other sectors to develop similar integrating frameworks for supporting a more coordinated approach for operationalising the 2030 Agenda for Sustainable Development. PMID:28588955

  19. The importance of an integrating framework for achieving the Sustainable Development Goals: the example of health and well-being.

    Science.gov (United States)

    Nunes, Ana Raquel; Lee, Kelley; O'Riordan, Tim

    2016-01-01

    The 2030 Agenda for Sustainable Development came into force in January 2016 as the central United Nations (UN) platform for achieving 'integrated and indivisible' goals and targets across the three characteristic dimensions of sustainable development: the social, environmental and economic. We argue that, despite the UN adoption of the Sustainable Development Goals (SDGs), a framework for operationalising them in an integrated fashion is lacking. This article puts forth a framework for integrating health and well-being across the SDGs as both preconditions and outcomes of sustainable development. We present a rationale for this approach, and identify the challenges and opportunities for implementing and monitoring such a framework through a series of examples. We encourage other sectors to develop similar integrating frameworks for supporting a more coordinated approach for operationalising the 2030 Agenda for Sustainable Development.

  20. [Implementation of the International Health Regulations in Cuba: evaluation of basic capacities of the health sector in selected provinces].

    Science.gov (United States)

    Gala, Ángela; Toledo, María Eugenia; Arias, Yanisnubia; Díaz González, Manuel; Alvarez Valdez, Angel Manuel; Estévez, Gonzalo; Abreu, Rolando Miyar; Flores, Gustavo Kourí

    2012-09-01

    Obtain baseline information on the status of the basic capacities of the health sector at the local, municipal, and provincial levels in order to facilitate identification of priorities and guide public policies that aim to comply with the requirements and capacities established in Annex 1A of the International Health Regulations 2005 (IHR-2005). A descriptive cross-sectional study was conducted by application of an instrument of evaluation of basic capacities referring to legal and institutional autonomy, the surveillance and research process, and the response to health emergencies in 36 entities involved in international sanitary control at the local, municipal, and provincial levels in the provinces of Havana, Cienfuegos, and Santiago de Cuba. The polyclinics and provincial centers of health and epidemiology in the three provinces had more than 75% of the basic capacities required. Twelve out of 36 units had implemented 50% of the legal and institutional framework. There was variable availability of routine surveillance and research, whereas the entities in Havana had more than 40% of the basic capacities in the area of events response. The provinces evaluated have integrated the basic capacities that will allow implementation of IHR-2005 within the period established by the World Health Organization. It is necessary to develop and establish effective action plans to consolidate surveillance as an essential activity of national and international security in terms of public health.

  1. Health technology assessment and its role in the future development of the Indian healthcare sector.

    Science.gov (United States)

    Hass, Bastian; Pooley, Jayne; Feuring, Martin; Suvarna, Viraj; Harrington, Adrian E

    2012-04-01

    Public expenditure on healthcare in India is low by international comparison, and access to essential treatment pushes many uninsured citizens below the poverty line. In many countries, policymakers utilize health technology assessment (HTA) methodologies to direct investments in healthcare, to obtain the maximum benefit for the population as a whole. With rising incomes and a commitment from the Government of India to increase the proportion of gross domestic product spent on health, this is an opportune moment to consider how HTA might help to allocate healthcare spending in India, in an equitable and efficient manner. Despite the predominance of out-of-pocket payments in the Indian healthcare sector, payers of all types are increasingly demanding value for money from expenditure on healthcare. In this review we demonstrate how HTA can be used to inform several aspects of healthcare provision. Areas in which HTA could be applied in the Indian context include, drug pricing, development of clinical practice guidelines, and prioritizing interventions that represent the greatest value within a limited budget. To illustrate the potential benefits of using the HTA approach, we present an example from a mature HTA market (Canada) that demonstrates how a new treatment for patients with atrial fibrillation - although more expensive than the current standard of care - improves clinical outcomes and represents a cost-effective use of public health resources. If aligned with the prevailing cultural and ethical considerations, and with the necessary investment in expert staff and resources, HTA promises to be a valuable tool for development of the Indian healthcare sector.

  2. Health technology assessment and its role in the future development of the Indian healthcare sector

    Directory of Open Access Journals (Sweden)

    Bastian Hass

    2012-01-01

    Full Text Available Public expenditure on healthcare in India is low by international comparison, and access to essential treatment pushes many uninsured citizens below the poverty line. In many countries, policymakers utilize health technology assessment (HTA methodologies to direct investments in healthcare, to obtain the maximum benefit for the population as a whole. With rising incomes and a commitment from the Government of India to increase the proportion of gross domestic product spent on health, this is an opportune moment to consider how HTA might help to allocate healthcare spending in India, in an equitable and efficient manner. Despite the predominance of out-of-pocket payments in the Indian healthcare sector, payers of all types are increasingly demanding value for money from expenditure on healthcare. In this review we demonstrate how HTA can be used to inform several aspects of healthcare provision. Areas in which HTA could be applied in the Indian context include, drug pricing, development of clinical practice guidelines, and prioritizing interventions that represent the greatest value within a limited budget. To illustrate the potential benefits of using the HTA approach, we present an example from a mature HTA market (Canada that demonstrates how a new treatment for patients with atrial fibrillation - although more expensive than the current standard of care - improves clinical outcomes and represents a cost-effective use of public health resources. If aligned with the prevailing cultural and ethical considerations, and with the necessary investment in expert staff and resources, HTA promises to be a valuable tool for development of the Indian healthcare sector.

  3. Health Care Public Sector Share and the U.S. Life Expectancy Lag: A Country-level Longitudinal Study.

    Science.gov (United States)

    Reynolds, Megan M

    2018-04-01

    Growing research on the political economy of health has begun to emphasize sociopolitical influences on cross-national differences in population health above and beyond economic growth. While this research investigates the impact of overall public health spending as a share of GDP ("health care effort"), it has for the most part overlooked the distribution of health care spending across the public and private spheres ("public sector</