scholarly journals Difficulties in implementation of the National Health Map in Bulgaria

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Georgieva ◽  
M Kamburova ◽  
D Tsanova
Keyword(s):  
Health Policy ◽  
Health System ◽  
General Practitioners ◽  
National Health ◽  
National Health Policy ◽  
Access To Health Services ◽  
Healthcare Facilities ◽  
Hospital Beds ◽  
European Standards ◽  
Population Ratio

Abstract Background National Health Map (NHM) of Bulgaria determines the required minimum of healthcare facilities, hospital beds and specialists at different levels of Health System to meet population's needs of healthcare. Its main objective is to adapt structure of the healthcare network to the population health needs ensuring for every Bulgarian citizen an equal access to health services. Through it healthcare resources have been planned on a territorial basis and the national health policy has been implemented. The aim of this report is to analyze the actual availability of healthcare facilities and staff, and compare with the minimum necessary according to the NHM. Methods Content and critical analysis of statistical data of the Bulgarian Ministry of Health. Results Bulgaria is among countries with relatively low number of general practitioners (GPs) among countries of EU where the range is between 42 and 253 per 100 000 inhabitants. According to the NHM, taking into account administrative division, infrastructure and morbidity, optimum GPs/population ratio is about 67/100 000 while an actual availability is 55.9/100 000. The most serious deficiency is in remote areas where the ratio is between 26 and 32 per 100 000. Quality of primary health care is affected by the fact that 23.89% of GPs are without acquired specialty. Number of practicing nurses in Bulgarian health system is 30% lower than the recommended minimum. Nurses/population ratio is unsatisfactory. Physicians/nurses ratio is not consistent with European standards. Hospital beds are 6.3/1000 which range Bulgaria among five European countries with the highest availability of hospital beds but they are unevenly distributed both on a territorial basis and on specialties. Conclusions There is a lack of human resources in Bulgarian Health System and unequal availability and accessibility of health facilities in different regions of the country. Distribution of hospital beds on specialties also must be optimized. Key messages National Health Map of Bulgaria determines population needs of accessible outpatient and hospital care, distributes health institutions on territorial bases and implements National Health Policy. Difficulties in implementation of National Health Map are insufficient number general practitioners (GPs), a large proportion of GPs without acquired specialty, inadequate ratio physicians/nurses etc.

scholarly journals DEVELOPMENT OF THEORETICAL APPROACHES TO PHARMACEUTICAL CARE IMPROVEMENT CONSIDERING THE MODERN REQUIREMENTS OF HEALTH-CARE SYSTEM IN UKRAINE

2018 ◽  
Vol 11 (8) ◽  
pp. 356 ◽  
Author(s):  
Igor A Zupanets ◽  
Victoriia Ye Dobrova ◽  
Olena O Shilkina
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Health System ◽  
Pharmaceutical Care ◽  
National Health ◽  
Care Process ◽  
National Health Policy ◽  
Care Policy ◽  
Structural Element ◽  
Theoretical Approaches

Objective: The objective of this research was to formulate the theoretical approaches to the improvement of pharmaceutical care considering the modern requirements of the public health system in Ukraine.Methods: The analysis of pharmaceutical care has been performed using “policy triangle” model. The pharmaceutical care policy model has been developed by applying the process approach.Results: The model of pharmaceutical care as a structural element of the national health policy has been developed. This model describes mechanisms by which the content, context, and process of the pharmaceutical care policy are influenced by the content, context, and process of the national health policy. Furthermore, we have defined the actors of the pharmaceutical care policy which are groups and organizations of various levels involved in the formation and development of the pharmaceutical care policy. Then, the structure of the pharmaceutical care policy has been elaborated. This policy is integrated into the national health-care system and is adapted to the good pharmacy practice requirements. The center of the policy is a process of pharmaceutical care delivering. The inputs, outcomes, management, and resources that are required for the pharmaceutical care process and provided by the actors have been identified. The data streams within this structure demonstrate implementation of the key elements of the pharmaceutical care process: Patient involvement, patient counseling and education, interprofessional collaboration, documentation of interaction, and follow-up. Furthermore, the mechanism of continual education and increasing of the professional level has been described in this structure.Conclusion: Proposed framework provides a comprehensive view of pharmaceutical care as a structural element of the national health policy considering new trends of the Ukrainian health system. The proposed model of the pharmaceutical care policy allows policy-makers to address all critical-to-quality aspects and stakeholders’ needs.

scholarly journals Opportunities and Challenges for effective implementations of Karnali Province Health Policy

