From Chronic Emergency to Development: An Analysis of the Health of the Urban Poor in Luanda, Angola

1992 ◽  
Vol 22 (2) ◽  
pp. 349-363 ◽  
Author(s):  
Najmi Kanji ◽  
Trudy Harpham
Keyword(s):  
Urban Poor ◽  
Structural Adjustment ◽  
Health Care Systems ◽  
Infant Mortality Rate ◽  
African Countries ◽  
Rapid Urbanization ◽  
Intestinal Infections ◽  
Health Related ◽  
Care Systems ◽  
Sub Saharan

There is a dearth of published literature on health care systems in Angola. Like many sub-Saharan African countries, Angola is experiencing rapid urbanization. The authors provide an analysis of the health status, environmental health conditions, and health-related behavior of the urban poor in Luanda, Angola. Although data are patchy and rarely disaggregated to reveal severe conditions in the shanty towns, a grave picture emerges. An average infant mortality rate of 104/1,000, with malaria and intestinal infections the main causes of death in children under 1 year old, reflects the poor environmental conditions, which are worsening as urbanization continues at a rapid rate. Use of health services is limited; for example, 50 percent of women give birth at home, mainly unassisted, and only 28 percent of children are covered by measles immunization (as validated by card). A discussion of existing health strategies, programs, and their constraints is set in the context of the future possibilities of the ending of the 15-year war and the introduction of structural adjustment policies.

scholarly journals The effect of the quality of institutions on the relationship between public health expenditure and the infant mortality rate: evidence from the PVAR (X) and PSTR approaches

2021 ◽  
Vol 1 (1) ◽  
pp. 16-35
Author(s):  
Arthur Evariste KOUASSI ◽  
Ya Assanhoun Guillaume KOUASSI ◽  
Nogbou Andetchi Aubin AMANZOU
Keyword(s):  
Public Health ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Health Expenditure ◽  
Infant Mortality Rate ◽  
African Countries ◽  
Important Indicator ◽  
Institutional Variables ◽  
Public Health Expenditure ◽  
Sub Saharan

Infant mortality is a major health problem in developing countries. It is an important indicator of a country's public health as it goes hand in hand with socio-economic conditions and many others. Public health spending has been committed to reducing this scourge. This has led to the completion of numerous studies which have yielded mixed results. The main objective of this study is to test the effect of public health expenditure (% GDP) on the infant mortality rate, taking into account the role that institutional quality can play. To achieve this, we use two approaches which are the autoregressive vector panel model with exogenous variables (PVAR (X)) and the smooth threshold regression model (PSTR) on annual data covering the period 2002-2016 and covering 37 African countries. Sub-Saharan. Our main results through the PVAR (X) reveal that in the absence of institutional variables, public health expenditure has a negative and significant effect on the infant mortality rate, whereas, in the presence of the various institutional variables, this effect is still negative but is no longer significant. Our results show that the presence of institutions halves the weight of public health expenditure in explaining the infant mortality rate. In addition, our results show through the PSTR that there is a certain level of institutional qualities that these countries must achieve for public health expenditure to positively affect infant mortality rates. These thresholds oscillate for all the institutional variables around 7%. Taking institutional variables into account will help reduce infant mortality in Sub-Saharan African countries.

scholarly journals Wider Dental Care Coverage Associated with Lower Oral Health Inequalities: A Comparison Study between Japan and England

2020 ◽  
Vol 17 (15) ◽  
pp. 5539
Author(s):  
Kanade Ito ◽  
Noriko Cable ◽  
Tatsuo Yamamoto ◽  
Kayo Suzuki ◽  
Katsunori Kondo ◽  
...  
Keyword(s):  
Oral Health ◽  
Educational Attainment ◽  
Dental Care ◽  
Social Inequalities ◽  
Health Care Systems ◽  
Relative Index ◽  
Health Related ◽  
Care Systems ◽  
Natural Teeth ◽  
Index Of Inequality

Countries with different oral health care systems may have different levels of oral health related inequalities. We compared the socioeconomic inequalities in oral health among older adults in Japan and England. We used the data for adults aged 65 years or over from Japan (N = 79,707) and England (N = 5115) and estimated absolute inequality (the Slope Index of Inequality, SII) and relative inequality (the Relative Index of Inequality, RII) for edentulism (the condition of having no natural teeth) by educational attainment and income. All analyses were adjusted for sex and age. Overall, 14% of the Japanese subjects and 21% of the English were edentulous. In both Japan and England, lower income and educational attainment were significantly associated with a higher risk of being edentulous. Education-based SII in Japan and England were 9.9% and 26.7%, respectively, and RII were 2.5 and 4.8, respectively. Income-based SII in Japan and England were 9.2% and 14.4%, respectively, and RII were 2.1 and 1.9, respectively. Social inequalities in edentulous individuals exist in both these high-income countries, but Japan, with wider coverage for dental care, had lower levels of inequality than England.

