Health strike is unlikely to shape Kenya national vote

Significance Public sector doctors have been on strike since early December citing multiple grievances including pay, conditions at facilities and lack of investment in the public health system. The bitter dispute is the latest in a series of public-sector strikes and comes amid campaigning for August’s general elections. Impacts Agreeing to the strikers' full demands would add pressure for higher salaries in private facilities and the public sector. A national settlement could slow progress towards full devolution of health responsibilities to the counties. Elite segments of society do not rely on the public health system and may be less sympathetic to health workers’ grievances.

2016 ◽  
Vol 19 (1) ◽  
pp. 26-37 ◽  
Author(s):  
Camila Nascimento Monteiro ◽  
Reinaldo José Gianini ◽  
Marilisa Berti de Azevedo Barros ◽  
Chester Luiz Galvão Cesar ◽  
Moisés Goldbaum

ABSTRACT: Introduction: Since 2003, the access to medication has been increasing in Brazil and particularly in São Paulo. The present study aimed to analyze the access to medication obtained in the public sector and the socioeconomic differences in this access in 2003 and 2008. Also, we explored the difference in access to medication from 2003 to 2008. Method: Data were obtained from two cross-sectional population-based household surveys from São Paulo, Brazil (ISA-Capital 2003 and ISA-Capital 2008). Concentration curve and concentration index were calculated to analyze the associations between socioeconomic factors and access to medication in the public sector. Additionally, the differences between 2003 and 2008 regarding socioeconomic characteristics and access to medication were studied. Results: Access to medication was 89.55% in 2003 and 92.99% in 2008, and the proportion of access to medication did not change in the period. Access in the public sector increased from 26.40% in 2003 to 48.55% in 2008 and there was a decrease in the concentration index between 2003 and 2008 in access to medication in the public sector. Conclusions: The findings indicate an expansion of Brazilian Unified Health System (Sistema Único de Saúde ) users, with the inclusion of people of higher socioeconomic position in the public sector. As the SUS gives more support to people of lower socioeconomic position in terms of medication provision, the SUS tends to equity. Nevertheless, universal coverage for medication and equity in access to medication in the public sector are still challenges for the Brazilian public health system.


2019 ◽  
Author(s):  
Jacopo Bianchi ◽  
Chiara Milani ◽  
Angela Bechini ◽  
Sara Boccalini ◽  
Maria José Caldes Pinilla ◽  
...  

Abstract Background Because of its low cost and its capability in reducing child mortality and morbidity, vaccination is considered a successful preventive deed in Low and Middle-Income Countries. In Senegal, vaccines are provided free of charge by the public health system, but the provision of the service is not evenly distributed between and within the Regions. Our study aimed at identifying barriers and enabling factors towards vaccination in three Regions of Senegal. Methods We performed 41 face-to-face semi-structured interviews with health services’ workers and three focus groups with local women in nine different structures in three different Regions of Senegal. We combined health workers’ (HW) and mothers’ points of view with direct observation in order to fulfill our purpose. Results We identified three groups of barriers – structural, personal and psychological – and many subthemes for each of them. Structural and personal barriers such as inadequacy of health structures, shortage of HW, lack of money, distance between villages and health facilities and lack of public transport, hamper mothers from utilising the vaccination service, even when they want to. The lack of effective communication between health personnel and mothers, the lack of collaboration between traditional and conventional medicine and the lack of trust in the public health system as a whole, are major problems to the vaccination uptake too. Conclusions The interlink of several elements in conditioning vaccination coverage suggests the need of implementing global and national strategies to overcome them. The key factor is the presence of a solid health system, publicly funded, based on primary health care. On the other hand, context-specific determinants cannot be detected based on global and non-specific information. The role of community health workers (CHWs) is crucial in overcoming wrong beliefs, lack of knowledge and distrust. They must be regarded as a bridge between HW and population. CHWs should be formally included in the organization of the social-health system, adequately formed and enhanced.


Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Matti Marklund ◽  
Rajeev Cherukupalli ◽  
Priya Pathak ◽  
Dinesh Neupane ◽  
Ashish Krishna ◽  
...  

Background: Approaches to scale up hypertension (HTN) treatment are needed in India, where only ~10% of individuals with HTN have controlled blood pressure. Objective: Estimate the current HTN treatment capacity of the public health system in India and model the effects of selected health system reform options. Methods: Using constrained optimization models, we estimated the HTN treatment capacity and salary costs of HTN-treating staff within the public health system; and simulated the potential effects of 1) increased workforce, 2) greater task sharing, and/or 3) reduced visit frequency (quarterly) vs the common practice of monthly visits for prescription refills. Results: An estimated 8% of all adults with HTN could be treated in the status quo (current number of health workers, no further task sharing, and monthly visits) (Figure). Treating 70% of adults with HTN with monthly visits without greater task sharing could require an additional 1.6 million staff, with ~200 billion ₹ (≈US$2.7 billion)) in additional annual salaries. Greater task sharing was estimated to allow the current workforce to treat ~25% of individuals with HTN with monthly visits. Quarterly visits (i.e., longer prescription periods) together with greater task sharing could allow the current workforce to treat ~70% of patients with HTN in India. Conclusion: Expanding HTN treatment coverage through workforce expansion alone will require substantial human and financial resources. The combination of greater task sharing and quarterly visits could increase the coverage of HTN treatment to ~70% of adults with HTN in India, without any expansion of the current workforce of the public health system.


