scholarly journals Visionarity and Health: The Semashko Model and the Sovietization of Public Health in Bulgaria (1944–1951)

2021 ◽  
Vol 30 (3) ◽  
pp. 74-103
Author(s):  
Milena Angelova
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Healthcare System ◽  
The State ◽  
Free Access ◽  
Access To Health Services ◽  
The Social ◽  
Soviet Russia ◽  
Communist Countries

After the Second World War and until 1990, Bulgaria, as most of the former communist countries from the Eastern Europe, implemented a Semashko healthcare system developed in the USSR. Named after the First People’s Commissar of Health of the Soviet Russia, Nikolai Semashko, Soviet health care was developed as “social health care”, trying also to eliminate the social reasons for illness, thus transforming society and economy as a whole. This type of system was based on the centrally planned principles, on rigid management and on the state monopoly. Consequently, the healthcare system created by the Ministry of Health was integrated and centralized, completely controlled by the state. The system of health services in Bulgara from 1944 to 1990 was inspired by the Soviet model Semashko, a centralized state system, which seemed to guarantee “free access to health services for the entire population”. In the research the author focuses on the policies in the field of public health in Bulgaria between 1944 and 1951, when the "Sovietization" in this field took place.

scholarly journals Cultural singularities: indigenous elderly access to Public Health Service

2015 ◽  
Vol 49 (4) ◽  
pp. 0589-0595 ◽  
Author(s):  
Ana Carla Borghi ◽  
Angela Maria Alvarez ◽  
Sonia Silva Marcon ◽  
Lígia Carreira
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Public Health Service ◽  
Primary Caregivers ◽  
The Elderly ◽  
Access To Health Services ◽  
Access To Health ◽  
Assistance Service ◽  
Routine Procedures

OBJECTIVEDescribing how Kaingang seniors and their primary caregivers experience access to public health services.METHODA qualitative study guided by ethnography, conducted with 28 elderly and 19 caregivers. Data were collected between November 2010 and February 2013 through interviews and participative observation analyzed by ethnography.RESULTSThe study revealed the benefits and difficulties of the elderly access to health services, the facility to obtain health care resources such as appointments, medications and routine procedures, and the difficulties such as special assistance service problems and delays in the dispatching process between reference services.CONCLUSIONThe importance of knowing and understanding the cultural specificities of the group in order to offer greater opportunities for the elderly access to health services was reinforced.

scholarly journals Exploring the interaction of activity limitations with context, systems, community and personal factors in accessing public health care services: A presentation of South African case studies

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Gubela Mji ◽  
Stine H. Braathen ◽  
Richard Vergunst ◽  
Elsje Scheffler ◽  
Janis Kritzinger ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Case Studies ◽  
Health Care Services ◽  
Public Health Care ◽  
Activity Limitations ◽  
Personal Factors ◽  
Access To Health Services ◽  
Public Health Services

Background: There are many factors that influence access to public health services, such as the context people live in, the existing health services, and personal, cultural and community factors. People with disabilities (activity limitations), through their experience of health services, may offer a particular understanding of the performance of the health services, thus exposing health system limitations more clearly than perhaps any other health service user.Aim: This article explores how activity limitations interact with factors related to context, systems, community and personal factors in accessing public health care services in South Africa.Setting: We present four case studies of people with disabilities from four low-resource diverse contexts in South Africa (rural, semi-rural, farming community and peri-urban) to highlight challenges of access to health services experienced by people with activity limitations in a variety of contexts.Methods: One case study of a person with disabilities was chosen from each study setting to build evidence using an intensive qualitative case study methodology to elucidate individual and household experiences of challenges experienced by people with activity limitations when attempting to access public health services. In-depth interviews were used to collect data, using an interview guide. The analysis was conducted in the form of a thematic analysis using the interview topics as a starting point.Results: First, these four case studies demonstrate that equitable access to health services for people with activity limitations is influenced by a complex interplay of a variety of factors for a single individual in a particular context. Secondly, that while problems with access to public health services are experienced by everyone, people with activity limitations are affected in particular ways making them particularly vulnerable in using public health services.Conclusion: The revitalisation of primary health care and the introduction of national health insurance by the Health Department of South Africa open a window of opportunity for policy makers and policy implementers to revisit and address the areas of access to public health services for people with activity limitations.

