scholarly journals Overcoming COVID-19 in China despite shortcomings of the public health system: what can we learn?

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mei Mei Wang ◽  
Steffen Fleßa
Keyword(s):  
Public Health System ◽  
Dynamics Model ◽  
The Public ◽  
Contact Rates ◽  
Digital Management ◽  
Short Period ◽  
Contact Tracking ◽  
The Impact ◽  
Second Wave ◽  
Tracking Technology

Abstract Background and objective The COVID-19 pandemic started in Wuhan, China, in December 2019. Although there are some doubts about the reporting of cases and deaths in China, it seems that this country was able to control the epidemic more effectively than many other countries. In this paper, we would like to analyze the measures taken in China and compare them with other countries in order to find out what they can learn from China. Methods We develop a system dynamics model of the COVID-19 pandemic in Wuhan. Based on a number of simulations we analyze the impact of changing parameters, such as contact rates, on the development of a second wave. Results Although China’s health care system seems to be poorly financed and inefficient, the epidemic was brought under control in a comparably short period of time and no second wave was experienced in Wuhan until today. The measures to contain the epidemic do not differ from what was implemented in other countries, but China applied them very early and rigorously. For instance, the consequent implementation of health codes and contact-tracking technology contributed to contain the disease and effectively prevented the second and third waves. Conclusions China’s success in fighting COVID-19 is based on a very strict implementation of a set of measures, including digital management. While other countries discuss relaxing the lock-down at a rate of 50 per 100,000 inhabitants, China started local lock-downs at a rate of 3 per 100,000. We call for a public debate whether this policy would be feasible for more liberal countries as well.

COVID’s Effect on India’s Health Services: A Commentary

Social Change ◽  
2021 ◽  
Vol 51 (4) ◽  
pp. 483-492
Author(s):  
Imrana Qadeer
Keyword(s):  
Public Sector ◽  
Health Services ◽  
Healthcare Services ◽  
The Public ◽  
State Authority ◽  
Comprehensive Framework ◽  
The Impact ◽  
Second Wave

Using a comprehensive framework (the state’s will to deliver, its institutional strength and its legitimacy), this article assesses the impact of the COVID-19 pandemic on public sector healthcare services in India. The power to deliver was explicit when the interventions were harsh, increasing the burden of death and disease on health services. But when it came to healthcare by the public sector we find a worsening of achievements of non-COVID ailments during the pandemic and an inability to tackle the second wave due to gaps in the nation's infrastructure, a centralised control undermining state authority; and visible results of a flawed policy that pushed further the agenda of making healthcare a profitable business.

scholarly journals OPEN VS LAPAROSCOPIC HERNIA REPAIR IN THE BRAZILIAN PUBLIC HEALTH SYSTEM. AN 11-YEAR NATIONWIDE POPULATION-BASED STUDY

2020 ◽  
Vol 57 (4) ◽  
pp. 484-490
Author(s):  
Eduardo Morais EVERLING ◽  
Daniela Santos BANDEIRA ◽  
Felipe Melloto GALLOTTI ◽  
Priscila BOSSARDI ◽  
Antoninho José TONATTO-FILHO ◽  
...  
Keyword(s):  
Public Health ◽  
Minimally Invasive ◽  
Hernia Repair ◽  
Health System ◽  
Public Health System ◽  
Laparoscopic Hernia Repair ◽  
Dominant Group ◽  
The Public ◽  
Early Return ◽  
The Impact

ABSTRACT BACKGROUND: Abdominal wall hernia is one of the most common surgical pathologies. The advent of minimally invasive surgery raised questions about the best technique to be applied, considering the possibility of reducing postoperative pain, a lower rate of complications, and early return to usual activities. OBJECTIVE: To evaluate the frequency of open and laparoscopic hernioplasties in Brazil from 2008 to 2018, analyzing the rates of urgent and elective surgeries, mortality, costs, and the impact of laparoscopic surgical training on the public health system. METHODS: Nationwide data from 2008 to 2018 were obtained from the public health registry database (DATASUS) for a descriptive analysis of the selected data and parameters. RESULTS: 2,671,347 hernioplasties were performed in the period, an average of 242,850 surgeries per year (99.4% open, 0.6% laparoscopic). The economically active population (aged 20-59) constituted the dominant group (54.5%). There was a significant reduction (P<0.01) in open surgeries, without a compensatory increase in laparoscopic procedures. 22.3% of surgeries were urgent, with a significant increase in mortality when compared to elective surgeries (P<0.01). The distribution of laparoscopic surgery varied widely, directly associated with the number of digestive surgeons. CONCLUSION: This study presents nationwide data on hernia repair surgeries in Brazil for the first time. Minimally invasive techniques represent a minor portion of hernioplasties. Urgent surgeries represent a high percentage when compared to other countries, with increased mortality. The data reinforce the need for improvement in the offer of services, specialized training, and equalization in the distribution of procedures in all regions.

