Leveraging Big Data Tools and Technologies: Addressing the Challenges of the Water Quality Sector

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Juan Manuel Ponce Romero

2017-11-01

Full Text Available The water utility sector is subject to stringent legislation, seeking to address both the evolution of practices within the chemical/pharmaceutical industry, and the safeguarding of environmental protection, and which is informed by stakeholder views. Growing public environmental awareness is balanced by fair apportionment of liability within-sector. This highly complex and dynamic context poses challenges for water utilities seeking to manage the diverse chemicals arising from disparate sources reaching Wastewater Treatment Plants, including residential, commercial, and industrial points of origin, and diffuse sources including agricultural and hard surface water run-off. Effluents contain broad ranges of organic and inorganic compounds, herbicides, pesticides, phosphorus, pharmaceuticals, and chemicals of emerging concern. These potential pollutants can be in dissolved form, or arise in association with organic matter, the associated risks posing significant environmental challenges. This paper examines how the adoption of new Big Data tools and computational technologies can offer great advantage to the water utility sector in addressing this challenge. Big Data approaches facilitate improved understanding and insight of these challenges, by industry, regulator, and public alike. We discuss how Big Data approaches can be used to improve the outputs of tools currently in use by the water industry, such as SAGIS (Source Apportionment GIS system, helping to reveal new relationships between chemicals, the environment, and human health, and in turn provide better understanding of contaminants in wastewater (origin, pathways, and persistence. We highlight how the sector can draw upon Big Data tools to add value to legacy datasets, such as the Chemicals Investigation Programme in the UK, combined with contemporary data sources, extending the lifespan of data, focusing monitoring strategies, and helping users adapt and plan more efficiently. Despite

Diagnostic framework and health check tool for engineering and technology projects

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Simon P Philbin

2014-10-01

Full Text Available Purpose: Development of a practitioner oriented diagnostic framework and health check tool to support the robust assessment of engineering and technology projects.Design/methodology/approach: The research is based on a literature review that draws together insights on project assessment and critical success factors to establish an integrated systems view of projects. This is extended to allow a comprehensive diagnostic framework to be developed along with a high-level health check tool that can be readily deployed on projects. The utility of the diagnostic framework and health check tool are explored through three illustrative case studies, with two from Canada and one from the United Kingdom. Findings andOriginality/value: The performance of engineering and technology projects can be viewed through a systems perspective and being a function of six sub-systems that are: process, technology, resources, impact, knowledge and culture. The diagnostic framework that is developed through this research integrates these sub-systems to provide a comprehensive assessment methodology for projects, which is linked to existing best practice for project reviews, performance management and maturity models. The case studies provide managerial insights that are related to the diagnostic framework but crucially also position the approach in the context of industrial applications for construction engineering and technology management.Research limitations/implications: The case study approach includes two case studies from the construction and facilities development sector with the third case study from the research and technology sector. Further work is required to investigate the use of the diagnostic framework and health check tool in other sectors.Practical implications: The health check tool will be of practical benefit to new projects managers that require access to a robust and convenient project review methodology for assessing the status and health of a

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

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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.

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...

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...

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.

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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

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

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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.

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

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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.

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

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

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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

Managing risk selection incentives in health sector reforms.

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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.

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...

The Challenges and Issues Regarding E-Health and Health Information Technology Trends in the Healthcare Sector

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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.

Performance Contracting as a Performance Management Tool in the Public Sector in Kenya: Lessons of learning

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Hope, Kempe Ronald, Sr.

2013-01-01

The purpose of this article is to provide an assessment and analysis of public sector performance contracting as a performance management tool in Kenya. It aims to demonstrate that performance contracting remains a viable and important tool for improving public sector performance as a key element of the on-going public sector transformation…

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.

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

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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.

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

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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.

Private sector health reform in South Africa.

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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.

Corporate social responsibility in health sector: a case study in the government hospitals in Medan, Indonesia

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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.

Tool for assessing health and equity impacts of interventions modifying air quality in urban environments.

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Cartier, Yuri; Benmarhnia, Tarik; Brousselle, Astrid

2015-12-01

Urban outdoor air pollution (AP) is a major public health concern but the mechanisms by which interventions impact health and social inequities are rarely assessed. Health and equity impacts of policies and interventions are questioned, but managers and policy agents in various institutional contexts have very few practical tools to help them better orient interventions in sectors other than the health sector. Our objective was to create such a tool to facilitate the assessment of health impacts of urban outdoor AP interventions by non-public health experts. An iterative process of reviewing the academic literature, brainstorming, and consultation with experts was used to identify the chain of effects of urban outdoor AP and the major modifying factors. To test its applicability, the tool was applied to two interventions, the London Low Emission Zone and the Montréal BIXI public bicycle-sharing program. We identify the chain of effects, six categories of modifying factors: those controlling the source of emissions, the quantity of emissions, concentrations of emitted pollutants, their spatial distribution, personal exposure, and individual vulnerability. Modifiable and non-modifiable factors are also identified. Results are presented in the text but also graphically, as we wanted it to be a practical tool, from pollution sources to emission, exposure, and finally, health effects. The tool represents a practical first step to assessing AP-related interventions for health and equity impacts. Understanding how different factors affect health and equity through air pollution can provide insight to city policymakers pursuing Health in All Policies. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Knowledge translation regarding financial abuse and dementia for the banking sector: the development and testing of an education tool.

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Peisah, Carmelle; Bhatia, Sangita; Macnab, Jenna; Brodaty, Henry

2016-07-01

Financial abuse is the most common form of elder abuse. Capacity Australia, established to promote education regarding capacity and abuse prevention across health, legal and financial sectors, was awarded a grant by the Dementia Collaborative Research Centre to educate the banking sector on financial abuse and dementia. We aimed to develop a knowledge translation tool for bank staff on this issue. The banking sector across Australia was engaged and consulted to develop a tailored education tool based on Australian Banking Association's Guidelines on Financial Abuse Prevention, supplemented by information related to dementia, financial capacity and supported decision-making. The tool was tested on 69 banking staff across Australia from two major banks. An online education tool using adaptive learning was developed, comprising a pretest of 15 multiple choice questions, followed by a learning module tailored to the individual's performance on the pretest, and a post-test to assess knowledge translation. A significant increase in scores was demonstrated when baseline scores were compared with post-course scores (mean difference in scores = 3.5; SD = 1.94; t = 15.1; df = 68; p tool took approximately 10-20 min to complete depending on the knowledge of participant and continuity of completion. The Australian banking industry was amenable to assist in the development of a tailored education tool on dementia, abuse and financial capacity. This online e-tool provides an effective medium for knowledge translation. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Sectoral job training as an intervention to improve health equity.

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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.

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

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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.

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

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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.

The Free Trade Agreement and the Mexican health sector.

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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.

Exploring corruption in the South African health sector.

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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

"Health in all policies" in practice: guidance and tools to quantifying the health effects of cycling and walking.

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Kahlmeier, Sonja; Racioppi, Francesca; Cavill, Nick; Rutter, Harry; Oja, Pekka

2010-03-01

There is growing interest in "Health in All Policies" approaches, aiming at promoting health through policies which are under the control of nonhealth sectors. While economic appraisal is an established practice in transport planning, health effects are rarely taken into account. An international project was carried out to develop guidance and tools for practitioners for quantifying the health effects of cycling and walking, supporting their full appraisal. A systematic review of existing approaches was carried out. Then, the products were developed with an international expert panel through an extensive consensus finding process. Methodological guidance was developed which addresses the main challenges practitioners encounter in the quantification of health effects from cycling and walking. A "Health Economic Assessment Tool (HEAT) for cycling" was developed which is being used in several countries. There is a need for a more consistent approach to the quantification of health benefits from cycling and walking. This project is providing guidance and an illustrative tool for cycling for practical application. Results show that substantial savings can be expected. Such tools illustrate the importance of considering health in transport policy and infrastructure planning, putting "Health in All Policies" into practice.

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

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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.

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.

Developing electronic cooperation tools: a case from norwegian health care.

Science.gov (United States)

Larsen, Eli; Mydske, Per Kristen

2013-06-19

Many countries aim to create electronic cooperational tools in health care, but the progress is rather slow. The study aimed to uncover how the authoritys' financing policies influence the development of electronic cooperational tools within public health care. An interpretative approach was used in this study. We performed 30 semistructured interviews with vendors, policy makers, and public authorities. Additionally, we conducted an extensive documentation study and participated in 18 workshops concerning information and communication technology (ICT) in Norwegian health care. We found that the interorganizational communication in sectors like health care, that have undergone an independent development of their internal information infrastructure would find it difficult to create electronic services that interconnect the organizations because such connections would affect all interconnected organizations within the heterogenic structure. The organizations would, to a large extent, depend on new functionality in existing information systems. Electronic patient records play a central role in all parts of the health care sector and therefore dependence is established to the information systems and theirs vendors. The Norwegian government authorities, which run more than 80% of the Norwegian health care, have not taken extraordinary steps to compensate for this dependency-the government's political philosophy is that each health care institution should pay for further electronic patient record development. However, cooperational tools are complex due to the number of players involved and the way they are intertwined with the overall workflow. The customers are not able to buy new functionalities on the drawing table, while the electronic patient record vendors are not willing to take the economic risk in developing cooperational tools. Thus, the market mechanisms in the domain are challenged. We also found that public projects that were only financed for the first

Rethinking health systems strengthening: key systems thinking tools and strategies for transformational change.

Science.gov (United States)

Swanson, R Chad; Cattaneo, Adriano; Bradley, Elizabeth; Chunharas, Somsak; Atun, Rifat; Abbas, Kaja M; Katsaliaki, Korina; Mustafee, Navonil; Mason Meier, Benjamin; Best, Allan

2012-10-01

While reaching consensus on future plans to address current global health challenges is far from easy, there is broad agreement that reductionist approaches that suggest a limited set of targeted interventions to improve health around the world are inadequate. We argue that a comprehensive systems perspective should guide health practice, education, research and policy. We propose key 'systems thinking' tools and strategies that have the potential for transformational change in health systems. Three overarching themes span these tools and strategies: collaboration across disciplines, sectors and organizations; ongoing, iterative learning; and transformational leadership. The proposed tools and strategies in this paper can be applied, in varying degrees, to every organization within health systems, from families and communities to national ministries of health. While our categorization is necessarily incomplete, this initial effort will provide a valuable contribution to the health systems strengthening debate, as the need for a more systemic, rigorous perspective in health has never been greater.

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...

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.

Incentives Usage as a Motivational Tool : Case: The Nigerian Banking Sector

OpenAIRE

Ogunmuyiwa, Adeshola

2013-01-01

The essence of this thesis is to ascertain the usage of incentives as a motivational tool using the Nigerian banking sector as a case study. Questionnaires were sent to employees in this sector and their responses were critically analysed and related to the theories. The research methodology was primarily quantitative, but also qualitative features were adopted in the thesis. Of related motivational theories, the Process and the Content Theories were adopted. Incentives usage as a motivat...

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.

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

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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.

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.

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 ...

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.

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

UTILIZATION OF QUALITY TOOLS: DOES SECTOR AND SIZE MATTER?

Directory of Open Access Journals (Sweden)

Luis Fonseca

2015-12-01

Full Text Available This research focuses on the influence of company sector and size on the level of utilization of Basic and Advanced Quality Tools. The paper starts with a literature review and then presents the methodology used for the survey. Based on the responses from 202 managers of Portuguese ISO 9001:2008 Quality Management System certified organizations, statistical tests were performed. Results show, with 95% confidence level, that industry and services have a similar proportion of use of Basic and Advanced Quality Tools. Concerning size, bigger companies show a higher trend to use Advanced Quality Tools than smaller ones. For Basic Quality Tools, there was no statistical significant difference at a 95% confidence level for different company sizes. The three basic Quality tools with higher utilization were Check sheets, Flow charts and Histograms (for Services or Control Charts/ (for Industry, however 22% of the surveyed organizations reported not using Basic Quality Tools, which highlights a major improvement opportunity for these companies. Additional studies addressing motivations, benefits and barriers for Quality Tools application should be undertaken for further validation and understanding of these results.

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.

From theoretical concept to organizational tool for public sector improvement:

DEFF Research Database (Denmark)

Ernst, Jette; Hindhede, Anette Lykke; Andersen, Vibeke

2018-01-01

Purpose – The purpose of this paper is to examine, first, how social capital was crafted and transformed from a theoretical concept to an organizational tool for public sector improvement that was adopted by a Danish region and implemented in all regional hospitals. Second, the paper examines...... produce a pressure on the department management and the nurses. Originality/value – The explanatory critical framework combined with the ethnographic approach is a useful approach for theorizing and understanding social capital as an example of the emergence and consequences of new managerial tools...

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...

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.

ForGATE - A Forest Sector Greenhouse Gas Assessment Tool for Maine: Calibration and Overview

Science.gov (United States)

Chris Hennigar; Luke Amos-Binks; Ryan Cameron; John Gunn; David A. MacLean; Mark Twery

2013-01-01

This report describes the background calibration, inputs, and outputs of ForGATE, a forest sector greenhouse gas (GHG) accounting tool designed primarily to communicate information relevant to the evaluation of projected net GHG exchange in the context of Maine's forests, the Northeast forest sector, and alternative national or regional carbon (C) accounting...

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.

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.

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.

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.

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

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

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

[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.

The Use of Management Accounting Tools in Third Sector Entities

Directory of Open Access Journals (Sweden)

Poueri do Carmo Mário

2013-04-01

Full Text Available The purpose of this article was to present the results of research about the use of management accounting tools by third sector entities. It was considered that the use of management tools assists in the management process and internal controls of the same, and consequently in its continuity. The literature discusses the importance of management accounting and its instruments for management purposes (Padoveze, 2004; Soutes, 2006; Pace, 2009 and presents relevant aspects of more traditional tools such as the Budget, Strategic Planning and Costing (Dubois, Kulpa and Souza, 2006; Martins, 2010; Padoveze, 2006. We tried to do a survey on a sample of NGOs in cities of Minas Gerais, which included at the end with 41 respondents institutions. The survey instrument for data collection was a questionnaire constructed from literature reviews related to objects of research (Third Sector and Management Accounting Instruments. The questionnaire had the purpose of gathering data from the entity and also know about of the respondent. In addition, interviews were conducted in some NGOs, complementing the research findings from the questionnaires. The results were divided into three topics: the respondent data, the organization and practices of management accounting. In general, although much progress has been made and success stories and effective improvements, most of these entities still need to develop their accounting information systems and the use of the instruments themselves. Causes of this may be the lack of knowledge about some of the entities management tools (maybe the respondents because of their formations, besides the reduced capacity of most of them have these "services" (controls and analyzes that run on its functional structure due lack of resources to do so.

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.

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

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)

Health promotion: An effective tool for global health

Directory of Open Access Journals (Sweden)

Sanjiv Kumar

2012-01-01

Full Text Available Health promotion is very relevant today. There is a global acceptance that health and social wellbeing are determined by many factors outside the health system which include socioeconomic conditions, patterns of consumption associated with food and communication, demographic patterns, learning environments, family patterns, the cultural and social fabric of societies; sociopolitical and economic changes, including commercialization and trade and global environmental change. In such a situation, health issues can be effectively addressed by adopting a holistic approach by empowering individuals and communities to take action for their health, fostering leadership for public health, promoting intersectoral action to build healthy public policies in all sectors and creating sustainable health systems. Although, not a new concept, health promotion received an impetus following Alma Ata declaration. Recently it has evolved through a series of international conferences, with the first conference in Canada producing the famous Ottawa charter. Efforts at promoting health encompassing actions at individual and community levels, health system strengthening and multi sectoral partnership can be directed at specific health conditions. It should also include settings-based approach to promote health in specific settings such as schools, hospitals, workplaces, residential areas etc. Health promotion needs to be built into all the policies and if utilized efficiently will lead to positive health outcomes.

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

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.

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.

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

[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.

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.

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 ...

Health sector governance: should we be investing more?

Science.gov (United States)

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.

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.

[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.

[Organization and technology in the catering sector].

