scholarly journals Opportunities and Challenges of Implementing Service Agreement between the Government and Faith Based Organizations in Ilala Municipality, Dar Es Salaam, Tanzania

2020 ◽  
Author(s):  
pankras wilbard luoga ◽  
Frumence Gasto
Keyword(s):  
Health Services ◽  
Private Sector ◽  
Dar Es Salaam ◽  
Political Support ◽  
Population Increase ◽  
Technological Advancement ◽  
Access To Health Services ◽  
The Government ◽  
Service Agreement ◽  
Partial Fulfillment

Abstract Background Access to essential health services is an important aspect of development. Due to the population increase and technological advancement, governments could no longer cater for the services needed. One of the solutions was to involve private sector through Public Private Partnerships (PPPs) in provision of the services. In 2007 Tanzania made a generic Service Agreement (SA) to govern PPPs in health sector. However, since its establishment, less is known on opportunities and challenges of implementing SA in the provision of health services in Tanzania. Therefore, the focus of this study was to assess the opportunities and challenges of implementing SA in Tanzania using a case of SA between the Cardinal Rugambwa Mission Hospital (CRMH) and the Ilala Municipality in Dar es Salaam. Methods The study employed a case study design using qualitative method of data collection. Data were collected by using in depth interview guide. Purposive sampling was used to select participants. The sample size was based on the principle of saturation level of the information collected. Data were analyzed using a thematic analysis approach. Results The opportunities of implementing SA in CRMH, Ilala Municipality include: the existence of guidelines and policies, Patients receive some health Services free of charges, availability of some services at reduced prices, presence of SA review meetings, good coordination, availability of supervision, training and mentorship opportunities, presence of political support, trust of the hospital by suppliers and trust between government and the hospital. The identified challenges in implementing SA include: - partial fulfillment of financial commitment, inadequacy deployment of HRH to CRMH by government, lack of transport for supervision and donor dependence. Conclusion There are a number of available opportunities for partnering between the private sector and the government in the delivery of health services. However, for the PPP to achieve its desired objective of improving access to health services particularly to most vulnerable population such as women and children, there is a need for the two parties (private and public) to address the identified challenges such as partial fulfillment of financial commitment and inadequacy deployment of HRH from the government to the private health facilities as per SA.

scholarly journals Lived Experiences of Pneumonia Victims in Davao City: A Phenomenological Study

2020 ◽  
Author(s):  
Joseph Dave Mendoza Pregoner ◽  
Stephen Aseo ◽  
Angel Dominguiano
Keyword(s):  
Health Services ◽  
Rural Areas ◽  
Phenomenological Study ◽  
Sampling Technique ◽  
Phenomenological Approach ◽  
Medical Society ◽  
Structural Barriers ◽  
Access To Health Services ◽  
Financial Barriers ◽  
The Government

An access to primary care offered by the government has been the major concern of this study, which are deprived with complicated perceptions specifically in rural areas. The study engaged a phenomenological approach that characterized human experiences, and mainly to observe the behavioral response of people involved in this research. Also, it uses a purposive sampling technique that involves handpicking participants based on pre-selected criteria. The results gained specified themes through the use of thematic analysis. Based on the identified results, there were four themes introduced in the study that encompasses the problem; and the four themes that were mentioned were Financial Barriers, Structural Barriers, Cognitive Barriers, and Psychological Barriers. Each theme has sub-themes that mimic the problem of the community to the medical society within its access to health services. With regards to this result, the researchers came up with certifying alternatives that would develop the governments’ capabilities in giving quality to health services. It was determined that people should be able to comprehend the barriers hindering them to access the health services. Thus, they should commit themselves on appealing an effective communication to the government. The lingering biases and prejudices of medical experts to the remote communities should be dissipated instantly to avoid future complications. In this similar way, the two should submit to an organized and to an effective stabilized relationship for a better response.