Equestrian-related injuries, predictors of fatalities, and the impact on the public health system in Sweden

Public Health ◽  
2019 ◽  
Vol 168 ◽  
pp. 67-75 ◽  
Author(s):  
L. Meredith ◽  
R. Thomson ◽  
R. Ekman ◽  
J. Kovaceva ◽  
H. Ekbrand ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
The Public ◽  
The Impact

Analysis of the Challenges and Problems in the Development of Public Health System in Beijing, China

2020 ◽  
Author(s):  
Ayan Mao ◽  
Cordia Chu ◽  
Yujie Yang ◽  
Yueli Meng ◽  
Wuqi Qiu
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Municipal Government ◽  
Legal Framework ◽  
System Capacity ◽  
Health Staff ◽  
The Public ◽  
Information Strategies ◽  
The Impact

Abstract Background: To discern the main problems of Beijing’s public health service system, in order to provide suggestions to modernize the public health system and to enforce the implementation of the “Health Beijing 2030” plan. Methods: We carried out a quantitative study mostly based on interviews. There are over 40 directors and scholars who came from public health institutions and government sectors or organization that related to the public health work in Beijing were interviewed. The interview records were summary analyzed on key issues in accordance with the interview outline. Results: The challenges for the system include the change of structure of the population, the impact of the changing spectrum of diseases and changing environmental factors, and macro-institutional changes. The main problems include structure of the public health system, capacity of public health staff, systems for information management and legal framework for public health. On this basis, several relevant policy recommendations are put forward. Conclusion: To improve the public health system, the Beijing municipal government should design and construction of a system planning and perfecting their investment mechanism on public health. Stability of personnel and encouragement of innovation in scientific research and reliable health information strategies are also urgent needed.

scholarly journals The Abolition of User Fees in the Jamaican Public Health System: Impact on Access, Care Provided and the Work of the Professional Nurse

2021 ◽  
Author(s):  
◽  
Adella Campbell
Keyword(s):  
Public Health ◽  
Health Care ◽  
Developing Countries ◽  
Health Services ◽  
Health System ◽  
Public Health System ◽  
User Fees ◽  
Professional Nurse ◽  
The Public ◽  
The Impact

<p>The negative impact of user fees on the utilisation of the health services by the poor in developing countries such as Uganda and Jamaica is well documented. Therefore, various governments have been engaged in reforming public health systems to increase access by underserved populations. One such reform is the introduction of free health services. In Jamaica, user fees were abolished in the public health sector in 2007 for children under 18 years and in 2008 free health care was introduced for all users of the public health system. This study evaluated the impact of the 2008 reform on the Jamaican public health system at 1) the national level, 2) the provider level, and 3) the user level. Perspectives were sought on access to care, the care provided, and the work of the professional nurse. Participants were selected from the Ministry of Health (MOH), the four Regional Health Authorities (RHAs), and urban and rural health facilities. Data collection was done during March – August 2010, using a multi-layered mixed methods evaluation approach, incorporating both qualitative and quantitative methods. Methods included individual interviews with key policymakers (eight) at the MOH and the four RHAs, as well as a senior medical officer of health (one) and pharmacists (three); focus groups with representatives of the main practitioners in the health system including nurses (six groups), pharmacists (one group) and doctors (two groups); document reviews of the MOH and RHAs‘ annual reports, and a survey of patients (200). Views on the impact of the abolition of user charges differed across the three levels and among the health authorities, facilities, and perspectives (policymakers, practitioners and users). Patient utilisation of the public health system increased exponentially immediately following the abolition of user fees, then declined, but remained above the pre-policy level. The work of health care providers, especially the professional nurse, was affected in that they had to provide the expected and required services to the patients despite an increase in workload and constraints such as inadequate resources. The research found that, while policymakers were optimistic about the policy, providers had concerns but patients were satisfied with the increased access and the quality care they were now receiving. Users also encountered challenges that constituted barriers to access. In addition to providing further evidence about the abolition of user fees in the public health system, this research provides important new insights into the impact of the nationwide abolition of user fees, as well as the impact of the policy change on the work of the professional nurse. Equally, the findings highlighted the potential benefits, gaps, and failures of the abolition of user fees‘ policy, and will serve as a catalyst to improve the policy process regarding access to health services and the work of the professional nurse. The findings of this research will be valuable in the planning of health-related programmes for the consumers of health care in developing countries. Despite the need for further research in this area, this research has contributed to the body of knowledge regarding user fees and access to health care in developing countries.</p>

scholarly journals Covid-Prev Observatory

2021 ◽  
Vol 20 ◽  
pp. e3199
Author(s):  
Diana Vaz de Lima ◽  
Marcelo Driemeyer Wilbert ◽  
Jailson Gomes de Araújo Júnior ◽  
Eduardo Augusto Reichert ◽  
Allan Ribeiro de Castro
Keyword(s):  
Social Networks ◽  
Social Security ◽  
Public Management ◽  
Vulnerable Groups ◽  
Dissemination Strategy ◽  
The Public ◽  
The Social ◽  
Short Period ◽  
The Impact ◽  
Transparency And Accountability

