scholarly journals Emerging challenges in the health systems of Kerala, India: qualitative analysis of literature reviews

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Manesh Muraleedharan ◽  
Alaka Omprakash Chandak

PurposeThe substantial increase in non-communicable diseases (NCDs) is considered a major threat to developing countries. According to various international organizations and researchers, Kerala is reputed to have the best health system in India. However, many economists and health-care experts have discussed the risks embedded in the asymmetrical developmental pattern of the state, considering its high health-care and human development index and low economic growth. This study, a scoping review, aims to explore four major health economic issues related to the Kerala health system.Design/methodology/approachA systematic review of the literature was performed using PRISMA to facilitate selection, sampling and analysis. Qualitative data were collected for thematic content analysis.FindingsChronic diseases in a significant proportion of the population, low compliance with emergency medical systems, high health-care costs and poor health insurance coverage were observed in the Kerala community.Research limitations/implicationsThe present study was undertaken to determine the scope for future research on Kerala's health system. Based on the study findings, a structured health economic survey is being conducted and is scheduled to be completed by 2021. In addition, the scope for future research on Kerala's health system includes: (1) research on pathways to address root causes of NCDs in the state, (2) determine socio-economic and health system factors that shape health-seeking behavior of the Kerala community, (3) evaluation of regional differences in health system performance within the state, (4) causes of high out-of-pocket expenditure within the state.Originality/valueGiven the internationally recognized standard of Kerala's vital statistics and health system, this review paper highlights some of the challenges encountered to elicit future research that contributes to the continuous development of health systems in Kerala.

2012 ◽  
Vol 2 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Caroline S. E. Homer ◽  
Tauaitala Lees ◽  
Pelenatete Stowers ◽  
Fulisia Aiavao ◽  
Annabel Sheehy ◽  
...  

A traditional birth attendant (TBA) is a person who assists the mother during childbirth and who initially acquired her skills by delivering babies herself or through apprenticeship to other TBAs. In many parts of the world, TBAs continue to provide a significant proportion of maternity care during pregnancy, birth, and the postpartum period. In Samoa, TBAs are recognized part of both the formal and informal health care system. The aim of this research was to examine the contribution that TBAs made in the provision of maternity care in Samoa. A descriptive study was undertaken, and 100 TBAs who had attended more than 400 births a year were interviewed as part of a broader Safe Motherhood Needs Assessment.The findings highlighted that although TBAs can work in collaboration with individual health providers or facilities or be integrated into the health system, TBAs were often practicing autonomously within their communities, independent of collaborative links. This study showed that formal recognition and registration of TBAs would improve the recording of births and augment their partnership to the formal health care system. This formal registration process has since been implemented to improve monitoring and evaluation and assist future research with this important group.


2019 ◽  
Vol 32 (4) ◽  
pp. 620-643
Author(s):  
Betty Onyura ◽  
Sara Crann ◽  
Risa Freeman ◽  
Mary-Kay Whittaker ◽  
David Tannenbaum

Purpose This paper aims to review a decade of evidence on physician participation in health system leadership with the view to better understand the current state of scholarship on physician leadership activity in health systems. This includes examining the available evidence on both physicians’ experiences of health systems leadership (HSL) and the impact of physician leadership on health system reform. Design/methodology/approach A state-of-the-art review of studies (between 2007 and 2017); 51 papers were identified, analyzed thematically and synthesized narratively. Findings Six main themes were identified in the literature as follows: (De)motivation for leadership, leadership readiness and career development, work demands and rewards, identity matters: acceptance of self (and other) as leader, leadership processes and relationships across health systems and leadership in relation to health system outcomes. There were seemingly contradictory findings across some studies, pointing to the influence of regional and cultural contextual variation on leadership practices as well entrenched paradoxical tensions in health system organizations. Research limitations/implications Future research should examine the influence of varying structural and psychological empowerment on physician leadership practices. Empirical attention to paradoxical tensions (e.g. between empowerment and control) in HSL is needed, with specific attention to questions on how such tensions influence leaders’ decision-making about system reform. Originality/value This review provides a broad synthesis of diverse papers about physician participation in health system leadership. Thus, it offers a comprehensive empirical synthesis of contemporary concerns and identifies important avenues for future research.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  