scholarly journals Covid 19: Antara Angka Kematian dan Angka Kelahiran

2020 ◽  
Vol 1 (3) ◽  
pp. 199-211
Author(s):  
Tuti Marjan Fuadi ◽  
Irdalisa
Keyword(s):  
Health Services ◽  
Death Rate ◽  
Large Scale ◽  
Baby Boom ◽  
Married Couples ◽  
Pregnancy Rates ◽  
Access To Health Services ◽  
Online Newspapers ◽  
The Government ◽  
In Pregnancy

This paper aims to see the phenomenon of increasing mortality rates and birthrates during the Covid 19 pandemic. Pandemic Covid 19 has a lot of life, the number of victims worldwide reached 1.49 million people, and Indonesia as many as 17.199 people. To break the chain of the spread of the coronavirus, the Indonesian government has implemented a Large-Scale Social Restriction (PSBB) policy. The PSBB policy taken by the government at least influenced the increase in pregnancy rates, so a baby boom was predicted in 2021. The data in this paper comes from literature studies and relevant online newspapers. The results of this study are; 1) The cause of the high death rate due to Covid-19 is caused by individual factors and external factors. 2) The death rate has reached 17,081 with the number of cases 543,975 where Male groups are more prone to becoming victims of Covid 19 than women. Covid-19 victims in men are 55% higher than women. The high number of men exposed to Covid 19 is influenced by biological factors and social factors. 3) The birth rate has increased due to several supporting factors i.e the implementation of PSBB by the government resulted in more time with family, which led to an increase in pregnancy rates. Furthermore, access to health services is difficult so that many married couples do not visit health services for contraceptive programs until many women conceding and unplanned pregnancies. Abstrak Tulisan ini bertujuan untuk melihat fenomena peningkatan angka kematian dan peningkatan angka kelahiran selama masa pandemi Covid-19. Pademi Covid-19 telah menelan korban jiwa yang tidak sedikit, jumlah korban jiwa seluruh dunia mencapai 1.49 juta jiwa dan di Indonesia sebanyak 17,199 jiwa. Untuk memutus mata rantai penyebaran virus corona pemerintah Indonesia menerapkan kebijakan Pembatasan Sosial Berskala Besar (PSBB). Kebijakan PSBB yang diambil oleh pemerintah setidaknya telah memberikan pengaruh terhadap peningkatan angka kehamilan, sehingga diprediksikan akan terjadi baby boom pada tahun 2021 . Data dalam tulisan ini diperoleh dari studi literatur serta surat kabar online yang relevan. Hasil dari penelitian ini adalah; 1) Penyebab tingginya angka kematian akibat Covid-19 disebabkan oleh faktor individu dan faktor eksternal. 2) Angka kematian telah mencapai 17.081 dengan jumlah kasus 543.975 dimana kelompok laki-laki lebih rentan menjadi korban Covid 19 dibandingkan perempuan. Korban Covid-19 pada pria 55% lebih tinggi dibandingkan wanita. Tingginya angka pria terpapar Covid 19 dipengaruhi oleh faktor biologis dan faktor sosial. 3) Angka kelahiran yang meningkat karena beberapa faktor pendukung yaitu pelaksanaan PSBB oleh pemerintah mengakibatkan lebih banyak waktu bersama keluarga sehingga menyebabkan peningkatan angka kehamilan. Terlebih lagi, akses terhadap layanan kesehatan sulit sehingga banyak pasangan suami istri yang tidak mengunjungi layanan kesehatan untuk program kontrasepsi hingga banyak ibu hamil yang melahirkan dan tidak direncanakan.

scholarly journals Being taken for a ride: privatisation of the Dar es Salaam transport system 1983–1998

2002 ◽  
Vol 40 (1) ◽  
pp. 133-157 ◽  
Author(s):  
Matteo Rizzo
Keyword(s):  
Private Sector ◽  
Transport System ◽  
Service Provision ◽  
Dar Es Salaam ◽  
State Regulation ◽  
Labour Relations ◽  
The Government ◽  
The Impact ◽  
Conditions Of Employment ◽  
Safety Rules

