scholarly journals Personal view: security sector health systems and global health

2020 ◽  
pp. bmjmilitary-2020-001607
Author(s):  
Martin Bricknell ◽  
S Horne
Keyword(s):  
Health Services ◽  
Global Health ◽  
Health System ◽  
Well Being ◽  
Crisis Response ◽  
Health Coverage ◽  
Personal View ◽  
Security Sector ◽  
Health Diplomacy ◽  
Development Goals

In many countries the security sector is a major contributor to the healthcare system. The role and transformation of a state’s security health system within the universal health coverage is important, in that it sits at the interface of the United Nations Sustainable Development Goals 3 (ensure healthy lives and promote well-being) and 16 (promote just, peaceful and inclusive societies). The paper describes the breadth of the security sector and outlines the potential beneficiaries, clinical services and macro-organisation of a security sector health system from the perspective of its contribution to wider government health services and crisis response. It examines the characteristics of the security sector compared with other providers of health services, including those generic to the sector and unique to a given service. Understanding civil–security relationships is a critical facet of effective Defence Healthcare Engagement (DHE), which includes the use of defence medical assets in support of capacity-building overseas. The analytical process described may form the basis of DHE planning. It may have even greater importance in the near future as countries review national resilience and global health diplomacy after the COVID-19 crisis.

scholarly journals Analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from Ethiopia

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Amare Worku Tadesse ◽  
Kassu Ketema Gurmu ◽  
Selamawit Tesfaye Kebede ◽  
Mahlet Kifle Habtemariam
Keyword(s):  
Health Promotion ◽  
Global Health ◽  
Health System ◽  
Universal Health Coverage ◽  
World Health ◽  
Health Coverage ◽  
Health Security ◽  
Universal Health ◽  
Health Agenda

Abstract Background Evidence exists about synergies among universal health coverage, health security and health promotion. Uniting these three global agendas has brought success to the country’s health sector. This study aimed to document the efforts Ethiopia has made to apply nationally synergistic approaches uniting these three global health agendas. Our study is part of the Lancet Commission on synergies between these global agendas. Methods We employed a case study design to describe the synergistic process in the Ethiopian health system based on a review of national strategies and policy documents, and key informant interviews with current and former policymakers, and academics. We analyzed the “hardware” (using the World Health Organization’s building blocks) and the “software” (ideas, interests, and power relations) of the Ethiopian health system according to the aforementioned three global agendas. Results Fragmentation of health system primarily manifested as inequities in access to health services, low health workforce and limited capacity to implementation guidelines. Donor driven vertical programs, multiple modalities of health financing, and inadequate multisectoral collaborations were also found to be key features of fragmentation. Several approaches were found to be instrumental in fostering synergies within the global health agenda. These included strong political and technical leadership within the government, transparent coordination, and engagement of stakeholders in the process of priority setting and annual resource mapping. Furthermore, harmonization and alignment of the national strategic plan with international commitments, joint financial arrangements with stakeholders and standing partnership platforms facilitated efforts for synergy. Conclusions Ethiopia has implemented multiple approaches to overcome fragmentation. Such synergistic efforts of the primary global health agendas have made significant contributions to the improvement of the country’s health indicators and may promote sustained functionality of the health system.

scholarly journals Evaluation of Access on the perspective of adult users of Primary Health Care in Fortaleza, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Borges Costa ◽  
C Salles Gazeta Vieira Fernandes ◽  
T Custódio Mota ◽  
E Torquato Santos ◽  
M Moura de Almeida ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health System ◽  
Assessment Tool ◽  
Health Coverage ◽  
Access To Health Services ◽  
Primary Health ◽  
Care Assessment ◽  
The City