scholarly journals Racismo institucional: percepção sobre a discriminação racial nos serviços de saúde / Institutional racism: perception about racial discrimination in health services

2021 ◽  
Vol 66 (1u) ◽  
pp. 1
Author(s):  
Grazielle de Oliveira Loduvico ◽  
Maria Marjorie Lima Martins ◽  
Thaís Izabel Ugeda Rocha ◽  
Maria Fernanda Terra ◽  
Pamela Lamarca Pigozi
Keyword(s):  
Health Care ◽  
Health Services ◽  
Racial Discrimination ◽  
Institutional Racism ◽  
Access To Health Services ◽  
Public Health Services ◽  
The Public ◽  
Black Person ◽  
The Social ◽  
Doctor's Office

Introdução: O racismo institucional se caracteriza por qualquer ação de discriminação racial praticada dentro de instituições, como a omissão de informação ou atendimento, fortalecimento de estereótipos racistas, comportamentos de desconfiança, de desrespeito e desvalorização da pessoa negra. Objetivo: Analisar a prática de racismo institucional no serviço de saúde público e/ou privado a partir da percepção dos usuários negros acerca do atendimento recebido. Material e Método: Estudo de abordagem quantitativa,realizado a partir de questionário fechado, construído via google forms, e veiculado na rede social Facebook. A coleta de dados ocorreu entre setembro e novembro de 2019, sob os critérios: ser negro, idade superior a18 anos e vivência de racismo nos serviços de saúde público e/ou privado. Participaram33 pessoas neste estudo: 28 pessoas se autodeclararam pretas e 5 pardas. Resultados: Dentre os principais achados, estão que 63,6% referiram ter sofrido racismo em serviços públicos de saúde; 51,5% relataram que a discriminação ocorreu no consultório médico, e 21,9% durante a triagemou na sala de medicação. Do total, 93,9% acreditam que a discriminação foi ocasionada por serem negros. Conclusão: Os usuários identificam o racismo durante a assistência em saúde recebida, e que a violência pode distanciá-los dos cuidados, principalmente de promoção e prevenção. Faz-se necessário efetivar a assistência em saúde à luz da Política Nacional de Saúde da População Negra. Palavras chave: Percepção, Discriminação, Iniquidade em saúde, Racismo, Acesso aos serviços de saúde ABSTRACTIntroduction: Institutional racism is characterized by any action of racial discrimination practiced within institutions, such as information or care omission, strengthening of racist stereotypes, behaviors of distrust, disrespect and devaluation of the black person. Objective: To analyze the practice ofinstitutional racism in the public and/or private health service from the perception of black users about the care received. Material and Method: Quantitative approach study, conducted from a closed questionnaire, built via google forms, and carried on the social network Facebook. Data collectionoccurred between September and November 2019, under the criteria: being black, aged over 18 years and experiencing racism in public and/or private health services. Thirty-three people participated in this study: 28 people declared themselves black and 5 brown. Results: Among the main findingsare that 63.6% reported having suffered racism in public health services; 51.5% reported that discrimination occurred in the doctor’s office, and 21.9% during screening or in the medication room. Of the total, 93.9% believe that discrimination was started because they were black. Conclusion:Users identify racism when receiving health care, and that violence can distance them from care, especially promotion and prevention. It is necessary to affect health care in the light of the National Health Policy of the Black Population.Keywords: Perception, Discrimination, Health inequities,Racism, Access to health services

scholarly journals Primary health care policy and vision for community pharmacy and pharmacists in Spain

2020 ◽  
Vol 18 (2) ◽  
pp. 1999 ◽  
Author(s):  
Miguel A. Gastelurrutia ◽  
Maria J. Faus ◽  
Fernando Martinez-Martinez
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Community Pharmacy ◽  
The State ◽  
Community Pharmacies ◽  
State Health ◽  
Primary Health

