Cuba and the Philippines: Contrasting Cases in World-System Analysis

1987 ◽  
Vol 17 (4) ◽  
pp. 681-701 ◽  
Author(s):  
Suzanne de Brun ◽  
Ray H. Elling
Keyword(s):  
Health Status ◽  
Health Services ◽  
Health System ◽  
Citizen Participation ◽  
System Analysis ◽  
World System ◽  
The United States ◽  
The Philippines ◽  
Historical Background ◽  
Capitalist Development

Cuba and the Philippines are countries with broad similarities in historical background yet sharp divergences in political economic developments and relations to the capitalist world-system in recent times. U.S. economic and political interests dominated both countries during the first half of the 20th century. The changes generated by the Cuban revolution resulted in the end of U.S. power in Cuba in 1959. The Philippines, however, remain profoundly dependent on the United States. The approach taken in this article contrasts these countries, asking what the results of their divergent paths are in terms of health and health services. The ability of Cuba and the Philippines to support the primary health care (PHC) approach by fostering socioeconomic justice, authentic citizen participation, and a regionalized health system is examined. It is clear that the last 25 years of socialist-oriented development in Cuba reversed the negative effects of the previous market economy by providing improved social and health services. The success of the political economy and the fully regionalized health system, supportive of the PHC approach in Cuba, is reflected in the high-level health status of the people. In contrast, poverty, gross social and economic inequities, high prevalence of infectious disease, and inaccessible, inadequate, and uncoordinated health services persist in the Philippines after some 85 years of international and national capitalist development. The poor health status of the Philippine people is a direct reflection of this underdeveloped system.

An Other Tongue, An Other Thinking, An Other Logic

2012 ◽  
Author(s):  
Walter D. Mignolo
Keyword(s):  
United States ◽  
System Analysis ◽  
World System ◽  
The United States

This afterword extends the observations from previous chapters, which distinguished postmodern from post-Occidental thinking as a critique of modernity from the interior borders (postmodernism) and from the exterior borders of the modern/colonial world (post-Occidentalism), to deconstruction and to world system analysis. Postmodern criticism of modernity as well as world system analysis is generated from the interior borders of the system—that is, they provide a Eurocentric critique of Eurocentrism. The colonial epistemic difference is located some place else, not in the interiority of modernity defined by its imperial conflicts and self-critiqued from a postmodern perspective. On the contrary, the epistemic colonial difference emerges in the exteriority of the modern/colonial world, and in that particular form of exteriority that comprises the Chicano/as and Latino/as in United States—a consequence of the national conflicts between Mexico and the United States in 1848 and of the imperial conflicts between the United States and Spain in 1898.

scholarly journals Health system governance following devolution: comparing experiences of decentralisation in Kenya and Indonesia

2018 ◽  
Vol 3 (5) ◽  
pp. e000939 ◽  
Author(s):  
Rosalind McCollum ◽  
Ralalicia Limato ◽  
Lilian Otiso ◽  
Sally Theobald ◽  
Miriam Taegtmeyer
Keyword(s):  
Health Services ◽  
Health System ◽  
Citizen Participation ◽  
Qualitative Data ◽  
Good Governance ◽  
Preventive Health Services ◽  
Power Relationships ◽  
Framework Analysis ◽  
Country Analysis ◽  
The Impact

IntroductionDevolution reforms in Indonesia and Kenya have brought extensive changes to governance structures and mechanisms for financing and delivering healthcare. Community health approaches can contribute towards attaining many of devolution’s objectives, including community participation, responsiveness, accountability and improved equity. We set out to examine governance in two countries at different stages in the devolution journey: Indonesia at 15 years postdevolution and Kenya at 3 years.MethodsWe collected qualitative data across multiple levels of the health system in one district in Indonesia and ten counties in Kenya, through 80 interviews and six focus group discussions (FGD) in Indonesia and 269 interviews and 14 FGDs in Kenya. Qualitative data were digitally recorded, transcribed and coded before thematic framework analysis. Common themes between contexts were identified inductively and deductively, and similarities and differences critically analysed during an inter-country analysis workshop.ResultsFollowing devolution both Indonesia and Kenya experienced similar challenges ensuring good governance for health. Devolution reforms transformed power relationships, increasing responsibilities at subnational levels and introducing opportunities for citizen participation. In both contexts, the impact of these mechanisms has been undermined by insufficiently clear guidance; failure to address pre-existing negative contextual norms and practices varied decision-maker values, limited priority-setting capacity and limited genuine community accountability. As a consequence, priorities in both contexts are too often placed on curative rather than preventive health services.ConclusionWe recommend consideration of increased intersectoral actions that address social determinants of health, challenge negative norms and practices and place emphasis on community-based primary health services.

