scholarly journals Analysis of the national health system of Cuba

2020 ◽  
Vol 28 (4) ◽  
pp. 737-750
Author(s):  
Yarima Pupo Ochoa
Keyword(s):  
Health System ◽  
National Health ◽  
User Satisfaction ◽  
Management Strategies ◽  
Health Sector ◽  
National Health System ◽  
Basic Structure ◽  
Ministry Of Health ◽  
Level Of Satisfaction ◽  
The Republic

This article discusses a set of issues relevant to the current state of the health care system of the Republic of Cuba. The purpose of the study is to give an idea of the dynamics of national health development and compare the results achieved in this sector from 2010 to 2018. The consideration of these problems begins with a description of the demographic context that reflects the general health status of the population. The basic structure of the health system, beneficiaries and benefits in the field of health, sources of financing and expenditures on health, available resources and user satisfaction with the services received were also taken into account. The paper also provides an assessment of the main problems that the Ministry of Health will have to solve in the short and medium term, which will entail the need to develop and implement new management strategies for health institutions. The study was based on a theory of analysis of the health sector adapted to the specifics of Cuban public health, providing guidance to the work of the Ministry of Health and health managers in order to achieve a higher level of satisfaction and quality.

scholarly journals Reflections on Health Management from a Systems Perspective: A Reinterpretation of the Italian National Health System

2021 ◽  
Vol 16 (5) ◽  
pp. 79
Author(s):  
Armando Masucci ◽  
Antonietta Megaro
Keyword(s):  
Health System ◽  
National Health ◽  
Systems Approach ◽  
Health Management ◽  
Health Sector ◽  
National Health System ◽  
Well Being ◽  
Economic Activities ◽  
Viable Systems ◽  
Italian National Health

The provision of health services represents a set of central activities in the social context since, through the offer of prevention, diagnostic, treatment, care and rehabilitation services, they allow the pursuit of the ultimate goal of any health system, the well-being of the population and public health. The considerable relevance of the topic, supported by the ethical-social purposes that the health system ultimately assumes, make it an important field of analysis in business studies in general, and in management in particular, considering the economic activities developed by the many actors involved in the dispensing process. The importance of these activities and their strategic nature make them a highly regulated context, in which over time the reference legislative framework has developed and articulated for the determination of reciprocal relations between the actors, for the regulation of the flow of resources, for the control of medical activities to protect citizens. However, the proliferation of laws and regulations at the various levels of government (community, national and regional) has contributed to increasing the interpretative complexity of the health system. This work proposes the use of the Viable Systems Approach (VSA) for the interpretation and management of complex phenomena in the health sector, concerning the Italian National Health System (NHS). The deepening of the implications arising from the analysis enables the VSA as a useful approach to the advancement of research in health management, through the understanding of complexity, stimulating the observer with analysis methodologies capable of better understanding the health context under exam.

scholarly journals Health, development, and institutional factors: The Mozambique case

2020 ◽  
Author(s):  
Paulo Ivo Garrido
Keyword(s):  
National Health ◽  
Health Sector ◽  
National Health System ◽  
The Elderly ◽  
Health Needs ◽  
The Social ◽  
The Disabled ◽  
Health Institutions ◽  
The Republic ◽  
The Impact

The central aim of this text is to show the impact institutions have on the performance of the health sector in Mozambique. The text shows that of the social determinants of health, institutions play a central role in the performance of the Mozambican health sector—and, through it, economic and social development—particularly for the poorer and more vulnerable, such as children, women, the disabled, and the elderly. It is also argued that the deficiencies and inefficiencies of the operation of the health sector in Mozambique are largely the result of the fact that the institutions with influence on the health sector are controlled by a minority of privileged people who do not give the appropriate priority to the basic health needs of the majority of the population. Finally, it is argued that the most important institutional measures for improving the state of health of Mozambicans are the revision of the Constitution of the Republic, the strengthening of the National Health System (particularly the National Health Service), and the reduction of poverty and economic and social inequality.

scholarly journals Challenges to effective governance in a low income healthcare system: a qualitative study of stakeholder perceptions in Malawi

2020 ◽  
Author(s):  
Sarah C Masefield ◽  
Alan Msosa ◽  
Jean Grugel
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Health System ◽  
National Health ◽  
Low Income ◽  
Service Providers ◽  
Health Sector ◽  
National Health System ◽  
Low Income Countries ◽  
Health Coverage