The Covid-19 pandemic and its countermeasures have brought pressures on social and welfare assistance. Along with this, come the challenges of information being dispersed and complex, susceptible to distortions, and a society with distinct capacities for assimilation and analysis. This paper aims to present the experience of the Covid-Prev Observatory as a tool for transparency and accountability in the public management of social security in times of pandemic. This experience with the social observatory has encompassed the choice of themes and variables to be disseminated and analyzed, the visual planning and dissemination strategy, and the discussion of the observatory's role and potential. Thus, a multidisciplinary team has developed a project aiming to analyze the impact of Covid-19 on the Brazilian Social Security System, from different perspectives, both with the reproduction of data and information, and for the elaboration of analyses: impacts of the pandemic on the labor market and its effects on the evolution of social security revenues and expenses, effects of the pandemic on vulnerable groups, sustainability of pension funds, impacts on the financial market, among others. This information was first disclosed on the Blogger platform, and then on an electronic website whose disclosure was made both on the social networks of the research participants themselves and on the social networks of entities interested in the topic, such as the Brazilian Association of State and Municipal Pension Institutions (ABIPEM). In its short period of existence, the observatory has obtained more than 10 thousand accesses, either from Brazil and other countries. The observatory has presented data and analyses in a simple way, based on scattered information with different levels of complexity. In these analyses, the aim has been to establish relationships between facts correlated to social security and welfare. Thus, it is understood that the observatory has collaborated as a transparency and accountability tool with respect to the theme of social security in Brazil, serving as a discussion of the challenges and potentialities of social observatories.

scholarly journals Os direitos humanos, a mercantilização da vida e a pandemia

2020 ◽  
Vol 8 (2) ◽  
pp. 27-39
Author(s):  
Castor M. M. Bartolomé Ruiz
Keyword(s):  
Human Rights ◽  
Public Health System ◽  
Human Life ◽  
Economic Variable ◽  
Homo Economicus ◽  
The Public ◽  
The Face ◽  
Individual Actions ◽  
Under Construction ◽  
The Impact

Os direitos humanos, enquanto discurso e prática, sempre estão em construção, desafiados pelos acontecimentos históricos de cada tempo. Nosso tempo vive sob o impacto de uma pandemia que tem provocado profundas mudanças no modo de vida e nas estratégias governamentais. Entre outras questões, a pandemia tem retirado a máscara dos principais argumentos do modelo neoliberal, particularmente em vários dos principios que sustentavam sua filosofia do homo economicus. A redução da vida humana a mera variável econômica, substrato do neoliberalismo, mostrou na pandemia as reais consequências de uma tanatopolítica que prioriza a economia em detrimento da vida humana. A obstinada negação pregada pelo neoliberalismo do valor do público e da dimensão comunitária, tem mostrado sua intrínseca fragilidade durante a pandemia, pois só os países que mantiveram um sistema público de saúde consistente conseguiram enfrentar de modo coletivo e efetivo as graves sequelas da pandemia. Por último, a cultura do individualismo, tão insistentemente inoculada em nossas subjetividades pelo neoliberalismo, também ruiu perante a radical interdepência que a pandemia mostrou existir entre todos nossos atos individuais e suas consequências comunitárias. A pandemia evidenciou que todos somos responsáveis por todos e que meus atos individuais repercutem diretamente sobre os demais.  Essa interdependência constitutiva do humano é o fio que mostra que os direitos individuais são o desdobramento das obrigações de nossa responsabilidade para com os outros.    Human rights, the commodification of life and the pandemic Human rights, as a discurse and practice, are always under construction, challenged by the historical events of each time. Our time lives under the impact of a pandemic that has removed the mask of the main arguments of the neoliberal model, particularly in several of the principles that supported its philosophy of homo economicus. The reduction of human life to a mere economic variable, a substrate of neoliberalism, showed in the pandemic the real consequences of a thanatopolitics that prioritizes the economy at the the expense of human life. The obstinate denial preached by neoliberalims of the value of the public and the community dimension, has shown its intrinsic fragility during the pandemic, as only countries that maintained a consistent public health system were able to face the serius consequences of the pandemic collectively ond effectively. Finally, the culture of individualism, so insistently inoculated into our subjetivities by neoliberalim, has also collapsed in the face of the radical interdepence that the pandemic has shown to exist between all our individual acts and their community consequences. The pandemic has shown that we are all responsible for everyone and that my individual actions have a direct impact on others. This constitutive interdependence of the humam is the thread that shows that individual rights are the unfolding of the obligations of our responsibility to others. Keywords: Human rights. Neoliberalism. Homo economicus. Pandemic. Alterity