This paper analyses the effects of privatisation and deregulation of the Dar es Salaam transport system. It starts with an account of the decline of the government-owned transport company and the first opening of the market to private buses in 1983. The analysis then moves to the progressive deregulation of the sector and its impact on transport supply. Competition between private operators in the oversupplied market manifests itself in non-compliance with safety rules, and inefficiencies in the fare structures. Labour relations with the private sector are then examined to illustrate the logic of the market. The results of a questionnaire answered by 668 workers suggest that the reaction of casual workers to exploitative conditions of employment characterises many aspects of the operation of the transport system. The impact of deregulation is therefore most clearly to be seen in the nature of labour relations within the sector, and it is argued that there is a need for state regulation to monitor and enforce conditions of employment within the private sector if service provision is to be improved.

scholarly journals Surviving on a mountain of rubbish: the state and access to health social security for female scavengers

2020 ◽  
Vol 5 (1) ◽  
pp. 119
Author(s):  
Fairus Dwi Putri ◽  
Khaerul Umam Noer
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Social Life ◽  
The State ◽  
Access To Health Services ◽  
Five Dimensions ◽  
Female Head ◽  
Access To Health ◽  
The Government ◽  
The Right

This paper focuses on the lives of women scavengers heads of households and how the state guarantees the fulfillment of the right to health. Women are relatively more vulnerable to various risks related to their life cycle and role in the family; thus, their access to health insurance is an obligation that must be met by the government. This paper has two objectives: to map social life and, at the same time, analyze the accessibility of the Healthy Indonesia National Health Insurance Card for female head of household scavengers in TPA Cipayung, Depok City. Using qualitative methods, and focusing on five dimensions of accessibility: availability, accessibility, accommodation, affordability, and acceptance, this study found that all health insurance arrangements are still very problematic. Even though these women scavengers are protected by JKN-KIS PBI, in reality, they are still challenging to get access to health services, ranging from the availability of doctors, the scarcity of drugs, to the discrimination of health services. This shows that they have not yet received full health insurance, which has a direct impact on the social and economic lives of the scavengers.

scholarly journals In search of universal health coverage – highlighting the accessibility of health services for students with disabilities in Ghana: a qualitative study

2019 ◽  
Author(s):  
Eric Abodey ◽  
Irene Vanderpuye ◽  
Isaac Mensah ◽  
Eric Badu
Keyword(s):  
Health Services ◽  
Students With Disabilities ◽  
Universal Health Coverage ◽  
Health Workers ◽  
Policy Formulation ◽  
Health Coverage ◽  
Access To Health Services ◽  
Accessibility Of Health Services ◽  
The Government ◽  
Universal Health

Abstract Background: Accessibility to health services for students with disabilities is a global concern. This is no less important in Ghana, however, to date, no study has been undertaken regarding access to health services for students with disabilities. This study, therefore, aims to explore the accessibility of health services for students with disabilities, in the quest of achieving universal health coverage in Ghana. Methods: Qualitative methods, involving in-depth interviews were employed to collect data from 54 participants (29 students with disabilities, 17 health workers and 8 school mothers), selected through purposive sampling. Thematic analysis was used to analyze the data. Results : The study identified three themes – accessibility, adequacy, and affordability. The study findings highlighted that universal health coverage for students with disabilities has not been achieved due to barriers in accessing health services. The barriers faced by students with disabilities are unfriendly physical environments, structures, equipment, limited support services and poor health insurance policy to finance health services. Conclusion : The study concludes that the government should prioritize disability-related issues in health policy formulation, implementation and monitoring. The current provisions and requirements in the disability act should be prioritized, enforced and monitored to ensure adequate inclusion of disability issues in health services. Further, the current exemption policy under the NHIS scheme should be revised to adequately address the needs of people with disabilities.