Abstract BackgroundAll countries face challenging decisions about healthcare coverage. Malawi has committed to achieving Universal Health Coverage (UHC) by 2030, the timeframe set out by the Sustainable Development Goals (SDGs). As in other low income countries, scarce resources stand in the way of more equitable health access and quality in Malawi. Its health sector is highly dependent on donor contributions, and recent poor governance of government-funded healthcare saw donors withdraw funding, limiting services and resources. The 2017 National Health Plan II and accompanying Health Strategic Plan II identify the importance of improved governance and strategies to achieve more effective cooperation with stakeholders. This study explores health sector stakeholders’ perceptions of the challenges to improving governance in Malawi’s national health system within the post-2017 context of government attempts to articulate a way forward.MethodsA qualitative study design was used. Interviews were conducted with 22 representatives of major international and faith-based non-government organisations, civil society organisations, local government and government-funded organisations, and governance bodies operating in Malawi. Open questions were asked about experiences and perceptions of the functioning of the health system and healthcare decision-making. Content relating to healthcare governance was identified in the transcripts and field notes and analysed using inductive content analysis.ResultsStakeholders view governance challenges as a significant barrier to achieving a more effective and equitable health system. Three categories were identified: accountability (enforceability; answerability; stakeholder-led initiatives); health resource management (healthcare financing; drug supply); influence in decision-making (unequal power; stakeholder engagement).ConclusionsHealth sector stakeholders see serious political, structural, and financial challenges to improving governance in the national health system in Malawi which will impact the government’s goal of achieving UHC by 2030. Stakeholders identify the need for improved oversight, implementation, service delivery and social accountability of government-funded service providers to communities. Eighteen months after the introduction of the policy documents, they see little evidence of improved governance and have little or no confidence in the government’s ability to deliver UHC. The difficulties stakeholders perceive in relation to building equitable and effective healthcare governance in Malawi have relevance for other resource-limited countries which have also committed to the goal of UHC.

scholarly journals Contextual and individual factors associated with dissatisfaction with the Brazilian Unified National Health System, 2011-2012

2016 ◽  
Vol 32 (10) ◽  
Author(s):  
Lúcia Gimenes Passero ◽  
Jessye Melgarejo do Amaral Giordani ◽  
Fernando Neves Hugo ◽  
Vanessa Bielefeldt Leotti Torman ◽  
Suzi Alves Camey ◽  
...  
Keyword(s):  
Health System ◽  
National Health ◽  
User Satisfaction ◽  
Strong Association ◽  
National Health System ◽  
Quality Of Healthcare ◽  
Outcome Variable ◽  
Individual Factors ◽  
Cross Sectional ◽  
Factors Associated

Abstract: User satisfaction is known to be related to quality of healthcare. The aim of this study was to evaluate the influence of contextual and individual factors associated with user dissatisfaction with the Brazilian Unified National Health System (SUS). This was a cross-sectional multilevel study. Data were collected via telephone by the ombudsman's office of the SUS. Telephone numbers were randomly selected from a telephone company database. Health services, socioeconomic, and individual demographic variables were evaluated, in addition to information on the municipalities. The outcome variable was dissatisfaction with the SUS. Hierarchical multilevel logistic regression was used, and 18,673 individuals were contacted. Prevalence of dissatisfaction was 63.4% (95%CI: 62.7-64.1). Unmet demand (OR = 3.66), waiting time > 4 hours (OR = 2.82), and number of Primary Healthcare Units (OR = 0.89) were associated statistically with dissatisfaction. Characteristics of the health teams' work process showed a strong association with dissatisfaction.

scholarly journals Challenges to effective governance in a low income healthcare system: a qualitative study of stakeholder perceptions in Malawi

2020 ◽  
Author(s):  
Sarah C Masefield ◽  
Alan Msosa ◽  
Jean Grugel
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Health System ◽  
National Health ◽  
Low Income ◽  
Service Providers ◽  
Health Sector ◽  
National Health System ◽  
Low Income Countries ◽  
Health Coverage