Abstract The Alma-Ata Conference promoted Primary Health Care (PHC) worldwide as a form of universal and continuous access to quality and effective health services. In Brazil, PHC, through the Family Health Strategy (FHS), aims to be the gateway to the health system and its structuring axis. For this, it is necessary to promote access, an essential condition for the quality of health care services, following the attributes systematized by Barbara Starfield. The aim of this study was to evaluate the presence of the attribute “First Contact Access” on the perspective of adult users of public PHC services in the city of Fortaleza, Ceará, Brazil. A transversal study was carried out, in 19 PHC Units, from June to December 2019, using the Primary Care Assessment Tool (PCATool) Brazil version for adult users. Kruskal-Wallis test was used for statistical analysis. 233 users participated, mostly women (69.5%), aged 30 to 59 years old (55.3%), mixed-race (69.5%), with complete high school (38.2%), without private health coverage (89.3%), homeowners (68.7%) and belonging to families of up to 4 members (87.9%). The “Accessibility” component had the lowest score, 2.83, and the “Utilization” had the highest score, 8.06. Older age was associated with higher “Accessibility” scores (p = 0,018), while lower values of “Utilization” were associated with higher education (p = 0,004). The main problems observed were: low access for acute demand consultations, lack of access at nighttime and weekends, little access through non-personal ways, bureaucratic barriers and a long time for scheduling appointments. We conclude that, although there was an improvement in PHC coverage in the city over the years, mainly due to FHS, there is still a lot to improve to ensure timely access to health services. Key messages Users consider PHC as the usual source of care, demonstrated by the high score of 'Utilization', however, they are unable to use it when necessary, demonstrated by the low score of 'Accessibility'. Expanding forms of access is essential to contribute to the strengthening of PHC in Fortaleza, Brazil, facilitating the entry to its national Universal Health System.

Reducing the Knowledge Gap in Global Health Delivery

2020 ◽  
pp. 152-165
Author(s):  
Andres Garchitorena ◽  
Megan B. Murray ◽  
Bethany Hedt-Gauthier ◽  
Paul E. Farmer ◽  
Matthew H. Bonds
Keyword(s):  
Global Health ◽  
International Development ◽  
Adaptive Systems ◽  
Care Delivery ◽  
Health Coverage ◽  
The Sustainable Development ◽  
New Era ◽  
Health Delivery ◽  
Development Goals ◽  
Universal Health

Randomized control trials (RCTs) are considered to be the gold standard for impact evaluation in international development and they are associated with a new era of evidence-based global health policies. However, there are inherent challenges in using RCTs to answer some of the most important questions in global health: why, if solutions are known, affordable at scale, and supported by existing evidence, do hundreds of millions of people lack access to essential health services? A lack of clarity on appropriate research methods for strengthening health systems has corresponded to a lack of investment in more complex and adaptive systems of integrated care delivery. This chapter reviews the use of RCTs in global health, highlighting major contributions, and addressing some pressing priorities in implementation research at a time when the Sustainable Development Goals emphasize the importance of sector-wide approaches, such as integrated primary care and universal health coverage.

scholarly journals Call to Action for Nurses/Nursing

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Shahirose S. Premji ◽  
Jennifer Hatfield
Keyword(s):  
Global Health ◽  
Well Being ◽  
Practice Research ◽  
Middle Income ◽  
The Sustainable Development ◽  
Call To Action ◽  
Middle Income Countries ◽  
Global Partnerships ◽  
Development Goals ◽  
New Vision

The 13 million nurses worldwide constitute most of the global healthcare workforce and are uniquely positioned to engage with others to address disparities in healthcare to achieve the goal of better health for all. A new vision for nurses involves active participation and collaboration with international colleagues across research practice and policy domains. Nursing can embrace new concepts and a new approach—“One World, One Health”—to animate nursing engagement in global health, as it is uniquely positioned to participate in novel ways to improve healthcare for the well-being of the global community. This opinion paper takes a historical and reflective approach to inform and inspire nurses to engage in global health practice, research, and policy to achieve the Sustainable Development Goals. It can be argued that a colonial perspective currently informs scholarship pertaining to nursing global health engagement. The notion of unidirectional relationships where those with resources support training of those less fortunate has dominated the framing of nursing involvement in low- and middle-income countries. This paper suggests moving beyond this conceptualization to a more collaborative and equitable approach that positions nurses as cocreators and brokers of knowledge. We propose two concepts, reverse innovation and two-way learning, to guide global partnerships where nurses are active participants.