scholarly journals PUBLIC INVESTMENT ON HEALTH SERVICES AND ITS DETERMINANTS IN MIZORAM: AN EMPIRICAL ANALYSIS

2020 ◽  
pp. 21-26
Author(s):  
Dr.Lalfakawmi
Keyword(s):  
Economic Growth ◽  
Health Care ◽  
Human Capital ◽  
Health Services ◽  
Poverty Reduction ◽  
Universal Access ◽  
Public Investment ◽  
Well Being ◽  
Access To Health Services ◽  
The Government

The health of human capital generates both higher income and individual well-being. Improved health generates economic growth and poverty reduction in the long- run. Good health is universally acknowledge being of intrinsic value and, therefore, constitutes an integral element of development. The expenditure on health is revealed as a kind of investment in human capital. Government has almost exclusive responsibility for providing public goods that create large positive externalities. Despite differences of opinion about the role of the government in health care, it seems that there is unanimity of view that universal access and equity are dependent on the government financial support of basic health care. The access to health services has to be need and state specific, depending on the socio-economic conditions, health outcomes and administrative capacity. Attempt is made in this paper to analyze the growth of public investment on health services and its determinants in Mizoram. The study shows that there has been commendable growth of public investment on health services, both in current and constant prices. It is further observed that there is more than proportional increase of public health expenditures with respect to population, while it is almost proportional to total budget of the state, and less than proportional to GSDP. KEYWORDS: health services, economic growth, public investment/expenditure, determinants.

Border Securitisation and the Emerging Health Challenges at the Indo-Bangladesh Borderland

2019 ◽  
Vol 1 (3) ◽  
pp. 234-253
Author(s):  
Bipin Jojo ◽  
Abhimanyu Datta
Keyword(s):  
Health Services ◽  
Health Issues ◽  
Access To Health Services ◽  
Major Health ◽  
Individual Interviews ◽  
Access To Health ◽  
Border Fence ◽  
Illegal Activities ◽  
The Government ◽  
Group Interviews

This article discuses some of the major health challenges and their impact on the Indian families living outside the Indo-Bangladesh border fence. Drawing on the qualitative data of 7 group interviews and 25 in-depth individual interviews conducted in the border area of Karimganj district of Assam, it analyses health issues experienced by people having no access to health services. The article argues that although the purpose of border fencing was to restrict the illegal activities across the border, it is causing serious problems for the Indian population who are left outside the border fence. The strict border rules and restriction in the movements across the border have led to lack of access to necessary health services, and people are experiencing a range of health issues without any treatment. Nevertheless, there is no proper intervention mechanism by the government. The article suggests some measures to address the problems of the border dwellers.

scholarly journals Liquid migration and patterns of health service consumption

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Reine
Keyword(s):  
Health Service ◽  
Health Services ◽  
Social Insurance ◽  
Medical Tourism ◽  
Longitudinal Design ◽  
Transnational Migration ◽  
Economic Policies ◽  
Access To Health Services ◽  
Transnational Migrants ◽  
The Government

Abstract Transnational migrants refuse to commit themselves to one national setting. Thus, the national social security administrations face a challenge to comply with EU regulations and directives on how the governmental and municipal forces and systems through economic policies, development agendas, social norms, social policies and political systems guarantee access to health services for European migrants. Using a longitudinal design, this study provides the most robust statistical assessment of the effect of migration on the patterns of health service consumption of Eastern European migrants. Using objective measurements and individual experiences of 6292 respondents, the study on Latvian migrants analyses perceived social insurance support (as it refers to health). The results suggest that the transnational migrants are aware of the quality, availability and costs of health services in their home country(-ies) and the country of origin. Despite the fear of the government of Latvia of the mass misuse of the social system, only four percent of the transnational migrants are using this possibility. The majority of the respondents admitted that they pay for the services themselves, and are mostly not aware or willing to use their rights in accordance with EU regulations. One of the main reasons for transnational migration depicting “medical tourism”, seems to be related to the health and social support needs, especially in regard to prophylactic check-ups, dentistry and different examinations not related to a serious illness. The results suggest that migrants in the EU are seeking for accessible and affordable health services disregard their social insurance benefits in any particular country. It remains to be studied what are the behavior patterns among migrants with acute and chronic conditions. Key messages The use of health services may not be related to the benefits of social insurance or economical aspects, rather on needs, quality and accessibility. Health services might trigger an extensive transnational migration, but not benefits because of social insurance.

