scholarly journals (P1-16) Local Health-Related Capacities in the Northern Haiti Post-Earthquake Response

2011 ◽  
Vol 26 (S1) ◽  
pp. s104-s104 ◽  
Author(s):  
R.A. King ◽  
D.S.K. Thomas ◽  
S. Montas ◽  
P. Minn ◽  
D. Varda ◽  
...  
Keyword(s):  
Health System ◽  
Disaster Preparedness ◽  
Current System ◽  
Health Sector ◽  
Local Health ◽  
Healthcare Organizations ◽  
Existing Structures ◽  
The North ◽  
Response Capacity ◽  
Health Related

BackgroundThe January 2010 earthquake affected many services in Haiti, including health care. After the disaster, top-down response from international sources seemed like the only solution. While the existing health system was fragile, opportunities likely existed for incorporating bottom-up approaches in the capital and other cities, such as Cap Haitien in the North.ObjectiveThe study aims to: (1) identify available local health-related resources; (2) examine how these were, or were not, utilized in response efforts; and (3) evaluate the level of coordination among health delivery groups, particularly preparedness and recovery.MethodsThis case study included 11 key informant interviews at two hospitals (six at Justinian and five at Milot) and an organizational analysis of cooperation among 16 health-related organizations operating in northern Haiti. Disaster preparedness and recovery data for the health-sector organizations were obtained using a validated survey instrument and the Program to Analyze, Record, and Track Networks to Enhance Relationships (PARTNER) tool that uses the principles of Social Network Analysis (SNA) to elucidate the makeup of collaborative relationships.ResultsDuring the response phase, command-and-control approaches from international healthcare organizations had a roll given the numbers of people affected and the overwhelmed local response capabilities. Pre-disaster vulnerabilities limited response capacity. Even during response, opportunities existed for integrating established groups. Generally, this was not a model utilized by international organizations, although some examples were present.ConclusionsThe external infusion of money, priorities, and forces potentially may harm the current system, rather than build upon it. International aid provides free health services beyond treatment of earthquake-related injuries, taking the place of some service functions of the Haitian system. Eventually, this could erode aspects of the Haitian health system. Alternative models of aid may better incorporate and integrate existing structures. Disaster planning is linked intrinsically to strengthening the health system as a whole.

scholarly journals What Medical Crowdfunding Campaigns Can Tell Us About Local Health System Gaps and Deficiencies: Exploratory Analysis of British Columbia, Canada

10.2196/16982 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e16982 ◽  
Author(s):  
Jeremy Snyder ◽  
Marco Zenone ◽  
Valorie Crooks ◽  
Nadine Schuurman
Keyword(s):  
Health System ◽  
Financial Support ◽  
Medical Condition ◽  
Common Factor ◽  
Perceived Health ◽  
Wait Times ◽  
Local Health ◽  
Specialist Care ◽  
Canadian Health ◽  
Health Related

Background There are a range of perceived gaps and shortcomings in the publicly funded Canadian health system. These include wait times for care, lack of public insurance coverage for dental care and pharmaceuticals, and difficulties accessing specialist care. Medical crowdfunding is a response to these gaps where individuals raise funds from their social networks to address health-related needs. Objective This study aimed to investigate the potential of crowdfunding data to better understand what health-related needs individuals are using crowdfunding for, how these needs compare with the existing commentary on health system deficiencies, and the advantages and limitations of using crowdfunding campaigns to enhance or augment our understanding of perceived health system deficiencies. Methods Crowdfunding campaigns were scraped from the GoFundMe website. These campaigns were then limited to those originating in the metropolitan Vancouver region of two health authorities during 2018. These campaigns were then further limited to those raising funds to allow the treatment of a medical problem or related to needs arising from ill health. These campaigns were then reviewed to identify the underlying health issue and motivation for pursuing crowdfunding. Results We identified 423 campaigns for health-related needs. These campaigns requested CAD $8,715,806 (US $6,088,078) in funding and were pledged CAD $3,477,384 (US $2,428,987) from 27,773 donors. The most common underlying medical condition for campaign recipients was cancer, followed by traumatic injuries from collisions and brain injury and stroke. By far, the most common factor of motivation for crowdfunding was seeking financial support for wages lost because of illness (232/684, 33.9%). Some campaigns (65/684, 9.5%) sought help with purchasing medical equipment and supplies; 8.2% (56/684) sought to fund complementary, alternative, or unproven treatments including experimental interventions; 7.2% (49/684) sought financial support to cover travel-related costs, including in-province and out-of-province (49/684, 7.2%) travel; and 6.3% (43/684) campaigns sought help to pay for medication. Conclusions This analysis demonstrates the potential of crowdfunding data to present timely and context-specific user-created insights into the perceived health-related financial needs of some Canadians. Although the literature on perceived limitations of the Canadian health system focuses on wait times for care and limited access to specialist services, among other issues, these campaigners were much more motivated by gaps in the wider social system such as costs related to unpaid time off work and travel to access care. Our findings demonstrate spatial differences in the underlying medical problems, motivations for crowdfunding, and success using crowdfunding that warrants additional attention. These differences may support established concerns that medical crowdfunding is most commonly used by individuals from relatively privileged socioeconomic backgrounds. We encourage the development of new resources to harness the power of crowdfunding data as a supplementary source of information for Canadian health system stakeholders.

