scholarly journals Structural violence and the biomedical innovation system: what responsibility do universities have in ensuring access to health technologies?

2021 ◽  
Vol 6 (5) ◽  
pp. e004916
Author(s):  
Sarai Keestra
Keyword(s):  
Structural Violence ◽  
Innovation System ◽  
Health Technologies ◽  
Biomedical Innovation ◽  
Access To Health

scholarly journals “Ashamed, Silent and Stuck in a System”—Applying a Structural Violence Lens to Midwives’ Stories on Social Disadvantage in Pregnancy

2020 ◽  
Vol 17 (24) ◽  
pp. 9355
Author(s):  
Eva Neely ◽  
Briony Raven ◽  
Lesley Dixon ◽  
Carol Bartle ◽  
Carmen Timu-Parata
Keyword(s):  
Access To Health Care ◽  
Structural Violence ◽  
Current System ◽  
Social Disadvantage ◽  
Individual Responsibility ◽  
Human Needs ◽  
Aotearoa New Zealand ◽  
Access To Health ◽  
Vulnerability To Poverty ◽  
The Impact

Historical and enduring maternal health inequities and injustices continue to grow in Aotearoa New Zealand, despite attempts to address the problem. Pregnancy increases vulnerability to poverty through a variety of mechanisms. This project qualitatively analysed an open survey response from midwives about their experiences of providing maternity care to women living with social disadvantage. We used a structural violence lens to examine the effects of social disadvantage on pregnant women. The analysis of midwives’ narratives exposed three mechanisms by which women were exposed to structural violence, these included structural disempowerment, inequitable risk and the neoliberal system. Women were structurally disempowered through reduced access to agency, lack of opportunities and inadequate meeting of basic human needs. Disadvantage exacerbated risks inequitably by increasing barriers to care, exacerbating the impact of adverse life circumstances and causing chronic stress. Lastly, the neoliberal system emphasised individual responsibility that perpetuated inequities. Despite the stated aim of equitable access to health care for all in policy documents, the current system and social structure continues to perpetuate systemic disadvantage.

scholarly journals Racism in European Health Care: Structural Violence and Beyond

2020 ◽  
Vol 30 (11) ◽  
pp. 1662-1673 ◽  
Author(s):  
Sarah Hamed ◽  
Suruchi Thapar-Björkert ◽  
Hannah Bradby ◽  
Beth Maina Ahlberg
Keyword(s):  
Health Care ◽  
Social Structure ◽  
Social Organization ◽  
Access To Health Care ◽  
Structural Violence ◽  
Theoretical Research ◽  
Subtle Racism ◽  
Access To Health ◽  
European Health ◽  
Unequal Access

Research shows how racism can negatively affect access to health care and treatment. However, limited theoretical research exists on conceptualizing racism in health care. In this article, we use structural violence as a theoretical tool to understand how racism as an institutionalized social structure is enacted in subtle ways and how the “violence” built into forms of social organization is rendered invisible through repetition and routinization. We draw on interviews with health care users from three European countries, namely, Sweden, Germany, and Portugal to demonstrate how two interrelated processes of unequal access to resources and inequalities in power can lead to the silencing of suffering and erosion of dignity, respectively. The strength of this article lies in illuminating the mechanisms of subtle racism that damages individuals and leads to loss of trust in health care. It is imperative to address these issues to ensure a responsive and equal health care for all users.

scholarly journals COVID-19 and the global public health: Tiered pricing of pharmaceutical drugs as a price-reducing policy tool

2020 ◽  
pp. 174113432096314
Author(s):  
Muhammad Zaheer Abbas
Keyword(s):  
Policy Option ◽  
Practical Significance ◽  
Pharmaceutical Drugs ◽  
Global Public Health ◽  
Health Technologies ◽  
Policy Tool ◽  
Tiered Pricing ◽  
Or Groups ◽  
Access To Health ◽  
Financial Burdens

The current COVID-19 pandemic has put the problem of equitable access to health technologies in the limelight because governments, even in the economically advanced countries, are struggling to meet the health needs of their populations. Tiered pricing of innovative health technologies, which involves the division of markets into different tiers or groups, provides a legitimate policy tool to alleviate some of the COVID-19 financial burdens on global health systems. Differential pricing denotes the practice of companies to charge different prices for the same product depending on the different classes of purchasers. This paper examines the legality and practical significance of tiered pricing as a price-reducing policy option and discusses some of the key limitations of this important policy tool. This study proposes the adoption of a global framework for sustainable pricing and tiered pricing of innovative health technologies. The proposed global framework will help in achieving a balance between fair access and fair profit levels.