The Ongoing Debate of and Direction for Future Research about the Impact of the 150-Hour Education Requirement on the Supply of Certified Public Accountants

2013 ◽  
Vol 28 (3) ◽  
pp. 503-512 ◽  
Author(s):  
Lawrence J. Gramling ◽  
Andrew J. Rosman
Keyword(s):  
Additional Research ◽  
Accounting Education ◽  
Future Research ◽  
Certified Public Accountants ◽  
Ongoing Debate ◽  
The Public ◽  
Short Period ◽  
Cpa Exam ◽  
Additional Education ◽  
The Impact

ABSTRACT: In this paper we reflect on two streams of research on CPA examination candidacy and accounting enrollments that include studies by Allen and Woodland (2006), Gramling and Rosman (2009), and Allen and Woodland (2012). In our response to the more recent Allen and Woodland (2012) article, we observe that the literature is split on causes for declines in accounting enrollments and CPA exam candidacy. The reversal of both of these declines in a relatively short period provides further evidence to question whether the 150-hour education requirement was actually the cause of decreases in accounting enrollments and CPA exam candidacy. With the adoption of 150-hour requirement in virtually all jurisdictions, we recommend that research refocus the questions to address how to structure the additional education to maximize the benefits of the increased education to the public, academe, students, and the profession. The continuing need for research into the content and the implications of the 150-hour requirement for members of the CPA profession is discussed and we call for additional research in a number of areas, including a concerted examination of the effects of changing delivery of accounting education on performance on the CPA exam and in practice.

scholarly journals The Abolition of User Fees in the Jamaican Public Health System: Impact on Access, Care Provided and the Work of the Professional Nurse

2021 ◽  
Author(s):  
◽  
Adella Campbell
Keyword(s):  
Public Health ◽  
Health Care ◽  
Developing Countries ◽  
Health Services ◽  
Health System ◽  
Public Health System ◽  
User Fees ◽  
Professional Nurse ◽  
The Public ◽  
The Impact

<p>The negative impact of user fees on the utilisation of the health services by the poor in developing countries such as Uganda and Jamaica is well documented. Therefore, various governments have been engaged in reforming public health systems to increase access by underserved populations. One such reform is the introduction of free health services. In Jamaica, user fees were abolished in the public health sector in 2007 for children under 18 years and in 2008 free health care was introduced for all users of the public health system. This study evaluated the impact of the 2008 reform on the Jamaican public health system at 1) the national level, 2) the provider level, and 3) the user level. Perspectives were sought on access to care, the care provided, and the work of the professional nurse. Participants were selected from the Ministry of Health (MOH), the four Regional Health Authorities (RHAs), and urban and rural health facilities. Data collection was done during March – August 2010, using a multi-layered mixed methods evaluation approach, incorporating both qualitative and quantitative methods. Methods included individual interviews with key policymakers (eight) at the MOH and the four RHAs, as well as a senior medical officer of health (one) and pharmacists (three); focus groups with representatives of the main practitioners in the health system including nurses (six groups), pharmacists (one group) and doctors (two groups); document reviews of the MOH and RHAs‘ annual reports, and a survey of patients (200). Views on the impact of the abolition of user charges differed across the three levels and among the health authorities, facilities, and perspectives (policymakers, practitioners and users). Patient utilisation of the public health system increased exponentially immediately following the abolition of user fees, then declined, but remained above the pre-policy level. The work of health care providers, especially the professional nurse, was affected in that they had to provide the expected and required services to the patients despite an increase in workload and constraints such as inadequate resources. The research found that, while policymakers were optimistic about the policy, providers had concerns but patients were satisfied with the increased access and the quality care they were now receiving. Users also encountered challenges that constituted barriers to access. In addition to providing further evidence about the abolition of user fees in the public health system, this research provides important new insights into the impact of the nationwide abolition of user fees, as well as the impact of the policy change on the work of the professional nurse. Equally, the findings highlighted the potential benefits, gaps, and failures of the abolition of user fees‘ policy, and will serve as a catalyst to improve the policy process regarding access to health services and the work of the professional nurse. The findings of this research will be valuable in the planning of health-related programmes for the consumers of health care in developing countries. Despite the need for further research in this area, this research has contributed to the body of knowledge regarding user fees and access to health care in developing countries.</p>

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