2019 ◽  
Vol 15 (S1) ◽  
Author(s):  
James Pfeiffer ◽  
Rachel R. Chapman

AbstractIn many African countries, hundreds of health-related NGOs are fed by a chaotic tangle of donor funding streams. The case of Mozambique illustrates how this NGO model impedes Universal Health Coverage. In the 1990s, NGOs multiplied across post-war Mozambique: the country’s structural adjustment program constrained public and foreign aid expenditures on the public health system, while donors favored private contractors and NGOs. In the 2000s, funding for HIV/AIDS and other vertical aid from many donors increased dramatically. In 2004, the United States introduced PEPFAR in Mozambique at nearly 500 million USD per year, roughly equivalent to the entire budget of the Ministry of Health. To be sure, PEPFAR funding has helped thousands access antiretroviral treatment, but over 90% of resources flow “off-budget” to NGO “implementing partners,” with little left for the public health system. After a decade of this major donor funding to NGOs, public sector health system coverage had barely changed. In 2014, the workforce/ population ratio was still among the five worst in the world at 71/10000; the health facility/per capita ratio worsened since 2009 to only 1 per 16,795. Achieving UHC will require rejection of austerity constraints on public sector health systems, and rechanneling of aid to public systems building rather than to NGOs.


Significance Long-standing weaknesses in governance and the public health system have left Libya unable to slow or prevent community transmission of COVID-19. Impacts Military decisions and commitments will remain unaffected by COVID-19 concerns. Public discontent will remain focused on broader issues affecting daily life. A major disruption to Libya's deteriorating water system, the Great Man-Made River, could affect hygiene as the pandemic gains pace.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Chanapong Rojanaworarit ◽  
Sarah El Bouzaidi

PurposeThis article analyzes deficiencies in public health services for international migrant workers (IMWs) during the COVID-19 pandemic and provides a policy brief for improvement of the public health system.Design/methodology/approachA COVID-19 outbreak that initially clustered in IMWs and further contributed to the resurgence of the disease across Thailand in December 2020 was analyzed to address the deficiencies in public health services based on the framework of the 10 Essential Public Health Services (EPHS). The EPHS framework was also applied to develop policy options and recommendations in the subsequent policy brief.FindingsThis outbreak unveiled unique challenges that make IMWs more vulnerable to COVID-19. The public health system, challenged by the COVID-19 outbreak among IMWs, manifested deficiencies in the planning and implementation of all essential services. Delayed detection of the outbreak along with the lack of policy accommodating undocumented IMWs and the lack of equitable access to testing and treatment for COVID-19 resulted in the transmission of the disease that harmed the public at large.Originality/valueThe comprehensive analysis of the deficiencies in public health services for IMWs enabled a clear description of problems that could be further prioritized by relevant stakeholders. The policy brief provides policymakers with evidence-based recommendations for improving public health services for IMWs during the COVID-19 pandemic and beyond.


Author(s):  
Bridgette Masters-Awatere ◽  
Donna Cormack ◽  
Rebekah Graham ◽  
Rachel Brown

The predominant focus of Aotearoa New Zealand’s public health system on biomedical models of health has left little room for meaningful engagement with holistic indigenous approaches. Culturally appropriate provision and support are recognized for their relevance and importance during hospital transferals. Hospital staff involved in transfers to one of New Zealand’s trauma centers share their observations of whānau Māori engagement during an admission away from their home base. Sixteen key informants share their experiences, which are presented as strategies and challenges to whānau engagement. Three main themes highlight challenges within the health system that make it difficult for hospital staff to engage whānau in the desired ways and as often as both parties would like. Key informants described services and practices that are not designed with patients and their whānau in mind; instead they are designed by clinicians around the needs of administrative systems. As employees within the public health system, key informants felt powerless to challenge dominant settings. Nevertheless, employees managed to circumnavigate processes. Our findings highlight the need for continued decolonization and anti-racism work within public health settings.


2015 ◽  
Vol 18 (3) ◽  
pp. A224
Author(s):  
J.A. Turri ◽  
L.B. Haddad ◽  
W. Andrauss ◽  
L.A. D’Albuquerque ◽  
M.A. Diniz

Author(s):  
Paulo Gabriel Santos Campos de Siqueira ◽  
Alexandre Calumbi Antunes de Oliveira ◽  
Heitor Oliveira Duarte ◽  
Márcio das Chagas Moura

We have developed a probabilistic model to quantify the risks of COVID-19 explosion in Brazil, the epicenter of COVID-19 in Latin America. By explosion, we mean an excessive number of new infections that would overload the public health system. We made predictions from July 12th to Oct 10th, 2020 for various containment strategies, including business as usual, stay at home (SAH) for young and elderly, flight restrictions among regions, gradual resumption of business and the compulsory wearing of masks. They indicate that: if a SAH strategy were sustained, there would be a negligible risk of explosion and the public health system would not be overloaded. For the other containment strategies, the scenario that combines the gradual resumption of business with the mandatory wearing of masks would be the most effective, reducing risk to considerable category. Should this strategy is applied together with the investment in more Intensive Care Unit beds, risk could be reduced to negligible levels. A sensitivity analysis sustained that risks would be negligible if SAH measures were adopted thoroughly.


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