Science.gov (United States)

Tinarelli, Arnaldo

2014-01-01

The catering industry is a service characterized by a contract between customer and supplier. In institutional catering industry, the customer is represented by public administration; in private catering industry, the customer is represented by privates. The annual catering trades size is about 6.74 billions of euros, equally distributed between health sector (hospitals, nursing homes), school sector and business sector (ivorkplace food service), with the participation of nearly 1.200 firms and 70.000 workers. Major services include off-premises catering (food prepared away from the location where it's served) and on-premises catering (meals prepared and served at the same place). Several tools and machineries are used during both warehousing and food refrigerating operations, and during preparation, cooking, packaging and transport of meals. In this sector, injuries, rarely resulting serious or deadly, show a downward trend in the last years. On the contrary, the number of occupational diseases shows an upward trend. About the near future, the firms should become global outsourcer, able to provide other services as cleaning, transport and maintenance. In addition, they should invest in innovation: from tools and machineries technology to work organization; from factory lay-out to safely and health in the workplaces.

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.

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.

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

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

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.

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.

Community Health Policy Assessment of a Rural Northeast Missouri County using the Centers for Disease Control and Prevention’s CHANGE Tool

Directory of Open Access Journals (Sweden)

Mitch Stewart

2013-06-01

Full Text Available Background: In order to build a framework to address policy gaps and needs, community’s risk factors were identified and the extent to which current policies were in place to address the risk factors were compared. Methods: Face-to-face interviews, using the US Centers for Disease Con¬trol and Prevention’s CHANGE tool were conducted in a rural Northeast Missouri county possessing exceptionally high chronic disease rates to as¬sess the factor(s had the greatest influence on the rates in each sector of the community. Results: The Health Care Agency sector possessed the most factors cate¬gorized as environmental and policy assets, and the Community-at-Large and Business/Worksite sectors seemed to possess the least environmental and policy factors categorized as assets.Conclusions: Because organizational policies can strongly influence community health practices and behaviors, collaborative leadership from the Health Care Agency sector, comprehensive worksite health promotion programs in the Business/Worksite and Community In¬stitu¬tions/Organizations sectors, and tobacco-free school policies are recom¬mended. Multiple community sectors must work together to change not only behaviors but also environments in this county.

District decision-making for health in low-income settings: a qualitative study in Uttar Pradesh, India, on engaging the private health sector in sharing health-related data

Science.gov (United States)

Gautham, Meenakshi; Spicer, Neil; Subharwal, Manish; Gupta, Sanjay; Srivastava, Aradhana; Bhattacharyya, Sanghita; Avan, Bilal Iqbal; Schellenberg, Joanna

2016-01-01

Health information systems are an important planning and monitoring tool for public health services, but may lack information from the private health sector. In this fourth article in a series on district decision-making for health, we assessed the extent of maternal, newborn and child health (MNCH)-related data sharing between the private and public sectors in two districts of Uttar Pradesh, India; analysed barriers to data sharing; and identified key inputs required for data sharing. Between March 2013 and August 2014, we conducted 74 key informant interviews at national, state and district levels. Respondents were stakeholders from national, state and district health departments, professional associations, non-governmental programmes and private commercial health facilities with 3–200 beds. Qualitative data were analysed using a framework based on a priori and emerging themes. Private facilities registered for ultrasounds and abortions submitted standardized records on these services, which is compulsory under Indian laws. Data sharing for other services was weak, but most facilities maintained basic records related to institutional deliveries and newborns. Public health facilities in blocks collected these data from a few private facilities using different methods. The major barriers to data sharing included the public sector’s non-standardized data collection and utilization systems for MNCH and lack of communication and follow up with private facilities. Private facilities feared information disclosure and the additional burden of reporting, but were willing to share data if asked officially, provided the process was simple and they were assured of confidentiality. Unregistered facilities, managed by providers without a biomedical qualification, also conducted institutional deliveries, but were outside any reporting loops. Our findings suggest that even without legislation, the public sector could set up an effective MNCH data sharing strategy with

Accelerating TB notification from the private health sector in Delhi, India.

Science.gov (United States)

Kundu, Debashish; Chopra, Kamal; Khanna, Ashwani; Babbar, Neeti; Padmini, T J

2016-01-01

In India, almost half of all patients with tuberculosis (TB) seek care in the private sector as the first point of care. The national programme is unable to support such TB patients and facilitate effective treatment, as there is no information on TB and Multi or Extensively Drug Resistant TB (M/XDR-TB) diagnosis and treatment in private sector. To improve this situation, Government of India declared TB a notifiable disease for establishing TB surveillance system, to extend supportive mechanism for TB treatment adherence and standardised practices in the private sector. But TB notification from the private sector is a challenge and still a lot needs to be done to accelerate TB notification. Delhi State TB Control Programme had taken initiatives for improving notification of TB cases from the private sector in 2014. Key steps taken were to constitute a state level TB notification committee to oversee the progress of TB notification efforts in the state and direct 'one to one' sensitisation of private practitioners (PPs) (in single PP's clinic, corporate hospitals and laboratories) by the state notification teams with the help of available tools for sensitising the PP on TB notification - TB Notification Government Order, Guidance Tool for TB Notification and Standards of TB Care in India. As a result of focussed state level interventions, without much external support, there was an accelerated notification of TB cases from the private sector. TB notification cases from the private sector rose from 341 (in 2013) to 4049 (by the end of March 2015). Active state level initiatives have led to increase in TB case notification. Copyright © 2016 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

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.

Tool, weapon, or white elephant? A realist analysis of the five phases of a twenty-year programme of occupational health information system implementation in the health sector.

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Spiegel, Jerry M; Lockhart, Karen; Dyck, Carmen; Wilson, Andrea; O'Hara, Lyndsay; Yassi, Annalee

2012-08-06

Although information systems (IS) have been extensively applied in the health sector worldwide, few initiatives have addressed the health and safety of health workers, a group acknowledged to be at high risk of injury and illness, as well as in great shortage globally, particularly in low and middle-income countries. Adapting a context-mechanism-outcome case study design, we analyze our team's own experience over two decades to address this gap: in two different Canadian provinces; and two distinct South African settings. Applying a realist analysis within an adapted structuration theory framing sensitive to power relations, we explore contextual (socio-political and technological) characteristics and mechanisms affecting outcomes at micro, meso and macro levels. Technological limitations hindered IS usefulness in the initial Canadian locale, while staffing inadequacies amid pronounced power imbalances affecting governance restricted IS usefulness in the subsequent Canadian application. Implementation in South Africa highlighted the special care needed to address power dynamics regarding both worker-employer relations (relevant to all occupational health settings) and North-south imbalances (common to all international interactions). Researchers, managers and front-line workers all view IS implementation differently; relationships amongst the workplace parties and between community and academic partners have been pivotal in determining outcome in all circumstances. Capacity building and applying creative commons and open source solutions are showing promise, as is international collaboration. There is worldwide consensus on the need for IS use to protect the health workforce. However, IS implementation is a resource-intensive undertaking; regardless of how carefully designed the software, contextual factors and the mechanisms adopted to address these are critical to mitigate threats and achieve outcomes of interest to all parties. Issues specific to IS development

Health sector employment growth calls for improvements in labor productivity.

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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.

Implementing health promotion tools in Australian Indigenous primary health care.

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Percival, Nikki A; McCalman, Janya; Armit, Christine; O'Donoghue, Lynette; Bainbridge, Roxanne; Rowley, Kevin; Doyle, Joyce; Tsey, Komla

2018-02-01

In Australia, significant resources have been invested in producing health promotion best practice guidelines, frameworks and tools (herein referred to as health promotion tools) as a strategy to improve Indigenous health promotion programmes. Yet, there has been very little rigorous implementation research about whether or how health promotion tools are implemented. This paper theorizes the complex processes of health promotion tool implementation in Indigenous comprehensive primary healthcare services. Data were derived from published and grey literature about the development and the implementation of four Indigenous health promotion tools. Tools were theoretically sampled to account for the key implementation types described in the literature. Data were analysed using the grounded-theory methods of coding and constant comparison with construct a theoretical implementation model. An Indigenous Health Promotion Tool Implementation Model was developed. Implementation is a social process, whereby researchers, practitioners and community members collectively interacted in creating culturally responsive health promotion to the common purpose of facilitating empowerment. The implementation of health promotion tools was influenced by the presence of change agents; a commitment to reciprocity and organizational governance and resourcing. The Indigenous Health Promotion Tool Implementation Model assists in explaining how health promotion tools are implemented and the conditions that influence these actions. Rather than simply developing more health promotion tools, our study suggests that continuous investment in developing conditions that support empowering implementation processes are required to maximize the beneficial impacts and effectiveness of health promotion tools. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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

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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.

Costs of Dengue Control Activities and Hospitalizations in the Public Health Sector during an Epidemic Year in Urban Sri Lanka.

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Thalagala, Neil; Tissera, Hasitha; Palihawadana, Paba; Amarasinghe, Ananda; Ambagahawita, Anuradha; Wilder-Smith, Annelies; Shepard, Donald S; Tozan, Yeşim

2016-02-01

Reported as a public health problem since the 1960s in Sri Lanka, dengue has become a high priority disease for public health authorities. The Ministry of Health is responsible for controlling dengue and other disease outbreaks and associated health care. The involvement of large numbers of public health staff in dengue control activities year-round and the provision of free medical care to dengue patients at secondary care hospitals place a formidable financial burden on the public health sector. We estimated the public sector costs of dengue control activities and the direct costs of hospitalizations in Colombo, the most heavily urbanized district in Sri Lanka, during the epidemic year of 2012 from the Ministry of Health's perspective. The financial costs borne by public health agencies and hospitals are collected using cost extraction tools designed specifically for the study and analysed retrospectively using a combination of activity-based and gross costing approaches. The total cost of dengue control and reported hospitalizations was estimated at US$3.45 million (US$1.50 per capita) in Colombo district in 2012. Personnel costs accounted for the largest shares of the total costs of dengue control activities (79%) and hospitalizations (46%). The results indicated a per capita cost of US$0.42 for dengue control activities. The average costs per hospitalization ranged between US$216-609 for pediatric cases and between US$196-866 for adult cases according to disease severity and treatment setting. This analysis is a first attempt to assess the economic burden of dengue response in the public health sector in Sri Lanka. Country-specific evidence is needed for setting public health priorities and deciding about the deployment of existing or new technologies. Our results suggest that dengue poses a major economic burden on the public health sector in Sri Lanka.

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

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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.

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

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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.

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...

Costs of Dengue Control Activities and Hospitalizations in the Public Health Sector during an Epidemic Year in Urban Sri Lanka

Science.gov (United States)

Thalagala, Neil; Tissera, Hasitha; Palihawadana, Paba; Amarasinghe, Ananda; Ambagahawita, Anuradha; Wilder-Smith, Annelies; Shepard, Donald S.; Tozan, Yeşim

2016-01-01

Background Reported as a public health problem since the 1960s in Sri Lanka, dengue has become a high priority disease for public health authorities. The Ministry of Health is responsible for controlling dengue and other disease outbreaks and associated health care. The involvement of large numbers of public health staff in dengue control activities year-round and the provision of free medical care to dengue patients at secondary care hospitals place a formidable financial burden on the public health sector. Methods We estimated the public sector costs of dengue control activities and the direct costs of hospitalizations in Colombo, the most heavily urbanized district in Sri Lanka, during the epidemic year of 2012 from the Ministry of Health’s perspective. The financial costs borne by public health agencies and hospitals are collected using cost extraction tools designed specifically for the study and analysed retrospectively using a combination of activity-based and gross costing approaches. Results The total cost of dengue control and reported hospitalizations was estimated at US$3.45 million (US$1.50 per capita) in Colombo district in 2012. Personnel costs accounted for the largest shares of the total costs of dengue control activities (79%) and hospitalizations (46%). The results indicated a per capita cost of US$0.42 for dengue control activities. The average costs per hospitalization ranged between US$216–609 for pediatric cases and between US$196–866 for adult cases according to disease severity and treatment setting. Conclusions This analysis is a first attempt to assess the economic burden of dengue response in the public health sector in Sri Lanka. Country-specific evidence is needed for setting public health priorities and deciding about the deployment of existing or new technologies. Our results suggest that dengue poses a major economic burden on the public health sector in Sri Lanka. PMID:26910907

Attractiveness of employment sectors for physical therapists in Ontario, Canada (1999-2007: implication for the long term care sector

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Landry Michel D

2012-05-01

Full Text Available Abstract Background Recruiting and retaining health professions remains a high priority for health system planners. Different employment sectors may vary in their appeal to providers. We used the concepts of inflow and stickiness to assess the relative attractiveness of sectors for physical therapists (PTs in Ontario, Canada. Inflow was defined as the percentage of PTs working in a sector who were not there the previous year. Stickiness was defined as the transition probability that a physical therapist will remain in a given employment sector year-to-year. Methods A longitudinal dataset of registered PTs in Ontario (1999-2007 was created, and primary employment sector was categorized as ‘hospital’, ‘community’, ‘long term care’ (LTC or ‘other.’ Inflow and stickiness values were then calculated for each sector, and trends were analyzed. Results There were 5003 PTs in 1999, which grew to 6064 by 2007, representing a 21.2% absolute growth. Inflow grew across all sectors, but the LTC sector had the highest inflow of 32.0%. PTs practicing in hospitals had the highest stickiness, with 87.4% of those who worked in this sector remaining year-to-year. The community and other employment sectors had stickiness values of 78.2% and 86.8% respectively, while the LTC sector had the lowest stickiness of 73.4%. Conclusion Among all employment sectors, LTC had highest inflow but lowest stickiness. Given expected increases in demand for services, understanding provider transitional probabilities and employment preferences may provide a useful policy and planning tool in developing a sustainable health human resource base across all employment sectors.

Attractiveness of employment sectors for physical therapists in Ontario, Canada (1999-2007): implication for the long term care sector

Science.gov (United States)

2012-01-01

Background Recruiting and retaining health professions remains a high priority for health system planners. Different employment sectors may vary in their appeal to providers. We used the concepts of inflow and stickiness to assess the relative attractiveness of sectors for physical therapists (PTs) in Ontario, Canada. Inflow was defined as the percentage of PTs working in a sector who were not there the previous year. Stickiness was defined as the transition probability that a physical therapist will remain in a given employment sector year-to-year. Methods A longitudinal dataset of registered PTs in Ontario (1999-2007) was created, and primary employment sector was categorized as ‘hospital’, ‘community’, ‘long term care’ (LTC) or ‘other.’ Inflow and stickiness values were then calculated for each sector, and trends were analyzed. Results There were 5003 PTs in 1999, which grew to 6064 by 2007, representing a 21.2% absolute growth. Inflow grew across all sectors, but the LTC sector had the highest inflow of 32.0%. PTs practicing in hospitals had the highest stickiness, with 87.4% of those who worked in this sector remaining year-to-year. The community and other employment sectors had stickiness values of 78.2% and 86.8% respectively, while the LTC sector had the lowest stickiness of 73.4%. Conclusion Among all employment sectors, LTC had highest inflow but lowest stickiness. Given expected increases in demand for services, understanding provider transitional probabilities and employment preferences may provide a useful policy and planning tool in developing a sustainable health human resource base across all employment sectors. PMID:22643111

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

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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?

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

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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.

Multi-Sectoral Action for Addressing Social Determinants of Noncommunicable Diseases and Mainstreaming Health Promotion in National Health Programmes in India

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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.

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

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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.

Analysis of leading sector of Jambi City

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Hardiani Hardiani

2017-09-01

Full Text Available This study aims to analyze the leading sectors in the city of Jambi. The main data used is GDP data of Jambi City series 2010 for the period of 2012-2014. Analysis tool that is used are Location Quotient, Shift Share, Klassen Typology and Overlay Analysis. The results of the analysis found that of the 14 basic sectors in Jambi City (based on LQ analysis, there are four priority sectors namely electricity and gas procurement, building, large and retail trade, car and motorcycle repairs, health service, and social activities. Keywords: Location Quotient, Shift Share, Klassen Tipology, Overlay Analysis

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

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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

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

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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

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

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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

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

Adaptation to climate change in the Ontario public health sector

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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

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

Health sector reform in Argentina: a cautionary tale.

