scholarly journals When universal health care isn’t truly universal: Beyond filling gaps in access to medicines

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L James ◽  
S Menezes ◽  
S Lawrence ◽  
M Aranago

Abstract Issue The Canadian healthcare system is defined by universality, but unfortunately that does not extend to drugs outside of hospitals. Access to medication remains an area of inequity, fragmentation and system failure, with millions struggling with cost related non-adherence. This has created major implications for public health, limiting the health status of populations. Canada's inequitable system and the recent pursuit to fix it, provides an opportunity to examine ways of balancing public health goals and health systems reform in a country with established public and private care services. Background The government mandated the creation of a plan to improve access to medications. Stakeholder consultations ran from June -September 2018 and the Heart & Stroke Foundation (H&S) aimed to create policy recommendations that would improve population health outcomes and inequities. Research review and analysis determined the scope of the problem and viable solutions. Questions arose around whether a solution could improve equity and lower health care costs without dismantling the existing private system. Results Visionary principles led to the recommendation of a universal pharmacare program, designed to improve access to cost-effective medicines for all people in Canada regardless of geography, age, or ability to pay. A hybrid -program would include a robust common formulary for which the public payer is the first payer creating cost efficiencies. Top-up private insurance would result in less strain on the public system and maintain the presence of the existing private industry. Lessons Health charities have a unique role to play in creating innovative policy solutions that also serve patient interests. In order to advance public health, health charities need to maintain focus on equity and avoid policy development that is biased with conflict of interest. Key messages Canada is primed to implement a unique universal pharmacare program that addresses healthy inequities. Varied stakeholder interests can block public health goals.

Author(s):  
Hari Walujo Sedjati

The research aimed to know problems policy health on Purbalingga district; province Central Java. Health planners have been more effective largely because of a policy regionalizing responsibility for the public health pure delivery assurance systems. Several kinds of health service provider’s hospital recommended by government for pure society in Purbalingga district. The Government as certain the efficiency and effectiveness of health services in public actors, these goals and options which frame a actor government Purbalingga district, choice in the health sector, are complicated by agreement over the criteria that determinant which patients are getting too much for pure society to health care. The policy Implementation goals to minimize mortalities and Invalid body for pure society in Purbalingga and policy health goals and standards are reached.


2021 ◽  
Vol 18 (3) ◽  
pp. 193-201
Author(s):  
Włodzimierz Cezary Włodarczyk ◽  
Grzegorz Juszczyk ◽  
Tomasz Zdrojewski ◽  
Wojciech Hanke ◽  
Bolesław Samoliński ◽  
...  

The Resolution of Public Health Committee Polish Academy of Science on Vaccination against COVID-19 Public health community worldwide encouraged by successes of former campaigns have always accepted vaccination as the most effective way to handle infectious diseases pandemics. Even before the outburst of SARS-CoV-2 pandemic in many countries mandatory vaccination against many diseases, especially child related had been implemented. From among 193 countries under study in as many as 105 (54%) such obligation existed and in 62 of them (59%) at least one form of punishment or harm for those opposing was involved. Following this sort of available solutions and facing COVID-19 pandemic disaster the authors on behalf of the Public Health Committee of the Polish Academy of Science recommend to the government implementation od mandatory vaccination against COVID-19 for all workers in sectors of health care, education and welfare.


2021 ◽  
Vol 4 (6) ◽  
Author(s):  
Ayim Aboagye D

The purpose of this article is to provide an overview of available research concerning covid-19 in Ghana. It presents challenges, measures from the health care delivery sector in the public health facilities. The article draws some strength from the fundamental laws of medicine as they aid to prepare the scientists in their combat against the novel Covid-19, its variants such as Delta and Omicron. Though the government has suffered economically from lockdowns and social interventions, its resilience efforts have been acclaimed to be successful and have to be emulated by other countries. The health care workers in Ghana's dissatisfaction with their jobs in these periods have not sidelined government efforts to lead and care for its citizens amid a pandemic.