Realisation of a joint consumer engagement strategy in the Nepean Blue Mountains region

2017 ◽  
Vol 23 (6) ◽  
pp. 531 ◽  
Author(s):  
Ilse Blignault ◽  
Diana Aspinall ◽  
Lizz Reay ◽  
Kay Hyman
Keyword(s):  
Health System ◽  
Success Factors ◽  
Health District ◽  
Direct Care ◽  
Consumer Participation ◽  
Local Health ◽  
Consumer Engagement ◽  
Blue Mountains ◽  
Existing Structures ◽  
Critical Success

Ensuring consumer engagement at different levels of the health system – direct care, organisational design and governance and policy – has become a strategic priority. This case study explored, through interviews with six purposively selected ‘insiders’ and document review, how one Medicare Local (now a Primary Health Network, PHN) and Local Health District worked together with consumers, to establish a common consumer engagement structure and mechanisms to support locally responsive, integrated and consumer-centred services. The two healthcare organisations worked as partners across the health system, sharing ownership and responsibility. Critical success factors included a consumer champion working with other highly motivated consumers concerned with improving the health system, a budget, and ongoing commitment from the Medicare Local or PHN and the Local Health District at executive and board level. Shared boundaries were an enormous advantage. Activities were jointly planned and executed, with consumer participation paramount. Training and mentoring enhanced consumer capacity and confidence. Bringing everyone on board and building on existing structures required time, effort and resources. The initiative produced immediate and lasting benefits, with consumer engagement now embedded in organisational governance and practice.

scholarly journals What Medical Crowdfunding Campaigns Can Tell Us About Local Health System Gaps and Deficiencies: Exploratory Analysis of British Columbia, Canada (Preprint)

2019 ◽  
Author(s):  
Jeremy Snyder ◽  
Marco Zenone ◽  
Valorie Crooks ◽  
Nadine Schuurman
Keyword(s):  
Health System ◽  
Financial Support ◽  
Medical Condition ◽  
Common Factor ◽  
Perceived Health ◽  
Wait Times ◽  
Local Health ◽  
Specialist Care ◽  
Canadian Health ◽  
Health Related

BACKGROUND There are a range of perceived gaps and shortcomings in the publicly funded Canadian health system. These include wait times for care, lack of public insurance coverage for dental care and pharmaceuticals, and difficulties accessing specialist care. Medical crowdfunding is a response to these gaps where individuals raise funds from their social networks to address health-related needs. OBJECTIVE This study aimed to investigate the potential of crowdfunding data to better understand what health-related needs individuals are using crowdfunding for, how these needs compare with the existing commentary on health system deficiencies, and the advantages and limitations of using crowdfunding campaigns to enhance or augment our understanding of perceived health system deficiencies. METHODS Crowdfunding campaigns were scraped from the GoFundMe website. These campaigns were then limited to those originating in the metropolitan Vancouver region of two health authorities during 2018. These campaigns were then further limited to those raising funds to allow the treatment of a medical problem or related to needs arising from ill health. These campaigns were then reviewed to identify the underlying health issue and motivation for pursuing crowdfunding. RESULTS We identified 423 campaigns for health-related needs. These campaigns requested CAD $8,715,806 (US $6,088,078) in funding and were pledged CAD $3,477,384 (US $2,428,987) from 27,773 donors. The most common underlying medical condition for campaign recipients was cancer, followed by traumatic injuries from collisions and brain injury and stroke. By far, the most common factor of motivation for crowdfunding was seeking financial support for wages lost because of illness (232/684, 33.9%). Some campaigns (65/684, 9.5%) sought help with purchasing medical equipment and supplies; 8.2% (56/684) sought to fund complementary, alternative, or unproven treatments including experimental interventions; 7.2% (49/684) sought financial support to cover travel-related costs, including in-province and out-of-province (49/684, 7.2%) travel; and 6.3% (43/684) campaigns sought help to pay for medication. CONCLUSIONS This analysis demonstrates the potential of crowdfunding data to present timely and context-specific user-created insights into the perceived health-related financial needs of some Canadians. Although the literature on perceived limitations of the Canadian health system focuses on wait times for care and limited access to specialist services, among other issues, these campaigners were much more motivated by gaps in the wider social system such as costs related to unpaid time off work and travel to access care. Our findings demonstrate spatial differences in the underlying medical problems, motivations for crowdfunding, and success using crowdfunding that warrants additional attention. These differences may support established concerns that medical crowdfunding is most commonly used by individuals from relatively privileged socioeconomic backgrounds. We encourage the development of new resources to harness the power of crowdfunding data as a supplementary source of information for Canadian health system stakeholders.