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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.

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

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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.

Tool, weapon, or white elephant? A realist analysis of the five phases of a twenty-year programme of occupational health information system implementation in the health sector

Directory of Open Access Journals (Sweden)

Spiegel Jerry M

2012-08-01

Full Text Available Abstract Background Although information systems (IS have been extensively applied in the health sector worldwide, few initiatives have addressed the health and safety of health workers, a group acknowledged to be at high risk of injury and illness, as well as in great shortage globally, particularly in low and middle-income countries. Methods Adapting a context-mechanism-outcome case study design, we analyze our team’s own experience over two decades to address this gap: in two different Canadian provinces; and two distinct South African settings. Applying a realist analysis within an adapted structuration theory framing sensitive to power relations, we explore contextual (socio-political and technological characteristics and mechanisms affecting outcomes at micro, meso and macro levels. Results Technological limitations hindered IS usefulness in the initial Canadian locale, while staffing inadequacies amid pronounced power imbalances affecting governance restricted IS usefulness in the subsequent Canadian application. Implementation in South Africa highlighted the special care needed to address power dynamics regarding both worker-employer relations (relevant to all occupational health settings and North–south imbalances (common to all international interactions. Researchers, managers and front-line workers all view IS implementation differently; relationships amongst the workplace parties and between community and academic partners have been pivotal in determining outcome in all circumstances. Capacity building and applying creative commons and open source solutions are showing promise, as is international collaboration. Conclusions There is worldwide consensus on the need for IS use to protect the health workforce. However, IS implementation is a resource-intensive undertaking; regardless of how carefully designed the software, contextual factors and the mechanisms adopted to address these are critical to mitigate threats and achieve

Co-operative bidding of SMEs in health care sector.

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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.

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.

[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.

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.

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

Promoting a Culture of Health Through Cross-Sector Collaborations.

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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."

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.

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...

Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

Energy Technology Data Exchange (ETDEWEB)

ORAU' s Oak Ridge Institute for Science Education (HCTT-CHE)

2011-04-14

The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

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

[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.

Safety and health practice among laboratory staff in Malaysian education sector

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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.

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.

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

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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

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.

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

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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.

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.

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

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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.

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.

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.

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)

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.

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...

A conceptual design and structural stabilities of in-pit assembly tools for the completion of final sector assembly at tokamak hall

International Nuclear Information System (INIS)

Nam, K.O.; Park, H.K.; Kim, D.J.; Ahn, H.J.; Kim, K.K.; Im, K.; Shaw, R.

2010-01-01

The final assembly of main components of the International Thermonuclear Experimental Reactor (ITER) tokamak, Vacuum Vessel (VV) and Toroidal Field Coils (TFCs), is achieved by the sequential assembly of the nine sub-assembled 40 o sectors in tokamak pit. Each sub-assembled 40 o sector is composed of one VV 40 o sector, two TFCs, and in-between Vacuum Vessel Thermal Shield (VVTS) segments. Sub-assembly is carried out in the assembly building and then the sub-assembled sectors are transferred into tokamak pit, in sequence, to complete sector assembly. The role of in-pit assembly tool is to support and align the sub-assembled sectors in tokamak pit. It also plays the role of reference datum during assembly until the completion of main components assembly. Korea Domestic Agency (KO DA) has developed the conceptual design of most ITER purpose-built assembly tools under the collaboration with the ITER Organization. Among the conceptual designs carried out, this paper describes the function, the structure, the selected material and the design results of the in-pit assembly tools comprising central column, radial beams and their supports, TF inner supports and in-pit working floor. The results of structural analysis using ANSYS for the various loading cases are given as well. The resultant stresses and deflections turned out to fall within the allowable ranges.

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.

Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

Energy Technology Data Exchange (ETDEWEB)

HCTT-CHE

2011-04-14

The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

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.

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...

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

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...

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 ...

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.

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.

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.

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...

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

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

Open Health Tools: Tooling for Interoperable Healthcare

Directory of Open Access Journals (Sweden)

Skip McGaughey

2008-11-01

Full Text Available The Open Health Tools initiative is creating an ecosystem focused on the production of software tooling that promotes the exchange of medical information across political, geographic, cultural, product, and technology lines. At its core, OHT believes that the availability of high-quality tooling that interoperates will propel the industry forward, enabling organizations and vendors to build products and systems that effectively work together. This will ?raise the interoperability bar? as a result of having tools that just work. To achieve these lofty goals, careful consideration must be made to the constituencies that will be most affected by an OHT-influenced world. This document outlines a vision of OHT?s impact to these stakeholders. It does not explain the OHT process itself or how the OHT community operates. Instead, we place emphasis on the impact of that process within the health industry. The catchphrase ?code is king? underpins this document, meaning that the manifestation of any open source community lies in the products and technology it produces.

Reflections on the use of the World Health Organization’s (WHO OneHealth Tool: Implications for health planning in low and middle income countries (LMICs [version 1; referees: 2 approved

Directory of Open Access Journals (Sweden)

John Q. Wong

2018-02-01

Full Text Available The World Health Organization (WHO launched the OneHealth Tool (OHT to help low and middle income countries to develop their capacities for sector-wide priority setting. In 2016, we sought to use the OHT to aid the Philippine Health Insurance Corporation (PHIC, the national health insurer of the Philippines, in decisions to expand benefit packages using cost-effectiveness analyses. With technical support from the WHO, we convened health planning officers from the Philippine Department of Health (DOH and the Philippine Health Insurance Corporation (PHIC conduct generalized cost-effective analyses (GCEA of selected un-financed noncommunicable disease interventions using OHT. We collected epidemiological and cost data through health facility surveys, review of literature such as cost libraries and clinical practice guidelines, and expert consultations. Although we were unable to use GCEA results directly to set policy, we learnt important policy lessons which we outline here that might help inform other countries looking to inform service coverage decisions. Additionally, the entire process and GCEA visualizations helped high-level policymakers in the health sector, who have traditionally relied on ad hoc decision making, to realize the need for a systematic and transparent priority-setting process that can continuously provide the evidence needed to inform service coverage decisions.

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.

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

Occupational health management: an audit tool.

Science.gov (United States)

Shelmerdine, L; Williams, N

2003-03-01

Organizations must manage occupational health risks in the workplace and the UK Health & Safety Executive (HSE) has published guidance on successful health and safety management. This paper describes a method of using the published guidance to audit the management of occupational health and safety, first at an organizational level and, secondly, to audit an occupational health service provider's role in the management of health risks. The paper outlines the legal framework in the UK for health risk management and describes the development and use of a tool for qualitative auditing of the efficiency, effectiveness and reliability of occupational health service provision within an organization. The audit tool is presented as a question set and the paper concludes with discussion of the strengths and weaknesses of using this tool, and recommendations on its use.

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.

A Survey of Job Satisfaction among Health Sector Staff of Tabriz Taleghani Educational Hospital

Directory of Open Access Journals (Sweden)

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.

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

Experiences with primary healthcare in Fuzhou, urban China, in the context of health sector reform: a mixed methods study.

Science.gov (United States)

McCollum, Rosalind; Chen, Lieping; ChenXiang, Tang; Liu, Xiaoyun; Starfield, Barbara; Jinhuan, Zheng; Tolhurst, Rachel

2014-01-01

China has recently placed increased emphasis on the provision of primary healthcare services through health sector reform, in response to inequitably distributed health services. With increasing funding for community level facilities, now is an opportune time to assess the quality of primary care delivery and identify areas in need of further improvement. A mixed methodology approach was adopted for this study. Quantitative data were collected using the Primary Care Assessment Tool-Chinese version (C-PCAT), a questionnaire previously adapted for use in China to assess the quality of care at each health facility, based on clients' experiences. In addition, qualitative data were gathered through eight semi-structured interviews exploring perceptions of primary care with health directors and a policy maker to place this issue in the context of health sector reform. The study found that patients attending community health and sub-community health centres are more likely to report better experiences with primary care attributes than patients attending hospital facilities. Generally low scores for community orientation, family centredness and coordination in all types of health facility indicate an urgent need for improvement in these areas. Healthcare directors and policy makers perceived the need for greater coordination between levels of health providers, better financial reimbursement, more formal government contracts and recognition/higher status for staff at the community level and more appropriate undergraduate and postgraduate training. Copyright © 2013 John Wiley & Sons, Ltd.

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

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

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.

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.

Cognitive ergonomics: the use of mind mapping tool in maintaining productive sector of a Brazilian paper company.

Science.gov (United States)

Mattos, Diego; Mateus, José Roberto; Merino, Eugenio

2012-01-01

The use of mind maps as a method of building knowledge, planning, organizing activities and ideas can be seen in the literature related to ergonomics. The results of such use are relevant and its use in academic area found. However, regarding to its use in industrial environments, studies can't not be found. With this scenario, and based on the perception of the ergonomist about the importance of using methods such as mind maps in support of human cognition, it seems pertinent to its use in industry sectors whose cognitive demand requires. Given these assumptions, this study aimed to apply the method of Mind Maps in Productive Maintenance sector of a Brazilian paper. The Productive Maintenance sector in the Paper Industry has an important contribution to operational performance. With practical Predictive Maintenance, Preventive Maintenance and Corrective Maintenance, the industry advocates to make the machines to produce paper is not to stop producing when they are programmed to do so. Among the practices cited, the Preventive Maintenance is one that leads to pre-determined intervals in order to reduce the possibility of placing the equipment in a condition below the required level of acceptance. Therefore, this article aims to propose using the tool "mental maps" in order to collaborate in planning and implementation of preventive maintenance activities in the sector of mechanical maintenance of a pulp and paper industry in southern Brazil. The study investigated the maintenance sector through its employees, who went through training about the tool and then use it and ergonomists company.

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.

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

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.

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...

National transparency assessment of Kuwait's pharmaceutical sector.

Science.gov (United States)

Badawi, Dalia A; Alkhamis, Yousif; Qaddoumi, Mohammad; Behbehani, Kazem

2015-09-01

Corruption is one of several factors that may hinder the access to pharmaceuticals. Since Kuwait has the highest per-capita spending on pharmaceuticals in the region, we wanted to evaluate the level of transparency in its pharmaceutical sector using an established assessment tool adapted by the World Health Organization. Standardized questionnaires were conducted via semi-structured interviews with key informants to measure the level of transparency in eight functions of the public pharmaceutical sector. The scores for the degree of vulnerability to corruption reflected marginal to moderate venerability to corruption for most pharmaceutical sectors. The perceived strengths included availability of appropriate laws, the presence of clear standard operating procedures, and the use of an efficient registration/distribution system. Weaknesses included lack of conflict of interest guidelines and written terms of reference, absence of pharmacoeconomic studies, and inconsistencies in law enforcement. Findings reveal that few functions of Kuwait pharmaceutical sector remain fairly vulnerable to corruption. However, the willingness of Kuwait Ministry of Health to adopt the assessment study and the acknowledgement of the weaknesses of current processes of the pharmaceutical sector may assist to achieve a transparent pharmaceutical system in the near future. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

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.

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.

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

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.

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.

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

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

Health and wellness trends in the oil and gas sector : insights from the Shepell-fgi Research Group

Energy Technology Data Exchange (ETDEWEB)

NONE

2009-07-01

This report discussed health and wellness trends in the oil and gas sector in relation to employee assistance program (EAP) data. The data were derived from oil and gas client organizations across Canada for 2008, and represented a population base of 14,685 employees. The data demonstrated that EAP utilization in the petroleum industry increased by approximately 5 per cent from 2006 to 2008. The sector's utilization was 34 per cent higher than the Canadian norm in 2006, and 40 per cent higher than in 2007 and 2008. Females used the EAP to a greater extent than males. A higher proportion of the spouses of workers accessed EAP than the national norm. Employees accessed EAP for assistance with work-life issues; family support services; and substance abuse interventions. Weight management and dietary consultations in relation to disease control were also of concern within the sector. A 66 per cent increase in childcare issues was noted, as well as a 148 per cent increase in eldercare issues, and a 112 per cent increase in addiction issues. The findings indicated that the EAP is being effectively communicated as a relevant and accessible tool. As the industry continues to develop in remote regions, new services and resources will be required to retain existing workforces and attract new employees. Prevention-focused training and services and program for at-risk groups are needed to ensure that employee health and productivity is maintained. 1 tab., 4 figs.

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

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

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.

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

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.

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.

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

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.

Using key performance indicators as knowledge-management tools at a regional health-care authority level.

Science.gov (United States)

Berler, Alexander; Pavlopoulos, Sotiris; Koutsouris, Dimitris

2005-06-01

The advantages of the introduction of information and communication technologies in the complex health-care sector are already well-known and well-stated in the past. It is, nevertheless, paradoxical that although the medical community has embraced with satisfaction most of the technological discoveries allowing the improvement in patient care, this has not happened when talking about health-care informatics. Taking the above issue of concern, our work proposes an information model for knowledge management (KM) based upon the use of key performance indicators (KPIs) in health-care systems. Based upon the use of the balanced scorecard (BSC) framework (Kaplan/Norton) and quality assurance techniques in health care (Donabedian), this paper is proposing a patient journey centered approach that drives information flow at all levels of the day-to-day process of delivering effective and managed care, toward information assessment and knowledge discovery. In order to persuade health-care decision-makers to assess the added value of KM tools, those should be used to propose new performance measurement and performance management techniques at all levels of a health-care system. The proposed KPIs are forming a complete set of metrics that enable the performance management of a regional health-care system. In addition, the performance framework established is technically applied by the use of state-of-the-art KM tools such as data warehouses and business intelligence information systems. In that sense, the proposed infrastructure is, technologically speaking, an important KM tool that enables knowledge sharing amongst various health-care stakeholders and between different health-care groups. The use of BSC is an enabling framework toward a KM strategy in health care.

[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.

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.

New Technologies to Assist Training in Hospitality Sector

Science.gov (United States)

Balta, Sabah

2007-01-01

Hospitality sector needs new technological training tools, which can assist to improve sector employees' skills and services quality. The sector might be more interactive when these technological training tools used on the job-training program. This study addresses to issue of illumination of new technologic tools that enforce training in which…

Assessing health impacts in complex eco-epidemiological settings in the humid tropics: Advancing tools and methods

International Nuclear Information System (INIS)

Winkler, Mirko S.; Divall, Mark J.; Krieger, Gary R.; Balge, Marci Z.; Singer, Burton H.; Utzinger, Juerg

2010-01-01

In the developing world, large-scale projects in the extractive industry and natural resources sectors are often controversial and associated with long-term adverse health consequences to local communities. In many industrialised countries, health impact assessment (HIA) has been institutionalized for the mitigation of anticipated negative health effects while enhancing the benefits of projects, programmes and policies. However, in developing country settings, relatively few HIAs have been performed. Hence, more HIAs with a focus on low- and middle-income countries are needed to advance and refine tools and methods for impact assessment and subsequent mitigation measures. We present a promising HIA approach, developed within the frame of a large gold-mining project in the Democratic Republic of the Congo. The articulation of environmental health areas, the spatial delineation of potentially affected communities and the use of a diversity of sources to obtain quality baseline health data are utilized for risk profiling. We demonstrate how these tools and data are fed into a risk analysis matrix, which facilitates ranking of potential health impacts for subsequent prioritization of mitigation strategies. The outcomes encapsulate a multitude of environmental and health determinants in a systematic manner, and will assist decision-makers in the development of mitigation measures that minimize potential adverse health effects and enhance positive ones.

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

Science.gov (United States)

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.

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.

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.

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...

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.

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.

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.