Abstract Background: All countries face challenging decisions about healthcare coverage. The scare resources of low income countries prevent improvements in equitable access and quality. Malawi, one of the poorest countries in the world, has committed to achieving Universal Health Coverage (UHC) by 2030. The health sector is highly dependent on donor contributions, but recent poor governance of government-funded healthcare saw donors withdraw funding, limiting services and resources. The 2017 updated National Health Plan II and accompanying Health Strategic Plan II identify the importance of improved governance and strategies to achieve it, including greater harmonisation with health stakeholders. This study explores health sector stakeholders’ perceptions of challenges to improving governance in the national health system. Methods: A qualitative study design was used. Interviews were conducted with 22 representatives of the major international and faith-based non-government organisations, civil society organisations, local government and government-funded organisations, and governance bodies operating in Malawi. Open questions were asked about experiences and perceptions of the functioning of the health system and healthcare decision-making. The transcripts and field notes were analysed using inductive content analysis.Results: Stakeholders view governance challenges as a barrier to achieving a more effective and equitable health system. Three types of challenges were identified: accountability (enforceability; answerability; stakeholder-led initiatives); health resource management (healthcare financing; drug supply); influence in decision-making (unequal power; stakeholder engagement).Conclusions: Health sector stakeholders see a range of serious challenges to improving governance in the national health system in Malawi which will impact on the government’s goal of achieving UHC by 2030. These can be categorised as political, structural, and financial challenges. Stakeholders identify the need for improved oversight, implementation, service delivery and social accountability of government-funded service providers to communities. Eighteen months after the introduction of the NHP II and HSSP II, they see little evidence of improved governance and have little or no confidence in the government’s ability to deliver UHC in the timeframe set out by the Sustainable Development Goals (SDGs). The difficulties stakeholders perceive in relation to building equitable and effective health governance in Malawi have relevance for other resource-limited countries which have also committed to the goal of UHC.

scholarly journals Opportunities and Challenges for effective implementations of Karnali Province Health Policy

2021 ◽  
Vol 3 (1) ◽  
pp. i-iii
Author(s):  
Padam Prasad Simkhada ◽  
Sharada Prasad Wasti
Keyword(s):  
Health Policy ◽  
Health System ◽  
National Health ◽  
Local Governments ◽  
Local Level ◽  
Health Sector ◽  
Governance Structure ◽  
National Health Policy ◽  
Ministry Of Health ◽  
Healthcare Needs

The health sector is complex, involving many stakeholders, multiple goals, and different beneficiaries. Health policy is an instrument to decide, plan and action that are undertaken to achieve health care goals within a society to combat the health problems. It is crucial for understanding it influences on health systems and prioritizing the health needs of the population.1 In 2015, Nepal became a federal republic and replaced a unitary government with a federal government at the central level, seven provincial and 753 local governments having more authority and resources in planning and managing than before. In the spirit of Constitution of Nepal 2015 and with the vision to make the health services of the country universal and qualitative, Ministry of health and population of Nepal (2019) revised National health policy in 2019. National Health policy 2019 of Nepal has expanded its plan and strategies according to federal structure of the country to improve health sector.2 The revision of health policy paved the way forward towards health system reform in the country which is further supported by Local Government operation act 2017.3 With the new governance structure, accountability has also been divided among the three tiers and the local level is responsible for the program implementation responsibilities.4 5 The Ministry of Health and Population (MoHP) is responsible for managing the health system at the federal level, whereas at the provincial level leads by the Ministry of Social Development and local governments metro/sub-metropolitan, municipality and rural municipality are responsible for its management.6 This indicates that the health system must gear up to meet the escalating healthcare needs of every citizen and upgrading the system as per the structure of the country.

scholarly journals THE ANALYSIS OF INTERNATIONAL PRACTICE OF MODERNIZATION OF NATIONAL HEALTH SYSTEMS

2017 ◽  
pp. 96-103
Author(s):  
A. A. Sokolov
Keyword(s):  
Health System ◽  
Medical Care ◽  
Health Systems ◽  
National Health ◽  
Medical Science ◽  
Health Sector ◽  
National Health System ◽  
Ecosystem Approach ◽  
Advantages And Disadvantages ◽  
Health System Efficiency

The article analyzes the main global health systems, their advantages and disadvantages. The evaluation of the introduction of each of them in reality. Recommendations for modernization of the national health system, which should be focused on the creation of effective national systems capable to provide the population with timely preventive measures, accessible and quality medical care, using medical science, rehabilitation and sanatorium-resort help. The task of providing free medical care to population throughout the Russian Federation in the conditions of insufficient financial support. Therefore, it is necessary to abandon single-payer systems to return to budgetary funding, to reinforce the insurance character of the OMC, to ensure the priority of quality indicators of health system efficiency, to ensure the continuity of the work of the modern Russian model of financing of the health sector of the country. The main conclusions of the study are the need to implement an alternative to the liberal-market approach to health reform ecosystem approach, to develop the ecosystem public health, involving its fuel economic modernization based on the achievements of the Semashko system. Applying this approach, it should abandon the mindless copying elements of Western health systems and to identify cooperative segments.