Global Health Diplomacy

2018 ◽  
pp. 101-121
Author(s):  
Akram Khazatzadeh-Mahani ◽  
Arne Ruckert ◽  
Ronald Labonté
Keyword(s):  
Foreign Policy ◽  
Global Health ◽  
Global Politics ◽  
Health Issues ◽  
Global Health Diplomacy ◽  
The Sustainable Development ◽  
Health Diplomacy ◽  
Development Goals ◽  
Health And Foreign Policy ◽  
Foreign Ministries

Health issues have received unprecedented attention in global policy negotiations in recent decades. Ongoing global health challenges, the pressing need to address global health disparities, and recent calls for collaboration as part of the sustainable development goals process have contributed to increasing consideration of the intersection among global health, foreign policy, and diplomacy. These developments have resulted in ‘global health diplomacy’. This chapter examines the links between health and foreign policy and how global health diplomacy is employed to influence global politics. It further investigates some of the instruments used in global health diplomacy, including recommendations/resolutions, international agreements, and regulations. How and why health issues reach the political agendas of foreign ministries are also examined. The chapter then discusses how to evaluate and improve global health diplomacy processes and raises research questions for advancing the academic study of global health diplomacy and why it remains important.

scholarly journals Universal Health Coverage Development in Thailand: How Global Ideas and a National Medical Professional Movement Made a Difference

2021 ◽  
Author(s):  
Rangsan Sukhampha
Keyword(s):  
Developing Countries ◽  
Global Health ◽  
Health System ◽  
National Health ◽  
Universal Health Coverage ◽  
Medical Professional ◽  
System Reform ◽  
Health Coverage ◽  
Health System Reform ◽  
Universal Health

Abstract Background: Universal health coverage is endorsed as the global development agenda in the 2015 SDGs for global achievement by 2030 and is expected to build national policymaking agendas. Common research often focuses on national processes in the first place. For example, accounts of Thailand's health system development mostly emphasise domestic factors and influences rather than the linkage of external/global health ideas. The paper questions how external/global health ideas influence national health policymaking and the linkage between them in achieving Thailand's universal health coverage policy.Methods: A qualitative method was employed to capture complex and historical narratives of the national medical professional movement for Thailand's health system reform through the lens of a global social policy approach for exploring external and global health ideas transfer. Moreover, the actor- and policy entrepreneur approaches would be employed to investigate national health policymaking and examine how ideas from the external and global levels have improved national equity in health. Results: The research locates the narratives on global ideas and practices that influence a national health system reform. This highlights the impact/role of global ideas on national professional movements, i.e. the rural doctor movement in Thailand mobilising the health system reform for all. The study found that national equity in health could not be achieved without external/global health ideas transfer. Such a case of national universal health coverage achievement in Thailand happened with the effort of the rural doctor movement and individual agency as policy entrepreneurs in translating external/global ideas and practices for their movement and mobilisation. The case contributed to a better understanding of the global process regarding ideas and practices that can be transferred directly and indirectly to the national level. Conclusions: Global ideas transfer can also happen in different aspects such as it can be seen the ideas transfer from developed to developed countries; from developed to developing countries. Besides, the author witnessed that the IOs ideas can also be transferred to developing countries or reverse, and again, between developing countries themselves.

scholarly journals Combating COVID-19: the India initiatives

2020 ◽  
Vol 7 (9) ◽  
pp. 3722
Author(s):  
Preeti Kharb ◽  
Vinod Kapoor ◽  
Nishant Madan
Keyword(s):  
Well Being ◽  
Health Coverage ◽  
Rapid Improvement ◽  
Global Challenge ◽  
Health Products ◽  
History Of ◽  
Development Goals ◽  
The Government ◽  
The Moment ◽  
Virus Spreading