Design of the ITER tokamak assembly tools

Energy Technology Data Exchange (ETDEWEB)

Park, Hyunki [National Fusion Research Institute, 52 Eoeun-Dong, Yuseong-Gu, Daejon 305-333 (Korea, Republic of)], E-mail: hkpark@nfri.re.kr; Lee, Jaehyuk; Kim, Taehyung [SFA Engineering Corp., 42-7 Palyong-dong, Changwon-si, Gyeongsangnam-do 641-847 (Korea, Republic of); Song, Yunju [National Fusion Research Institute, 52 Eoeun-Dong, Yuseong-Gu, Daejon 305-333 (Korea, Republic of); Im, Kihak [ITER Organization, CEA Cadarasche, 13108 Saint Paul-lez-Durance (France); Kim, Byungchul; Lee, Hyeongon; Jung, Ki-Jung [National Fusion Research Institute, 52 Eoeun-Dong, Yuseong-Gu, Daejon 305-333 (Korea, Republic of)

2008-12-15

ITER tokamak assembly is mainly composed of lower cryostat activities, sector sub-assembly, sector assembly, in-vessel activities and ex-vessel activities. The main tools for sector sub-assembly procedures consists of upending tool, sector lifting tool, vacuum vessel support and bracing tool and sector sub-assembly tool. Conceptual design of assembly tools for sector sub-assembly procedures is described herein. The basic structure for upending tool has been developed under the assumption that upending is performed with crane which will be installed in Tokamak building. Sector lifting tool is designed to adjust the position of a sector to minimize the difference between the center of the tokamak building crane and the center of gravity of the sector. Sector sub-assembly tool is composed of special frame for the fine adjustment of position control with 6 degrees of freedom. The design of VV support and bracing tool for four kinds of VV 40 deg. sectors has been developed. Also, structural analysis for upending tool, sector sub-assembly tool has been studied using ANSYS for the situation of an applied load with the same dead weight multiplied by 3/4. The results of structural analyses for these tools were below the allowable values.

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.

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.

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.

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

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

Revisiting Public Health Challenges in the New Millennium | Anish ...

African Journals Online (AJOL)

Positive Health of the communities could only be brought out through the interrelationship between conventional health sector and other development sectors. It was a dream that came true when World Health Organization (WHO) accepted Primary Health Care (PHC) as the major tool to achieve its proposed goal of Health ...

Study on the impact of air quality in agricultural and health sectors

Science.gov (United States)

Chairani, S.

2018-03-01

This study focused on the impact of air quality in agricultural and health sectors. The impact of CO2 on the agricultural crops was conducted by using literature review and the impact of air quality was conducted using secondary data to calculate the Air Quality Index (AQI), derived from some monitoring stations available in Indonesia. Numerous studies showed that the elevated CO2 decreased the agricultural productivity. Maize yields decreased by 15 % in areas which used irrigation system and 8 % in areas which used rainfed. Maize yields had already experienced severe losses without increasing CO2 concentrations. It decreased by 21 % for irrigated maize and 26 % by rainfed maize. In addition, it turned out that other elevated pollutants, such as SO2, NO2, SPM, O3, CH4, PM2.5, PM10 and TSP also occurred in the atmosphere. These pollutants’ effects might harm human being in term of health concern. The USEPA had developed a tool, called the Air Quality Index (AQI) calculator to calculate the pollutants’ concentrations in a daily basis. This tool’s function to inform how clean or polluted the air that we breathed was with the health effects based on the concentrations of each pollutant. The AQI also provided the information on sensitive groups, health effects and cautionary statements. Based on the air daily data which derived from Board of Meteorology, Climatology and Geophysics (BMKG) of Indonesia, the AQI in Indonesia varied from good, moderate to unhealthy categories; with level of health concern was respiratory diseases, such as asthma.

Effect of a nine-month web- and app-based workplace intervention to promote healthy lifestyle and weight loss for employees in the social welfare and health care sector

DEFF Research Database (Denmark)

Balk-Møller, Nina Charlotte; Poulsen, Sanne Kellebjerg; Larsen, Thomas Meinert

2017-01-01

Su-life") on employees in the social welfare and health care sector in Denmark. METHODS: A randomized controlled trial was carried out as a workplace intervention. The tool was designed to help users make healthy lifestyle changes such as losing weight, exercise more, and quit smoking. A team competition between...

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.

Design of the ITER Tokamak Assembly Tools

International Nuclear Information System (INIS)

Park, Hyunki; Her, Namil; Kim, Byungchul; Im, Kihak; Jung, Kijung; Lee, Jaehyuk; Im, Kisuk

2006-01-01

ITER (International Thermonuclear Experimental Reactor) Procurement allocation among the seven Parties, EU, JA, CN, IN , KO, RF and US had been decided in Dec. 2005. ITER Tokamak assembly tools is one of the nine components allocated to Korea for the construction of the ITER. Assembly tools except measurement and common tools are supplied to assemble the ITER Tokamak and classified into 9 groups according to components to be assembled. Among the 9 groups of assembly tools, large-sized Sector Sub-assembly Tools and Sector Assembly Tools are used at the first stage of ITER Tokamak construction and need to be designed faster than seven other assembly tools. ITER IT (International Team) proposed Korea to accomplish ITA (ITER Transitional Arrangements) Task on detailed design, manufacturing feasibility and contract specification of specific, large sized tools such as Upending Tool, Lifting Tool, Sector Sub-assembly Tool and Sector Assembly Tool in Oct. 2004. Based on the concept design by ITER IT, Korea carried out ITA Task on detailed design of large-sized and specific Sector Sub-assembly and Sector Assembly Tools until Mar. 2006. The Sector Sub-assembly Tools mainly consist of the Upending, Lifting, Vacuum Vessel Support and Bracing, and Sector Sub-assembly Tool, among which the design of three tools are herein. The Sector Assembly Tools mainly consist of the Toroidal Field (TF) Gravity Support Assembly, Sector In-pit Assembly, TF Coil Assembly, Vacuum Vessel (VV) Welding and Vacuum Vessel Thermal Shield (TS) Assembly Tool, among which the design of Sector In-pit Assembly Tool is described herein

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

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.

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.

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

Research, development and innovation in the electrical energy sector of Brazil: toward a tool for the support of the decision-making process

Energy Technology Data Exchange (ETDEWEB)

Machado, Fernando Vieira; Salles-Filho, Sergio; Brittes, Jose Juiz Pereira; Corder, Solange Maria; Boer, Denile Cominato [Universidade Estadual de Campinas (UNICAMP), SP (Brazil)

2008-07-01

The objective of this article is to present a tool to help in the decision making process for the allocation of resources for research, development and innovation in the electrical energy sector in Brazil. It provides a computerized tool for the management of a portfolio of projects which contains myriads of information of projects of research, development, and innovation financed by companies in the area of the generation, transmission and distribution of electrical energy in Brazil. This tool permits the collection and analysis of this information with a view to evaluating the direction and progress of investments made in the past five years. The electrical energy sector of Brazil invests hundreds of millions of reals each year in research and development (henceforth 'R and D'). The investment of these resources is required by a set of federal laws. This legal framework is a consequence of the process of the privatization of the sector which began in 1997. The investment of the financial resources in R and D projects is supervised by the Brazilian Electricity Regulatory Agency (henceforth 'ANEEL'). It is the responsibility of ANEEL to evaluate and approve proposed R and D projects, and monitor their results, as per the 'Handbook of R and D of the Electrical Energy Sector.' This tool for supporting the decision-making process serves exactly the purpose of helping both ANEEL in the approval of resources under its supervision, as well as helping companies within the electrical energy sector in the management of applied resources. Almost one billion reals (approximately US $500,000,000) were invested in more than 3000 projects from 1998 to 2006. The data base associated with these projects already contains information concerning 1412 projects from 1998 to 2004, permitting significant analyses of the results and impacts of the allocation of resources. (author)

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...

Regional health workforce monitoring as governance innovation: a German model to coordinate sectoral demand, skill mix and mobility.

Science.gov (United States)

Kuhlmann, E; Lauxen, O; Larsen, C

2016-11-28

As health workforce policy is gaining momentum, data sources and monitoring systems have significantly improved in the European Union and internationally. Yet data remain poorly connected to policy-making and implementation and often do not adequately support integrated approaches. This brings the importance of governance and the need for innovation into play. The present case study introduces a regional health workforce monitor in the German Federal State of Rhineland-Palatinate and seeks to explore the capacity of monitoring to innovate health workforce governance. The monitor applies an approach from the European Network on Regional Labour Market Monitoring to the health workforce. The novel aspect of this model is an integrated, procedural approach that promotes a 'learning system' of governance based on three interconnected pillars: mixed methods and bottom-up data collection, strong stakeholder involvement with complex communication tools and shared decision- and policy-making. Selected empirical examples illustrate the approach and the tools focusing on two aspects: the connection between sectoral, occupational and mobility data to analyse skill/qualification mixes and the supply-demand matches and the connection between monitoring and stakeholder-driven policy. Regional health workforce monitoring can promote effective governance in high-income countries like Germany with overall high density of health workers but maldistribution of staff and skills. The regional stakeholder networks are cost-effective and easily accessible and might therefore be appealing also to low- and middle-income countries.

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 ...

Health care marketing: Basic features

OpenAIRE

Gajić-Stevanović Milena

2006-01-01

Paper discuss an introduction to importance's as well as challenges facing health care sector in many countries. Particular attention is devoted to the preconditions and/or basic requirements have to be developed in order to make health sector to functioned. Focusing to end users as well as employing marketing tools ought to be right orientation.

Multi-Sector Sustainability Browser (MSSB) User Manual: A ...

Science.gov (United States)

EPA’s Sustainable and Healthy Communities (SHC) Research Program is developing methodologies, resources, and tools to assist community members and local decision makers in implementing policy choices that facilitate sustainable approaches in managing their resources affecting the built environment, natural environment, and human health. In order to assist communities and decision makers in implementing sustainable practices, EPA is developing computer-based systems including models, databases, web tools, and web browsers to help communities decide upon approaches that support their desired outcomes. Communities need access to resources that will allow them to achieve their sustainability objectives through intelligent decisions in four key sustainability areas: • Land Use • Buildings and Infrastructure • Transportation • Materials Management (i.e., Municipal Solid Waste [MSW] processing and disposal) The Multi-Sector Sustainability Browser (MSSB) is designed to support sustainable decision-making for communities, local and regional planners, and policy and decision makers. Document is an EPA Technical Report, which is the user manual for the Multi-Sector Sustainability Browser (MSSB) tool. The purpose of the document is to provide basic guidance on use of the tool for users

Extending coverage to informal sector populations in Kenya: design preferences and implications for financing policy.

Science.gov (United States)

Okungu, Vincent; Chuma, Jane; Mulupi, Stephen; McIntyre, Diane

2018-01-09

Universal health coverage (UHC) is important in terms of improving access to quality health care while protecting households from the risk of catastrophic health spending and impoverishment. However, progress to UHC has been hampered by the measures to increase mandatory prepaid funds especially in low- and middle-income countries where there are large populations in the informal sector. Important considerations in expanding coverage to the informal sector should include an exploration of the type of prepayment system that is acceptable to the informal sector and the features of such a design that would encourage prepayment for health care among this population group. The objective of the study was to document the views of informal sector workers regarding different prepayment mechanisms, and critically analyze key design features of a future health system and the policy implications of financing UHC in Kenya. This was part of larger study which involved a mixed-methods approach. The following tools were used to collect data from informal sector workers: focus group discussions [N = 16 (rural = 7; urban = 9)], individual in-depth interviews [N = 26 (rural = 14; urban = 12)] and a questionnaire survey [N = 455(rural = 129; urban = 326)]. Thematic approach was used to analyze qualitative data while Stata v.11 involving mainly descriptive analysis was used in quantitative data. The tools mentioned were used to collect data to meet various objectives of a larger study and what is presented here constitutes a small section of the data generated by these tools. The findings show that informal sector workers in rural and urban areas prefer different prepayment systems for financing UHC. Preference for a non-contributory system of financing UHC was particularly strong in the urban study site (58%). Over 70% in the rural area preferred a contributory mechanism in financing UHC. The main concern for informal sector workers regardless of

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

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

Health impact assessment in planning: Development of the design for health HIA tools

International Nuclear Information System (INIS)

Forsyth, Ann; Slotterback, Carissa Schively; Krizek, Kevin J.

2010-01-01

How can planners more systematically incorporate health concerns into practical planning processes? This paper describes a suite of health impact assessment tools (HIAs) developed specifically for planning practice. Taking an evidence-based approach the tools are designed to fit into existing planning activities. The tools include: a short audit tool, the Preliminary Checklist; a structured participatory workshop, the Rapid HIA; an intermediate health impact assessment, the Threshold Analysis; and a set of Plan Review Checklists. This description provides a basis for future work including assessing tool validity, refining specific tools, and creating alternatives.

What is the private sector? Understanding private provision in the health systems of low-income and middle-income countries.

Science.gov (United States)

Mackintosh, Maureen; Channon, Amos; Karan, Anup; Selvaraj, Sakthivel; Cavagnero, Eleonora; Zhao, Hongwen

2016-08-06

Private health care in low-income and middle-income countries is very extensive and very heterogeneous, ranging from itinerant medicine sellers, through millions of independent practitioners-both unlicensed and licensed-to corporate hospital chains and large private insurers. Policies for universal health coverage (UHC) must address this complex private sector. However, no agreed measures exist to assess the scale and scope of the private health sector in these countries, and policy makers tasked with managing and regulating mixed health systems struggle to identify the key features of their private sectors. In this report, we propose a set of metrics, drawn from existing data that can form a starting point for policy makers to identify the structure and dynamics of private provision in their particular mixed health systems; that is, to identify the consequences of specific structures, the drivers of change, and levers available to improve efficiency and outcomes. The central message is that private sectors cannot be understood except within their context of mixed health systems since private and public sectors interact. We develop an illustrative and partial country typology, using the metrics and other country information, to illustrate how the scale and operation of the public sector can shape the private sector's structure and behaviour, and vice versa. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

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

Directory of Open Access Journals (Sweden)

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.

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

Contribution analysis as an evaluation strategy in the context of a sector-wide approach: Performance-based health financing in Rwanda

Directory of Open Access Journals (Sweden)

Martin Noltze

2014-12-01

Full Text Available Sector-wide approaches (SWAps emerged as a response to donor fragmentation and non-adjusted and parallel programming. In the health sector, SWAps have received considerable support by the international donor community due to their potential to reduce inefficiencies through alignment to common procedures and hence to increase development effectiveness. Evaluating development cooperation in the context of a SWAp, however, translates into methodological challenges for evaluators who have to disentangle the cumulative effects in strongly donor-aligned, complex sector environments. In this article the authors discussed the application of a methodological strategy for evaluating development interventions in complex settings – for example in the context of a SWAp –and reflected the suitability of the approach. The authors conducted a contribution analysis, a theory-based approach to evaluation, and exemplified the approach for an intervention of performance-based financing for Rwandan health workers supported by the Rwanda-German cooperation. The findings suggested that the Rwandan system of performance based financing increased service orientation and outputs of health professionals, but also indicated that negative motivational side effects and resource constraints are real. With regard to the methodological approach, the authors conclude that contribution analysis has a high potential to evaluate development cooperation in the context of a SWAp dueto its high flexibility to use different data collection tools and its capability to assess risks and rival explanations. Challenges can be identified with regard to the efficiency of the evaluation strategy and a remaining trade-off between scope and causal strength ofevidence.

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.

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.

The use and design of the BSC in the health care sector: A systematic literature review for Italy, Spain, and Portugal.

Science.gov (United States)

Gonzalez-Sanchez, Maria Beatriz; Broccardo, Laura; Martins Pires, Amélia Maria

2018-01-01

The aim of this paper is to gain a better understanding of how the balanced scorecard (BSC) has evolved in Spain, Italy, and Portugal. It reviews all the articles on the BSC in the health care sector written between 1992 and 2015 by Spanish, Italian, or Portuguese authors and published in Spanish, Italian, or Portuguese as well as in English. Our study first shows the state of knowledge on BSC in health care for a homogeneous group of Southern European countries. Second, it uncovers the perspectives, indicators, and generation used in the countries under observation to reveal the extent to which this management tool has evolved. Third, it analyses international variations in design and use within the health care context, especially in the United States. Moreover, it also highlights a number of important issues. The BSC is in its early stage of development in these 3 countries, which do not use it as a tool to implement strategy and align all of the elements that help integrate the organization. Copyright © 2017 John Wiley & Sons, Ltd.

Multi-sectoral action for child safety-a European study exploring implicated sectors.