From a political and governance perspective Spain is a decentralized country with 17 states [comunidades autónomas] resulting in a governmental structure similar to a federal state. The various state regional health services organizational and management structures are focused on caring for acute illnesses and are dominated by hospitals and technology. In a review by the Interstate Council, a body for intercommunication and cooperation between the state health care services and national government, there is a move to improve health care through an integrative approach between specialized care and primary care at the state level. Community pharmacy does not appear to have a major role in this review. Primary health care is becoming more important and leading the change to improve the roles of the health care teams. Primary care pharmacists as the rest of public health professionals are employed by the respective states and are considered public servants. Total health care expenditure is 9.0% of its GDP with the public health sector accounting for the 71% and the private sector 29% of this expenditure. Community pharmacy contracts with each state health administration for the supply and dispensing of medicines and a very limited number of services. There are approximately 22,000 community pharmacies and 52,000 community pharmacists for a population of 47 million people. All community pharmacies are privately owned with only pharmacists owning a single pharmacy. Pharmacy chain stores are not legally permitted. Community pharmacy practice is based on dispensing of medications and dealing with consumer minor symptoms and requests for nonprescription medications although extensive philosophical deep debates on the conceptual and practical development of new clinical services have resulted in national consensually agreed classifications, definitions and protocolized services. There are a few remunerated services in Spain and these are funded at state, provincial or municipal level. There are no health services approved or funded at a national level. Although the profession promulgates a patient orientated community pharmacy it appears to be reluctant to advocate for a change in the remuneration model. The profession as a whole should reflect on the role of community pharmacy and advocate for a change to practice that is patient orientated alongside the maintenance of its stance on being a medication supplier. The future strategic position of community pharmacy in Spain as a primary health care partner with government would then be enhanced.

scholarly journals EL DERECHO A LA SALUD Y SU VULNERACIÓN EN LOS CASOS DE VIOLENCIA OBSTETRICA EN TABASCO

2020 ◽  
Vol 9 (01) ◽  
Author(s):  
León Felipe Morales Ariza ◽  
José Antonio Morales Notario
Keyword(s):  
Human Rights ◽  
Health Services ◽  
Social Economic ◽  
Right To Health ◽  
The State ◽  
Access To Health Services ◽  
Access To Health ◽  
The Social ◽  
The Individual ◽  
The Right

The Mexican Constitution establishes that everyone has the right to health protection and therefore, the law itself will define the bases and modalities for all to have access to health services. However, not everyone has access to quality medical services despite being in the supreme regulation. The State must understand that any alteration to health generates social security problems, mainly due to its consequences. The right to health is inalienable and does not distinguish between the social, economic, cultural or racial status of the individual. And, by stablishing it as a constitutional regulation, it amounted to an obligation of the State, which must provide quality services for all the society.  There are cases in which the right to health is violated, such as obstetrics, where pregnant women suffer the consequences of bad practices, or where minors are involved and their human rights are violated. We must focus our attention in the fact that their neglect has serious consequences and their impact generates human conditions that affect the dignity of the human being.

scholarly journals A Panel Evaluation of the Changes in the General Public’s Social-Media-Following of United States’ Public Health Departments during COVID-19 Pandemic

2021 ◽  
Vol 12 ◽  
pp. 215013272199545
Author(s):  
Areej Khokhar ◽  
Aaron Spaulding ◽  
Zuhair Niazi ◽  
Sikander Ailawadhi ◽  
Rami Manochakian ◽  
...  
Keyword(s):  
Public Health ◽  
Social Media ◽  
State Level ◽  
The State ◽  
Public Health Department ◽  
Health Departments ◽  
The Public ◽  
Public Health Departments ◽  
The Social ◽  
The U.S

