scholarly journals Overcoming fragmentation and waste in health care systems in Africa: Collaboration of health care professionals with pastoral caregivers

2014 ◽  
Vol 70 (2) ◽  
Author(s):  
Emem Agbiji ◽  
Christina Landman

This article explores the possibility and limits of collaboration between medical professionals and pastoral caregivers with a view to overcoming fragmentation and waste in the African hospital care sector. It argues that the quality of health and health care in many African countries is poor. Therefore, a purposeful reform of health care delivery systems in Africa is necessary. Building on the World Health Organization’s statement that the medical model that focuses on medicine and surgery and ignores the factors of belief and faith in healing is no longer satisfactory, it further argues that the medical model (including the bio-psychosocial model) is not sufficient for holistic hospital care; it therefore needs to accommodate complementary approaches (such as pastoral care) and include these as collaborative treatments. The connection of collaboration with quality, value, relationships and the ending of life implies that collaboration is an ethical process of reflection – which could have a legal implication.

2006 ◽  
Vol 5 (3) ◽  
pp. 375-385 ◽  
Author(s):  
Bob Matthews ◽  
Yoonsoon Jung

This paper discusses and compares the origin and development of the health care systems of South Korea and the UK from the end of WW2 and endeavours to compare outcomes. The paper emphasises the importance of war as a stimulus to the development of national health services in both countries and argues that there is convergence between the UK's nationalised NHS and South Korea's US-modelled capitalist system. Overall, we conclude that there is a possibility not only that the financing and nature of the Korean and UK health care delivery systems may show convergence, but it is not impossible that they will ‘change places’ with the UK system dominated by private provision and South Korea's by public provision.


2005 ◽  
Vol 44 (02) ◽  
pp. 273-277
Author(s):  
D. M. Lawrence

Summary Purpose: To compare organized and traditional health care delivery systems and their ability to meet several major challenges facing health care in the next 25 years. Approach: Analysis of traditional and organized health care systems based on a career spent in organized health care systems. Conclusions: The traditional health care system based on independent autonomous physicians is not able to meet the challenges of current healthcare. Stronger integration and coordination, i.e., organized health care delivery systems are required.


Author(s):  
Dominique Kerouedan

The fight against infectious diseases necessarily involves medical entomology and biology, medicine and public health. Other dimensions are influential in the field of international health care cooperation because of pressures inflicted on national policies, particularly in Africa. Based on a historical review of cooperation and the analysis of its evolutions over the past 15 years, we highlight the paradox of world health safety: owing to targeting almost exclusively the AIDS pandemic over the course of decades, disequilibria can be observed in health care systems, especially with regard to epidemiological alert and surveillance and health care personnel, two essential pillars in the control of infectious diseases. We suggest that the Ebola epidemic and its rapid propagation in several West African countries might be a result of over a decade security policies relating to AIDS. The private sector cannot take the place of this democratic governance, neither in rich nor in poor countries. It is time to restore the standards for national and world governance in this field.


2000 ◽  
Vol 5 (2) ◽  
pp. 29-36
Author(s):  
Valerie Ehlers

The RSA, like most African countries, have two health care systems. The most visible one is the Westernised hospital and/or clinic based treatment of diseases. This system was introduced by the colonisers and perpetuated by the current formal education programmes of most health care professionals in the RSA. Traditional African medicine has existed since time immemorial and continues to treat vast numbers of people. Both these health care systems will be briefly discussed. Then the role of nurses in the RSA's health care system(s) will be examined. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.


2021 ◽  
pp. 025371762110323
Author(s):  
Sharad Philip ◽  
Gopi Gajera ◽  
P Lakshmi Nirisha ◽  
Palanimuthu Thangaraju Sivakumar ◽  
Malathesh C. Barikar ◽  
...  

Background: A burgeoning rise in the elderly subpopulation is being noted in India. This rise has already earned the designation as a shining nation by the United Nations/World Health Organization. This growth will take the elderly subpopulation to 324 million persons above 60 years by 2050. The mental health needs of this subpopulation are varied and nuanced compared to that of the general population. The risk and prevalence of mental health morbidity are also greater. There is an urgent need to gear up the health care systems. Considerations: Various aspects of the ongoing demographic transitions are considered alongside available health information. Legislative mandates and laws are also reviewed to provide context to qualify the action points and recommendations.  Recommendations, India must act urgently to strengthen health care delivery systems in a concurrent multipronged approach. These efforts should focus on developing trained Human Resources and adequate infrastructural resources. Review mechanisms to inform on required updates on best practices and evidence-based medicine must also be incorporated and developed to perform periodically.


