Financing Health Services in Developing Countries

Consecutive new patients presenting at a Nigerian psychiatric unit over a 14-month period and fulfilling the DSM-III criteria for schizophreniform disorder, (active) schizophrenia and residual schizophrenia were studied. There were no differences between the three groups with respect to background social data. The schizophreniform patients had a lower incidence of previous psychotic episodes. There were no differences between the first two groups with respect to the distribution of PSE symptoms and signs, Schneider's First Rank Symptoms, or severity of psychopathology. Initial clinical outcome, and longer-term clinical and social outcome, assessed 25–38 months after index presentation, was best in the schizophreniform patients and worst in the patients with residual schizophrenia. The findings are consistent with schizophreniform disorder lying on a spectrum of schizophrenic disorders. They also highlight inadequacies in mental health services in Nigeria and other developing countries.

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Contracting out of health services in developing countries

Health Policy and Planning ◽

10.1093/heapol/9.1.25 ◽

1994 ◽

Vol 9 (1) ◽

pp. 25-30 ◽

Cited By ~ 19

Author(s):

BARBARA McPAKE ◽

ELIAS E NGALANDE BANDA

Keyword(s):

Developing Countries ◽

Health Services ◽

Contracting Out

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The Untold Story: How the Health Care Systems in Developing Countries Contribute to Maternal Mortality

International Journal of Health Services ◽

10.2190/91yh-a52t-afbb-1lea ◽

1992 ◽

Vol 22 (3) ◽

pp. 513-528 ◽

Cited By ~ 49

Author(s):

T. K. Sundari

Keyword(s):

Health Care ◽

Developing Countries ◽

Health Services ◽

Maternal Mortality ◽

Health Care Systems ◽

Health Services Delivery ◽

Services Delivery ◽

Life Saving ◽

Referral Hospitals ◽

Care Systems

This article attempts to put together evidence from maternal mortality studies in developing countries of how an inadequate health care system characterized by misplaced priorities contributes to high maternal mortality rates. Inaccessibility of essential health information to the women most affected, and the physical as well as economic and sociocultural distance separating health services from the vast majority of women, are only part of the problem. Even when the woman reaches a health facility, there are a number of obstacles to her receiving adequate and appropriate care. These are a result of failures in the health services delivery system: the lack of minimal life-saving equipment at the first referral level; the lack of equipment, personnel, and know-how even in referral hospitals; and worst of all, faulty patient management. Prevention of maternal deaths requires fundamental changes not only in resource allocation, but in the very structures of health services delivery. These will have to be fought for as part of a wider struggle for equity and social justice.

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Compulsory community mental health care: Oceania

10.1093/med/9780198788065.003.0020 ◽

2016 ◽

Author(s):

Anthony J. O’Brien

Keyword(s):

Mental Health ◽

Health Care ◽

Developing Countries ◽

Mental Health Services ◽

Community Mental Health ◽

Health Services ◽

Mental Health Care ◽

Developed Countries ◽

Community Treatment ◽

Community Mental Health Care

Oceania is characterized by the diversity of countries and by highly variable provision of mental health services and community mental health care. Countries such as Australian and New Zealand have well-developed mental health services with a high level of provision, but many less developed countries lack mental health infrastructure. Some developing countries such as Samoa and Tonga have passed mental health legislation with provision for community treatment orders, but this legal measure is probably not a useful mechanism for advancing mental health care in developing countries. Instead, efforts to improve provision of care seem best directed to the primary care sector, and to the general health workforce, rather than to specialists. The UN CRPD offer extensions of human rights to people with mental illness and most countries in Oceania have signed it. However, the absence of a regional rights tribunal potentially limits the realization of those rights.

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A PLEA for an Initiative to Strengthen Family Medicine in Public Health Care Services of Developing Countries

International Journal of Health Services ◽

10.2190/fn20-agdq-gycp-p8r6 ◽

2002 ◽

Vol 32 (4) ◽

pp. 799-815 ◽

Cited By ~ 14

Author(s):

Jean-Pierre Unger ◽

Monique Van Dormael ◽

Bart Criel ◽

Jean Van der Vennet ◽

Paul De Munck

Keyword(s):

Public Health ◽

Health Care ◽

Developing Countries ◽

Family Medicine ◽

Health Services ◽

Clinical Skills ◽

Hospital Medicine ◽

Care Practice ◽

Care Organization ◽

Patient Centered

An analysis of standards for the best practice of family medicine in Northern European countries provides a framework for identifying the difficulties and deficiencies in the health services of developing countries, and offers strategies and criteria for improving primary health care practice. Besides well-documented socioeconomic and political problems, poor quality of care is an important factor in the weaknesses of health services. In particular, a patient-centered perspective in primary care practice is barely reflected in the medical curriculum of developing countries. Instead, public sector general practitioners are required to concentrate on preventive programs that tackle a few well-defined diseases and that tend to be dominated by quantitative objectives, at the expense of individually tailored prevention and treatment. Reasons for this include training oriented to hospital medicine and aspects of GPs' social status and health care organization that have undermined motivation and restricted change. A range of strategies is urgently required, including training to improve both clinical skills and aspects of the doctor-patient interaction. More effective government health policies are also needed. Co-operation agencies can contribute by granting political protection to public health centers and working to orient the care delivered at this level toward patient-centered medicine.

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