Importance: Social media is widely used by various segments of society. Its role as a tool of communication by the Public Health Departments in the U.S. remains unknown. Objective: To determine the impact of the COVID-19 pandemic on social media following of the Public Health Departments of the 50 States of the U.S. Design, Setting, and Participants: Data were collected by visiting the Public Health Department web page for each social media platform. State-level demographics were collected from the U.S. Census Bureau. The Center for Disease Control and Prevention was utilized to collect information regarding the Governance of each State’s Public Health Department. Health rankings were collected from “America’s Health Rankings” 2019 Annual report from the United Health Foundation. The U.S. News and World Report Education Rankings were utilized to provide information regarding the public education of each State. Exposure: Data were pulled on 3 separate dates: first on March 5th (baseline and pre-national emergency declaration (NED) for COVID-19), March 18th (week following NED), and March 25th (2 weeks after NED). In addition, a variable identifying the total change across platforms was also created. All data were collected at the State level. Main Outcome: Overall, the social media following of the state Public Health Departments was very low. There was a significant increase in the public interest in following the Public Health Departments during the early phase of the COVID-19 pandemic. Results: With the declaration of National Emergency, there was a 150% increase in overall public following of the State Public Health Departments in the U.S. The increase was most noted in the Midwest and South regions of the U.S. The overall following in the pandemic “hotspots,” such as New York, California, and Florida, was significantly lower. Interesting correlations were noted between various demographic variables, health, and education ranking of the States and the social media following of their Health Departments. Conclusion and Relevance: Social media following of Public Health Departments across all States of the U.S. was very low. Though, the social media following significantly increased during the early course of the COVID-19 pandemic, but it still remains low. Significant opportunity exists for Public Health Departments to improve social media use to engage the public better.

Health Care for South Lebanon's Civilian Population Following the June 1982 War

1985 ◽  
Vol 1 (1) ◽  
pp. 50-54
Author(s):  
T.H. Tulchinsky ◽  
Yakov Adler
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Child Nutrition ◽  
Renal Dialysis ◽  
Nutrition Status ◽  
Local Health ◽  
Dialysis Unit ◽  
Medical Needs ◽  
South Lebanon

AbstractFollowing the June 1982 war in South Lebanon, the Israel Ministry of Health sent a medical team to assess health conditions in the area, to assist in the restoration of local health services, and to provide additional medical assistance as needed in public health and specialized medical services. For the approximately 600,000 population of the area, public health sanitary conditions were restored by local authorities, with some external assistance. Sanitation and housing for the refugee camp populations were difficult to solve because of extensive damage in the camps; but United Nations activities, supported by international and Israeli sources, were effective. Epidemic conditions did not occur. Monitoring for specific infectious diseases showed increases not exceeding usual summer conditions. Child nutrition status was satisfactory. Medical needs for specialty services, not available in South Lebanon, were arranged through screening and referral to Israeli hospitals. Renal dialysis needs were met by establishing a dialysis unit using local personnel in a damaged and non-functioning government hospital. Private medical and hospital services, the bulk of health care in the area, functioned except for minor dislocations throughout the war and post-war period. Israeli medical aid, managed by a small multidisciplinary team, was designed to assist and, where necessary, augment rather than replace local health services.

BPJS Kesehatan Memberikan Jaminan Kesehatan Terhadap Pasien Atau Masyarakat

2021 ◽  
Vol 7 (2) ◽  
pp. 146-154
Author(s):  
Aidha Puteri Mustikasari
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Social Security ◽  
The State ◽  
Universal Health Care ◽  
Universal Health Insurance ◽  
Universal Health ◽  
Provide Health Insurance

Abstrak. Kepesertaan BPJS Kesehatan pada tahun 2020 tidak akan mencakup 90% penduduk Indonesia, namun rencana Universal Health Care Implementation (UHC) telah direncanakan sejak tahun sebelumnya. Di masa pandemi Covid, sejumlah besar status kepesertaan BPJS Kesehatan  dicabut karena terlambat, padahal masyarakat membutuhkan layanan kesehatan dan asuransi dengan kondisi yang ada. Kajian ini bersifat norma deskriptif , dibahas dalam konteks kepesertaan BPJS kesehatan, dan cukup  menggunakan prinsip asuransi dengan hanya memberikan jaminan kepada peserta, tetapi negara mengikuti kewajiban UUD 1945 yaitu memberikan jaminan kesehatan dan pelayanan kepada warga negara. Untuk mendukung keberadaan jaminan kesehatan universal, Indonesia perlu menerapkan formulir kepesertaan dan  sanksi untuk ketentuan wajib  peserta jaminan sosial yang efektif dan efisien. Abstract. BPJS Health membership in 2020 will not cover 90% of Indonesia's population, but the Universal Health Care Implementation (UHC) plan has been planned since the previous year. During the Covid pandemic, a large number of BPJS Health membership statuses were revoked because they were late, even though people needed health services and insurance with the existing conditions. This study is descriptive in nature, discussed in the context of BPJS health participation, and it is sufficient to use the insurance principle by only providing guarantees to participants, but the state follows the obligations of the 1945 Constitution, namely to provide health insurance and services to citizens. To support the existence of universal health insurance, Indonesia needs to implement an effective and efficient membership form and sanctions for mandatory provisions for social security participants.

