Primary Care and Reform of Health Systems: A Framework for the Analysis of Latin American Experiences

1992 ◽  
Vol 5 (1) ◽  
pp. 32-43 ◽  
Author(s):  
Julio Frenk
Keyword(s):  
Health Care ◽  
Latin American ◽  
Health Sector ◽  
Analytical Framework ◽  
Two Dimensions ◽  
Formal Aspect ◽  
Health Care Reforms ◽  
Health Sector Reforms ◽  
Reform Strategies ◽  
Use Of Services

The article first proposes a framework within which to assess the potential of health sector reforms in Latin America for primary health care (PHC). Two dimensions are recognized: the scope of the reforms, content, and the means of participation that are put into play. This framework is then complemented through a critique of the often-sought but little-analyzed PHC reform strategies of decentralization and health sector integration. The analytical framework is next directed to the financing of health services, a chief aspect of any reform aiming toward PHC. Two facets of health service finance are first distinguished: its formal aspect as a means for economic subsistence and growth, and its substantive aspect as a means to promote the rational use of services and thus improvement of health. Once finance is understood in this microeconomic perspective, the focus shifts to the analysis of health care reforms at the macro, health policy level. The article concludes by positing that PHC is in essence a new health care paradigm, oriented by the values of universality, redistribution, integration, plurality, quality, and efficiency.

scholarly journals Supporting Primary Health Care in Mongolia: Experiences, Lessons Learned, and Future Directions

2021 ◽  
Author(s):  
Altantuya Jigjidsuren ◽  
Bayar Oyun ◽  
Najibullah Habib
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Human Resources ◽  
Health Sector ◽  
Asian Development Bank ◽  
Lessons Learned ◽  
Development Bank ◽  
Future Directions ◽  
Health Sector Reforms ◽  
Primary Health

ince the early 1990s, the Asian Development Bank (ADB) has broadly supported health sector reforms in Mongolia. This paper describes primary health care (PHC) in Mongolia and ADB support in its reform. It highlights results achieved and the lessons drawn that could be useful for future programs in Mongolia and other countries. PHC reform in Mongolia aimed at facilitating a shift from hospital-based curative services toward preventive approaches. It included introducing new management models based on public–private partnerships, increasing the range of services, applying more effective financing methods, building human resources, and creating better infrastructure. The paper outlines remaining challenges and future directions for ADB support to PHC reform in the country.

scholarly journals Health financing changes in the context of health care decentralization: the case of three Latin American countries

2000 ◽  
Vol 34 (5) ◽  
pp. 449-460 ◽  
Author(s):  
Armando Arredondo ◽  
Irene Parada
Keyword(s):  
Health Care ◽  
Latin American ◽  
Health Sector ◽  
Health Financing ◽  
Primary Data ◽  
Second Phase ◽  
Secondary Sources ◽  
Use Of Resources ◽  
Methodological Tool ◽  
Latin American Countries

OBJECTIVE: The results of an evaluative longitudinal study, which identified the effects of health care decentralization on health financing in Mexico, Nicaragua and Peru are presented in this article. METHODS: The methodology had two main phases. In the first, secondary sources of data and documents were analyzed with the following variables: type of decentralization implemented, source of financing, funds for financing, providers, final use of resources, mechanisms for resource allocation. In the second phase, primary data were collected by a survey of key personnel in the health sector. RESULTS: Results of the comparative analysis are presented, showing the changes implemented in the three countries, as well as the strengths and weaknesses of each country in matters of financing and decentralization. CONCLUSIONS: The main financing changes implemented and quantitative trends with respect to the five financing indicators are presented as a methodological tool to implement corrections and adjustments in health financing.

