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 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.

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 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 COVID-19 and healthcare-associated infections

2020 ◽  
Vol 31 (4) ◽  
pp. 181-182 ◽  
Author(s):  
Andrea Cioffi ◽  
Raffaella Rinaldi
Keyword(s):  
Health System ◽  
Health Systems ◽  
Economic Crisis ◽  
National Health ◽  
National Health System ◽  
Healthcare Associated Infections ◽  
Economic Stability ◽  
Health Crisis ◽  
Exponential Increase ◽  
Healthcare Associated

National Health Systems are facing a very serious health emergency related to COVID-19. In this phase of emergency, it is essential to ensure the care of all affected patients but also to ensure the economic stability of the National Health System. This stability is undermined by the potential exponential increase in claims caused by healthcare-associated infections related to COVID-19. That is why it will be essential to use all means necessary to prevent this economic crisis, which could overlap with the health crisis.

scholarly journals Examining health sector stakeholder perceptions on the efficiency of county health systems in Kenya

2021 ◽  
Vol 1 (12) ◽  
pp. e0000077
Author(s):  
Lizah Nyawira ◽  
Rahab Mbau ◽  
Julie Jemutai ◽  
Anita Musiega ◽  
Kara Hanson ◽  
...  
Keyword(s):  
Human Resources ◽  
Health System ◽  
Health Systems ◽  
Human Resources For Health ◽  
Health Sector ◽  
System Efficiency ◽  
Finance Management ◽  
Political Interests ◽  
Management Capacity ◽  
Health System Efficiency

Efficiency gains is a potential strategy to expand Kenya’s fiscal space for health. We explored health sector stakeholders’ understanding of efficiency and their perceptions of the factors that influence the efficiency of county health systems in Kenya. We conducted a qualitative cross-sectional study and collected data using three focus group discussions during a stakeholder engagement workshop. Workshop participants included health sector stakeholders from the national ministry of health and 10 (out 47) county health departments, and non-state actors in Kenya. A total of 25 health sector stakeholders participated. We analysed data using a thematic approach. Health sector stakeholders indicated the need for the outputs and outcomes of a health system to be aligned to community health needs. They felt that both hardware aspects of the system (such as the financial resources, infrastructure, human resources for health) and software aspects of the system (such as health sector policies, public finance management systems, actor relationships) should be considered as inputs in the analysis of county health system efficiency. They also felt that while traditional indicators of health system performance such as intervention coverage or outcomes for infectious diseases, and reproductive, maternal, neonatal and child health are still relevant, emerging epidemiological trends such as an increase in the burden of non-communicable diseases should also be considered. The stakeholders identified public finance management, human resources for health, political interests, corruption, management capacity, and poor coordination as factors that influence the efficiency of county health systems. An in-depth examination of the factors that influence the efficiency of county health systems could illuminate potential policy levers for generating efficiency gains. Mixed methods approaches could facilitate the study of both hardware and software factors that are considered inputs, outputs or factors that influence health system efficiency. County health system efficiency in Kenya could be enhanced by improving the timeliness of financial flows to counties and health facilities, giving health facilities financial autonomy, improving the number, skill mix, and motivation of healthcare staff, managing political interests, enhancing anticorruption strategies, strengthening management capacity and coordination in the health sector.

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 Examining Health Sector Stakeholder Perceptions on the Efficiency of County Health Systems in Kenya

2020 ◽  
Author(s):  
Lizah Nyawira ◽  
Rahab Mbau ◽  
Julie Jemutai ◽  
Kara Hanson ◽  
Sassy Molyneux ◽  
...  
Keyword(s):  
Public Finance ◽  
Human Resources ◽  
Health System ◽  
Health Systems ◽  
Human Resources For Health ◽  
Health Sector ◽  
System Efficiency ◽  
Efficiency Gains ◽  
Finance Management ◽  
Health System Efficiency

Efficiency gains is a potential strategy to expand Kenyas fiscal space for health. We explored health sector stakeholders understanding of efficiency and their perceptions of the factors that influence the efficiency of county health systems in Kenya. We collected data during a stakeholder engagement workshop. Workshop participants included health sector stakeholders from the national ministry of health and 10 (out 47) county health departments, and non-state actors in Kenya. We divided stakeholders into three groups and carried out facilitated group discussions followed by whole group feedback and discussion session. A total of 25 health sector stakeholders participated. We analysed data using a thematic approach. Health sector stakeholders indicated the need for the outputs and outcomes of a health system to be aligned to community health needs. They felt that both hardware aspects of the system (such as the financial resources, infrastructure, human resources for health) and software aspects of the system (such as health sector policies, public finance management systems, actor relationships) should be considered as inputs in the analysis of county health system efficiency. They also felt that while traditional indicators of health system performance such as intervention coverage or outcomes for infectious diseases, and reproductive, maternal, neonatal and child health (RMNCH) are still relevant, emerging epidemiological trends characterized by an increase in the burden of non-communicable diseases (NCDs) should also be considered. The stakeholders identified public finance management, human resources for health, political interests, corruption, management capacity, and poor coordination as factors that influence the efficiency of county health systems. An in-depth examination of the factors that influence the efficiency of county health systems could illuminate potential policy levers for generating efficiency gains. Mixed methods approaches could facilitate the study of both hardware and software factors that are considered inputs, outputs or factors that influence health system efficiency.

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 Framework for Assessing the Performance of the Ghanaian Health System: Study Protocol

2020 ◽  
Author(s):  
Emmanuel Kumah ◽  
Samuel E. Ankomah ◽  
Adam Fusheini ◽  
Peter Agyei Baffour ◽  
Martin A. Ayanore ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
National Health ◽  
System Performance ◽  
Health Sector ◽  
Holistic Health ◽  
Health System Performance ◽  
Middle Income ◽  
Health System Performance Assessment ◽  
Comprehensive Framework

Abstract Background: Assessing the performance of health systems through quantitative and qualitative methods is recognized as an effective approach to strengthening national health systems. However, while many high-income countries have institutionalized health system performance assessment (HSPA) as an integral component of their respective health systems, few studies on HSPA have been documented in low and middle-income countries, including Ghana. This study aims at providing a comprehensive framework for periodic assessment of the performance of the entire health system in Ghana.Methods: The study will have four work packages. First, a structured review will be conducted to identify both international and national HSPA frameworks that could be applied to the Ghanaian context. Second, based on the structured review, an assessment framework tailored to the Ghanaian health system context will be developed. Third, the draft framework will be presented and discussed with experts and stakeholders for its appropriateness, feasibility and acceptability. Finally, the framework will be piloted to assess its effectiveness and suitability for full-scale implementation.Discussion: Currently, Ghana does not have a full-fledged HSPA tool that provides a holistic health sector-wide approach to assessing health system performance. Thus, developing this HSPA framework for the country will provide a tool for periodic and comprehensive assessment of the performance of the health system, which can be compared with that of other countries. Such a comparison will offer the opportunity for mutual learning and for exploring new options for formulating more effective national health policies. As this is expected to be the first attempt to develop a comprehensive HSPA framework in Ghana, this study will provide a basis for future discussions on how to further develop and implement HSPA programs in the country.

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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