Abstract The European Commission's State of Health in the EU (SoHEU) initiative aims to provide factual, comparative data and insights into health and health systems in EU countries. The resulting Country Health Profiles, published every two years (current editions: November 2019) are the joint work of the European Observatory on Health Systems and Policies and the OECD, in cooperation with the European Commission. They are designed to support the efforts of Member States in their evidence-based policy making and to contribute to health care systems' strengthening. In addition to short syntheses of population health status, determinants of health and the organisation of the health system, the Country Profiles provide an assessment of the health system, looking at its effectiveness, accessibility and resilience. The idea of resilient health systems has been gaining traction among policy makers. The framework developed for the Country Profiles template sets out three dimensions and associated policy strategies and indicators as building blocks for assessing resilience. The framework adopts a broader definition of resilience, covering the ability to respond to extreme shocks as well as measures to address more predictable and chronic health system strains, such as population ageing or multimorbidity. However, the current framework predates the onset of the novel coronavirus pandemic as well as new work on resilience being done by the SoHEU project partners. This workshop aims to present resilience-enhancing strategies and challenges to a wide audience and to explore how using the evidence from the Country Profiles can contribute to strengthening health systems and improving their performance. A brief introduction on the SoHEU initiative will be followed by the main presentation on the analytical framework on resilience used for the Country Profiles. Along with country examples, we will present the wider results of an audit of the most common health system resilience strategies and challenges emerging from the 30 Country Profiles in 2019. A roundtable discussion will follow, incorporating audience contributions online. The Panel will discuss the results on resilience actions from the 2019 Country Profiles evidence, including: Why is resilience important as a practical objective and how is it related to health system strengthening and performance? How can countries use their resilience-related findings to steer national reform efforts? In addition, panellists will outline how lessons learned from country responses to the Covid-19 pandemic and new work on resilience by the Observatory (resilience policy briefs), OECD (2020 Health at a Glance) and the EC (Expert Group on Health Systems Performance Assessment (HSPA) Report on Resilience) can feed in and improve the resilience framework that will be used in the 2021 Country Profiles. Key messages Knowing what makes health systems resilient can improve their performance and ability to meet the current and future needs of their populations. The State of Health in the EU country profiles generate EU-wide evidence on the common resilience challenges facing countries’ health systems and the strategies being employed to address them.


Author(s):  
Katarzyna Krot ◽  
Iga Rudawska

Overconsumption of health care is an ever-present and complex problem in health systems. It is especially significant in countries in transition that assign relatively small budgets to health care. In these circumstances, trust in the health system and its institutions is of utmost importance. Many researchers have studied interpersonal trust. Relatively less attention, however, has been paid to public trust in health systems and its impact on overconsumption. Therefore, this paper seeks to identify and examine the link between public trust and the moral hazard experienced by the patient with regard to health care consumption. Moreover, it explores the mediating role of patient satisfaction and patient non-adherence. For these purposes, quantitative research was conducted based on a representative sample of patients in Poland. Interesting findings were made on the issues examined. Patients were shown not to overconsume health care if they trusted the system and were satisfied with their doctor-patient relationship. On the other hand, nonadherence to medical recommendations was shown to increase overuse of medical services. The present study contributes to the existing knowledge by identifying phenomena on the macro (public trust in health care) and micro (patient satisfaction and non-adherence) scales that modify patient behavior with regard to health care consumption. Our results also provide valuable knowledge for health system policymakers. They can be of benefit in developing communication plans at different levels of local government.


