scholarly journals LEGAL PRINCIPLES OF RURAL MEDICINE DEVELOPMENT IN THE CONTEXT OF MEDICAL REFORM IN UKRAINE

2020 ◽  
Vol 1 (383) ◽  
pp. 113-120
Author(s):  
V. M. Yermolenko ◽  
O. V. Hafurova ◽  
M. A. Deineha
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Rural Health ◽  
Rural Areas ◽  
Medical Equipment ◽  
The State ◽  
Health Facilities ◽  
Medical Services ◽  
Rural Medicine ◽  
Medical Reform

Legal support for the constitutional right of citizens to health care and medical care is an important condition for the realization of the principle of recognition the individual on the highest social value. The state guarantees everyone the right to protection of health, medical care and medical insurance; creates the conditions for effective and affordable medical care for all citizens. At the same time, the low level of provision of modern medical equipment, machinery and medicines makes it virtually impossible to provide timely and high-quality medical services in rural areas. The quality of primary health care in rural areas is in terrible condition and the people who live there, and this is more than 30 % of the total population of Ukraine, were very looking forward to changes in this area. After all, most of the old buildings and medical equipment are in poor condition. Medical institutions do not have a complete set of equipment, medical supplies and equipment necessary for primary care. The state of the legal regulation of providing medical care to the rural population of Ukraine objectively needs to be improved. Despite the adoption of numerous normative legal acts, the issues of providing health facilities located in rural areas with the necessary modern equipment and technology remained unresolved until recently. The goal of the article is to investigate the current problems of the legal support for providing medical care in the rural settlements. Particular attention is paid to the reform of the network of the rural health facilities and the problems of staffing. According to the results of the study it is established that from January 1, 2018, the implementation of the rural health reform began in Ukraine. This was due to the need to improve the availability of medical services for the population living in rural areas, to increase the efficiency and effectiveness of the use of funds allocated for the development of health care in the village, to bring the network of healthcare institutions in rural areas and their material and technical support into line with the needs of the population. Rural medicine reform is the lengthy process that requires not only careful adherence to legislation, but also a preliminary assessment of the real state of medicine in the remotest corners of Ukraine in order to prepare a platform for change. It is determined that the implementation of medical reform in cities is perceived better, and therefore much faster is happening, what not to say about the countryside. The prompt and timely solution of the problems of reforming rural medicine is possible with the assistance of the state authorities and local self-government, domestic businesses, foreign investors and financial donors, without which it is extremely difficult to cope with decentralization.

scholarly journals Interventions in increasing availability of skilled healthcare providers in rural areas: A Case Study of Bihar (India)

2021 ◽  
Vol 24 ◽  
pp. 853-864
Author(s):  
Dilip Kumar
Keyword(s):  
Rural Health ◽  
Rural Areas ◽  
Service Providers ◽  
State Level ◽  
The State ◽  
Health Facilities ◽  
Working Environment ◽  
Health Staff ◽  
Personal Support ◽  
Rural Service

Population of rural areas face distinct health challenges due to economic conditions, cultural/behavioural factors, and health provider shortages that combine to impose striking disparities in health outcomes among them. The process of recruitment takes about four to six months for Recruitment of Medical officers and paramedics. The number of applicants is quite limited because of dearth of doctors and paramedics in the State. It was felt that the health staffs incentives will help to increase the turnover of health staffs to some extent in the rural and remote areas. Monitoring cell has been constituted at the state level. The trainings are being monitored at regular intervals of time. The motivational level of health staff at all levels seems to be low. Continuous communication and feedback by state level programme officers is needed on regular basis. Placement of the suitable trained personnel is needed at those health facilities where sufficient infrastructure is available. Since 2010-11, there has been a continuous focus on the capacity building of the existing manpower in  the  state.  Trainings  as  per  GOI  guidelines  on  Immunization,  IMNCI,  EmOC,  LSAS,  SBA  and Minilap/MVA etc. have been taken up with full strength. In addition, the State wide training on immunization for Medical Officers, IPC skills for breast feeding and basic training in neonatal resuscitation also has been taken up at various levels. More than four-fifth of the total staffs in the health facilities were agreed on all the educational interventions for retention of health staffs in rural areas. For the regulatory interventions such as enhanced scope of practice, different types of health workers; multi skilling of alternate service providers, compulsory rural service which may be mandatory for obtaining license to practice or can be a prerequisite for entry into specialization and subsidized education in return of assured services were agreed by four-fifth of the total staffs. For the interventions related to professional and personal support such as better living conditions (water, sanitation, electricity, telecommunications, schools, etc.), safe and supportive working environment, outreach activities to facilitate cooperation between health workforce from better served and underserved areas; use of tele-health, designing career development programmes linked with rural service: more senior posts in rural areas and professional networks for rural areas such as rural health professional associations, rural health journals, etc. about 88 percent of the HR categories of Staffs were agreed in the health facilities