COVID-19 pandemic is one of the few in the history of mankind and presents an enormous global challenge requiring intervention on unprecedented levels. SARS-CoV-2 is a novel virus spreading exceptionally fast and carries high mortality. Health is an important component for human well-being and economic progress. The healthcare set ups globally are being overwhelmed to treat the serious patients with the needs of medical devices such as ventilators for which there is a global shortage. The COVID-19 pandemic has clearly shown the need for further research, developing new vaccines and treatment for COVID-19. To prevent the disease is the only option countries have at the moment for which nationwide lockdown have been implemented. The Government of India has taken several steps from implementing lockdown, announcing a relief package of Rs. 1.7 lakh crores, and rapid improvement in testing capacity among many others. Government of India is committed to facilitate universal and affordable access to all relevant medical products and technologies, both existing and new, to tackle COVID-19 to accelerate progress towards achieving sustainable development goals and universal health coverage. In this article we present the initiatives taken by government to combat COVID-19 pandemic specifically related to the health products.

The Future of Global Governance for Health

2018 ◽  
Author(s):  
Michel Sidibé ◽  
Helena Nygren-Krug ◽  
Bronwyn McBride ◽  
Kent Buse
Keyword(s):  
Global Health ◽  
Global Governance ◽  
Well Being ◽  
Decision Makers ◽  
Access To Justice ◽  
The Sustainable Development ◽  
Development Goals ◽  
The Right ◽  
Development Paradigm ◽  
Global Governance For Health

This chapter argues that the current global health agenda has failed to put people and their rights at the center. With communities unable to have their voices heard, challenge injustice, and hold decision makers to account, states are ill-equipped to realize the Sustainable Development Goals (SDGs), including SDG 3 to ensure healthy lives and well-being for all. The chapter articulates a shift from a discretionary development paradigm to a rights-based paradigm for global health, building on rights-based approaches that have been proven to work—as in the AIDS response. Seven reforms are proposed, addressing: (1) priority-setting, (2) systems for health, (3) data and monitoring, (4) access to justice, (5) the need to safeguard the right to health across sectors, (6) partnerships, and (7) financing. These reforms call for a broad social movement for global governance for health, advancing and operationalizing rights-based approaches across the SDGs.

Responsive and Responsible Science, Technology, and Innovation for Global Health

2020 ◽  
pp. 310-324
Author(s):  
Nora Engel ◽  
Agnes Meershoek ◽  
Anja Krumeich
Keyword(s):  
Global Health ◽  
Well Being ◽  
Noncommunicable Diseases ◽  
The Sustainable Development ◽  
Technology And Innovation ◽  
Science Technology ◽  
Point Of Care Diagnostics ◽  
Mother And Child ◽  
Development Goals ◽  
Science Technology And Innovation

In contrast to the millennium development goals (MDGs), the sustainable development goals (SDGs) entail a universal and equitable approach to global health by defining health problems as multidimensional issues. SDG3, which aims to “ensure healthy lives and promote well‐being for all at all ages,” targets a broad range of communicable diseases, mother and child health, noncommunicable diseases, mental health, substance abuse, traffic accidents, and health threats from hazardous environmental pollution, and to that end suggests supporting research and development of appropriate technology. This chapter will review how science, technology and innovation (STI) are conceptualized in the SDGs and how they are assumed to tackle health inequalities. Inspired by insights from science and technology studies, and using examples from the authors’ ethnographic studies on development and implementation of point-of-care diagnostics and development of cookstoves, it will discuss what the challenges are with the way in which STI is conceptualized in SDG policies. Based on these analyses, the authors propose a responsive and responsible approach to STI that is based on a thick description of the different stakeholder settings involved and of their perceptions and needs; takes the coproduction of knowledge, innovation, and society into consideration; and continuously reflects on the (un-)intended consequences.

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