scholarly journals Southern social world-regionalisms: The place of health in nine African regional economic communities

2020 ◽  
pp. 146801812096185
Author(s):  
Nicola Yeates ◽  
Rebecca Surender
Keyword(s):  
Health Care ◽  
Public Policy ◽  
Social Policy ◽  
Health Systems ◽  
Regional Integration ◽  
Regional Cooperation ◽  
Health Sector ◽  
World Health ◽  
Regional Health ◽  
Regional Economic

This article presents key results from a comparative qualitative Social Policy study of nine African regional economic communities’ (RECs) regional health policies. The article asks to what extent has health been incorporated into RECs’ public policy functions and actions, and what similarities and differences are evident among the RECs. Utilising a World Health Organization (WHO) framework for conceptualising health systems, the research evidence routes the article’s arguments towards the following principal conclusions. First, the health sector is a key component of the public policy functions of most of the RECs. In these RECs, innovations in health sector organisation are notable; there is considerable regulatory, organisational, resourcing and programmatic diversity among the RECs alongside under-resourcing and fragmentation within each of them. Second, there are indications of important tangible benefits of regional cooperation and coordination in health, and growing interest by international donors in regional mechanisms through which to disburse health and -related Official Development Assistance (ODA). Third, content analysis of RECs’ regional health strategies suggests fairly minimal strategic ambitions as well as significant limitations of current approaches to advancing effective and progressive health reform. The lack of emphasis on universal health care and reliance on piecemeal donor funding are out of step with approaches and recommendations increasingly emphasising health systems development, sector-wide approaches (SWAPs) and primary health care as the bedrock of health services expansion. Overall, the health component of RECs’ development priorities is consistent with an instrumentalist social policy approach. The development of a more comprehensive sustainable world-regional health policy is unlikely to come from the African Continental Free-Trade Area, which lacks requisite social and health clauses to underpin ‘positive’ forms of regional integration.

scholarly journals Strategies for post-conflict development of the Health Systems in Somalia: lessons from selected countries

2021 ◽  
Author(s):  
Maye Omar
Keyword(s):  
Health Care ◽  
Health Status ◽  
Health System ◽  
Health Systems ◽  
Health Care System ◽  
Health Sector ◽  
World Health ◽  
Post Conflict ◽  
The World ◽  
Care System

Until the beginning of 1991, Somalia had a reasonable health care system with a good number of tertiary hospitals in Mogadishu and Hargeisa, some regional hospitals, district hospitals, clinics, child and mother health centres (CMH) and out-patient dispensaries. However, the conflict resulting from the civil war has destroyed the public health care system which existed in the country. Somalia was not alone in having conflicts. The total number of conflicts in the world in 2017 was 49, many of them have now entered post-conflict phases, where open warfare has come to an end. There is growing evidence that conflict has a devastating impact on health systems and the health status of the population. In Somalia, the post-conflict phase provides a unique window of opportunity for health sector development and reform. At this juncture, health systems in Somalia face the double burden of a flawed pre-conflict health system, characterised by deficiencies and inequities, and the long-term impact of conflict on the health status of the population and its resultant strain on the health system. This review article analyses the framework for the rehabilitation of health systems in post-conflict countries. Such knowledge can be applied in the rehabilitation and development of health systems in Somalia along the lines of the World Health Organization’s health system building blocks. The impact of conflict on the health status of the population as well as the health system can be catastrophic and be felt for years after the State has entered the post-conflict phase, but also provides an opportunity for reforms of the affected State’s health sector.

The regulation of health care in Scandinavia: professionals, the public interest and trust

2018 ◽  
pp. 61-76
Author(s):  
Karsten Vrangbæk
Keyword(s):  
Health Care ◽  
Public Policy ◽  
Health Insurance ◽  
Health System ◽  
Health Systems ◽  
Public Interest ◽  
State Level ◽  
Professional Regulation ◽  
The Public ◽  
Voluntary Health Insurance

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?

Comparing health policy: An assessment of typologies of health systems

2010 ◽  
pp. 185-201
Author(s):  
Keyword(s):  
Health Care ◽  
Public Policy ◽  
Health Policy ◽  
Comparative Study ◽  
Health Systems ◽  
Institutional Context ◽  
Health Policies ◽  
Ideal Types

Typologies have been central to the comparative turn in public policy and this paper contributes to the debate by assessing the capacity of typologies of health systems to capture the institutional context of health care and to contribute to explaining health policies across countries. Using a recent comparative study of health policy and focusing on the concept of the health care state the paper suggests three things. First, the concept of the health care state holds as a set of ideal types. Second, as such the concept of the health care state provides a useful springboard for analyzing health policy, but one which needs to be complemented by more specific institutional explanations. Third, the concept of the health care state is less applicable to increasingly important, non-medical areas of health policy. Instead, different aspects of institutional context come into play and they can be combined as part of a looser ‘‘organizing framework''.