scholarly journals Całkowicie prywatna opieka medyczna — próba zarysu

Ekonomia ◽  
2020 ◽  
Vol 26 (1) ◽  
pp. 155-195
Author(s):  
Stanisław Wójtowicz ◽  
Kamil Rozynek
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Service Providers ◽  
Free Market ◽  
Medical Insurance ◽  
Economic Incentives ◽  
The State ◽  
Medical Services ◽  
Market Mechanisms ◽  
Quality Of Medical Care

In this paper, we explore what the market for medical services and products could look like if the state completely withdrew from the area of medical care. In section 1, we demonstrate that medical services would be purchased mainly through direct payments and medical insurance. We analyse two models of medical insurance: guaranteed renewable insurance and health-status insurance. Other types of insurance that may emerge on the market are also discussed. In section 2, we exam-ine how the privatisation of the health-care system would affect the prices of medical services. We analyse fundamental problems of the state-run health care and discuss how they contribute to small-er supply and higher prices of medical services. We then describe how the introduction of market mechanisms would allow to solve many of these problems. We argue that internalisation of the costs of medical care in a free market order would create strong economic incentives for individuals to take better care of their health, and we contrast this with the state-run health care in which these costs are externalised. In section 3, we explore how medical services could be obtained by individuals without sufficient funds. In section 4, we discuss how the quality of medical care could be ensured without the help of the state. We argue that competition between service providers would be the main guarantor of quality. We also identify mechanisms that would lead to spontaneous emergence of a system of private medical licencing.

scholarly journals INTERNATIONAL ECONOMIC STANDARDS OF MEDICAL PROVISION: LEGAL CHARACTERISTICS AND PROBLEMS OF IMPLEMENTATION IN UKRAINE

2020 ◽  
Vol 5 (5) ◽  
pp. 28
Author(s):  
Dmytro Bilinskyi ◽  
Mushfik Damirchyiev
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Care Delivery ◽  
Synthesis Method ◽  
Legal Regulation ◽  
Right To Health ◽  
The State ◽  
International Standards ◽  
Medical Reform ◽  
The Right

The purpose of the paper is to analyze the current legislation on medical reform in the context of harmonization with international standards. In the conditions of social state building in Ukraine, the thesis is axiomatic regarding that the state should show concern for their citizens, including for the protection of their health. In this context, it is relevant to study the implementation of medical reform in Ukraine, since its content and the degree to which the proclaimed provisions are enforced depend on the ability of each person to access quality health care. Methodology. The article is based on international legal acts, laws and by-laws of Ukraine in the field of legal regulation of medical care. Both general scientific and special methodology were used for the research. Methods of analysis and synthesis, method of description, method of induction, method of deduction, method of correlation, etc. were applied. Results. The article defines the directions for harmonization of the legislation of Ukraine on health protection in accordance with international standards. Based on the ECHR practice, proposals have been formulated to improve the legislation of Ukraine. Conclusions. The ECHR has repeatedly concluded that the right to health is complex and includes: the right to information about one's health and the confidentiality of such information; the right to health care; the right to choose the doctor and the remedies freely; the right to a safe environment that affects health and so on. The state does not cover all aspects of providing medical care to citizens, but resorts to limited funding, since the state budget funds are only one of the types of sources of financing. Practical implications. We have formulated the following tasks: to analyze Ukraine's international legal obligations regarding health care; to identify major changes in health care financing and health care delivery in line with health care reform standards in Ukraine; to identify major health care funding issues.