PP155 The Impact Of Lawsuits In The Brazilian Public Health System

2017 ◽  
Vol 33 (S1) ◽  
pp. 141-141
Author(s):  
Carla Biella ◽  
Viviane Pereira ◽  
Fabiana Raynal ◽  
Jorge Barreto ◽  
Vania Canuto ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Public Health System ◽  
Scientific Evidence ◽  
Health Technology ◽  
Health Technologies ◽  
Access To Health ◽  
The Right ◽  
The Impact

INTRODUCTION:The increase of litigation in Brazil on the right to health, and the Brazilian Public Health System (SUS) targets of litigation, are phenomena that generate discussions both in the judiciary, and among researchers and managers of health. The lawsuits are based on the integrality that includes the right to any health technology. Our aim was to gather information on the use of scientific evidence by judges and other law professionals to support their decisions in lawsuits involving health care in Brazil.METHODS:A narrative review by literature search using key terms of legalization in specific databases was conducted.RESULTS:Twenty-five studies showed litigation matters relating to health care which were focused on legal claims about drugs. In general, law operators used the scientific evidences in a limited way when making decisions, by considering the medical report and medication label indications and disregarding therapeutic alternatives contemplated in the SUS list. The access to health technologies, by litigation, reveals that the gap between scientific knowledge and legal practice are similar to those found between science and decision-making in the formulation and implementation of health policies. The Health Technology Assessment studies have high potential for use by the judiciary as a reference source to support technical and scientific decisions in lawsuits on health care.CONCLUSIONS:For the judiciary to ensure not only access to health technologies, but also the efficacy and safety of technologies to system users, their decisions must be substantiated by scientific evidence. The National Committee for Health Technology Incorporation (CONITEC) in SUS has established actions in conjunction with law operators and society, such as a communication using e-mail, aiding the decision for the injunction and elaboration of technical reports and a policy brief, with the intention that the decisions are taken with the greatest possible knowledge about technologies provided by SUS, and based on scientific evidence.

An emergent sectoral innovation system for healthcare services

2014 ◽  
Vol 27 (6) ◽  
pp. 512-529 ◽  
Author(s):  
Clive Savory ◽  
Joyce Fortune
Keyword(s):  
Policy Development ◽  
Innovation Policy ◽  
Single Case ◽  
Innovation System ◽  
Healthcare Services ◽  
Primary Data ◽  
Case Study Methodology ◽  
Content Type ◽  
Health Technologies

Purpose – The purpose of this paper is to explore, through a case study, and using Pawson and Tilley's notion of context-mechanism-outcome configurations, how a sectoral innovation system (SIS) for health technologies has developed. Design/methodology/approach – The case study data were collected as part of a large study that looked at technology innovation and adoption in the UK's National Health Service and were collected using an interpretive case study methodology. Primary data came from interviews and secondary data from published sources, including articles authored by members of the innovation team. Findings – The paper identifies three specific configurations of context, mechanism and outcome that were important in the case and discusses how these contribute to a broader understanding of a healthcare services SIS. Research limitations/implications – Research conducted through a single case study is open to the criticism that its findings are not generalisable but it has offered an economical way of gaining a deep description of a situation and an understanding of the contextual factors affecting a phenomenon. The paper presents a refined model for understanding SISs that though primarily rooted within the healthcare care sector has potential for application in other sectors, especially those that encompass a significant public-sector component. Practical implications – The paper's findings and conclusions have relevance to healthcare service innovation policy development. The findings will also be useful to professionals responsible for innovation projects and their support within the sector. Originality/value – The paper makes an important contribution to the understanding of a SIS for healthcare services as well as refining a general model of SISs.

Poverty, Welfare Reform and the "Culture of Wealth"

2007 ◽  
Vol 29 (4) ◽  
pp. 43-45 ◽  
Author(s):  
Merrill Singer
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Partner Violence ◽  
Access To Health Care ◽  
Structural Violence ◽  
Well Being ◽  
Legal Rights ◽  
True Nature ◽  
Care Access ◽  
Access To Health

An important shift has occurred in anthropology over the last 30 years. A notable expression of this change is seen in the contemporary anthropology of poverty. As dramatically contrasted with the anthropology of poverty of an earlier era, when the notion of a "culture of poverty" had currency within the discipline, current thinking has been significantly influenced by a structural approach that seeks to understand poverty and its health consequences in terms of what has been called "structural violence." Structural violence was introduced into the lexicon of anthropology to label relations of inequality that are so grave in their effect that they can be seen as a form of sanctioned violence (like the structuring of access to health care in terms of possession of health insurance or the exclusion from quality housing, or even any housing, on the basis of ethnicity and social class). Unlike street violence or intimate partner violence, both forms of physical harm that are criminalized, structural violence is legal and hence unpunished. Indeed, perpetrators, if they are corporate heads, may be rewarded with stock options and other perks that boost their salaries to obscene levels relative to the prevailing wage system in society generally. Structural violence has been publicly denied its true nature as a direct assault on the health and well-being of the poor and other marginalized populations because access to health care, access to housing, and access to food are not legal rights.

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