scholarly journals Health services delivery in Asir, Saudi Arabia: regional experience of integration

1997 ◽  
Vol 3 (2) ◽  
pp. 228-235
Author(s):  
Abdul Aziz M. Al Khuzayem ◽  
Ahmed A. Mahfouz ◽  
Abdalla I. Shehata ◽  
Reda A. G. Al Erian
Keyword(s):  
Saudi Arabia ◽  
Health Services ◽  
Health System ◽  
Historical Background ◽  
Recent Past ◽  
Health Services Delivery ◽  
Services Delivery ◽  
Local Experience ◽  
System Changes ◽  
Management Functions

Thispaper presents the local experience of the General Directorate of Health Affairs in Asir, Saudi Arabia, regarding integration of health services. The geographical, sociodemographic and administrative situations of the region necessitate this approach. A historical background of the development of health services in the region in the recent past is presented. Restructuring of the health system, changes in management functions and advantages of integration of health services are discussed

An American Perspective of the Dental and Public Health Initiatives in Cuba

2021 ◽  
pp. 232020682110301
Author(s):  
Colleen Watson ◽  
Laura Rhein ◽  
Stephanie M. Fanelli
Keyword(s):  
Public Health ◽  
United States ◽  
Health Status ◽  
Health System ◽  
Healthcare System ◽  
National Health ◽  
National Health System ◽  
The United States ◽  
Healthcare Systems ◽  
The Us

Aim: To compare following the Cuban Revolution, Cuba’s economy and civil society was transformed by the initiation of a program of nationalization and political consolidation. The Cuban government operates a national health system and assumes fiscal and administrative responsibility for the healthcare of its citizens. Other industrialized nations continue to surpass the US in health-related outcomes indicating areas of improvement in its healthcare system. Assessing the successes and failures as well as the advantages and disadvantages of other countries’ healthcare systems may be instrumental in the development of modifications to the organization and delivery system of healthcare in the US. This paper aims to report the information attained from previous literature as well as from first-hand observations from a public health trip to Cuba in order to compare the healthcare systems in Cuba and the United States. Materials and Methods: A group of New York University College of Dentistry faculty and students traveled to Cuba in April 2019 for professional research and professional meetings (CFR 515.564). While in Cuba, the researchers took written notes of the lecture-based material and conversations. Upon return to the United States, published literature was searched for the collection of any additional data and all qualitative data and quantitative data was compiled and organized. Since 1959, Cuba has made continuous adjustments and improvements to its universal, free and accessible healthcare system. Results: There have been notable improvements to the country’s public health status, such as the implementation of an immunization program and subsequent eradication of communicable diseases, such as polio and rubella. Additionally, the implementation of the National Program on Dentistry guarantees dental care to all Cuban children under the age of 19. Today, the Cuban National Health System (NHS) initiatives have evolved to combat the novel coronavirus (COVID-19) pandemic. Conclusion: Recognizing the advantages as well as the disadvantages of the Cuba’s National Health System (NHS) would be useful for future policymakers in the United States. Cuban approaches to health could be tailored to the United States environment to improve healthcare effectiveness and population health status in the future.

1984 Update on the World Economic Crisis and the Children: A United States Case Study

1985 ◽  
Vol 15 (3) ◽  
pp. 431-450 ◽  
Author(s):  
C. Arden Miller ◽  
Elizabeth J. Coulter ◽  
Amy Fine ◽  
Sharon Adams-Taylor ◽  
Lisbeth B. Schorr
Keyword(s):  
United States ◽  
Health Status ◽  
Health Services ◽  
Well Being ◽  
The United States ◽  
Current Data ◽  
Access To Health Services ◽  
Health Trends ◽  
Welfare Benefits ◽  
The Impact

A previously published report by these authors on the impact in the United States of recession on children's health emphasized four points: 1) available monitoring systems are not adequate for reporting on the health of children in a timely fashion; 2) the monitoring of maternal and child health must emphasize data on population subgroups, i.e., minorities, the poor and those hardest hit by recession; 3) the health of poor children is adversely affected and their numbers dramatically increased during the recession of 1981–82; and 4) comparisons between the recession of 1974–75 and that of 1981–82 suggest that expansion of health services and social support systems during the recession of 1974–75 had a cushioning effect that protected the health of children, while the curtailment of many of these programs during the 1981–82 recession is associated with adverse health trends, especially among the most vulnerable population subgroups. Data on these issues are appreciably better now than they were nine months ago, thus further validating the points made above. As with the previous report, officially released current data are abundant for economic indicators (even for early 1984), but are sparse for health status indicators. The previous report also observed that the health status of children is influenced by interdependent and interlocking factors that include economic well-being and access to health services and social supports. A new analysis attempts to unlock those relationships and measure the impact of lost welfare benefits, implemented as a result of the Omnibus Reconciliation Act of 1981 (OBRA), and the separate impact of the serious recession of 1981–82. That analysis shows the poverty rate for children increased by 7.6 percentage points between 1981 and 1982. Approximately 60 percent of the increase is attributable to the recession and 40 percent to social policy changes effected after 1981.