Administrative and legal aspects of the state policy of ensuring the national security of Ukraine in the field of health care at the present stage

2020 ◽  
Vol 4 (4) ◽  
pp. 167-173
Author(s):  
Oleksandr Komisarov ◽  
Yuriy Shvets
Keyword(s):  
Health Care ◽  
Medical Care ◽  
National Security ◽  
Health Care Reform ◽  
Health Care System ◽  
State Policy ◽  
Legal Aspects ◽  
The State ◽  
Medical Reform ◽  
Care System

The article considers the main administrative and legal aspects of the state policy of national security of Ukraine in the field of health care. On this theoretical basis, the current challenges of medical reform are identified and proposals are developed to find the best ways to prevent and optimize them. Under the administrative and legal support of health care, we understand a set of organizational and legal forms and mechanisms to ensure socio-economic, health, anti-epidemic measures carried out by specialized organizations, the purpose of which is to preserve, strengthen and maintain human health, provide professional, high-quality and high-tech medical care to all who need it, as well as ensuring the availability of such care. It is concluded that the state policy of national security of Ukraine in the field of health care is aimed at creating such conditions for the health care system that allow for health education, disease prevention, provide medical care to citizens, conduct scientific research in the field of health care and training of medical and pharmaceutical workers, to maintain and develop the material and technical base of the health care system. Today in Ukraine the directions of the state policy of national security of Ukraine in the field of health care are determined by the European integration directions of our state and the commitments made by Ukraine in connection with the signing in June 2014 of the Association Agreement between Ukraine, on the one hand, and The EU, the European Atomic Energy Community and their Member States, on the other hand. However, the concept of health care reform in terms of its implementation to meet the relevant obligations has significant differences with the constitutional principle of free medical care, and therefore needs further refinement and improvement. It is substantiated that the highlighted topical issues of administrative and legal provision of health care should be taken into account in the implementation of the second stage of medical reform, which started on April 1, 2020. In addition, the experience of preventing and counteracting the spread of COVID-19 coronavirus infection should be an important aspect of health care reform.

Rural Health and State Construction in Post-Revolutionary Mexico: The Nicolaita Project for Rural Medical Services

2001 ◽  
Vol 58 (2) ◽  
pp. 261-283 ◽  
Author(s):  
Ana María Kapelusz-Poppi
Keyword(s):  
Health Care ◽  
Social Development ◽  
Rural Health ◽  
The State ◽  
Capital City ◽  
Medical Services ◽  
Nineteen Twenties ◽  
Federal Policies ◽  
State Construction

In the nineteen twenties a group of graduates from the Colegio de San Nicolás and the Universidad Michoacana in Morelia, the capital city of the state of Michoacán, drafted a program for the economic and social development of the countryside that, in the next decade, influenced federal policies and ideas about health care. This article examines the ideas and efforts of two Morelian physicians, Jesús Díaz Barriga (1891-1971) and Enrique Arreguín Vélez (1907-1989) who, during the 1920s and early 1930s, developed an incipient system of rural health in Michoacán. In 1935 they organized the First Congreso of Rural Hygiene, an event which they hoped would launch a state-managed system of rural health, and eventually the socialization of medicine in Mexico.

scholarly journals Experience of EU countries in organizing of the circulation and availability of medicines for the population

2021 ◽  
Vol 2 (1) ◽  
pp. 1-15
Author(s):  
Svitlana Zbrozhek
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Social Insurance ◽  
Health Care Systems ◽  
The Elderly ◽  
The State ◽  
Medical Services ◽  
Selling Price ◽  
Social Insurance System ◽  
Eu Countries