Epidemiology and Public Policy

2017 ◽  
Author(s):  
Carlos E. Molina
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Public Policy ◽  
Health Systems ◽  
Research Design ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Health Care Economics ◽  
Mental Health Systems

This chapter reviews topics on epidemiology, biostatistics and research design. In addition, topics on mental health systems, evidence-based practice and health care economics will be reviewed. Topics on public policy and law and psychiatry will be reviewed in this chapter

Political Parties and Social Policy

2014 ◽  
Author(s):  
Jeffrey M. Stonecash
Keyword(s):  
Health Care ◽  
Public Policy ◽  
Economic Policy ◽  
Social Policy ◽  
Political Parties ◽  
Government Programs ◽  
Policy Goals ◽  
Party Control ◽  
The Impact ◽  
Over Time

Party battles for control of government are seen as efforts to reshape public policy. In prior decades, the impact of parties was limited by divided control of branches of government. The impact of party control was also limited because neither party had a distinctive constituency with clear and different policy goals. Over time, realignment has produced parties with very different electoral bases. Republicans now are more unified and willing to cut government while Democrats are more supportive of government programs. This chapter reviews our expectations of the impact of parties, the changes that have made party control mean more, and how these changes affect policy areas like economic policy, welfare, and health care.

scholarly journals Measuring Regional Performance in the Italian NHS: Are Disparities Decreasing?

2021 ◽  
Author(s):  
Silvia Bruzzi ◽  
Enrico Ivaldi ◽  
Marta Santagata
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Health Care Quality ◽  
Health Care Systems ◽  
Care Quality ◽  
Regional Disparities ◽  
Future Research ◽  
Regional Health ◽  
Regional Health Care ◽  
Composite Indexes

AbstractGiven the regional disparities that historically characterize the Italian context, in this paper we propose a framework to evaluate the regional health care systems’ performance in order to contribute to the debate on the relationship between decentralisation of health care and equity. To investigate the regional health systems performance, we refer to the OECD Health Care Quality Indicators project to construct of a set of five composite indexes. The composite indexes are built on the basis of the non-compensatory Adjusted Mazziotta-Pareto Index, that allows comparability of the data across units and over time. We propose three indexes of health system performance, namely Quality Index, Accessibility Index and Cost-Expenditure Index, along with a Health Status Index and a Lifestyles Index. Our framework highlights that regional disparities still persist. Consistently with the evidence at the institutional level, there are regions, particularly in Southern Italy, which record lower levels of performance with high levels of expenditure. Continuous research is needed to provide policy makers with appropriate data and tools to build a cohesive health care system for the benefit of the whole population. Even if future research is needed to integrate our framework with new indicators for the calculation of the indexes and with the identification of new indexes, the study shows that a scientific reflection on decentralisation of health systems is necessary in order to reduce inequalities.

scholarly journals Does the Great Recession Contribute to the Convergence of Health Care Expenditures in the US States?

2019 ◽  
Author(s):  
Jesús Clemente ◽  
Angelina Lázaro-Alquézar ◽  
Antonino Montañés
Keyword(s):  
Health Care ◽  
Great Recession ◽  
Null Hypothesis ◽  
Health Sector ◽  
Health Care Expenditures ◽  
Regional Health ◽  
The Great Recession ◽  
Regional Health Care ◽  
Capita Health Expenditure ◽  
The Us

This paper examines whether the Great Recession has altered the disparities of the US regional health care expenditures. We test the null hypothesis of convergence for the US real per capita health expenditure for the period 1980-2014. Our results indicate that the null hypothesis of convergence is clearly rejected for the total sample as well as for the pre-Great Recession period. Thus, no changes are found in this regard. However, we find that the Great Recession has modified the composition of the estimated convergence clubs, offering a much more concentrated picture in 2014 than in 2008, with most of the states included in a big club, and only 5 (Nevada, Utah, Arizona, Colorado and Georgia) exhibiting a different pattern of behavior. These two estimated clubs diverge and, consequently, the disparities in the regional health sector have increased.

scholarly journals Building health system resilience in the context of primary health care revitalization for attainment of UHC: proceedings from the Fifth Health Sector Directors’ Policy and Planning Meeting for the WHO African Region