Liquidity ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 110-118
Author(s):  
Iwan Subandi ◽  
Fathurrahman Djamil

Health is the basic right for everybody, therefore every citizen is entitled to get the health care. In enforcing the regulation for Jaringan Kesehatan Nasional (National Health Supports), it is heavily influenced by the foreign interests. Economically, this program does not reduce the people’s burdens, on the contrary, it will increase them. This means the health supports in which should place the government as the guarantor of the public health, but the people themselves that should pay for the health care. In the realization of the health support the are elements against the Syariah principles. Indonesian Muslim Religious Leaders (MUI) only say that the BPJS Kesehatan (Sosial Support Institution for Health) does not conform with the syariah. The society is asked to register and continue the participation in the program of Social Supports Institution for Health. The best solution is to enforce the mechanism which is in accordance with the syariah principles. The establishment of BPJS based on syariah has to be carried out in cooperation from the elements of Social Supports Institution (BPJS), Indonesian Muslim Religious (MUI), Financial Institution Authorities, National Social Supports Council, Ministry of Health, and Ministry of Finance. Accordingly, the Social Supports Institution for Helath (BPJS Kesehatan) based on syariah principles could be obtained and could became the solution of the polemics in the society.


2020 ◽  
Vol 18 (2) ◽  
pp. 149
Author(s):  
Mohammed Mustapha Namadi

Corruption is pervasive in Nigeria at all levels. Thus, despite recent gains in healthcare provision, the health sector faces numerous corruption related challenges. This study aims at examining areas of corruption in the health sector with specific focus on its types and nature. A sample size of 480 respondents aged 18 years and above was drawn from the eight Metropolitan Local Government Areas of Kano State, using the multistage sampling technique. The results revealed evidence of corrupt practices including those related to unnecessary-absenteeism, diversion of patients from the public health facilities to the private sector, diverting money meant for the purchase of equipment, fuel and diesel, bribery, stealing of medications, fraud, misappropriation of medications and unjustifiable reimbursement claims. In order to resolve the problem of corrupt practices in the healthcare sector, the study recommended the need for enforcement of appropriate code of ethics guiding the conduct of the health professionals, adoption of anti-corruption strategies, and strengthening the government monitoring system to check corruption in public health sector in order to ensure equitable access to healthcare services among the under-privileged people in the society.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T Vivas ◽  
M Duarte ◽  
A Pitta ◽  
B Christovam

Abstract Background The government investments in quality primary healthcare are the basis to strengthening the health systems and monitoring the public expenditure in this area is a way to assess the effectiveness and efficiency of the public health policies. The Brazil Ministry of Health changed, in 2017, the method of onlending federal resources to states and cities seeking to make the public funds management more flexible. This change, however, suppressed mandatory investments in primary healthcare. This research aims to determine the difference of expenditures on primary healthcare in Salvador, Bahia, Brazil metropolitan area before and after this funding reform, seeking to verify how it can impact the quality of primary healthcare services and programs. Methods This is an ecological time-series study that used data obtained in the Brazil Ministry of Health budget reports. The median and interquartile range of expenditures on primary healthcare (set as the percentage of total public health budget applied in primary care services and programs) of the 13 cities in the Salvador metropolitan area were compared two years before and after the reform. Results The median of expenditures on primary healthcare in Salvador metropolitan area was 25.5% (13,9% - 32,2%) of total public health budget before and 24.8% (20.8% - 30.0%) of total public health budget after the reform (-0.7% difference). Seven cities decreased the expenditures on primary healthcare after the reform, ranging from 1.2% to 10.8% reduction in the primary healthcare budget in five years. Conclusions Expenditures on primary healthcare in Salvador metropolitan area decreased after the 2017 funding reform. Seven of 13 cities reduced the government investments on primary healthcare services and programs in this scenario. Although the overall difference was -0.7%, the budget cuts ranged from 1.2% to 10.8% in the analyzed period and sample. More studies should assess these events in wide areas and with long time ranges. Key messages Public health funding models can impact the primary healthcare settings regardless of the health policy. Reforms in the funding models should consider the possible benefits before implementation. Funding models and methods that require mandatory investments in primary healthcare may be considered over more flexible ones.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Magnusson ◽  
I-Z Jama