scholarly journals Community health workers at the dawn of a new era: 3. Programme governance

2021 ◽  
Vol 19 (S3) ◽  
Author(s):  
Simon Lewin ◽  
Uta Lehmann ◽  
Henry B. Perry
Keyword(s):  
Health System ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Critical Role ◽  
Decision Makers ◽  
Local Health ◽  
New Era ◽  
Wide Range ◽  
Health Related

Abstract Background Community health workers (CHWs) can play a critical role in primary healthcare and are seen widely as important to achieving the health-related Sustainable Development Goals (SDGs). The COVID-19 pandemic has emphasized the key role of CHWs. Improving how CHW programmes are governed is increasingly recognized as important for achieving universal access to healthcare and other health-related goals. This paper, the third in a series on “Community Health Workers at the Dawn of a New Era”, aims to raise critical questions that decision-makers need to consider for governing CHW programmes, illustrate the options for governance using examples of national CHW programmes, and set out a research agenda for understanding how CHW programmes are governed and how this can be improved. Methods We draw from a review of the literature as well as from the knowledge and experience of those involved in the planning and management of CHW programmes. Results Governing comprises the processes and structures through which individuals, groups, programmes, and organizations exercise rights, resolve differences, and express interests. Because CHW programmes are located between the formal health system and communities, and because they involve a wide range of stakeholders, their governance is complex. In addition, these programmes frequently fall outside of the governance structures of the formal health system or are poorly integrated with it, making governing these programmes more challenging. We discuss the following important questions that decision-makers need to consider in relation to governing CHW programmes: (1) How and where within political structures are policies made for CHW programmes? (2) Who implements decisions regarding CHW programmes and at what levels of government? (3) What laws and regulations are needed to support the programme? (4) How should the programme be adapted across different settings or groups within the country or region? Conclusion The most appropriate and acceptable models for governing CHW programmes depend on communities, on local health systems, and on the political system in which the programme is located. Stakeholders in each setting need to consider what systems are currently in place and how they might be adapted to local needs and systems.

scholarly journals The patient voice: a survey of worries and anxieties during health system transition in HIV services in Vietnam

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shoko Matsumoto ◽  
Hoai Dung Thi Nguyen ◽  
Dung Thi Nguyen ◽  
Giang Van Tran ◽  
Junko Tanuma ◽  
...  
Keyword(s):  
Health System ◽  
Current System ◽  
Insurance Coverage ◽  
Social Health Insurance ◽  
Health Facilities ◽  
Local Health ◽  
Hiv Services ◽  
The Public ◽  
System Transition ◽  
Lack Of Information

Abstract Background Vietnam is shifting toward integrating HIV services into the public health system using social health insurance (SHI), and the HIV service delivery system is becoming decentralized. The study aim was to investigate current SHI coverage and patients’ perspectives on this transition. Methods A survey of 1348 HIV-positive patients on antiretroviral therapy (aged ≥18 years) was conducted at an HIV outpatient clinic at a central-level hospital in Hanoi, Vietnam, in October and November 2018. Insurance coverage, reasons for not having a SHI card, perceived concerns about receiving HIV services in SHI-registered local health facilities, and willingness to continue regularly visiting the current hospital were self-reported. Logistic regression analyses were performed to analyze factors associated with not having a SHI card and having concerns about receiving HIV services in SHI-registered hospitals/clinics. Results SHI coverage was 78.0%. The most frequently reported reason for not having a SHI card was that obtaining one was burdensome, followed by lack of information on how to obtain a card, and financial problems. Most patients (86.6%) had concerns about receiving HIV services at SHI-registered local health facilities, and disclosure of HIV status to neighbors and low quality of HIV services were the main concerns reported. Participants aged < 40 years old and unmarried were more likely to report lack of SHI cards, and women and those aged ≥40 years were more likely to have concerns. However, 91.4% of patients showed willingness to continue regular visits to the current hospital. Conclusions Although SHI coverage has been rapidly improving among HIV patients, most participants had concerns about the current system transition in Vietnam. In response to their voiced concerns, strengthening the link between higher-level and lower-level facilities may help to ensure good quality HIV services at all levels while mitigating patients’ worries and anxieties.