Science.gov (United States)

Scholtes, Beatrice; Schröder-Bäck, Peter; Förster, Katharina; MacKay, Morag; Vincenten, Joanne; Brand, Helmut

2017-06-01

Injury to children in Europe, resulting in both death and disability, constitutes a significant burden on individuals, families and society. Inequalities between high and low-income countries are growing. The World Health Organisation Health 2020 strategy calls for inter-sectoral collaboration to address injury in Europe and advocates the whole of government and whole of society approaches to wicked problems. In this study we explore which sectors (e.g. health, transport, education) are relevant for four domains of child safety (intentional injury, water, road and home safety). We used the organigraph methodology, originally developed to demonstrate how organizations work, to describe the governance of child safety interventions. Members of the European Child Safety Alliance, working in the field of child safety in 24 European countries, drew organigraphs of evidence-based interventions. They included the different actors involved and the processes between them. We analyzed the organigraphs by counting the actors presented and categorizing them into sectors using a pre-defined analysis framework. We received 44 organigraphs from participants in 24 countries. Twenty-seven sectors were identified across the four domains. Nine of the 27 identified sectors were classified as 'core sectors' (education, health, home affairs, justice, media, recreation, research, social/welfare services and consumers). This study reveals the multi-sectoral nature of child safety in practice. It provides information for stakeholders working in child safety to help them implement inter-sectoral child safety interventions taking a whole-of-government and whole-of-society approach to health governance. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

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 share"). I evaluate the relative contributions of health care effort, public sector share, and GDP to the large and growing disadvantage in U.S. life expectancy at birth relative to peer nations. I do so using fixed effects models with data from 16 wealthy democratic nations between 1960 and 2010. Results indicate that public sector share has a beneficial effect on longevity net of the effect of health care effort and that this effect is nonlinear, decreasing in magnitude as levels rise. Moreover, public sector share is a more powerful predictor of life expectancy at birth than GDP per capita. This study contributes to discussions around the political economy of health, the growth consensus, and the American lag in life expectancy. Policy implications vis-à-vis the U.S. Affordable Care Act are discussed.

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.

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 ...

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.

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

Brazilian healthcare in the context of austerity: private sector dominant, government sector failing.

Science.gov (United States)

Costa, Nilson do Rosário

2017-04-01

This paper presents the arguments in favor of government intervention in financing and regulation of health in Brazil. It describes the organizational arrangement of the Brazilian health system, for the purpose of reflection on the austerity agenda proposed for the country. Based on the literature in health economics, it discusses the hypothesis that the health sector in Brazil functions under the dominance of the private sector. The categories employed for analysis are those of the national health spending figures. An international comparison of indicators of health expenses shows that Brazilian public spending is a low proportion of total spending on Brazilian health. Expenditure on individuals' health by out-of-pocket payments is high, and this works against equitability. The private health services sector plays a crucial role in provision, and financing. Contrary to the belief put forward by the austerity agenda, public expenditure cannot be constrained because the government has failed in adequate provision of services to the poor. This paper argues that, since the Constitution did not veto activity by the private sector segment of the market, those interests that have the greatest capacity to vocalize have been successful in imposing their preferences in the configuration of the sector.

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

Health impact assessment – A survey on quantifying tools

Energy Technology Data Exchange (ETDEWEB)

Fehr, Rainer, E-mail: rainer.fehr@uni-bielefeld.de [Fakultaet fuer Gesundheitswissenschaften, Universitaet Bielefeld, Universitaetsstr. 25, 33615 Bielefeld (Germany); Mekel, Odile C.L., E-mail: odile.mekel@lzg.nrw.de [Gesundheitsdaten und analysen, Versorgungsstrukturen, Landeszentrum Gesundheit Nordrhein-Westfalen (LZG.NRW), Westerfeldstr. 35-37, 33611 Bielefeld (Germany); Fintan Hurley, J., E-mail: fintan.hurley@iom-world.org [Institute of Occupational Medicine (IOM), Research Avenue North, Riccarton, Edinburgh EH14 4AP, Scotland (United Kingdom); Mackenbach, Johan P., E-mail: j.mackenbach@erasmusmc.nl [Department of Public Health, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam (Netherlands)

2016-02-15

Integrating human health into prospective impact assessments is known to be challenging. This is true for both approaches: dedicated health impact assessments (HIA) as well as inclusion of health into more general impact assessments. Acknowledging the full range of participatory, qualitative, and quantitative approaches, this study focuses on the latter, especially on computational tools for quantitative health modelling. We conducted a survey among tool developers concerning the status quo of development and availability of such tools; experiences made with model usage in real-life situations; and priorities for further development. Responding toolmaker groups described 17 such tools, most of them being maintained and reported as ready for use and covering a wide range of topics, including risk & protective factors, exposures, policies, and health outcomes. In recent years, existing models have been improved and were applied in new ways, and completely new models emerged. There was high agreement among respondents on the need to further develop methods for assessment of inequalities and uncertainty. The contribution of quantitative modeling to health foresight would benefit from building joint strategies of further tool development, improving the visibility of quantitative tools and methods, and engaging continuously with actual and potential users. - Highlights: • A survey investigated computational tools for health impact quantification. • Formal evaluation of such tools has been rare. • Handling inequalities and uncertainties are priority areas for further development. • Health foresight would benefit from tool developers and users forming a community. • Joint development strategies across computational tools are needed.

Health impact assessment – A survey on quantifying tools

International Nuclear Information System (INIS)

Fehr, Rainer; Mekel, Odile C.L.; Fintan Hurley, J.; Mackenbach, Johan P.

2016-01-01

Integrating human health into prospective impact assessments is known to be challenging. This is true for both approaches: dedicated health impact assessments (HIA) as well as inclusion of health into more general impact assessments. Acknowledging the full range of participatory, qualitative, and quantitative approaches, this study focuses on the latter, especially on computational tools for quantitative health modelling. We conducted a survey among tool developers concerning the status quo of development and availability of such tools; experiences made with model usage in real-life situations; and priorities for further development. Responding toolmaker groups described 17 such tools, most of them being maintained and reported as ready for use and covering a wide range of topics, including risk & protective factors, exposures, policies, and health outcomes. In recent years, existing models have been improved and were applied in new ways, and completely new models emerged. There was high agreement among respondents on the need to further develop methods for assessment of inequalities and uncertainty. The contribution of quantitative modeling to health foresight would benefit from building joint strategies of further tool development, improving the visibility of quantitative tools and methods, and engaging continuously with actual and potential users. - Highlights: • A survey investigated computational tools for health impact quantification. • Formal evaluation of such tools has been rare. • Handling inequalities and uncertainties are priority areas for further development. • Health foresight would benefit from tool developers and users forming a community. • Joint development strategies across computational tools are needed.

Health worker experiences of and movement between public and private not-for-profit sectors-findings from post-conflict Northern Uganda.

Science.gov (United States)

Namakula, Justine; Witter, Sophie; Ssengooba, Freddie

2016-05-05

Northern Uganda suffered 20 years of conflict which devastated lives and the health system. Since 2006, there has been investment in reconstruction, which includes efforts to rebuild the health workforce. This article has two objectives: first, to understand health workers' experiences of working in public and private not-for-profit (PNFP) sectors during and after the conflict in Northern Uganda, and second, to understand the factors that influenced health workers' movement between public and PNFP sectors during and after the conflict. A life history approach was used with 26 health staff purposively selected from public and PNFP facilities in four districts of Northern Uganda. Staff with at least 10 years' experience were selected, which resulted in a sample which was largely female and mid-level. Two thirds were currently employed in the public sector and just over a third in the PNFP sector. A thematic data analysis was guided by the framework analysis approach, analysis framework stages and ATLAS.ti software version 7.0. Analysis reveals that most of the current staff were trained in the PNFP sector, which appears to offer higher quality training experiences. During the conflict period, the PNFP sector also functioned more effectively and was relatively better able to support its staff. However, since the end of the conflict, the public sector has been reconstructed and is now viewed as offering a better overall package for staff. Most reported movement has been in that direction, and many in the PNFP sector state intention to move to the public sector. While there is sectoral loyalty on both sides and some bonds created through training, the PNFP sector needs to become more competitive to retain staff so as to continue delivering services to deprived communities in Northern Uganda. There has been limited previous longitudinal analysis of how health staff perceive different sectors and why they move between them, particularly in conflict-affected contexts

A web-tool to find spatially explicit climate-smart solutions for the sector agriculture

Science.gov (United States)

Verzandvoort, Simone; Kuikman, Peter; Walvoort, Dennis

2017-04-01

Europe faces the challenge to produce more food and more biomass for the bio-economy, to adapt its agricultural sector to negative consequences of climate change, and to reduce greenhouse gas emissions from agriculture. Climate-smart agriculture (CSA) solutions and technologies improve agriculture's productivity and provide economic growth and stability, increase resilience, and help to reduce GHG emissions from agricultural activities. The Climate Smart Agriculture Booster (CSAb) (http://csabooster.climate-kic.org/) is a Flagship Program under Climate-KIC, aiming to facilitate the adoption of CSA solutions and technologies in the European agro-food sector. This adoption requires spatially explicit, contextual information on farming activities and risks and opportunities related to climate change in regions across Europe. Other spatial information supporting adoption includes Information on where successful implementations were already done, on where CSA would profit from enabling policy conditions, and where markets or business opportunities for selling or purchasing technology and knowledge are located or emerging. The Spatial Solution Finder is a web-based spatial tool aiming to help agri-food companies (supply and processing), authorities or agricultural organisations find CSA solutions and technologies that fit local farmers and regions, and to demonstrate examples of successful implementations as well as expected impact at the farm and regional level. The tool is based on state of the art (geo)datasets of environmental and socio-economic conditions (partly open access, partly derived from previous research) and open source web-technology. The philosophy of the tool is that combining existing datasets with contextual information on the region of interest with personalized information entered by the user provides a suitable basis for offering a basket of options for CSA solutions and technologies. Solutions and technologies are recommended to the user based on

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.

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

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

Effectively engaging the private sector through vouchers and contracting - A case for analysing health governance and context.

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Nachtnebel, Matthias; O'Mahony, Ashleigh; Pillai, Nandini; Hort, Kris

2015-11-01

Health systems of low and middle income countries in the Asia Pacific have been described as mixed, where public and private sector operate in parallel. Gaps in the provision of primary health care (PHC) services have been picked up by the private sector and led to its growth; as can an enabling regulatory environment. The question whether governments should purchase services from the private sector to address gaps in service provision has been fiercely debated. This purposive review draws evidence from systematic reviews, and additional published and grey literature, for input into a policy brief on purchasing PHC-services from the private sector for underserved areas in the Asia Pacific region. Additional published and grey literature on vouchers and contracting as mechanisms to engage the private sector was used to supplement the conclusions from systematic reviews. We analysed the literature through a policy lens, or alternatively, a 'bottom-up' approach which incorporates components of a realist review. Evidence indicates that both vouchers and contracting can improve health service outcomes in underserved areas. These outcomes however are strongly influenced by (1) contextual factors, such as roles and functions attributable to a shared set of key actors (2) the type of delivered services and community demand (3) design of the intervention, notably provider autonomy and trust (4) governance capacity and provision of stewardship. Examining the experience of vouchers and contracting to expand health services through engagement with private sector providers in the Asia Pacific found positive effects with regards to access and utilisation of health services, but more importantly, highlighted the significance of contextual factors, appropriate selection of mechanism for services provided, and governance arrangements and stewardship capacity. In fact, for governments seeking to engage the private sector, analysis of context and capacities are potentially a more

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

Are people with epilepsy using eHealth-tools?

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Leenen, Loes A M; Wijnen, Ben F M; de Kinderen, Reina J A; van Heugten, Caroline M; Evers, Silvia M A A; Majoie, Marian H J M

2016-11-01

Self-management for people with epilepsy (PWE) should lead to shared decision-making and thus to adherence to the treatment plan. eHealth is an important way of supporting PWE in their self-management. In this survey, we used a mixed method to explore the following: 1) which factors were monitored by PWE and how (using pen and paper or eHealth-tools), 2) how many PWE own a computer or smartphone, and 3) how do they perceive the use of eHealth. A consecutive series of 1000 PWE attending the outpatient clinic of a tertiary epilepsy center were asked to fill in a questionnaire. In comparison with the general population, fewer PWE owned a computer or smartphone. They were, however, more likely to self-monitor their health than other patients suffering from a chronic condition. Although PWE did not use eHealth-tools often, they perceived it as a user-friendly tool, promoting health behavior as well as adherence. On the other hand, problems with privacy and the perception that not everyone is able to use eHealth were considered as disadvantages by PWE. Promoting self-care was perceived as both an advantage and a disadvantage. It was seen as an advantage when PWE mentioned the option of eHealth-tools in order to gain insight into one's epilepsy. At the same time, it was seen as a disadvantage because it confronts PWE with their disease, which causes emotional stress. The high level of self-monitoring combined with a low usage of eHealth-tools seems to indicate that there is a need for a more tailored approach to stimulate the use of eHealth-tools by PWE. Further research should focus on this aspect, e.g., what PWE need in order to make more use of eHealth-tools in their self-care. Copyright © 2016 Elsevier Inc. All rights reserved.

Are patient surveys valuable as a service-improvement tool in health services? An overview

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Patwardhan A

2012-05-01

Full Text Available Anjali Patwardhan,1 Charles H Spencer21Nationwide Children’s Hospital Columbus, 2Ohio State University, Columbus, OH, USAAbstract: Improving the quality of care in international health services was made a high priority in 1977. The World Health Assembly passed a resolution to greatly improve “Health for all” by the year 2000. Since 1977, the use of patient surveys for quality improvement has become a common practice in the health-care industry. The use of surveys reflects the concept that patient satisfaction is closely linked with that of organizational performance, which is in turn closely linked with organizational culture. This article is a review of the role of patient surveys as a quality-improvement tool in health care. The article explores the characteristics, types, merits, and pitfalls of various patient surveys, as well as the impact of their wide-ranging application in dissimilar scenarios to identify gaps in service provision. It is demonstrated that the conducting of patient surveys and using the results to improve the quality of care are two different processes. The value of patient surveys depends on the interplay between these two processes and several other factors that can influence the final outcome. The article also discusses the business aspect of the patient surveys in detail. Finally, the authors make future recommendations on how the patient survey tool can be best used to improve the quality of care in the health-care sector.Keywords: patient surveys, quality improvement, service gaps 

‘Feedback: Where data finally get thrilling’ – tools for facility managers to use data for improved health outcomes in the prevention of mother-to-child transmission of HIV and antiretroviral therapy

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J Murphy

2013-09-01

Full Text Available Data use and data quality continue to be a challenge for government sector health facilities and districts across South Africa. Led by the National Department of Health, key stakeholders, such as the Anova Health Institute and district health management teams, are aligning efforts to address these gaps. Coverage and correct implementation of existing tools – including TIER.net, routine data collection forms and the South African District Health Information System – must be ensured. This conference report provides an overview of such tools and summarises suggestions for quality improvement, data use and systematic evaluation of data-related interventions.

The contribution of health selection to occupational status inequality in Germany - differences by gender and between the public and private sectors.

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Kröger, H

2016-04-01

Estimating the size of health inequalities between hierarchical levels of job status and the contribution of direct health selection to these inequalities for men and women in the private and public sector in Germany. The study uses prospective data from the Socio-Economic Panel study on 11,788 women and 11,494 men working in the public and private sector in Germany. Direct selection effects of self-rated health on job status are estimated using fixed-effects linear probability models. The contribution of health selection to overall health-related inequalities between high and low status jobs is calculated. Women in the private sector who report very good health have a 1.9 [95% CI: 0.275; 3.507] percentage point higher probability of securing a high status job than women in poor self-rated health. This direct selection effect constitutes 20.12% of total health inequalities between women in high and low status jobs. For men in the private and men and women in the public sector no relevant health selection effects were identified. The contribution of health selection to total health inequalities between high and low status jobs varies with gender and public versus private sector. Women in the private sector in Germany experience the strongest health selection. Possible explanations are general occupational disadvantages that women have to overcome to secure high status jobs. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

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 ...