2021 ◽  
Vol 3 (1) ◽  
pp. i-iii
Author(s):  
Padam Prasad Simkhada ◽  
Sharada Prasad Wasti
Keyword(s):  
Health Policy ◽  
Health System ◽  
National Health ◽  
Local Governments ◽  
Local Level ◽  
Health Sector ◽  
Governance Structure ◽  
National Health Policy ◽  
Ministry Of Health ◽  
Healthcare Needs

The health sector is complex, involving many stakeholders, multiple goals, and different beneficiaries. Health policy is an instrument to decide, plan and action that are undertaken to achieve health care goals within a society to combat the health problems. It is crucial for understanding it influences on health systems and prioritizing the health needs of the population.1 In 2015, Nepal became a federal republic and replaced a unitary government with a federal government at the central level, seven provincial and 753 local governments having more authority and resources in planning and managing than before. In the spirit of Constitution of Nepal 2015 and with the vision to make the health services of the country universal and qualitative, Ministry of health and population of Nepal (2019) revised National health policy in 2019. National Health policy 2019 of Nepal has expanded its plan and strategies according to federal structure of the country to improve health sector.2 The revision of health policy paved the way forward towards health system reform in the country which is further supported by Local Government operation act 2017.3 With the new governance structure, accountability has also been divided among the three tiers and the local level is responsible for the program implementation responsibilities.4 5 The Ministry of Health and Population (MoHP) is responsible for managing the health system at the federal level, whereas at the provincial level leads by the Ministry of Social Development and local governments metro/sub-metropolitan, municipality and rural municipality are responsible for its management.6 This indicates that the health system must gear up to meet the escalating healthcare needs of every citizen and upgrading the system as per the structure of the country.

scholarly journals Tecendo as circunstâncias de reformulação e operacionalização do sistema nacional de saúde de 1973 a 1979

2009 ◽  
Vol 3 (2) ◽  
pp. 346
Author(s):  
Erica Toledo Mendonça ◽  
Wellington Mendonça Amorim
Keyword(s):  
Health Policy ◽  
Health System ◽  
National Health ◽  
National Health System ◽  
Social Study ◽  
National Health Policy ◽  
Basic Point ◽  
Socioeconomic Structure ◽  
The Government ◽  
Pass Through

ABSTRACT Objective: to describe the circumstances in which was gave the proposal for recasting and operationalization of the National Health Policy, in the period from 1973 to 1979. Methodology: historical and social study, based on documentary analysis. Results: in reviewing the circumstances in which was gave the proposal for recasting and operationalization of the National Health Policy in the 1970s, we found that it was striking inequality that existed in the level of health of people, caused by factors constraints of the most varied and characterized so peculiar to each company, led the government, the international organizations and world community had the primary targets in its policies. It was in that moment that the federal government, through Law No. 6229/1975, organized the National Health System. So, in the 1970s, it was started the discussions about the politics of the extension of coverage, which centered in the primary care basic point of departure that can be achieved better care coverage to people, to try to reach adequate levels of health. Conclusion: as actors participants of the constitution of the new health system, called "network", the nurses, in order to understand the social reality and to articulate in socioeconomic structure, they needed to pass through a process with significant changes in their academic training, and consequently, in the care. Descriptors: nursing; public health; health policies.RESUMOObjetivo: descrever as circunstâncias em que se deu a proposta de reformulação e operacionalização da Política Nacional de Saúde, no período de 1973 a 1979. Metodologia: estudo histórico-social, embasado na análise documental. Resultados: ao analisarmos as circunstâncias em que se deu a proposta de reformulação e operacionalização da Política Nacional de Saúde, na década de 1970, encontramos que, era marcante a desigualdade que existia no nível de saúde dos povos, provocada por fatores condicionantes dos mais variados e caracterizada de modo peculiar em cada sociedade, o que fez com que o governo, as organizações internacionais e a comunidade mundial tivessem como preocupação primordial metas em suas políticas de saúde. Foi nesse momento que o governo federal, por meio da Lei nº 6229/1975, estruturou o Sistema Nacional de Saúde. A partir daí, nos anos de 1970, começaram as discussões acerca das políticas de extensão de cobertura, que centravam, na assistência primária o ponto básico de partida para que fosse alcançada melhor assistência de cobertura às populações, a fim de que atingisse níveis adequados de saúde. Conclusão: como atores participantes da constituição do novo sistema de saúde, denominado “rede”, as enfermeiras, no intuito de apreender a realidade social e se articular na estrutura socioeconômica, necessitavam passar por um processo de mudanças significativas em sua formação acadêmica, e conseqüentemente, assistencial. Descritores: enfermagem; saúde pública; políticas de saúde.RESUMENObjetivo: describir las circunstancias en que se dio a la propuesta de la refundición y la puesta en marcha de la Política Nacional de Salud, en el período comprendido entre 1973 a 1979. Metodologia: estudio histórico y social sobre la base de análisis documental. Resultados: al examinar las circunstancias en que se dio a la propuesta de la refundición y la puesta en marcha de la Política Nacional de Salud en el decenio de 1970, encontramos que era notable la desigualdad que existía en el nivel de salud de las personas, causados por factores de las limitaciones de las más variadas y caracterizado por lo peculiar de cada una de las empresas, llevó al gobierno, las organizaciones internacionales y la comunidad mundial son los principales objetivos en sus políticas. Fue entonces que el gobierno federal, a través de la Ley N º 6229/1975, organizado el Consejo Nacional de Salud. A partir desde alli, en el decenio de 1970, inició los debates sobre la política de la ampliación de la cobertura, que se centró en la atención primaria punto básico de partida que se puede lograr una mejor cobertura de atención a las personas a fin de que alcance niveles adecuados de salud. Conclusión: como los actores participantes de la constitución del nuevo sistema de salud, denominado red, las enfermeras, a fin de comprender la realidad social y se articulan en la estructura socioeconómica, es necesario pasar por un proceso de importantes cambios en su formación académica y, en consecuencia, asistencial. Descriptores: enfermería; salud pública; politicas de salud.