2020 ◽  
Vol 14 (S19) ◽  
Author(s):  
Prosper Tumusiime ◽  
Humphrey Karamagi ◽  
Regina Titi-Ofei ◽  
Michelle Amri ◽  
Aminata Binetou Wahebine Seydi ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Health Systems ◽  
Health Sector ◽  
Health Systems Strengthening ◽  
Health Coverage ◽  
African Region ◽  
Health Service Provision ◽  
Primary Health

Abstract Background The recent 2018 Declaration of Astana recognized primary health care (PHC) as a means to achieve universal health coverage (UHC) and the health-related Sustainable Development Goals (SDGs). Following this declaration, country progress on operationalization of the PHC agenda and attainment of UHC has been stalled by the new challenges posed by the COVID-19 pandemic. The pandemic has also disrupted the continuity of essential health service provision and tested the resilience of the region’s health systems. Methods In accordance with this, the WHO Regional Office for Africa convened the Fifth Health Sector Directors’ Planning and Policy Meeting across the 47 Member States of the Region. The two-day forum focused on building health system resilience to facilitate service continuity during health threats, PHC revitalization, and health systems strengthening towards UHC. Results The Regional Forum provided evidence on building resilient health systems in the WHO African Region and engaged participants in meaningful and critical discussion. It is from these discussions that four key themes emerged: (1) working multisectorally/intersectorally, (2) moving from fragmentation to integration, (3) ensuring implementation and knowledge exchange, and (4) rethinking resilience and embracing antifragility. These discussions and associated groupings by thematic areas lend themselves to recommendations for the WHO. Conclusions This paper details the proceedings and key findings on building resilient health systems, the four themes that emerged from participant deliberation, and the recommendations that have emerged from the meeting. Deliberations from the Regional Forum are critical, as they have the potential to directly inform policy and program design, given that the meeting convenes health sector technocrats, who are at the helm of policy design, action, and implementation.

The role of regional health systems on the waiting time inequalities in health care services: Evidences from Italy

2020 ◽  
pp. 095148482092830
Author(s):  
Stefano Landi ◽  
Enrico Ivaldi ◽  
Angela Testi
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Waiting Time ◽  
Health Care Access ◽  
Health Care Services ◽  
Waiting Times ◽  
Healthcare Services ◽  
Regional Health ◽  
Health Authorities ◽  
Regional Health Authorities

Inequalities in effective access to healthcare are present among countries and within the same country. Despite in Italy exist the principle of equity in access to health system, there are evidence of different access rates in the form of unequal waiting time within the country. Waiting times are an instruments to ration healthcare services dealing with resource scarsity. Theoretically, it is a fair tool because waiting times should depend only on health needs and not on the ability to pay. However, a growing literature has pointed out that belonging to a particular socioeconomic status leads to waiting times inequalities for healthcare services. Many countries have socioeconomic disparities among regions, and healthcare organizations need to take into account these differences. The increasing power of Regional Health Authorities in decentralized health systems, as in the case of Italy, has generated different organizational ways to provide health care, possibly leading to different access rates in the form of unequal waiting time within the country. This paper aims to understand if the administrative area (Regional Health Authorities) in charge of health services affects waiting times lowering or strengthening health care access inequalities. Using a series of logistic regression models, this work suggests the presence of two vectors: socioeconomic inequalities and regional inequalities. Health organizations need to implement different kinds of answers for each vectors of inequalities.

Regional Health Development Partnerships

1999 ◽  
Vol 5 (3) ◽  
pp. 94
Author(s):  
Rosie King ◽  
Michael Bentley ◽  
Charlie Murray ◽  
Fran Baum
Keyword(s):  
Health Sector ◽  
South Australia ◽  
World Health ◽  
Health Issues ◽  
Regional Health ◽  
Community Groups ◽  
Health Development ◽  
Partnership Development ◽  
Health Organization ◽  
Potential Collaboration

This paper outlines a project funded by the World Health Organization (WHO) in the Hills Mallee Southern Region of rural South Australia. The project involves trialling guidelines produced by the WHO to assist regional health services to develop and support partnerships for health development with community groups and organisations. The guidelines suggest the following steps: identifying what Health Development Structures exist in their region by making an inventory of community groups and organisations in their area; analysing them for potential collaboration; and building sustainable alliances for health promotion and joint action on broader health issues. Six hundred community groups and organisations were identified and from the responses an inventory summarising the activities of 228 groups has been prepared. Seventy five percent of these groups and organisations consider that their activities relate to health and 28% have worked with a health service, although few had participated in 'joint projects' with the formal health sector. Detailed case studies were conducted with five groups from which a set of principles for partnership development was established.

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