[The Unified National Health System and the third sector: Characterization of non-hospital facilities providing basic health care services in Belo Horizonte, Minas Gerais, Brazil].

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Canabrava, Claudia Marques; Andrade, Eli Iôla Gurgel; Janones, Fúlvio Alves; Alves, Thiago Andrade; Cherchiglia, Mariangela Leal

2007-01-01

In Brazil, nonprofit or charitable organizations are the oldest and most traditional and institutionalized form of relationship between the third sector and the state. Despite the historical importance of charitable hospital care, little research has been done on the participation of the nonprofit sector in basic health care in the country. This article identifies and describes non-hospital nonprofit facilities providing systematically organized basic health care in Belo Horizonte, Minas Gerais, Brazil, in 2004. The research focused on the facilities registered with the National Council on Social Work, using computer-assisted telephone and semi-structured interviews. Identification and description of these organizations showed that the charitable segment of the third sector conducts organized and systematic basic health care services but is not recognized by the Unified National Health System as a potential partner, even though it receives referrals from basic government services. The study showed spatial and temporal overlapping of government and third-sector services in the same target population.

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

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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.

Countdown to 2015 country case studies: systematic tools to address the "black box" of health systems and policy assessment.

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Singh, Neha S; Huicho, Luis; Afnan-Holmes, Hoviyeh; John, Theopista; Moran, Allisyn C; Colbourn, Tim; Grundy, Chris; Matthews, Zoe; Maliqi, Blerta; Mathai, Matthews; Daelmans, Bernadette; Requejo, Jennifer; Lawn, Joy E

2016-09-12

Evaluating health systems and policy (HSP) change and implementation is critical in understanding reproductive, maternal, newborn and child health (RMNCH) progress within and across countries. Whilst data for health outcomes, coverage and equity have advanced in the last decade, comparable analyses of HSP changes are lacking. We present a set of novel tools developed by Countdown to 2015 (Countdown) to systematically analyse and describe HSP change for RMNCH indicators, enabling multi-country comparisons. International experts worked with eight country teams to develop HSP tools via mixed methods. These tools assess RMNCH change over time (e.g. 1990-2015) and include: (i) Policy and Programme Timeline Tool (depicting change according to level of policy); (ii) Health Policy Tracer Indicators Dashboard (showing 11 selected RMNCH policies over time); (iii) Health Systems Tracer Indicators Dashboard (showing four selected systems indicators over time); and (iv) Programme implementation assessment. To illustrate these tools, we present results from Tanzania and Peru, two of eight Countdown case studies. The Policy and Programme Timeline tool shows that Tanzania's RMNCH environment is complex, with increased funding and programmes for child survival, particularly primary-care implementation. Maternal health was prioritised since mid-1990s, yet with variable programme implementation, mainly targeting facilities. Newborn health only received attention since 2005, yet is rapidly scaling-up interventions at facility- and community-levels. Reproductive health lost momentum, with re-investment since 2010. Contrastingly, Peru moved from standalone to integrated RMNCH programme implementation, combined with multi-sectoral, anti-poverty strategies. The HSP Tracer Indicators Dashboards show that Peru has adopted nine of 11 policy tracer indicators and Tanzania has adopted seven. Peru costed national RMNCH plans pre-2000, whereas Tanzania developed a national RMNCH plan in 2006 but

The size, characteristics and partnership networks of the health-related non-profit sector in three regions of South Africa: implications of changing primary health care policy for community-based care.

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van Pletzen, Ermien; Zulliger, R; Moshabela, M; Schneider, H

2014-09-01

Health-related community-based care in South Africa is mostly provided through non-profit organizations (NPOs), but little is known about the sector. In the light of emerging government policy on greater formalization of community-based care in South Africa, this article assesses the size, characteristics and partnership networks of health-related NPOs in three South African communities and explores implications of changing primary health care policy for this sector. Data were collected (2009-11) from three sites: Khayelitsha (urban), Botshabelo (semi-rural) and Bushbuckridge (semi/deep rural). Separate data sources were used to identify all health-related NPOs in the sites. Key characteristics of identified NPOs were gathered using a standardized tool. A typology of NPOs was developed combining level of resources (well, moderate, poor) and orientation of activities ('Direct service', 'Developmental' and/or 'Activist'). Network analysis was performed to establish degree and density of partnerships among NPOs. The 138 NPOs (n = 56 in Khayelitsha, n = 47 in Bushbuckridge; n = 35 in Botshabelo) were mostly local community-based organizations (CBOs). The main NPO orientation was 'Direct service' (n = 120, 87%). Well- and moderately resourced NPOs were successful at combining orientations. Most organizations with an 'Activist' orientation were urban. No poorly resourced organizations had this orientation. Well-resourced organizations with an 'Activist' orientation were highly connected in Khayelitsha NPO networks, while poorly resourced CBOs were marginalized. A contrasting picture emerged in Botshabelo where CBOs were highly connected. Networks in Bushbuckridge were fragmented and linear. The NPO sector varies geographically in numbers, resources, orientation of activities and partnership networks. NPOs may perform important developmental roles and strong potential for social capital may reside in organizational networks operating in otherwise impoverished environments

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

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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.

Health worker motivation in Africa: the role of non-financial incentives and human resource management tools

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Imhoff Ingo

2006-08-01

Full Text Available Abstract Background There is a serious human resource crisis in the health sector in developing countries, particularly in Africa. One of the challenges is the low motivation of health workers. Experience and the evidence suggest that any comprehensive strategy to maximize health worker motivation in a developing country context has to involve a mix of financial and non-financial incentives. This study assesses the role of non-financial incentives for motivation in two cases, in Benin and Kenya. Methods The study design entailed semi-structured qualitative interviews with doctors and nurses from public, private and NGO facilities in rural areas. The selection of health professionals was the result of a layered sampling process. In Benin 62 interviews with health professionals were carried out; in Kenya 37 were obtained. Results from individual interviews were backed up with information from focus group discussions. For further contextual information, interviews with civil servants in the Ministry of Health and at the district level were carried out. The interview material was coded and quantitative data was analysed with SPSS software. Results and discussion The study shows that health workers overall are strongly guided by their professional conscience and similar aspects related to professional ethos. In fact, many health workers are demotivated and frustrated precisely because they are unable to satisfy their professional conscience and impeded in pursuing their vocation due to lack of means and supplies and due to inadequate or inappropriately applied human resources management (HRM tools. The paper also indicates that even some HRM tools that are applied may adversely affect the motivation of health workers. Conclusion The findings confirm the starting hypothesis that non-financial incentives and HRM tools play an important role with respect to increasing motivation of health professionals. Adequate HRM tools can uphold and strengthen the

Health worker motivation in Africa: the role of non-financial incentives and human resource management tools.

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Mathauer, Inke; Imhoff, Ingo

2006-08-29

There is a serious human resource crisis in the health sector in developing countries, particularly in Africa. One of the challenges is the low motivation of health workers. Experience and the evidence suggest that any comprehensive strategy to maximize health worker motivation in a developing country context has to involve a mix of financial and non-financial incentives. This study assesses the role of non-financial incentives for motivation in two cases, in Benin and Kenya. The study design entailed semi-structured qualitative interviews with doctors and nurses from public, private and NGO facilities in rural areas. The selection of health professionals was the result of a layered sampling process. In Benin 62 interviews with health professionals were carried out; in Kenya 37 were obtained. Results from individual interviews were backed up with information from focus group discussions. For further contextual information, interviews with civil servants in the Ministry of Health and at the district level were carried out. The interview material was coded and quantitative data was analysed with SPSS software. The study shows that health workers overall are strongly guided by their professional conscience and similar aspects related to professional ethos. In fact, many health workers are demotivated and frustrated precisely because they are unable to satisfy their professional conscience and impeded in pursuing their vocation due to lack of means and supplies and due to inadequate or inappropriately applied human resources management (HRM) tools. The paper also indicates that even some HRM tools that are applied may adversely affect the motivation of health workers. The findings confirm the starting hypothesis that non-financial incentives and HRM tools play an important role with respect to increasing motivation of health professionals. Adequate HRM tools can uphold and strengthen the professional ethos of doctors and nurses. This entails acknowledging their

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

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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.

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.

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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

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

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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.

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

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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.

Can eHealth tools enable health organizations to reach their target audience?

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Zbib, Ahmad; Hodgson, Corinne; Calderwood, Sarah

2011-01-01

Data from the health risk assessment operated by the Heart and Stroke Foundation found users were more likely to be female; married; have completed post secondary education; and report hypertension, stroke, or being overweight or obese. In developing and operating eHealth tools for health promotion, organizations should compare users to their target population(s). eHealth tools may not be optimal for reaching some higher-risk sub-groups, and a range of social marketing approaches may be required.

The Evolution of School Health and Nutrition in the Education Sector 2000-2015 in sub-Saharan Africa.

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Sarr, Bachir; Fernandes, Meena; Banham, Louise; Bundy, Donald; Gillespie, Amaya; McMahon, Brie; Peel, Francis; Tang, K C; Tembon, Andy; Drake, Lesley

2016-01-01

To document the progression of school health and nutrition and its integration within the education sector in sub-Saharan Africa between 2000 and 2015. School health and nutrition programs have contributed to "Education for All" objectives by helping ensure that children benefit from quality education and reach their educational potential. Analysis of education sector plans (ESPs) in terms of the Focusing Resources on Effective School Health (FRESH) framework and the World Bank Systems Approach for Better Education Results (SABER) School Health survey from a set of countries in sub-Saharan Africa. Between 2000 and 2015, the presence and scope of school health and nutrition as reflected in the four FRESH pillars grew substantially in ESPs. Three of these pillars have large, upfront costs. The fourth pillar requires recurring annual budgetary allotments. Governments clearly recognize that evidence-based, contextually designed school health and nutrition programs can contribute to education sector goals. Moving into the post-2015 era, these programs can also help draw the last 10% of children into school and enhance their readiness to learn.

Public and private sector in the health care system of the Federation bosnia and herzegovina: policy and strategy.

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Slipicevic, Osman; Malicbegovic, Adisa

2012-01-01

In Bosnia and Herzegovina citizens receive health care from both public and private providers. The current situation calls for a clear government policy and strategy to ensure better position and services from both parts. This article examines how health care services are delivered, particularly with respect to relationship between public and private providers. The paper notes that the public sector is plagued by a number of weaknesses in terms of inefficiency of services provision, poorly motivated staff, prevalent dual practice of public employees, poor working conditions and geographical imbalances. Private sector is not developing in ways that address the weaknesses of the public sector. Poorly regulated, it operates as an isolated entity, strongly profit-driven. The increasing burdens on public health care system calls for government to abandon its passive role and take action to direct growth and use potential of private sector. The paper proposes a number of mechanisms that can be used to influence private as well as public sector, since actions directed toward one part of the system will inevitable influence the other.

The project organization as a policy tool in implementing welfare reforms in the public sector.

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Jensen, Christian; Johansson, Staffan; Löfström, Mikael

2013-01-01

Organizational design is considered in policy literature as a forceful policy tool to put policy to action. However, previous research has not analyzed the project organization as a specific form of organizational design and, hence, has not given much attention to such organizations as a strategic choice when selecting policy tools. The purpose of the article is to investigate the project as a policy tool; how do such temporary organizations function as a specific form of organization when public policy is implemented? The article is based on a framework of policy implementation and is illustrated with two welfare reforms in the Swedish public sector, which were organized and implemented as project organizations. The case studies and the analysis show that it is crucial that a project organization fits into the overall governance structure when used as a policy tool. If not, the project will remain encapsulated and will not have sufficient impact on the permanent organizational structure. The concept of encapsulation indicates a need to protect the project from a potential hostile environment. The implication of this is that organizational design as a policy tool is a matter that deserves more attention in the strategic discussion on implementing public policies and on the suitability of using certain policy tools. Copyright © 2012 John Wiley & Sons, Ltd.

Intra Sector Policy Interventions for Improvement of Iranian Health Financing System

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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.

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

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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

Sector-wide or disease-specific? Implications of trends in development assistance for health for the SDG era.

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Buffardi, Anne L

2018-04-01

The record of the Millennium Development Goals broadly reflects the trade-offs of disease-specific financing: substantial progress in particular areas, facilitated by time-bound targets that are easy to measure and communicate, which shifted attention and resources away from other areas, masked inequalities and exacerbated fragmentation. In many ways, the Sustainable Development Goals reflect a profound shift towards a more holistic, system-wide approach. To inform responses to this shift, this article builds upon existing work on aggregate trends in donor financing, bringing together what have largely been disparate analyses of sector-wide and disease-specific financing approaches. Looking across the last 26 years, the article examines how international donors have allocated development assistance for health (DAH) between these two approaches and how attempts to bridge them have fared in practice. Since 1990, DAH has overwhelmingly favoured disease-specific earmarks over health sector support, with the latter peaking in 1998. Attempts to integrate system strengthening elements into disease-specific funding mechanisms have varied by disease, and more integrated funding platforms have failed to gain traction. Health sector support largely remains an unfulfilled promise: proportionately low amounts (albeit absolute increases) which have been inconsistently allocated, and the overall approach inconsistently applied in practice. Thus, the expansive orientation of the Sustainable Development Goals runs counter to trends over the last several decades. Financing proposals and efforts to adapt global health institutions must acknowledge and account for the persistent challenges in the financing and implementation of integrated, cross-sector policies. National and subnational experimentation may offer alternatives within and beyond the health sector.

Optimising the benefits of community health workers' unique position between communities and the health sector: A comparative analysis of factors shaping relationships in four countries.

Science.gov (United States)

Kok, Maryse C; Ormel, Hermen; Broerse, Jacqueline E W; Kane, Sumit; Namakhoma, Ireen; Otiso, Lilian; Sidat, Moshin; Kea, Aschenaki Z; Taegtmeyer, Miriam; Theobald, Sally; Dieleman, Marjolein

2017-11-01

Community health workers (CHWs) have a unique position between communities and the health sector. The strength of CHWs' relationships with both sides influences their motivation and performance. This qualitative comparative study aimed at understanding similarities and differences in how relationships between CHWs, communities and the health sector were shaped in different Sub-Saharan African settings. The study demonstrates a complex interplay of influences on trust and CHWs' relationships with their communities and actors in the health sector. Mechanisms influencing relationships were feelings of (dis)connectedness, (un)familiarity and serving the same goals, and perceptions of received support, respect, competence, honesty, fairness and recognition. Sometimes, constrained relationships between CHWs and the health sector resulted in weaker relationships between CHWs and communities. The broader context (such as the socio-economic situation) and programme context (related to, for example, task-shifting, volunteering and supervision) in which these mechanisms took place were identified. Policy-makers and programme managers should take into account the broader context and could adjust CHW programmes so that they trigger mechanisms that generate trusting relationships between CHWs, communities and other actors in the health system. This can contribute to enabling CHWs to perform well and responding to the opportunities offered by their unique intermediary position.

Sectoral Innovatiohn Performance in the Biotechnology Sector. Final Report. Task 1

NARCIS (Netherlands)

Enzing, C.M.; Valk, T. van der

2010-01-01

In general the biotechnology sector can be qualified as a science driven and high tech sector. This applies for both the group of biotech start-ups that are present in each of the three sub-sectors (red biotech: health/pharma, green biotech: agrifood and white biotech: chemicals) as for the red

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

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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.

Designing Health Information Technology Tools to Prevent Gaps in Public Health Insurance.

Science.gov (United States)

Hall, Jennifer D; Harding, Rose L; DeVoe, Jennifer E; Gold, Rachel; Angier, Heather; Sumic, Aleksandra; Nelson, Christine A; Likumahuwa-Ackman, Sonja; Cohen, Deborah J

2017-06-23

Changes in health insurance policies have increased coverage opportunities, but enrollees are required to annually reapply for benefits which, if not managed appropriately, can lead to insurance gaps. Electronic health records (EHRs) can automate processes for assisting patients with health insurance enrollment and re-enrollment. We describe community health centers' (CHC) workflow, documentation, and tracking needs for assisting families with insurance application processes, and the health information technology (IT) tool components that were developed to meet those needs. We conducted a qualitative study using semi-structured interviews and observation of clinic operations and insurance application assistance processes. Data were analyzed using a grounded theory approach. We diagramed workflows and shared information with a team of developers who built the EHR-based tools. Four steps to the insurance assistance workflow were common among CHCs: 1) Identifying patients for public health insurance application assistance; 2) Completing and submitting the public health insurance application when clinic staff met with patients to collect requisite information and helped them apply for benefits; 3) Tracking public health insurance approval to monitor for decisions; and 4) assisting with annual health insurance reapplication. We developed EHR-based tools to support clinical staff with each of these steps. CHCs are uniquely positioned to help patients and families with public health insurance applications. CHCs have invested in staff to assist patients with insurance applications and help prevent coverage gaps. To best assist patients and to foster efficiency, EHR based insurance tools need comprehensive, timely, and accurate health insurance information.