Psychology and National Health Policy.

1981 ◽  
Vol 26 (2) ◽  
pp. 88-89
Author(s):  
Theodore H. Blau
Keyword(s):  
Health Policy ◽  
National Health ◽  
National Health Policy

Advanced practice in ophthalmic nursing: A comparison of roles and the effects of policy on practice in the UK and New Zealand

2010 ◽  
Vol 18 (1) ◽  
pp. 7-18 ◽  
Author(s):  
Janet Marsden ◽  
Mary E. Shaw ◽  
Sue Raynel
Keyword(s):  
Health Policy ◽  
New Zealand ◽  
National Health ◽  
Mixed Method ◽  
Advanced Practice ◽  
National Health Policy ◽  
Minimal Effect ◽  
Questionnaire Data ◽  
Role Development ◽  
The Uk

This paper compares the results of studies of ophthalmic advanced practice in two similar but distinct health economies and integrates the effects of the setting, health policy and professional regulation on such roles. A mixed method questionnaire design was used, distributed at national ophthalmic nursing conferences in the UK and in New Zealand. Participants were nurses undertaking advanced practice who opted to return the questionnaire. Data were analysed separately, and are compared here, integrated with national health policy and role regulation to provide commentary on the findings. The findings suggest that health policy priorities stimulate the areas in which advanced practice roles in ophthalmic nursing emerge. The drivers of role development appear similar and include a lack of experienced doctors and an unmanageable rise in healthcare demand. Titles and remuneration are different in the two health economies, reflecting the organisation and regulation of nursing. In clinical terms, there are few differences between practice in the two settings and it appears that the distinct systems of regulation have minimal effect on role development. Ophthalmic nursing, as a reactive, needs based profession and in common with nursing in general, evolves in order that practice reflects what is needed by patients and services.

A view from abroad: a New Zealand perspective on the English NHS health reforms

2016 ◽  
Author(s):  
Robin Gauld
Keyword(s):  
Health Policy ◽  
New Zealand ◽  
Health System ◽  
Access To Care ◽  
Healthcare System ◽  
National Health ◽  
Universal Access ◽  
National Health System ◽  
High Income ◽  
Coalition Government

The English NHS is of significance among health policy observers around the globe for various reasons. The NHS is particularly noteworthy for the fact that, for many, it represents the high-income world’s best attempt to have built and maintained a ‘national’ health system with a focus on universal access to care that is free at point of service. The NHS has been in transition for several years. Many commentators have highlighted the role and influence of US market ideals in this transition, with various UK governments clearly pushing this agenda. However, is often useful to look to countries more closely comparable to England, such as New Zealand, for comparison with a view to improvement. This chapter takes such an approach in looking at the NHS from abroad. It draws upon the case of NZ which, in many ways, is very similar to England when it comes to health policy and the healthcare system. In doing so, it aims to provide a critique of the NHS reforms and demonstrate that there are alternatives to the policies and structures being pursued for the English NHS by the Coalition government.

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