Abstract The Right to health framework supports available, accessible and acceptable health care of high quality for all (AAAQ). Health of migrants often worsen in the new country. AAAQ may be hindered by poverty, discrimination, health cares' shortcomings and misunderstandings, respectively. Advocating for marginalised groups' Right to health include action. Interventions based on shared influence, participation and control need to be launched. Cultural mediators (CM), i.e. persons that are knowledgeable in both cultures and with networks in migrant groups help overcome lingual problems, lack of trust and uneven power relations. This resource needs to be further examined. How can a CM strengthen AAAQ in a public health setting? Women with Somalian origin living in an underserved neighborhood in Sweden contacted the Public Health Unit of a local hospital, asking for support for a health focused group-activity. Weight loss after delivery was a primary concern. Women gathered monthly 2018-19. The objective was to support healthy life style habits drawing on issues raised by the women. The intervention was conducted by group talks, led by the CM and a public health planner. Methods were based on Social Cognitive Theory focusing on self-efficacy. The CM recruited women, helped them to find the venue, encouraged them to trust the public health planner and broadened perspectives to include female genital mutilation, children's food, how to seek care and workforce issues. Trust developed over time. 70 women participated. Reported gains were raised awareness of ones' rights, increased self-efficacy in relation to food, physical activity and how to support children to a healthy life style. Support for a healthy lifestyle was made more available, accessible and acceptable by the cooperation with the CM, as was the quality of the support. A CM bridges distances regarding spoken language, trust and cultural understanding. S/he puts forward perspectives and needs from the group in question Key messages The Right to health framework highlights areas that need to be in focus when advocating for health equity. Health care workers in settings with many migrants should strive to include cultural mediators in planning, execution and evaluation of interventions.


Health Policy ◽  
2011 ◽  
Vol 99 (3) ◽  
pp. 261-266 ◽  
Author(s):  
Susan Cleary ◽  
Sheetal Silal ◽  
Stephen Birch ◽  
Henri Carrara ◽  
Victoria Pillay-van Wyk ◽  
...  

2021 ◽  
Vol 111 (S3) ◽  
pp. S224-S231
Author(s):  
Lan N. Đoàn ◽  
Stella K. Chong ◽  
Supriya Misra ◽  
Simona C. Kwon ◽  
Stella S. Yi

The COVID-19 pandemic has exposed the many broken fragments of US health care and social service systems, reinforcing extant health and socioeconomic inequities faced by structurally marginalized immigrant communities. Throughout the pandemic, even during the most critical period of rising cases in different epicenters, immigrants continued to work in high-risk-exposure environments while simultaneously having less access to health care and economic relief and facing discrimination. We describe systemic factors that have adversely affected low-income immigrants, including limiting their work opportunities to essential jobs, living in substandard housing conditions that do not allow for social distancing or space to safely isolate from others in the household, and policies that discourage access to public resources that are available to them or that make resources completely inaccessible. We demonstrate that the current public health infrastructure has not improved health care access or linkages to necessary services, treatments, or culturally competent health care providers, and we provide suggestions for how the Public Health 3.0 framework could advance this. We recommend the following strategies to improve the Public Health 3.0 public health infrastructure and mitigate widening disparities: (1) address the social determinants of health, (2) broaden engagement with stakeholders across multiple sectors, and (3) develop appropriate tools and technologies. (Am J Public Health. 2021;111(S3):S224–S231. https://doi.org/10.2105/AJPH.2021.306433 )


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