scholarly journals The therapeutic journey of families of children with respiratory diseases in the public health service

2012 ◽  
Vol 20 (3) ◽  
pp. 453-461 ◽  
Author(s):  
Beatriz Rosana Gonçalves de Oliveira ◽  
Neusa Collet ◽  
Débora Falleiros de Mello ◽  
Regina Aparecida Garcia de Lima
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Respiratory Diseases ◽  
Health Issues ◽  
Public Health Services ◽  
The Public ◽  
Primary Health ◽  
Therapeutic Encounters ◽  
Access To Medical Care

This study's purpose was to identify the therapeutic journey of families seeking health care for their children with respiratory diseases. This qualitative study had the participation of parents of children younger than five years old who were hospitalized with respiratory diseases. Path mapping was used as an instrument to collect data, which was analyzed through thematic analysis. The findings indicate that families sought the health services as soon as they perceived symptoms and had access to medical care, however such care was not decisive in resolving their health issues. Even though the families returned to the service at least another three times, the children had to be hospitalized. The attributes of primary health care were not observed in the public health services, while therapeutic encounters had no practical success.

scholarly journals Evaluation of Access on the perspective of adult users of Primary Health Care in Fortaleza, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Borges Costa ◽  
C Salles Gazeta Vieira Fernandes ◽  
T Custódio Mota ◽  
E Torquato Santos ◽  
M Moura de Almeida ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health System ◽  
Assessment Tool ◽  
Health Coverage ◽  
Access To Health Services ◽  
Primary Health ◽  
Care Assessment ◽  
The City

Abstract The Alma-Ata Conference promoted Primary Health Care (PHC) worldwide as a form of universal and continuous access to quality and effective health services. In Brazil, PHC, through the Family Health Strategy (FHS), aims to be the gateway to the health system and its structuring axis. For this, it is necessary to promote access, an essential condition for the quality of health care services, following the attributes systematized by Barbara Starfield. The aim of this study was to evaluate the presence of the attribute “First Contact Access” on the perspective of adult users of public PHC services in the city of Fortaleza, Ceará, Brazil. A transversal study was carried out, in 19 PHC Units, from June to December 2019, using the Primary Care Assessment Tool (PCATool) Brazil version for adult users. Kruskal-Wallis test was used for statistical analysis. 233 users participated, mostly women (69.5%), aged 30 to 59 years old (55.3%), mixed-race (69.5%), with complete high school (38.2%), without private health coverage (89.3%), homeowners (68.7%) and belonging to families of up to 4 members (87.9%). The “Accessibility” component had the lowest score, 2.83, and the “Utilization” had the highest score, 8.06. Older age was associated with higher “Accessibility” scores (p = 0,018), while lower values of “Utilization” were associated with higher education (p = 0,004). The main problems observed were: low access for acute demand consultations, lack of access at nighttime and weekends, little access through non-personal ways, bureaucratic barriers and a long time for scheduling appointments. We conclude that, although there was an improvement in PHC coverage in the city over the years, mainly due to FHS, there is still a lot to improve to ensure timely access to health services. Key messages Users consider PHC as the usual source of care, demonstrated by the high score of 'Utilization', however, they are unable to use it when necessary, demonstrated by the low score of 'Accessibility'. Expanding forms of access is essential to contribute to the strengthening of PHC in Fortaleza, Brazil, facilitating the entry to its national Universal Health System.

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