scholarly journals Experiences of Tuberculosis in a Tarai Village, Nepal

2019 ◽  
Vol 13 ◽  
pp. 1-10
Author(s):  
Ulla-Britt Engelbrektsson ◽  
Madhusudan Subedi
Keyword(s):  
Qualitative Study ◽  
Health Services ◽  
Private Sector ◽  
Distribution System ◽  
Preventive Measures ◽  
Patient Support ◽  
The Public ◽  
Treatment Centre ◽  
The Government ◽  
Rural Nepal

In focus is the experience of being a Tuberculosis (TB) patient in the mid-west Tarai of rural Nepal. The information derives from a longitudinal qualitative study between 2005 to 2017 in one and the same community. The findings show few changes in the experience of being a TB patient. The availability of anti-TB medicine free of cost within the government health services was greatly appreciated. The cause of TB, ways and means of transmissions, and the need for preventive measures, however, were not well understood. In the case of Child-TB, the expectation of numerous visits to the government treatment centre for the picking up of medicines was a strong deterrant. In consequence, most child-TB cases were diagnosed and treated within the private sector. The distribution system of the medicines, particularly within the government system, clearly added to the burden of being a TB patient and much would have been gained had the arrangement been more patient-friendly, a difference which most likely had also resulted in more children being treated within the public services rather than within the money-geared private sector. Various misunderstandings about the cause/s of the disease need to be addressed. And, much would be gained was the central directive of “patient support”, truly implemented and was a true “two-way communication” to take place.

scholarly journals Financing Healthcare in Indonesia

2016 ◽  
Vol 11 (2) ◽  
pp. 33-38 ◽  
Author(s):  
Suryanto Suryanto ◽  
Virginia Plummer ◽  
Malcolm Boyle
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Private Sector ◽  
Grey Literature ◽  
Relevant Literature ◽  
Major Transitions ◽  
Inappropriate Use ◽  
Ovid Medline ◽  
The Government ◽  
Universal Health

Introduction: There have been two major transitions for healthcare in Indonesia: the implementation of government decentralisation and universal health insurance. A universal public health insurance called Badan Penyelenggara Jaminan Sosial (BPJS) was launched in January 2014 and aims to cover all Indonesian people. Objective: The objective of this paper is to discuss the funding of healthcare in Indonesia through a comparison with other South East Asian countries. Methodology: A search for relevant literature was undertaken using electronic databases, Ovid Medline, ProQuest Central, and Scopus from their commencement date until December 2015. The grey literature from the Indonesian government, the WHO’s and World Bank’s website, has been included. Results: There were nine articles from Ovid Medline, eight from ProQuest Central, and 12 from Scopus that met the criteria. Seventeen articles were duplicates leaving 12 articles to be reviewed. Nine documents have been identified from grey literature. Discussion: Most people in Indonesia sought health services from the private sector and were out-ofpocket financially or did not receive the required care. The private sector delivered 62.1% of health services compared to 37.9% by the government. Despite some inappropriate use of previous health insurance, the BPJS is expected to have improved management and will cover all citizens by the end of 2019. Conclusion: Indonesia has undergone a series of changes to health system funding and health insurance. There are lessons that can be learnt from other countries, such as Thailand, Cambodia, and Vietnam, so that Indonesia can improve its health funding. Abbreviations: BPJS – Badan Penyelenggara Jaminan Sosial.

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