scholarly journals Allocating resources to support universal health coverage: development of a geographical funding formula in Malawi

2020 ◽  
Vol 5 (9) ◽  
pp. e002763
Author(s):  
Finn McGuire ◽  
Paul Revill ◽  
Pakwanja Twea ◽  
Sakshi Mohan ◽  
Gerald Manthalu ◽  
...  
Keyword(s):  
Service Delivery ◽  
Universal Health Coverage ◽  
Current System ◽  
Health Sector ◽  
Cost Effective ◽  
Local Health ◽  
Health Coverage ◽  
Effective Interventions ◽  
Wide Range ◽  
Universal Health

BackgroundUniversal health coverage (UHC) requires that local health sector institutions—such as local authorities—are properly funded to fulfil their service delivery commitments. In this study, we examine how formula funding can align sub-national resource allocations with national priorities. This is illustrated by outlining alternative options for using mathematical formula to guide the allocation of national drug and service delivery budgets to district councils in Malawi in 2018/2019.MethodsWe use demographic, epidemiological and health sector budget data with information on implementation constraints to construct three variant allocation formulae. The first gives an equal per capita allocation to each district, and is included as a baseline to compare alternatives. The second allocates funds to districts using estimates of the resources required to provide Malawi’s essential health package of priority cost-effective interventions to the full population in need of each intervention. The third adjusts these estimates to reflect a practicable level of attainable coverage for each intervention, based on the current configurations of health services and demand for interventions.FindingsCompared with current district allocations, not underpinned by an explicit formula, the formulae presented in this study suggest sizeable shifts in the allocations received by many districts. In some cases, the magnitude of these shifts exceed 50% reductions or doubling of district budgets. The large shifts illustrate inequities in the current system of budget allocation and the potential improvements possible.ConclusionThe use of mathematical formulae can guide the efficient and equitable allocation of healthcare funds to local health authorities. The formulae developed were facilitated by the existence of an explicit package of priority interventions. The approach can be replicated in wide range of countries seeking to achieve UHC.

A Pluralidade do Conceito de Saúde: o Poder de Voz dos Usuários do SUS em uma Conferência Municipal de Saúde/The Plurality of the Concept of Health: the Voice Power of Unified Health System (SUS) Users in a Municipal Health Conference

1970 ◽  
Vol 5 (2) ◽  
pp. 91-99 ◽  
Author(s):  
Renato Augusto Passos ◽  
Sylvia da Silveira Nunes ◽  
Luiz Felipe Silva
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Sector ◽  
Minas Gerais ◽  
Ethnographic Study ◽  
Local Health ◽  
Research Committee ◽  
Unified Health System ◽  
Concept Of Health ◽  
Municipal Health

RESUMOObjetivo: O presente trabalho teve como objetivo principal analisar o conceito de saúde sob a perspectiva de um grupo de usuários do SUS moradores de um município de pequeno porte situado no sul de Minas Gerais, em uma conferência municipal de saúde. Materiais e métodos: Tratou-se de um recorte da dissertação intitulada “Cotidiano e saúde(s): estudo etnográfico dos usuários do SUS em um município do Sul de Minas” aprovado pelo comitê de ética em pesquisas da Faculdade de Medicina de Itajubá (FMIT), sob parecer 618.702. O estudo foi transversal de pesquisa qualitativa etnográfica, com levantamento de dados realizado por meio de observação participante. Resultados e discussão: Ao refletir sobre as necessidades em saúde, o grupo demonstrou a pluralidade de situações que envolvem o conceito de saúde relacionando-o a questões como a necessidade de atividades físicas regulares, a necessidade de água tratada, os riscos da ingestão de alimentos contaminados, a necessidade da coleta de lixo acumulado nos bairros rurais, a inclusão de terapias alternativas (homeopatia e acupuntura) nos serviços de saúde, entre outros. Conclusão: As propostas finais aprovadas na Conferência Municipal de Saúde demonstram a necessidade em ampliar os modos de lidar com métodos centrados em produção de dados ligados às doenças, visto a pluralidade de maneiras de lidar com o conceito de saúde(s). Apontam para necessidade do setor público de saúde planejar suas ações baseadas nas necessidades da comunidade e atuar em conjunto com outros setores, como o de infraestrutura urbana e rural, transporte, meio ambiente, educação, entre outros.Palavras chave: Conferências de saúde, Sistema Único de Saúde, Formação de conceito. ABSTRACTObjective: This study aimed to analyze the concept of health from the perspective of a group of public health system (SUS) users who live in a small city  in southern Minas Gerais, in a local health conference. Materials and methods: This was a clipping of the dissertation entitled "Daily life and health: ethnographic study of SUS users in a southern city of Minas" approved by the ethics in research committee of the Medicine School of Itajubá (FMIT), under report 618,702. The study was a cross ethnographic qualitative research, with data collection conducted through participant observation. Results and discussion: When thinking over health needs, the group demonstrated the plurality of situations involving the concept of health relating it to issues such as the need for regular physical activity, the need for clean water, the risks of contaminated food intake, the need of accumulated garbage collection in rural districts, the inclusion of alternative therapies (homeopathy and acupuncture) in health services, among others. Conclusion: The final proposals approved at the Municipal Health Conference demonstrate the need to broaden the ways of dealing with methods focusing on data production linked to disease, considering the plurality of ways to deal with the concept of health. It points to the need for the public health sector to plan their actions based on community needs and work together with other sectors, such as urban and rural infrastructure, transport, environment and education among others. Keywords: Health conferences, Unified Health System, Concept Formation.