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...

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

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

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...

Renewing the Future: Social Innovation Systems, Sector Shift, and Innoweave

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Stephen Huddart

2012-07-01

Full Text Available Against a backdrop of various “occupy” movements signifying civic dissatisfaction with the social contract, and in an era of fiscal restraint affecting governments and communities in many parts of the world, we need new and more effective ways to address complex social challenges. While continuous innovation is commonly understood to be a source of growth, productivity improvement, and competitive advantage in the technology and manufacturing sectors, the author’s focus is on social innovation systems, designed to replace maladaptive institutions and obsolete policy frameworks with novel and disruptive means for improving outcomes on issues such as population health and climate change. This article proposes a definition of such systems, and examines how system-level tools including impact investing, open data platforms, and “change labs” are fostering collaboration among the private, public, and community sectors. We argue that a key priority at this time is to make these and other tools and processes for social innovation available to community organizations and their government and business partners everywhere, in a manner that allows for continuous cycles of implementation and learning. The author describes one such project currently being developed in Canada by Social Innovation Generation and other partners, called Innoweave. Innoweave is a technology-enabled social innovation system for sharing the tools and processes of social innovation with the community sector. The article concludes with a call for multi-sectoral participation in social innovation systems as an investment in society’s adaptive capacity and future wellbeing.

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).

Material flow cost accounting as a tool for improved resource efficiency in the hotel sector: A case of emerging market

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Celani John Nyide

2016-12-01

Full Text Available Material Flow Cost Accounting (MFCA is one of the Environmental Management Accounting (EMA tools that has been developed to enable environmentally and economically efficient material usage and thus improve resource efficiency. However, the use of this tool to improve resource efficiency in the South African hotel sector remains unknown. An exploratory study, qualitative in nature, was conducted using a single case study with embedded units approach. A Hotel Management Group that met the selection criteria formed part of this study. In-depth interviews were conducted with 10 participants and additional documents were analysed. The investigated hotels have developed technologies that provide an environmental account in both physical and monetary units which constitute the use of MFCA to improve resource efficiencies. However, the study established a number of factors that affect the implementation of MFCA by the hotel sector in a South African context

Equilibrium between resources and expenditure of health sector of Social Security Fund: a case study of Iran

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Azadeh Ahmadi Dashtian

2017-10-01

Full Text Available In Iran, Social Security is the most important institution of social insurance fund, currently insuring more than a half of country population, and it has a significant role in fulfilling short-term and long-term commitments. Therefore investigation of the balance of resources and expenditure of health sector of the fund can be a scientific process of the funding the future and can pave the way to provide necessary revisions in this sector. Analyzing equilibrium between resources and expenditure of health sector of Social Security Fund in the past years, the present study offers recommendations for improving it in terms of parametric and structural dimensions. The methodology includes documentary library methods and statistical part is descriptive using Excel. Findings indicated that, regarding the present lack of balance of resources and expenditure of health sector, keeping on with the present conditions can lead to many crises. As a result, to escape from the present conditions of the funds where lack of balance of resources and expenditure exists, carrying out parametric and management-structural revisions seems necessary.

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.

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.

Staff and bed distribution in public sector mental health services in the Eastern Cape Province, South Africa

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Kiran Sukeri

2014-11-01

Full Text Available 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. Method. In this descriptive cross-sectional study, an audit questionnaire was submitted to all public sector mental health facilities. Norms and indicators were calculated at provincial and district level. This article investigates staff and bed distribution only. Results. Results demonstrated that within the province, only three of its seven districts have acute beds above the national baseline norm requirement of 13/100 000. The private mental health sector provides approximately double the number of medium- to long-stay beds available in the public sector. Only two regions have staff/population ratios above the baseline norm of 20/100 000. However, there are significant differences in this ratio among specific staff categories. There is an inequitable distribution of resources between the eastern and western regions of the province. When compared with the western regions, the eastern regions have poorer access to mental health facilities, human resources and non-governmental organisations.  Conclusion. Owing to the inequitable distribution of resources, the provincial authorities urgently need to develop an equitable model of service delivery. The province has to address the absence of a reliable mental health information system.

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.

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

District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia

Science.gov (United States)

Bhattacharyya, Sanghita; Berhanu, Della; Taddesse, Nolawi; Srivastava, Aradhana; Wickremasinghe, Deepthi; Schellenberg, Joanna

2016-01-01

Many low- and middle-income countries have pluralistic health systems where private for-profit and not-for-profit sectors complement the public sector: data shared across sectors can provide information for local decision-making. The third article in a series of four on district decision-making for health in low-income settings, this study shows the untapped potential of existing data through documenting the nature and type of data collected by the public and private health systems, data flow and sharing, use and inter-sectoral linkages in India and Ethiopia. In two districts in each country, semi-structured interviews were conducted with administrators and data managers to understand the type of data maintained and linkages with other sectors in terms of data sharing, flow and use. We created a database of all data elements maintained at district level, categorized by form and according to the six World Health Organization health system blocks. We used content analysis to capture the type of data available for different health system levels. Data flow in the public health sectors of both counties is sequential, formal and systematic. Although multiple sources of data exist outside the public health system, there is little formal sharing of data between sectors. Though not fully operational, Ethiopia has better developed formal structures for data sharing than India. In the private and public sectors, health data in both countries are collected in all six health system categories, with greatest focus on service delivery data and limited focus on supplies, health workforce, governance and contextual information. In the Indian private sector, there is a better balance than in the public sector of data across the six categories. In both India and Ethiopia the majority of data collected relate to maternal and child health. Both countries have huge potential for increased use of health data to guide district decision-making. PMID:27591203

Marketing strategy for the BC oil and gas service sector

Energy Technology Data Exchange (ETDEWEB)

NONE

2004-10-29

The British Columbia (BC) oil and gas service sector is collaborating with the BC Ministry of Energy and Mines (MEM) to enhance the competitiveness of oil and gas service providers in Northeast BC. The MEM agreed to provide one-time funding to develop this marketing strategy for the oil and gas sector, particularly for small to medium-sized companies with limited resources. This document is also a resource tool for suppliers in the sector that have developed and are implementing their own marketing plans and wish to enhance elements of their own plans. The strategy also outlines the potential role of associations in Northeast BC that represent the service sector. It links their marketing activities with the activities of individual service providers. Local service providers (LSP) include companies in a wide range of businesses such as drilling support, transportation, health and safety services, and construction. Six issues that directly impact the competitiveness of LSPs were also presented along with recommendations for participants in the service sector, associations and individual companies. tabs., figs., 11 appendices.

Marketing strategy for the BC oil and gas service sector

International Nuclear Information System (INIS)

2004-01-01

The British Columbia (BC) oil and gas service sector is collaborating with the BC Ministry of Energy and Mines (MEM) to enhance the competitiveness of oil and gas service providers in Northeast BC. The MEM agreed to provide one-time funding to develop this marketing strategy for the oil and gas sector, particularly for small to medium-sized companies with limited resources. This document is also a resource tool for suppliers in the sector that have developed and are implementing their own marketing plans and wish to enhance elements of their own plans. The strategy also outlines the potential role of associations in Northeast BC that represent the service sector. It links their marketing activities with the activities of individual service providers. Local service providers (LSP) include companies in a wide range of businesses such as drilling support, transportation, health and safety services, and construction. Six issues that directly impact the competitiveness of LSPs were also presented along with recommendations for participants in the service sector, associations and individual companies. tabs., figs., 11 appendices

Structural analysis of ITER sub-assembly tools

International Nuclear Information System (INIS)

Nam, K.O.; Park, H.K.; Kim, D.J.; Ahn, H.J.; Lee, J.H.; Kim, K.K.; Im, K.; Shaw, R.

2011-01-01

The ITER Tokamak assembly tools are purpose-built assembly tools to complete the ITER Tokamak machine which includes the cryostat and the components contained therein. The sector sub-assembly tools descried in this paper are main assembly tools to assemble vacuum vessel, thermal shield and toroidal filed coils into a complete 40 o sector. The 40 o sector sub-assembly tools are composed of sector sub-assembly tool, including radial beam, vacuum vessel supports and mid-plane brace tools. These tools shall have sufficient strength to transport and handle heavy weight of the ITER Tokamak machine reached several hundred tons. Therefore these tools should be designed and analyzed to confirm both the strength and structural stability even in the case of conservative assumptions. To verify structural stabilities of the sector sub-assembly tools in terms of strength and deflection, ANSYS code was used for linear static analysis. The results of the analysis show that these tools are designed with sufficient strength and stiffness. The conceptual designs of these tools are briefly described in this paper also.

Visual Data Comm: A Tool for Visualizing Data Communication in the Multi Sector Planner Study

Science.gov (United States)

Lee, Hwasoo Eric

2010-01-01

Data comm is a new technology proposed in future air transport system as a potential tool to provide comprehensive data connectivity. It is a key enabler to manage 4D trajectory digitally, potentially resulting in improved flight times and increased throughput. Future concepts with data comm integration have been tested in a number of human-in-the-loop studies but analyzing the results has proven to be particularly challenging because future traffic environment in which data comm is fully enabled has assumed high traffic density, resulting in data set with large amount of information. This paper describes the motivation, design, current and potential future application of Visual Data Comm (VDC), a tool for visualizing data developed in Java using Processing library which is a tool package designed for interactive visualization programming. This paper includes an example of an application of VDC on data pertaining to the most recent Multi Sector Planner study, conducted at NASA s Airspace Operations Laboratory in 2009, in which VDC was used to visualize and interpret data comm activities

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

Economic impacts from PM2.5 pollution-related health effects in China's road transport sector: A provincial-level analysis.

Science.gov (United States)

Tian, Xu; Dai, Hancheng; Geng, Yong; Wilson, Jeffrey; Wu, Rui; Xie, Yang; Hao, Han

2018-06-01

Economic impact assessments of air pollution-related health effects from a sectoral perspective in China is still deficient. This study evaluates the PM 2.5 pollution-related health impacts of the road transport sector on China's economy at both national and provincial levels in 2030 under various air mitigation technologies scenarios. Health impacts are estimated using an integrated approach that combines the Greenhouse Gas and Air Pollution Interactions and Synergies (GAINS) model, a computable general equilibrium (CGE) model and a health model. Results show that at a national level, the road transport sector leads to 163.64 thousand deaths per year, increases the per capita risk of morbidity by 0.37% and accounts for 1.43 billion Yuan in health care expenditures. We estimate 442.90 billion Yuan of the value of statistical life loss and 2.09 h/capita of work time loss in 2015. Without additional control measures, air pollution related to the transport sector will cause 177.50 thousand deaths in 2030, a 0.40% per capita increase in the risk of morbidity, accounting for 4.12 billion Yuan in health care expenditures, 737.15 billion Yuan of statistical life loss and 2.23 h/capita of work time loss. Based on our model, implementing the most strict control strategy scenario would decrease mortality by 42.14%, morbidity risk by 42.14%, health care expenditures by 41.94%, statistical life loss by 26.22% and hours of work time loss by 42.65%, comparing with the no control measure scenario. In addition, PM 2.5 pollution from the road transport sector will cause 0.68% GDP loss in 2030. At a provincial level, GDP losses in 14 out of 30 provinces far exceed the national rate. Henan (1.20%), Sichuan (1.07%), Chongqing (0.99%), Hubei (0.94%), and Shandong (0.90%) would experience the highest GDP loss in 2030. Implementing control strategies to reduce PM 2.5 pollution in the road transport sector could bring positive benefits in half of the Chinese provinces especially in

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).

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.

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

Directory of Open Access Journals (Sweden)

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

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

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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.

Integration of eHealth Tools in the Process of Workplace Health Promotion: Proposal for Design and Implementation

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2018-01-01

Background Electronic health (eHealth) and mobile health (mHealth) tools can support and improve the whole process of workplace health promotion (WHP) projects. However, several challenges and opportunities have to be considered while integrating these tools in WHP projects. Currently, a large number of eHealth tools are developed for changing health behavior, but these tools can support the whole WHP process, including group administration, information flow, assessment, intervention development process, or evaluation. Objective To support a successful implementation of eHealth tools in the whole WHP processes, we introduce a concept of WHP (life cycle model of WHP) with 7 steps and present critical and success factors for the implementation of eHealth tools in each step. Methods We developed a life cycle model of WHP based on the World Health Organization (WHO) model of healthy workplace continual improvement process. We suggest adaptations to the WHO model to demonstrate the large number of possibilities to implement eHealth tools in WHP as well as possible critical points in the implementation process. Results eHealth tools can enhance the efficiency of WHP in each of the 7 steps of the presented life cycle model of WHP. Specifically, eHealth tools can support by offering easier administration, providing an information and communication platform, supporting assessments, presenting and discussing assessment results in a dashboard, and offering interventions to change individual health behavior. Important success factors include the possibility to give automatic feedback about health parameters, create incentive systems, or bring together a large number of health experts in one place. Critical factors such as data security, anonymity, or lack of management involvement have to be addressed carefully to prevent nonparticipation and dropouts. Conclusions Using eHealth tools can support WHP, but clear regulations for the usage and implementation of these tools at the

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 ...

Digital marketing strategies in the luxury fashion sector. Interaction and social networks as a necessary tool

OpenAIRE

González Romo, Zahaira; Plaza Romero, Noemí

2017-01-01

Luxury brands reinvent themselves in their marketing and business strategies to adapt and approach emerging markets eager to consume luxury fashion, which is why digital marketing becomes an essential tool for the communication of luxury brands leaders in the market with their younger audiences. The present research aims to know what are the current strategies in digital marketing that are being carried out by the brands of the luxury fashion sector. The aim is to identify the most relevant a...

An assessment of opportunities and challenges for public sector involvement in the maternal health voucher program in Uganda.

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Okal, Jerry; Kanya, Lucy; Obare, Francis; Njuki, Rebecca; Abuya, Timothy; Bange, Teresah; Warren, Charlotte; Askew, Ian; Bellows, Ben

2013-10-18

Continued inequities in coverage, low quality of care, and high out-of-pocket expenses for health services threaten attainment of Millennium Development Goals 4 and 5 in many sub-Saharan African countries. Existing health systems largely rely on input-based supply mechanisms that have a poor track record meeting the reproductive health needs of low-income and underserved segments of national populations. As a result, there is increased interest in and experimentation with results-based mechanisms like supply-side performance incentives to providers and demand-side vouchers that place purchasing power in the hands of low-income consumers to improve uptake of facility services and reduce the burden of out-of-pocket expenditures. This paper describes a reproductive health voucher program that contracts private facilities in Uganda and explores the policy and implementation issues associated with expansion of the program to include public sector facilities. Data presented here describes the results of interviews of six district health officers and four health facility managers purposefully selected from seven districts with the voucher program in southwestern Uganda. Interviews were transcribed and organized thematically, barriers to seeking RH care were identified, and how to address the barriers in a context where voucher coverage is incomplete as well as opportunities and challenges for expanding the program by involving public sector facilities were investigated. The findings show that access to sexual and reproductive health services in southwestern Uganda is constrained by both facility and individual level factors which can be addressed by inclusion of the public facilities in the program. This will widen the geographical reach of facilities for potential clients, effectively addressing distance related barriers to access of health care services. Further, intensifying ongoing health education, continuous monitoring and evaluation, and integrating the voucher

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

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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.

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).

Setting research priorities across science, technology, and health sectors: the Tanzania experience.

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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.