Equity and Distributive Justice in European Health Care Reform

1997 ◽  
Vol 27 (3) ◽  
pp. 443-453 ◽  
Author(s):  
Richard B. Saltman
Keyword(s):  
Health Care ◽  
Distributive Justice ◽  
Health Care Reform ◽  
Health Care Systems ◽  
Health Sector ◽  
Health Sector Reforms ◽  
Central Objective ◽  
Care Systems ◽  
European Health ◽  
The Relationship

Equity is a central objective of most European health care systems, yet equity, particularly in the form of distributive justice, has not been a central objective of many recent health sector reforms. This article considers three aspects of the relationship between equity and recent health reforms. After defining what is meant by equity in the health sector, the author briefly examines available evidence on present levels of equality then discusses the equity implications of ongoing reforms in European health care systems.

scholarly journals Unpaid Health Care Work: A Gender Equality Perspective

2021 ◽  
Keyword(s):  
Health Care ◽  
Latin American ◽  
Health Sector ◽  
Essential Element ◽  
Recovery Process ◽  
Human Right ◽  
Unpaid Care ◽  
The Public ◽  
Health Care Work ◽  
Care Models

A debate on public goods is urgently needed in health care. Care must be recognized as a social function, as an occupation and, at the same time, as a human right—which imposes binding obligations to comply with precise standards of quality, quantity, suitability, adaptability, and accessibility, among others. It is a complex and invisible task, that may be done as part of a medical treatment, post-surgical recovery process, or permanent support in cases of chronic illness, disability, or mental health conditions. And it tends to be provided mainly in the home, by women, without remuneration. In Latin America, care has not been included in a coordinated and specific public health policy agenda but has been advanced through isolated actions—in many cases highly fragmented and heterogeneous—without a clear awareness of the public nature of care and the associated responsibility of the State. Accordingly, this document takes a gender and rights-based approach. It starts with an analysis of the main definitions of unpaid work in the health sector, and then focuses on initiatives in three Latin American countries (Colombia, Costa Rica, and Uruguay) with regard to measurement, valuation, integration, and recognition in national health systems or policies, in care models, and in time-use surveys. The conclusions propose recommendations aimed at addressing unpaid care as an essential element of social policies in general, and health policies in particular, from a gender and rights-based perspective.

scholarly journals HISTORICAL AND LEGAL ANALYSIS OF THE HEALTH CARE WORKERS’ LEGAL STATUS DEVELOPMENT

Medicne pravo ◽  
2021 ◽  
pp. 9-17
Author(s):  
N. V. Kniazevych
Keyword(s):  
Health Care ◽  
Public Relations ◽  
Health Care Workers ◽  
Legal Status ◽  
Practical Importance ◽  
Health Sector ◽  
Legal Analysis ◽  
Health Sector Reforms ◽  
Care Workers ◽  
Reform Processes

The article is devoted to historical and legal analysis of the health care workers’ legal status development. The paper analyses the beginning of the establishment of the first rules of behavior and professional responsibilities of medical workers in Ukraine, as well as regulations governing the legal status of medical workers in different years in Ukraine. It has been emphasized on the importance of research in the context of the modern health sector reforms for the formation of its directions of implementation. The administrative and legal status of a medical worker makes it possible to determine their place and role in public administration and other public relations. The rights and responsibilities of health care workers are of great scientific and practical importance, especially in view of the ongoing health care reform processes in the country. In view of this, it is important to study the peculiarities of the formation of certain rights and responsibilities of medical workers, which constitute their current legal status, over a significant period of the Ukrainian history.

scholarly journals The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain

2014 ◽  
Vol 30 (11) ◽  
pp. 2263-2281 ◽  
Author(s):  
Lígia Giovanella ◽  
Klaus Stegmüller
Keyword(s):  
Health Care ◽  
United Kingdom ◽  
Health Systems ◽  
Health Care Systems ◽  
Health Sector ◽  
State Intervention ◽  
Three Dimensions ◽  
The United Kingdom ◽  
Health Sector Reforms ◽  
Care Systems

The paper analyzes trends in contemporary health sector reforms in three European countries with Bismarckian and Beveridgean models of national health systems within the context of strong financial pressure resulting from the economic crisis (2008-date), and proceeds to discuss the implications for universal care. The authors examine recent health system reforms in Spain, Germany, and the United Kingdom. Health systems are described using a matrix to compare state intervention in financing, regulation, organization, and services delivery. The reforms’ impacts on universal care are examined in three dimensions: breadth of population coverage, depth of the services package, and height of coverage by public financing. Models of health protection, institutionality, stakeholder constellations, and differing positions in the European economy are factors that condition the repercussions of restrictive policies that have undermined universality to different degrees in the three dimensions specified above and have extended policies for regulated competition as well as commercialization in health care systems.

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