scholarly journals Use of social media in public and private hospitals in Italy: preliminary results

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
U Gelatti ◽  
A De Bernardis ◽  
L Covolo
Keyword(s):  
Social Media ◽  
Public Hospitals ◽  
Local Health ◽  
Healthcare Organizations ◽  
Private Hospitals ◽  
Public And Private ◽  
Preliminary Results ◽  
The North ◽  
Public And Private Hospitals ◽  
Use Of Social Media

Abstract Background In 2010, the Italian Ministry of Health set out recommendations for the use of Web 2.0, inviting organizations within the Italian National Health Service (INHS) to implement these tools. In 2014, a study carried out by the National Institute of Health showed a low presence of Local Health Authorities and Italian public hospitals on social media. Considering the constant increase of the use of social media in the population, the aim of the study is to understand if and how healthcare context is moving towards this direction. Methods The list of all public and private hospitals in Italy were retrieved by the official website of INHS. The websites of all the hospitals (n = 1054) will be visited to look for the presence of social media. Engagement level and use of social media will be evaluated. Results A preliminary analysis focused one 97 hospitals, of which 64 public and 33 private. Social media are present in 38 (39%) of them, particularly Facebook, Twitter and You Tube (92%). Only Twitter or YouTube are present in three hospitals. Social media are present more in hospitals in the North of Italy (58%) compared to Center (29%) and South (13%) (p = 0.002). Furthermore social media are present more in private hospitals than public (55% vs 44%, p &lt; 0.001). Conclusions Preliminary results show a low presence of hospitals on social media, with some differences between geographical areas and type of hospitals. Adherence to Ministry of Health’s recommendations seems still low. Key messages Public health communication need to implement new strategies to increase public participation and provide reliable information using the information channels most used by the population. Considering the spread of health information through social media, an active presence of healthcare organizations on these channels could be an opportunity to engage people in health interventions.

Impact of health sector reforms on hospital productivity in Turkey

2018 ◽  
Vol 21 (2) ◽  
pp. 72-84 ◽  
Author(s):  
Saleh Mollahaliloglu ◽  
Sahin Kavuncubasi ◽  
Fikriye Yilmaz ◽  
Mustafa Z. Younis ◽  
Fatih Simsek ◽  
...  
Keyword(s):  
Health System ◽  
Positive Impact ◽  
Current System ◽  
Health Sector ◽  
Malmquist Index ◽  
Turkish Population ◽  
Hospital System ◽  
System Productivity ◽  
Content Type ◽  
Health Sector Reforms

Purpose Turkish Ministry of Health (MoH) has Health Transformation Program (HTP). The purpose of this program has been to modify the structure of the current system in order to enhance health system productivity, quality, and access in the Turkish health system. The paper aims to discuss these issues. Design/methodology/approach To measure the productivity, a data envelopment analysis-based Malmquist index approach was employed. Findings Results showed that the overall HTP have had a considerable positive impact on the productivity of general hospitals. Research limitations/implications The limitation is the availability of some data that might not be collected or reported to the MoH in Turkey. Practical implications This research’s findings will have an impact on reforming the health care system in Turkey to be competitive and efficient as possible. Social implications The research will have implication on reducing cost and provide value to the Turkish population. Originality/value This is one of the very few articles that targeted the efficiency of hospital system in Turkey.

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