PERCC Tools: Public Health Preparedness for Clinicians

Centers for Disease Control (CDC) Podcasts

CDC’s Office of Public Health Preparedness and Response funds Preparedness and Emergency Response Research Centers (PERRCs) to examine components of the public health system. This podcast is an overview of mental and behavioral health tools developed by the Johns Hopkins PERRC.

Structural integration and performance of inter-sectoral public health-related policy networks: An analysis across policy phases.

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Peters, D T J M; Raab, J; Grêaux, K M; Stronks, K; Harting, J

2017-12-01

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 addressing environmental determinants of health. This study examines these relations in different phases of the policy process. A multiple-case study was performed on four public health-related policy networks. Using a snowball method among network actors, overall and sub-networks per policy phase were identified and the policy sector of each actor was assigned. To operationalise the outcome variable, interventions were classified by the proportion of environmental determinants they addressed. In the overall networks, no relation was found between structural network characteristics and network performance. In most effective cases, the policy development sub-networks were characterised by integration with less interrelations between actors (low cohesion), more equally distributed distances between the actors (low closeness centralisation), and horizontal integration in inter-sectoral cliques. The most effective case had non-public health central actors with less connections in all sub-networks. The results suggest that, to address environmental determinants of health, sub-networks should be inter-sectorally composed in the policy development rather than in the intervention development and implementation phases, and that policy development actors should have the opportunity to connect with other actors, without strong direction from a central actor. Copyright © 2017 Elsevier B.V. All rights reserved.

District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia.

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Bhattacharyya, Sanghita; Berhanu, Della; Taddesse, Nolawi; Srivastava, Aradhana; Wickremasinghe, Deepthi; Schellenberg, Joanna; Iqbal Avan, Bilal

2016-09-01

Many low- and middle-income countries have pluralistic health systems where private for-profit and not-for-profit sectors complement the public sector: data shared across sectors can provide information for local decision-making. The third article in a series of four on district decision-making for health in low-income settings, this study shows the untapped potential of existing data through documenting the nature and type of data collected by the public and private health systems, data flow and sharing, use and inter-sectoral linkages in India and Ethiopia. In two districts in each country, semi-structured interviews were conducted with administrators and data managers to understand the type of data maintained and linkages with other sectors in terms of data sharing, flow and use. We created a database of all data elements maintained at district level, categorized by form and according to the six World Health Organization health system blocks. We used content analysis to capture the type of data available for different health system levels. Data flow in the public health sectors of both counties is sequential, formal and systematic. Although multiple sources of data exist outside the public health system, there is little formal sharing of data between sectors. Though not fully operational, Ethiopia has better developed formal structures for data sharing than India. In the private and public sectors, health data in both countries are collected in all six health system categories, with greatest focus on service delivery data and limited focus on supplies, health workforce, governance and contextual information. In the Indian private sector, there is a better balance than in the public sector of data across the six categories. In both India and Ethiopia the majority of data collected relate to maternal and child health. Both countries have huge potential for increased use of health data to guide district decision-making. © The Author 2016. Published by Oxford

Third sector primary care for vulnerable populations.

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Crampton, P; Dowell, A; Woodward, A

2001-12-01

This paper aims to describe and explain the development of third sector primary care organisations in New Zealand. The third sector is the non-government, non-profit sector. International literature suggests that this sector fulfils an important role in democratic societies with market-based economies, providing services otherwise neglected by the government and private for-profit sectors. Third sector organisations provided a range of social services throughout New Zealand's colonial history. However, it was not until the 1980s that third sector organisations providing comprehensive primary medical and related services started having a significant presence in New Zealand. In 1994 a range of union health centres, tribally based Mäori health providers, and community-based primary care providers established a formal network -- Health Care Aotearoa. While not representing all third sector primary care providers in New Zealand, Health Care Aotearoa was the best-developed example of a grouping of third sector primary care organisations. Member organisations served populations that were largely non-European and lived in deprived areas, and tended to adopt population approaches to funding and provision of services. The development of Health Care Aotearoa has been consistent with international experience of third sector involvement -- there were perceived "failures" in government policies for funding primary care and private sector responses to these policies, resulting in lack of universal funding and provision of primary care and continuing patient co-payments. The principal policy implication concerns the role of the third sector in providing primary care services for vulnerable populations as a partial alternative to universal funding and provision of primary care. Such an alternative may be convenient for proponents of reduced state involvement in funding and provision of health care, but may not be desirable from the point of view of equity and social cohesion

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

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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.

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

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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.

Wireless security in mobile health.

Science.gov (United States)

Osunmuyiwa, Olufolabi; Ulusoy, Ali Hakan

2012-12-01

Mobile health (m-health) is an extremely broad term that embraces mobile communication in the health sector and data packaging. The four broad categories of wireless networks are wireless personal area network, wireless metropolitan area network, wireless wide area network, and wireless local area network. Wireless local area network is the most notable of the wireless networking tools obtainable in the health sector. Transfer of delicate and critical information on radio frequencies should be secure, and the right to use must be meticulous. This article covers the business opportunities in m-health, threats faced by wireless networks in hospitals, and methods of mitigating these threats.

Modern principles used in conformity assessment of machinery from forestry sector

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Antonov Anca Elena

2017-01-01

Full Text Available The paper is aiming to implement the general principles of risk prevention at employer’s level, with respect to occupational risks evaluation, the elimination of risk and accident factors, and information of workers which are using the machinery in the forestry sector. For the use of machinery in the forestry sector in terms of economic performance and a level of maximum safety, it is necessary to ensure the user guides set by the manufacturer in terms of commissioning, use and to provide appropriate safe working operations and interventions and to guarantee the technical and environmental requirements, including appropriate measures and means of protection against accidents and occupational disease. The impact of occupational risks for machinery used in this sector can be reduced through the application of modern principles in conformity assessment and certification and, where appropriate, through technical diagnostics and inspection, taking into account the provisions of the new Machinery Directive 2006/42 / EC which is imposing the obligation of manufacturer to implement conformity assessment procedures in accordance with the methods of assessment and verification of safety at the certification bodies, notified at the European Commission. The paper aims to develop modern technical tools for conformity assessment and verification of this category of machines used in the forestry sector that would provide prerequisite for increasing competitiveness of employers in the market economy. Applying these tools of modern technology for manufacturers and users of this category of machinery provides the necessary conditions for placing on the market of safe products with a appropriate safety level, in the intended using conditions, in order to guarantee the essential requirements for safety and health, technical and environmental conditions, including measures and means of protection. The result of this research is to develop technical tools needed to

The role of information and communication policies in the governance of the healthcare sector

Directory of Open Access Journals (Sweden)

Barileé B. Baridam

2016-07-01

Full Text Available Information and communication technology (ICT is today an indispensable tool in the development of countries and economies, driving growth in many other sectors, including the health sector. The effective governance of the health sector demands enabling ICT policies. Healthcare is a key area in the development and growth of nations. A country that neglects this sector will definitely witness a decline in socio-economic development. Application of ICT in this sector is non-negotiable and an imperative. However, with diversities in policy ICT’s impact is not felt in many communities, and linking ICT and other business strategies is a big challenge. Availability of resources upon which ICT itself thrives is another factor limiting its impact upon the lives of the populations of most developing nations. Cultural diversity and technology problems seem to stand prominent among challenges impeding the impact of ICT on developing nations. Against this backdrop, this paper takes a critical look at the implementation and efficiency of ICT in healthcare delivery within the Nigerian context. The purpose is to assist those bodies responsible for ICT policy and implementation to enable the benefits of ICT to trickle through to the populace. We are also of the opinion that the adequate implementation of ICT policy in the health sector in the most populous black nation (Nigeria will go a long way to influence its implementation in neighbouring nations

Reduction of inequalities in health: assessing evidence-based tools

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Shea Beverley

2006-09-01

Full Text Available Abstract Background The reduction of health inequalities is a focus of many national and international health organisations. The need for pragmatic evidence-based approaches has led to the development of a number of evidence-based equity initiatives. This paper describes a new program that focuses upon evidence- based tools, which are useful for policy initiatives that reduce inequities. Methods This paper is based on a presentation that was given at the "Regional Consultation on Policy Tools: Equity in Population Health Reports," held in Toronto, Canada in June 2002. Results Five assessment tools were presented. 1. A database of systematic reviews on the effects of educational, legal, social, and health interventions to reduce unfair inequalities is being established through the Cochrane and Campbell Collaborations. 2 Decision aids and shared decision making can be facilitated in disadvantaged groups by 'health coaches' to help people become better decision makers, negotiators, and navigators of the health system; a pilot study in Chile has provided proof of this concept. 3. The CIET Cycle: Combining adapted cluster survey techniques with qualitative methods, CIET's population based applications support evidence-based decision making at local and national levels. The CIET map generates maps directly from survey or routine institutional data, to be used as evidence-based decisions aids. Complex data can be displayed attractively, providing an important tool for studying and comparing health indicators among and between different populations. 4. The Ottawa Equity Gauge is applying the Global Equity Gauge Alliance framework to an industrialised country setting. 5 The Needs-Based Health Assessment Toolkit, established to assemble information on which clinical and health policy decisions can be based, is being expanded to ensure a focus on distribution and average health indicators. Conclusion Evidence-based planning tools have much to offer the

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

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.

Countdown to 2015 country case studies: systematic tools to address the “black box” of health systems and policy assessment

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Neha S. Singh

2016-09-01

Full Text Available Abstract Background Evaluating health systems and policy (HSP change and implementation is critical in understanding reproductive, maternal, newborn and child health (RMNCH progress within and across countries. Whilst data for health outcomes, coverage and equity have advanced in the last decade, comparable analyses of HSP changes are lacking. We present a set of novel tools developed by Countdown to 2015 (Countdown to systematically analyse and describe HSP change for RMNCH indicators, enabling multi-country comparisons. Methods International experts worked with eight country teams to develop HSP tools via mixed methods. These tools assess RMNCH change over time (e.g. 1990–2015 and include: (i Policy and Programme Timeline Tool (depicting change according to level of policy; (ii Health Policy Tracer Indicators Dashboard (showing 11 selected RMNCH policies over time; (iii Health Systems Tracer Indicators Dashboard (showing four selected systems indicators over time; and (iv Programme implementation assessment. To illustrate these tools, we present results from Tanzania and Peru, two of eight Countdown case studies. Results The Policy and Programme Timeline tool shows that Tanzania’s RMNCH environment is complex, with increased funding and programmes for child survival, particularly primary-care implementation. Maternal health was prioritised since mid-1990s, yet with variable programme implementation, mainly targeting facilities. Newborn health only received attention since 2005, yet is rapidly scaling-up interventions at facility- and community-levels. Reproductive health lost momentum, with re-investment since 2010. Contrastingly, Peru moved from standalone to integrated RMNCH programme implementation, combined with multi-sectoral, anti-poverty strategies. The HSP Tracer Indicators Dashboards show that Peru has adopted nine of 11 policy tracer indicators and Tanzania has adopted seven. Peru costed national RMNCH plans pre-2000, whereas

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

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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.

Willingness to pay for social health insurance among informal sector workers in Wuhan, China: a contingent valuation study

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Zhang Xinping

2007-07-01

Full Text Available Abstract Background Most of the about 140 million informal sector workers in urban China do not have health insurance. A 1998 central government policy leaves it to the discretion of municipal governments to offer informal sector workers in cities voluntary participation in a social health insurance for formal sector workers, the so-called 'basic health insurance' (BHI. Methods We used the contingent valuation method to assess the maximum willingness to pay (WTP for BHI among informal sector workers, including unregistered rural-to-urban migrants, in Wuhan City, China. We selected respondents in a two-stage self-weighted cluster sampling scheme. Results On average, informal sector workers were willing to pay substantial amounts for BHI (30 Renminbi (RMB, 95% confidence interval (CI 27-33 as well as substantial proportions of their incomes (4.6%, 95% CI 4.1-5.1%. Average WTP increased significantly when any one of the copayments of the BHI was removed in the valuation: to 51 RMB (95% CI 46-56 without reimbursement ceiling; to 43 RMB (95% CI 37-49 without deductible; and to 47 RMB (95% CI 40-54 without coinsurance. WTP was higher than estimates of the cost of BHI based on past health expenditure or on premium contributions of formal sector workers. Predicted coverage with BHI declined steeply with the premium contribution at low contribution levels. When we applied equity weighting in the aggregation of individual WTP values in order to adjust for inequity in the distribution of income, mean WTP for BHI increased with inequality aversion over a plausible range of the aversion parameter. Holding other factors constant in multiple regression analysis, for a 1% increase in income WTP for BHI with different copayments increased by 0.434-0.499% (all p Conclusion Our results suggest that Chinese municipal governments should allow informal sector workers to participate in the BHI. From a normative perspective, BHI for informal sector workers is likely to

Implementation of collaborative governance in cross-sector innovation and education networks: evidence from the National Health Service in England.

Science.gov (United States)

Ovseiko, Pavel V; O'Sullivan, Catherine; Powell, Susan C; Davies, Stephen M; Buchan, Alastair M

2014-11-08

Increasingly, health policy-makers and managers all over the world look for alternative forms of organisation and governance in order to add more value and quality to their health systems. In recent years, the central government in England mandated several cross-sector health initiatives based on collaborative governance arrangements. However, there is little empirical evidence that examines local implementation responses to such centrally-mandated collaborations. Data from the national study of Health Innovation and Education Clusters (HIECs) are used to provide comprehensive empirical evidence about the implementation of collaborative governance arrangements in cross-sector health networks in England. The study employed a mixed-methods approach, integrating both quantitative and qualitative data from a national survey of the entire population of HIEC directors (N = 17; response rate = 100%), a group discussion with 7 HIEC directors, and 15 in-depth interviews with HIEC directors and chairs. The study provides a description and analysis of local implementation responses to the central government mandate to establish HIECs. The latter represent cross-sector health networks characterised by a vague mandate with the provision of a small amount of new resources. Our findings indicate that in the case of HIECs such a mandate resulted in the creation of rather fluid and informal partnerships, which over the period of three years made partial-to-full progress on governance activities and, in most cases, did not become self-sustaining without government funding. This study has produced valuable insights into the implementation responses in HIECs and possibly other cross-sector collaborations characterised by a vague mandate with the provision of a small amount of new resources. There is little evidence that local dominant coalitions appropriated the central HIEC mandate to their own ends. On the other hand, there is evidence of interpretation and implementation of the

Big data analysis framework for healthcare and social sectors in Korea.

Science.gov (United States)

Song, Tae-Min; Ryu, Seewon

2015-01-01

We reviewed applications of big data analysis of healthcare and social services in developed countries, and subsequently devised a framework for such an analysis in Korea. We reviewed the status of implementing big data analysis of health care and social services in developed countries, and strategies used by the Ministry of Health and Welfare of Korea (Government 3.0). We formulated a conceptual framework of big data in the healthcare and social service sectors at the national level. As a specific case, we designed a process and method of social big data analysis on suicide buzz. Developed countries (e.g., the United States, the UK, Singapore, Australia, and even OECD and EU) are emphasizing the potential of big data, and using it as a tool to solve their long-standing problems. Big data strategies for the healthcare and social service sectors were formulated based on an ICT-based policy of current government and the strategic goals of the Ministry of Health and Welfare. We suggest a framework of big data analysis in the healthcare and welfare service sectors separately and assigned them tentative names: 'health risk analysis center' and 'integrated social welfare service network'. A framework of social big data analysis is presented by applying it to the prevention and proactive detection of suicide in Korea. There are some concerns with the utilization of big data in the healthcare and social welfare sectors. Thus, research on these issues must be conducted so that sophisticated and practical solutions can be reached.

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

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....

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 ...

Introduction of EDI in the public sector

DEFF Research Database (Denmark)

Falch, Morten

1997-01-01

Reviews the status of EDI in the sectors of health, public transport and taxation and public administration. The impact of this on the diffusion of EDI in other sectors is analysed.......Reviews the status of EDI in the sectors of health, public transport and taxation and public administration. The impact of this on the diffusion of EDI in other sectors is analysed....

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�

The use of e-health and m-health tools in health promotion and primary prevention among older adults: a systematic literature review.