2020 ◽  
Vol 25 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Brianne Redquest ◽  
Yona Lunsky

Purpose There has been an increase in research exploring the area of intellectual and developmental disabilities (IDD) and diabetes. Despite being described as instrumental to diabetes care for people with IDD, the role and experiences of family carers, such as parents and siblings, are often neglected in this research. However, it is clear that family carers do not feel that they have sufficient knowledge about diabetes. The purpose of this commentary is to extend the content from “Diabetes and people with learning disabilities: Issues for policy, practice, and education (Maine et al., 2020)” and discuss how family carers can feel better supported when caring for someone with IDD and diabetes. Design/methodology/approach This commentary discusses specific efforts such as STOP diabetes, DESMOND-ID and OK-diabetes for people with IDD including family carers. Encouragement is given for health care providers to recommend such programmes to people with IDD and their family carers. It is also suggested that health care providers involve family carers in diabetes care planning and implementation for people with IDD. Findings It is hoped that if changes are made to current diabetes practices and more research with family carers is conducted, diabetes prevention and management for people with IDD will be more successful and family carers can feel more confident in providing support to their loved ones. Originality/value Research exploring the role of family carers in diabetes care for people with IDD and diabetes is very limited. This commentary makes recommendations to help family carers feel better supported in their role. It also provides areas for future research.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rajesh Kumar Singh ◽  
Saurabh Agrawal ◽  
Abhishek Sahu ◽  
Yigit Kazancoglu

PurposeThe proposed article is aimed at exploring the opportunities, challenges and possible outcomes of incorporating big data analytics (BDA) into health-care sector. The purpose of this study is to find the research gaps in the literature and to investigate the scope of incorporating new strategies in the health-care sector for increasing the efficiency of the system.Design/methodology/approachFora state-of-the-art literature review, a systematic literature review has been carried out to find out research gaps in the field of healthcare using big data (BD) applications. A detailed research methodology including material collection, descriptive analysis and categorization is utilized to carry out the literature review.FindingsBD analysis is rapidly being adopted in health-care sector for utilizing precious information available in terms of BD. However, it puts forth certain challenges that need to be focused upon. The article identifies and explains the challenges thoroughly.Research limitations/implicationsThe proposed study will provide useful guidance to the health-care sector professionals for managing health-care system. It will help academicians and physicians for evaluating, improving and benchmarking the health-care strategies through BDA in the health-care sector. One of the limitations of the study is that it is based on literature review and more in-depth studies may be carried out for the generalization of results.Originality/valueThere are certain effective tools available in the market today that are currently being used by both small and large businesses and corporations. One of them is BD, which may be very useful for health-care sector. A comprehensive literature review is carried out for research papers published between 1974 and 2021.


Kybernetes ◽  
2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jie Lei ◽  
Jianming Liu ◽  
Wu Li

Purpose Hospital information system (HIS) can be examined as a vital factor for developing the quality of health care and cost managing. There exists abundant literature on HISs, but implementation-based literature of HIS is rare, typically about progressive countries. However, a study that can comprehensively review published articles is scarce. Therefore, this paper aims to examine the systematic and comprehensive study of HIS in developed countries. Together, the benefits and harms relevant to HIS’s different mechanisms have been considered, and the fundamental challenges of them are addressed to design more efficient HIS in the future. Design/methodology/approach HIS has been used globally for numerous years and is now being used in a wide area. HIS is broadly used in clinical settings. Information technology (IT) and information system have been suggested as a required piece to solve the health-care-related issues. Hence, to improve HIS’s ability, this paper conducted a review method concentratating on research related to HIS until 2019. A total of 21 papers were recognized and examined as principal research for the summary. Findings The authors found that HIS can help in reduction of medical mistakes, enhancement doctors’ performance and increase in the quality of the care provided. HIS management can be used to provide better health-care services. Therefore, HIS must be sensible and use clear structures. The authors conclude that, generally, with an increase in awareness, acceptability and the need for HIS worldwide, there will be more strategies and approaches available. Research limitations/implications First, this paper provides an outline of the status of HIS. Second, it identifies some distinct research gaps that could be worth studying. Some flawless work may be removed because of applying some filters to select the original articles. Surveying all the papers on the topic of HIS is impossible, too. Practical implications Design and sustainability of HIS is still a big issue for most developing countries, despite its wide usage in the developed countries. The technology is changing rapidly, so the field should be reviewed regularly. This paper suggests a suitable framework that will guide HIS in the local conditions of developing countries. Social implications The government will be assisted by the suggested solving ways in its performance and design of electronic health-care projects. Originality/value The study brings the viewpoints on the state of HIS mechanisms in developing countries. The paper’s results can offer visions into future research requirements. By providing comparative information and analyzing the current growths in this area, this study will support researchers and professionals to understand the progress in HIS mechanisms better.


