scholarly journals Development of a gender-relevant tobacco cessation intervention for women in Brazil—an intervention mapping approach to planning

2019 ◽  
Vol 34 (5) ◽  
pp. 505-520
Author(s):  
N�dia Kienen ◽  
Tha�s Dist�fano Wiltenburg ◽  
Lorna Bittencourt ◽  
Isabel C Scarinci

Abstract The purpose of this article is to describe the development of a theory-based, culturally and gender-relevant Community Health Worker (CWH)-led tobacco cessation intervention for low-income Brazilian women who augments the tobacco cessation program offered through the public health system using Intervention Mapping (IM). We began with the establishment of a network of representatives from different segments of society followed by comprehensive needs assessments. We then established a logical planning process that was guided by a theoretical framework (Social Cognitive Theory) and existing evidence-based tobacco cessation programs, taking into account socio-political context of a universal health care system. Given the gender-relevance of our intervention and the importance of social support in tobacco cessation among women, we chose an intervention that would be delivered within the public health system but augmented by CHWs that would be trained in behavior change by researchers. One of major advantages of utilizing IM was that decisions were made in a transparent and supportive manner with involvement of all stakeholders throughout the process. Despite the fact that this process is very taxing on researchers and the health care system as it takes time, resources and negotiation skills, it builds trust and promotes ownership which can assure sustainability.

2014 ◽  
Vol 61 (1) ◽  
pp. 36-44 ◽  
Author(s):  
Milena Gajic-Stevanovic ◽  
Jovana Aleksic ◽  
Neda Stojanovic ◽  
Slavoljub Zivkovic

Introduction. The backbone of Serbian health system forms the public healthcare provider network with 355 institutions and around 112,000 employees, owned and controlled by the Ministry of Health and financed mainly by the Republican Health Insurance Fund. The law recognizes private practice that was not included, till recently, in the public funding scheme. New Health Insurance Law (2005) decreased the number of entitlements in the basic health service package. It abolished the right to dental health care for adults (exceptions are: children, older than 65, pregnant women and emergency cases) as well as the right to compensate travel expenses. The aim of this study was to evaluate the effects of health care system of the Republic of Serbia and indicate parameters that determine the state of health of the population, on the ground of data obtained by the Institute of Public Health of Serbia. Results. In the period 2004-2012, cardiovascular diseases represented the main cause of illness in Serbia (50%). In 2012 digestive system diseases were on the second place. Neoplasm and nervous system diseases were on the third place. From 2007 to 2012 there was slight decline in the birth rate and number of deaths, but the death rate increased from 13.9 to 14.2. Health care system in Serbia is funded through the combination of public finances and private contributions. Primary care is provided in 158 health care centres and health care stations, secondary and tertiary care services are offered in general hospitals, specialized hospitals, clinics, clinico-hospital centers and clinical centres. Conclusion. A significant but not satisfactory progress has been achieved in the field of health status indicators as the most important outcome of the final performance of the health system. The transition of public health care system in Serbia since the communist period to present and slow integration with European Union is unfinished process.


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

2019 ◽  
Vol 88 (1) ◽  
pp. 39-46
Author(s):  
Mohammad Yasser Sabbah

The health care system in the State of Israel consists of two sectors - the public sector, which includes government-owned hospitals and medical institutes. The public health sector includes the community health system, health funds, family medicine, the general care system and the mental health care system. The second sector is the private sector, which includes private hospitals and medical institutes. Both sectors are supervised by the Israeli Ministry of Health, which is the supreme governmental authority through which it implements its policy in the entire health system in Israel. The law provides and guarantees medical insurance for every resident of Israel, the right to receive medical treatment, the prohibition of discrimination, informed consent to medical treatment, the right to receive an additional medical opinion, the dignity and privacy of the patient and the right to attend. Health funds in Israel were established before the State of Israel was established. The ideological concept of the health funds was based on the principle of equality and mutual assistance.


2011 ◽  
Vol 14 (3) ◽  
pp. A177
Author(s):  
R.A. Schmerling ◽  
S.D. Stefani ◽  
E. Barbosa ◽  
E. Asano ◽  
M.E. Nita ◽  
...  

Author(s):  
R Evans

Background: Noncommunicable diseases (NCDs) are increasingly prevalent within South Africa. Physical inactivity is a significant, independent and modifiable risk factor increasing the prevalence of NCDs.Discussion: The integration of physical activity programmes into the primary health care system through multidisciplinary platforms is thus advocated for and envisioned to be more cost-effective than current practices. However, currently within the primary health care setting of South Africa, there is an absence of health care professionals adequately equipped to develop and implement physical activity programmes. Biokineticists, whose scope of practice is to improve physical functioning and health through exercise as a modality, are ideally suited to developing and implementing physical activity programmes in the public sector. Yet despite their evident demand, the role of the biokineticist is not incorporated into the national public health care system.Conclusion: This short report calls firstly, for the inclusion of biokinetics into the public health care sector, and secondly, for the funding of multidisciplinary community health programmes supporting education, healthy eating and physical activity levels.


Author(s):  
S. Gopalakrishnan ◽  
A. Immanuel

National rural health mission (NRHM) was initiated in the year 2005 in eleventh five year plan, with the objective of providing quality health care services to the rural population. The mission brought out salient strategies by involving various sectors and forging partnerships with various organizations to unify health and family welfare services into a single window. Though the mission strived for a sustainable health care system, it did not envisage certain challenges in implementation. The public health system in India could take off from the foundations laid by the NRHM to overcome these challenges, in order to achieve various goals of health and development and put India on the road map of healthful development. The objective of this review article is to critically evaluate the implementation of national rural health mission and highlight its success and to make recommendations on the future health care planning and implementation in achieving universal health coverage for the rural India. NRHM has been a mammoth effort by the Union Government to build the public health infrastructure of the nation. The mission deserves its credit for empowering the rural India in health care, especially in States with poor health related indicators. NRHM has been a pioneer in reiterating the need for community participation, coupled with intersectoral convergence, to bring about a paradigm shift in the indicators, which has been reasonably achieved in most of the States. Taking forward the foundations laid by the NRHM, it is essential for the forthcoming policies and plans to focus on capacity building, not only on the infrastructure and technical aspects, but also on streamlining the health workforce, which is crucial to sustaining the public health infrastructure. The public health system in India should take off from the foundations laid by the NRHM. There is an imminent need to focus on forging a sustainable public private partnership, which will deliver quality services, and not compromise on the principles and identity of the public health system of the country, in its pursuit to achieve universal health coverage and sustainable development goals.


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