Finland's health care system has evolved over the years, with its distinctive features being tax funding, the provision of the vast majority of medicines and medical services by public and municipal authorities. to study the experience of EU countries in the field of health care in the organization of circulation and availability of medicines. To achieve this goal used the methods of regulatory, documentary, comparative and graphical analysis. The increase in the cost of medical care leads to the fact that the state is increasingly thinking about containing costs. The level of co-financing by patients is growing, at the same time measures are being taken to limit the selling price of medicines. The existing system of reference prices promotes the entry of generics into the market and, apparently, this direction will develop. A characteristic feature of the health care and pharmaceutical supply system in the Nordic countries is coordination, which is implemented at different levels and in many forms. The organization of the circulation and accessibility of medicines for the population in Finland is based on covering the costs of medicines through the social insurance system, but with the participation of the state. The priority common aspects of the functioning of the national health care systems of the Scandinavian region remain: coordination between hospitals and definition of their areas of activity; coordination between general services and specialized assistance centers; coordination of the organization of drug circulation and medical care for certain categories of patients (privileged categories, patients with oncological diseases, etc.); coordination of pharmaceutical support and medical services for patients with chronic diseases (diabetes, etc.); coordination of long-term pharmaceutical provision and medical care for the elderly.

Main improvement organizations of federal specialized (oncologic) institute as a unit of health system

2015 ◽  
Vol 6 (4) ◽  
pp. 116-123
Author(s):  
Andrey Petrovich Karitsky
Keyword(s):  
Health Care ◽  
Health System ◽  
Medical Care ◽  
National Health System ◽  
Medical Insurance ◽  
State Regulation ◽  
The State ◽  
Insurance Companies ◽  
Medical Services ◽  
Research Institute

Recently economic analysis of health care is demanded and actual due to becoming more and more urgent need for restructuring and a choice of priorities for this boundary section of medicine. In the article are considered strong and weaknesses of health system models, including in option of a so-called transitional economy on the example of federal N. N. Petrov Research Institute of Oncology. Now the N. N. Petrov Research Institute of Oncology can call establishment of national health system with state regulation of programs of general obligatory medical insurance. In this model of health care the state obliges employers and citizens to deduct part of the income on the health insurance, and producers of medical services to provide the population with medical care, including with mediation of insurance companies within obligatory medical insurance. Introduction of this model allowed to provide citizens with full medical care at the expressed reduction of expenses (to 8-12 % of gross domestic product). In the majority of medical institutions medical care is “free”, therefore, to maintain market balance at increase in demand for service, "waiting lists" are entered, patients with “priority” diseases are exposed to treatment, often there are complaints to the unfriendly attitude towards patients. The ideal health system has to provide medical services in unlimited volume without insurance premiums, deductions or individual share at a full freedom of choice of the doctor. Common problem for all systems, mentioning in no small measure functioning of oncologic establishments, is uncertainty of a state role and involvement of each of participants (the state, insurance companies, suppliers of medical services) in realization of various potential functions and problems of health care.

scholarly journals FELDSHER-OBSTETRIC POINTS WITHIN THE FRAMEWORK OF MEDICAL REFORM

2019 ◽  
pp. 20-25
Author(s):  
B.O. Pavlenko ◽  
L.L. Kravchenko
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Rural Areas ◽  
Medical Center ◽  
Public Health Services ◽  
Rural Medicine ◽  
Intermediate Point ◽  
Medical Reform ◽  
Medical Centers ◽  
The Law