Determinants of export-oriented industrial output in Ghana: the case of formal wood processing in an era of economic recovery

2001 ◽  
Vol 39 (1) ◽  
pp. 51-80 ◽  
Author(s):  
J. Henry Owusu
Keyword(s):  
Empirical Study ◽  
Structural Adjustment ◽  
Manufacturing Industries ◽  
Economic Recovery ◽  
Industrial Output ◽  
African Countries ◽  
Processing Industry ◽  
Adjustment Programme ◽  
Wood Processing ◽  
Sub Saharan

Like many other Sub-Saharan African countries, Ghana implemented an orthodox Structural Adjustment Programme (SAP), to resuscitate its ailing economy, in the early 1980s. Subsequently, there has been a dramatic expansion in the production and export of processed wood. Based on an empirical study of Ghana's formal wood processing industry, this paper discusses the various determinants that have combined to boost the export-oriented output in the industry, particularly in the first decade of the programme, and assesses the extent to which the SAP-based policy actions account for the change. The study concludes that adjustment played a major role in the change, and suggests that even though SAP supporters and critics disagree on the nature, dynamics and effects of the programme, government measures under the programme are an indicator of what real commitment on the part of African governments can do to engender production expansion in comparable African manufacturing industries.

scholarly journals Ayushman Bharat: An Ethical Analysis of the World’s Biggest Health Scheme

2021 ◽  
pp. 82-88
Author(s):  
Rajesh Kumar Bhola ◽  
B. B. Pradhan
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Tertiary Care ◽  
Indian Government ◽  
Private Hospitals ◽  
Indian People ◽  
Quality Healthcare ◽  
The People ◽  
Health Related ◽  
Care Systems

An affordable health scheme has been always required by the Indian people. Even after passing74 years of Indian independence, quality healthcare has not been accessible to the Indian people. The data have shown out of the vast population of India only 25 percent of people are insured under the private and government insurance scheme. To overcome this problem Indian government has launched the Ayushman Bharat scheme on 25 December 2018 on the occasion of the birth anniversary of Pt. Deen Dayal Upadhyaya. The Ayushman Bharat is the Hindi translation of “India blessed with long life”. This scheme is the biggest health care scheme in the world which covers the huge population of India and the covered population under this scheme is more than 100 million. The scheme has categories into the primary, secondary, and tertiary care domain to address the health-related problems of the people and the most important and fascinating feature of the scheme is that a beneficiary avails the facilities in government hospital along with private hospitals. The present study reviews different aspects of the scheme in relevance to the helath sector to provide better perpective towards Indian health care systems.

scholarly journals Chronic care models and opportunities for improving health care practice and outcomes in Sub-Saharan Africa: Protocol for systematic review

2020 ◽  
Author(s):  
Peter Otieno ◽  
Charles Agyemang ◽  
Razak M. Gyasi ◽  
Anthony K. Ngugi ◽  
Catherine Kyobutungi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Chronic Care ◽  
Critical Appraisal ◽  
Health Care Systems ◽  
Grey Literature ◽  
Sub Saharan Africa ◽  
Care Models ◽  
Care Systems ◽  
Sub Saharan

Abstract Background: The rising burden of chronic diseases in sub-Saharan Africa (SSA) where health care systems are least developed has led to recent calls for increased investment in chronic care models (CCM) appropriate for low-resource settings. In SSA, limited resources are often allocated to treating acute diseases thus management of chronic conditions is a major challenge for health care systems. A large diversity of CCM exist in the literature but evidence supporting their use has been derived from high income settings. This is the motivation for conducting a systematic review to identify the existing CCM and their relevance and applicability in SSA.Methods and analysis: All peer-reviewed published and grey literature on CCM will be included. PubMed/MEDLINE, Embase, Scopus, Web of Science and Global Health Cinahl, African Journals Online, Informit Online, and PsycINFO will be searched to identify relevant articles. OpenSIGLE will be reviewed for grey literature. The articles retrieved will be independently screened for inclusion by two independent investigators while a third reviewer will arbitrate the disagreements. An independent critical appraisal of retrieved studies will be performed using standardized critical appraisal checklists. The data will be extracted from the key elements of CCM. Outcome measures for the effectiveness of the models in the context of SSA will include any reported improvement to the health care service delivery or changes in the health outcomes of patients with chronic illnesses. The study findings will be reported according to the Preferred Reporting Items for Systematic Reviews (PRISMA).Discussion: This systematic review is expected to generate crucial evidence on the applicability of CCM in SSA and unearth the CCM components that are suitable for different levels of health care delivery systems and the emerging needs of the people living with comorbidities and multimorbidities in SSA.Systematic review registration: This review is registered in PROSPERO International Prospective Register of Systematic reviews CRD42020187756.

scholarly journals National Health Reforms in Georgia during 1994-2021 and their Success

2021 ◽  
Vol 12 (2) ◽  
pp. 102-108
Author(s):  
Iza Gigauri ◽  
Kakhaber Djakeli
Keyword(s):  
Health Care ◽  
Health Reform ◽  
Health Care Systems ◽  
Universal Coverage ◽  
Health Care Reforms ◽  
Health Reforms ◽  
Health Related ◽  
Care Systems ◽  
Cost Efficient ◽  
Health Model