scholarly journals User satisfaction in the spanish health system: trend analysis

2019 ◽  
Vol 53 ◽  
pp. 87
Author(s):  
Víctor Pérez-Cantó ◽  
Loreto Maciá-Soler ◽  
Víctor M González-Chordá
Keyword(s):  
Health System ◽  
Social Services ◽  
National Health ◽  
User Satisfaction ◽  
Family Doctor ◽  
National Health System ◽  
Quality Management Systems ◽  
Autonomous Communities ◽  
Spanish National Health System ◽  
Nursing Professionals

OBJECTIVE: To analyze the trend of opinion and satisfaction indicators of the Spanish national health system from 2005 to 2017 METHODS: Ecological study of time series analyzing the trend of eight indicators of opinion and satisfaction on the Spanish national health system and its autonomous communities from 2005 to 2017. The data was obtained from the Ministry of Health, Social Services and Equality and from the Health Barometer. The Prais-Winsten regression method was used. RESULTS: A static tendency was observed in the perception of users on how the health system works (APC = 1.898, 95%CI -0.954 – 4.751) and decreasing opinion on the improvement of primary care (APC = -0.283; 95%CI -0.335 – -0.121), specialized (APC = -0.241, 95%CI -0.74 – -0.109) and hospitalization (APC = -0.171, 95%CI -0.307 – -0.036). Satisfaction with knowledge and follow-up by the family doctor and pediatrician showed an increasing trend (APC = 7.939, 95%CI 3.965 – 11.914). Satisfaction with medical and nursing professionals was static. No large differences were observed in the trends of the indicators studied in the autonomous communities. CONCLUSIONS: A negative trend was observed in the opinion of the Spanish national health system users. Financing, human resources, quality management systems and differences in the autonomous communities may be some of the causes.

scholarly journals The Privatization of the Italian National Health System and its Impact on Health Emergency Preparedness and Response: The COVID-19 Case

2021 ◽  
pp. 002073142110249
Author(s):  
Maria Luisa Buzelli ◽  
Tammy Boyce
Keyword(s):  
Health System ◽  
Health Systems ◽  
National Health ◽  
Emergency Preparedness ◽  
Critical Role ◽  
Health Sector ◽  
National Health System ◽  
Lessons Learned ◽  
Future Health ◽  
The Public

Hospitals play a critical role in providing essential care during emergencies; however, this essential care can overwhelm the functional capacity of health systems. In Italy, substantial cuts in funding have drastically reduced the resources of the National Health Service (NHS) and contributed to the expansion of the private health sector which, unlike the public health system, does not have the capacity to deal with a health emergency such as coronavirus disease 2019 (COVID-19). The purpose of this article is to show how the privatization of the NHS contributed to making Italy more vulnerable and unprepared to tackle the COVID-19 pandemic. The available capacity and resources in the public and private emergency services systems in Italy are compared, including a focus on the numbers of hospital staff, hospitals, and hospital beds. The reduced funding and subsequent shortfalls in services in the NHS are reasons why extreme measures were needed to increase these resources during the COVID-19 pandemic. A public NHS in Italy would be better prepared for future health emergencies. The lessons learned from the COVID-19 pandemic can help to inform future health systems strategies, to halt the current financial decline and performance loss of national health systems, and to enable better preparation for future health emergencies.

Iceland's Health Sector Database: A Significant Head Start in the Search for the Biological Grail or an Irreversible Error?

2000 ◽  
Vol 26 (1) ◽  
pp. 31-67
Author(s):  
Hróbjartur Jónatansson
Keyword(s):  
Head Start ◽  
Health System ◽  
National Health ◽  
Medical Information ◽  
Health Sector ◽  
National Health System ◽  
Entire Population ◽  
The World ◽  
And Storage ◽  
Biotechnology Corporation

AbstractIn December 1998, Iceland's Parliament, the Althing, passed the Act on a Health Sector Database (the Database Act or Act), a highly controversial law authorizing the development of a Health Sector Database (the Database) to collect genetic and medical information already contained in various locations around Iceland as part of Iceland's national health system. As a result of the Database Act, Iceland is the only country in the world with laws authorizing collection and storage of the genetic heritage of an entire population by a private biotechnology corporation with rights to exploit the data as a commercial commodity. Many databases now exist in Iceland as individual and segregated entities that contain detailed medical information about every Icelandic person, both living and dead, dating back to 1915 when the recording commenced.

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