The article examines the most urgent problems of medical-midwifery points that arose as a result of medical reform. An important element in the effective operation of midwives is their legal support. The importance of scientific research on the consequences of medical reform for midwives is explained by the following elements: – first, one-third of the population of Ukraine lives in rural areas and does not receive proper medical services, as paramedics and obstetric centers have ceased to serve as the primary link of the health care system, and have become an intermediate point between the patient and the clinic; – secondly, the demographic situation of the villages, and consequently Ukraine, depends on the activity of the midwifery-midwifery centers, since the lack of medical centers in the rural areas causes the extinction of the villages: an increasing number of people move to other settlements, some patients may simply not be able to wait. providing emergency medical care. Therefore, there is a need to investigate changes in the activities of the midwifery units after the introduction of the primary health care reform. Therefore, the creation of a legal framework that will include the rights and responsibilities of midwives and midwives, and clearly regulate their activities, will allow these medical centers to work effectively and serve most on-site primary care applications. Notwithstanding the importance of research on this issue, midwives are only mentioned in the Regulations on Midwifery / Paramedics and the Law of Ukraine “On increasing the availability and quality of health care in rural areas”, the main proposal of which is the introduction of telemedicine in rural medicine. Of Ukraine. Although the Law of Ukraine “On State Financial Guarantees of Public Health Services” also left its mark on rural health centers, including negative ones. Therefore, it is necessary to analyze the situation of the medical midwifery points before and after the medical reform, identify the shortcomings for the medical centers, and find ways to solve them. Keywords: paramedics, medical reform, primary care reform, medical center, rural medicine.

scholarly journals Health Facilities in Kokrajhar District of Assam, India

2020 ◽  
Vol 4 (10) ◽  
pp. 103-112
Keyword(s):  
Health Care ◽  
Health Status ◽  
Rural Areas ◽  
Research Work ◽  
Health Care Facilities ◽  
The State ◽  
Health Facilities ◽  
Quality Health Care ◽  
Care Facilities

Health can be considered as the state of being free from illness or injury. A health facility is a facility where quality health care access is provided. The number and quality of health facilities in a country or region is common measures of that area’s prosperity and quality of life. Therefore, health infrastructure is one of socio economic indicators of an area. As per the guideline of the WHO, the Doctor Population ratio should be 1:1000 but in case of India it is very pathetic as the ratio stands at 1:1456 (Economic survey 2019-20) and the state of Assam is more pathetic i.e 1:1800. A health status of a region is dependent on the health care availability provided in the region. The district Kokrajhar is situated in the westernmost part of Assam and is lacking far behind in health care facilities as compared to other districts of the state. Most of the families belong to the Below Poverty Line (BPL) category and their PCI is also one of the lowest. The reason for poor health care facilities in the district is mainly because of Doctors unwillingness to join the government services and their reluctance to serve in the rural areas. The main objective of this paper is to highlight the health facilities and health status of the district in comparison to the state and the country. The study is based on the secondary data sources and both descriptive and analytic methods have been used for the study. Statistical techniques are also used to represent the data. The study reveals that the causes of low status of health facilities in the region is due to lack of accessibility, poverty, insufficient medical equipment and insufficient workforce and cultural norms and due to all this, people of the district is facing many problems. The diseases like Typhoid, Jaundice, Eye problem, Malaria, Tuberculosis, Pneumonia etc are commonly seen in the district. . This study will aid the governments, NGOs, planners, administrators and above all the society as the research work highlights some of the hidden truths pertaining to health care facilities in the district.

RURAL MEDICINE. CONDITION AND ISSUES

2020 ◽  
pp. 103-110
Author(s):  
Yuliya M. Beglyakova ◽  
◽  
Aleksander S. Shchirskii ◽  
Keyword(s):  
Health Services ◽  
Medical Care ◽  
Rural Areas ◽  
Rural Population ◽  
Rural Medicine ◽  
Self Medication ◽  
Medical Facilities ◽  
Treatment Facilities ◽  
Number Of Treatment ◽  
The Village

The article analyses the accessibility of medical facilities in rural areas of modern Russia and the specifics of their organization and development. The authors reveal causes why rural residents have much less opportunities to seek quality medical care than urban ones, what leads to a disparity between the inhabitants of the city and the village. The thesis is substantiated that state programmes that should make health services accessible to the rural population to a greater extent do not cope with the task at hand. An attempt is made to highlight the public’s response to the existing disparity in the health services of the villagers compared to urban dwellers. Such a reaction can be considered an outflow of people from rural areas, and an increase in self-medication among rural people as a result of the difficulty in obtaining health services. The decrease in the number of treatment facilities in rural areas leads to a deterioration in the medicine situation in rural areas. That, according to the authors of the article, justifies the need to study the issues associated with the provision of medical care to the rural population.

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