Abstract The Health Reform of the country is a very difficult burden for two reasons: firstly, we need an appropriate economy level in the country, that can bear the new health model, established through reform, and secondly, the country needs a health system that is appropriate either for its economic system or for its tradition and history. Health reformers need to match all the points of the health reform concept, its implementation, and the systems of the country. Due to its Soviet past, Georgia struggled in the last twenty years to find an effective and cost efficient health model for its citizens. Starting from the 90s, Georgia instituted three health reforms and finally found some sustainable measures. The present article explores the three waves of the Georgian Health Care reforms, and analyses the factors of their success and the reasons for their failures. The importance of studying the Health Care systems is derived from Sustainable Development Goals targeting Health issues including health-related topics to improve the population’s health and wellbeing as well as achieve universal coverage of health services. The research contributes to the knowledge regarding the Health Care Reforms, and their practical implications on a country.

African and global health care prospects: the importance of the use of knowledge

2018 ◽  
Author(s):  
Dominique Kerouedan
Keyword(s):  
Health Care ◽  
Infectious Diseases ◽  
Health Care Systems ◽  
International Health ◽  
Historical Review ◽  
World Health ◽  
African Countries ◽  
Poor Countries ◽  
Care Systems ◽  
Use Of Knowledge

The fight against infectious diseases necessarily involves medical entomology and biology, medicine and public health. Other dimensions are influential in the field of international health care cooperation because of pressures inflicted on national policies, particularly in Africa. Based on a historical review of cooperation and the analysis of its evolutions over the past 15 years, we highlight the paradox of world health safety: owing to targeting almost exclusively the AIDS pandemic over the course of decades, disequilibria can be observed in health care systems, especially with regard to epidemiological alert and surveillance and health care personnel, two essential pillars in the control of infectious diseases. We suggest that the Ebola epidemic and its rapid propagation in several West African countries might be a result of over a decade security policies relating to AIDS. The private sector cannot take the place of this democratic governance, neither in rich nor in poor countries. It is time to restore the standards for national and world governance in this field.

scholarly journals Overcoming fragmentation and waste in health care systems in Africa: Collaboration of health care professionals with pastoral caregivers

2014 ◽  
Vol 70 (2) ◽  
Author(s):  
Emem Agbiji ◽  
Christina Landman
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Hospital Care ◽  
Care Delivery ◽  
Health Care Systems ◽  
Medical Model ◽  
World Health ◽  
African Countries ◽  
Care Systems ◽  
Health Care Delivery Systems

This article explores the possibility and limits of collaboration between medical professionals and pastoral caregivers with a view to overcoming fragmentation and waste in the African hospital care sector. It argues that the quality of health and health care in many African countries is poor. Therefore, a purposeful reform of health care delivery systems in Africa is necessary. Building on the World Health Organization’s statement that the medical model that focuses on medicine and surgery and ignores the factors of belief and faith in healing is no longer satisfactory, it further argues that the medical model (including the bio-psychosocial model) is not sufficient for holistic hospital care; it therefore needs to accommodate complementary approaches (such as pastoral care) and include these as collaborative treatments. The connection of collaboration with quality, value, relationships and the ending of life implies that collaboration is an ethical process of reflection – which could have a legal implication.

scholarly journals Maternal cumulative prevalence measures of child mortality show heavy burden in sub-Saharan Africa

2020 ◽  
Vol 117 (8) ◽  
pp. 4027-4033 ◽  
Author(s):  
Emily Smith-Greenaway ◽  
Jenny Trinitapoli
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Age Groups ◽  
Infant Mortality Rate ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Sub Saharan ◽  
Offspring Mortality ◽  
Cumulative Prevalence

We advance a set of population-level indicators that quantify the prevalence of mothers who have ever experienced an infant, under 5-y-old child, or any-age child die. The maternal cumulative prevalence of infant mortality (mIM), the maternal cumulative prevalence of under 5 mortality (mU5M), and the maternal cumulative prevalence of offspring mortality (mOM) bring theoretical and practical value to a variety of disciplines. Here we introduce maternal cumulative prevalence measures of mortality for multiple age groups of mothers in 20 sub-Saharan African countries with Demographic and Health Surveys data spanning more than two decades. The exercise demonstrates the persistently high prevalence of African mothers who have ever experienced a child die. In some African countries, more than one-half of 45- to 49-y-old mothers have experienced the death of a child under age 5, and nearly two-thirds have experienced the death of any child, irrespective of age. Fewer young mothers have experienced a child die, yet in many countries, up to one-third have. Our results show that the mIM and mU5M can follow distinct trajectories from the infant mortality rate (IMR) and under 5 mortality rate (U5MR), offering an experiential view of mortality decline that annualized measures conceal. These measures can be adapted to quantify the prevalence of recurrent offspring mortality (mROM) and calculated for subgroups to identify within-country inequality in the mortality burden. These indicators can be used to improve current understandings of mortality change, bereavement as a public health threat, and population dynamics.

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