Author(s):  
Karsten Vrangbæk

Scandinavian health systems have traditionally been portrayed as relatively similar examples of decentralised, public integrated health systems. However, recent decades have seen significant public policy developments in the region that should lead us to modify our understanding. Several dimensions are important for understanding such developments. First, several of the countries have undergone structural reforms creating larger governance units and strengthening the state level capacity to regulate professionals and steer developments at the regional and municipal levels. Secondly, the three Nordic countries studied experienced an increase in the purchase of voluntary health insurance and the use of private providers. This introduces several issues for the equality of users and the efficiency of the system. This paper will investigate such trends and address the question: Is the Nordic health system model changing, and what are the consequences for trust, professional regulation and the public interest?


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Syed S.M Sadrul Huda ◽  
Afsana Akhtar ◽  
Segufta Dilshad ◽  
Syeeda Raisa Maliha

PurposeThe study aims to gain insights into the management of COVID-19 in Bangladesh to identify the factors that are relevant to managing the pandemic in a developing country.Design/methodology/approachThe study was carried out by pursuing the archival method. The information was collected from credible newspaper reports over the previous months, as well as articles published on the subject of COVID-19.FindingsThe research revealed important and relevant dimensions of the health sector in managing the COVID-19 pandemic. The major factors were doctors, nurses (health service providers), patients, (customers) and society. This is a pioneering paper, which documents the major lessons learned from the management of COVID-19 in Bangladesh concerning three stakeholders of the health-care system, i.e. providers, patients and society. This paper covers the situation regarding the ongoing pandemic from three perspectives – provider, customers and society, and thus, may help to develop future research regarding the development of health-care management models for addressing the pandemic.Research limitations/implicationsThe major limitations of this paper is its over dependence on secondary sources for collecting the information.Practical implicationsThis paper presents the learnings from the pandemic in health-care management in different categories (e.g. social, doctor/nurse, patients), which can help the managers in understanding different dimensions of the health-care sector from different perspectives. The problems as well as the learnings stated in the paper can help the policy makers implement such strategies to ensure better delivery of the medical health-care service during a pandemic.Social implicationsThis paper clearly reveals the social dimensions of the COVID-19 by assessing the social aspects of COVID-19 management. Both social stigma and support are traced out during evaluating the situation. Thus, the social forces will be able to rethink about their role in addressing the social costs of pandemic.Originality/valueThis is a commentary piece.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Yuri Basile Tukoff-Guimarães ◽  
Claudia Terezinha Kniess ◽  
Renato Penha ◽  
Mauro Silva Ruiz

Purpose The purpose of this paper is to assess how technology transfer offices (TTOs) of a public university of the state of São Paulo use patent valuation methods in the process of using developed technology value and transferring technology to industry. Design/methodology/approach This study is an exploratory qualitative investigation based on a case study conducted in a public university in the state of São Paulo. The university has a TTO and an internal structure for technology transfer. In-depth interviews were conducted with the TTO manager about patent valuation and the answers given were analysed. Findings The results on how TTOs use patent valuation methods in the process of assigning value to technology indicate which factors facilitate and which factors hinder the valuation of patents in technologies developed at universities. Research limitations/implications The possible lack of data disclosure due to confidentiality regarding royalties and trading fees makes further comparisons between Brazilian public universities difficult. Therefore, this study recommends that further studies on patent valuation and technology transfer process at private universities, research institutes and public and private companies should be performed. Practical implications In the practice, this study contributes to companies and TTOs by increasing their synergies in licensing negotiations, as well as by reducing the gap of information, between the business parties for assignment and transfer of technologies. With regard to theoretical contribution, this study can cite advances in the methods to measure the financial benefits arising from the valuation of technologies embedded in the patents. Originality/value Owing to the lack of research on the methods of valuation used by TTOs of Brazilian universities, the present study can be useful in serving as a theoretical source for future research and in supporting future TTO negotiations in the process of transferring technologies to productive industry.


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