Indicators of Health Status in Adolescence

1976 ◽  
Vol 6 (3) ◽  
pp. 475-492 ◽  
Author(s):  
Ann F. Brunswick
Keyword(s):  
Health Status ◽  
Health Services ◽  
Community Sample ◽  
Composite Index ◽  
The United States ◽  
Health Problems ◽  
Illness Behavior ◽  
Health And Illness ◽  
Reported Health ◽  
Inclusive Analysis

The study reported here is based on data obtained in 1968–1970 from a representative community sample of urban black youths in the United States aged 12–17 years, inclusive. Analysis is directed at conceptual and methodological issues in measuring health status. It suggests the need for greater attention to subjective self-evaluated and self-reported components of health status, specified here as “ontological” health. This is related to health and illness behavior generally, to utilization of health services more particularly. The case is made for a multiple-indicator approach to measuring health status as being more consistent with the multidimensional phenomenon to which it refers. The method used in this study for deriving a composite health status index from four component self-reported indicators is described. The distribution of the sample on this composite was used to identify self-reported health conditions that warrant attention from providers of adolescent health services. Since subjective evaluations influence experienced severity of health problems, the health status composite index was applied in this study as a means of discriminating differential seriousness in self-reported health problems. Finally, some differences between indicators of “ontological” health and “medical” health also are analyzed for commonalities and differences between them.

scholarly journals Why Community Health Systems Have Not Flourished in High Income Countries: What the Australian Experience Tells Us

2021 ◽  
Author(s):  
Fran Baum ◽  
Toby Freeman
Keyword(s):  
Health Promotion ◽  
Health Services ◽  
Health System ◽  
Community Health ◽  
Health Systems ◽  
The United States ◽  
Community Health Services ◽  
High Income ◽  
Community Health Systems ◽  
Effective Community

Background: Despite the value of community health systems, they have not flourished in high income countries and there are no system-wide examples in high income countries where community health is regarded as the mainstream model. Those that do exist in Australia, Canada, the United States and the United Kingdom provide examples of comprehensive primary healthcare (PHC) but are marginal to bio-medical primary medical care. The aim of this paper is to examine the factors that account for the absence of strong community health systems in high income countries, using Australia as an example. Methods: Data are drawn from two Australian PHC studies led by the authors. One examined seven case studies of community health services over a five-year period which saw considerable health system change. The second examined regional PHC organisations. We conducted new analysis using the ‘three I’s’ framework (interests, institutions, ideas) to examine why community health systems have not flourished in high-income countries. Results: The elements of the community health services that provide insights on how they could become the basis of an effective community health system are: a focus on equity and accessibility, effective community participation/control; multidisciplinary teamwork; and strategies from care to health promotion. Key barriers identified were: when general practitioners (GPs) were seen to lead rather than be part of a team; funding models that encourage curative services rather than disease prevention and health promotion; and professional and medical dominance so that community voices are drowned out. Conclusion: Our study of the community health system in Australia indicates that instituting such a system in high income countries will require systematic ideological, political and institutional change to shift the overarching government policy environment, and health sector policies and practices towards a social model of health which allows community control, and multidisciplinary service provision.

scholarly journals A Historical Overview and Initiating Historiography of Islam in the Philippines

2015 ◽  
Vol 3 (2) ◽  
pp. 1-18
Author(s):  
Ajid Thohir
Keyword(s):  
United States ◽  
East Asia ◽  
The United States ◽  
The Philippines ◽  
The Other ◽  
Historical Background ◽  
South East Asia ◽  
Islamic Culture ◽  
Colonial Policy ◽  
Muslim Communities

Understanding the history of Islam in the Southeast Asia will be more accurate through the geo-political and historical background perspective in particular. This assumption is based on Western Colonial influence in the past such as Spanish, Portuguese, Dutch, British, French, and United States that makes up the typology of Islamic culture in South East Asian region, which is strengthens the plurality of Islamic character. It also seems increasingly clear, especially for the Muslim communities in Philippine, who represented the community formed of Moro Islamic movement. Islamic culture in the Philippine is produced by the Spanish and the United States colonial policy which determines the fate and the treats of Muslims as a conquered state. This historical background results the emergence of a heroic character in Philippines Muslims that is different from the other Muslims community in South East Asia who are relatively considered quiet and peaceful. This paper will briefly explain the historiography of Islam in South East Asia region through involving cases of Muslims in the Philippine who will not found the plurality of character in the other country.

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