Author(s):  
Blánaid Daly ◽  
Paul Batchelor ◽  
Elizabeth Treasure ◽  
Richard Watt

The World Health Organization defines a health care system as: . . . all organizations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence determinants of health as well as more direct health-improving activities. . . . . . . (WHO 2007) . . . Such a definition covers a myriad of potential elements and factors, of which the dental element is but one. A health care system is not static: it evolves as part of the more general social and welfare arrangements in a society. As a member of a health care profession, all dental care providers need to have an appreciation of the wider aspects of any arrangements of health, its determinants, and care delivery, if only to understand how the pressures on a system may impact on their current and future activities. This chapter provides an overview of health care systems and provides the framework for Chapters 18–23. Health care systems are complex organizations that are in a constant process of change and evolution. Dentistry is one very small component of the wider health care system, which is itself part of the overall social welfare system within society. Dentists, as health professionals, need to understand the basic elements of the health care system within which they are working. The development of health care systems is an ongoing process in which all societies try to meet the health needs of its citizens. There is no society that has yet designed a system that meets the needs of all its citizens. Indeed, historically in many countries it was only the wealthy that were able to access health care in a society. As societies evolved, the pressures to make the health care system accessible to all its members grew. Mays (1991) has highlighted the political importance of health care, showing that many health care systems reforms were designed to prevent political instability and improve the fitness of army recruits. Indeed, the development of the then School Dental Service in the UK was brought about following questions in Parliament about the poor state of soldiers’ teeth in the Boer War.


2016 ◽  
Vol 29 (2) ◽  
pp. 122-135
Author(s):  
Randolph K. Quaye

Purpose This paper examines the changing role of general practitioners (GPs) in Nordic countries of Sweden, Norway and Denmark. It aims to explore the “gate keeping” role of GPs in the face of current changes in the health care delivery systems in these countries. Design/methodology/approach Data were collected from existing literature, interviews with GPs, hospital specialists and representatives of Danish regions and Norwegian Medical Association. Findings The paper contends that in all these changes, the position of the GPs in the medical division of labor has been strengthened, and patients now have increased and broadened access to choice. Research limitations/implications Health care cost and high cancer mortality rates have forced Nordic countries of Sweden, Norway and Denmark to rethink their health care systems. Several attempts have been made to reduce health care cost through market reform and by strenghtening the position of GPs. The evidence suggests that in Norway and Denmark, right incentives are in place to achieve this goal. Sweden is not far behind. The paper has limitations of a small sample size and an exclusive focus on GPs. Practical implications Anecdotal evidence suggests that physicians are becoming extremely unhappy. Understanding the changing status of primary care physicians will yield valuable information for assessing the effectiveness of Nordic health care delivery systems. Social implications This study has wider implications of how GPs see their role as potential gatekeepers in the Nordic health care systems. The role of GPs is changing as a result of recent health care reforms. Originality/value This paper contends that in Norway and Denmark, right incentives are in place to strengthen the position of GPs.


2021 ◽  
Vol 13 (23) ◽  
pp. 13082
Author(s):  
Willemine Willems

In the health sciences and policy, it is common to view rising health care costs as a tragedy of the commons, i.e., a situation in which the unhampered use of a resource by rational individuals leads to its depletion. By monitoring a set of outcomes, not only the costs but also patient experience and population health, simultaneously, it is claimed that the “triple aim” approach changes what is rational for health care stakeholders and, thus, can counter the rapidly rising health care costs. This approach has an important limitation: it reduces the monitored innovations to merely their outcomes; yet, how health care professionals and patients give shape to care delivery remains invisible. To get a more in-depth understanding of the consequences of adopting such an approach, in this article I use the method of exnovation instead. Exnovation foregrounds the everyday accomplishments of health care practices to enable reflection and learning. I draw on an ethnographic study into an innovation in care delivery aimed at rendering it more sustainable: Primary Care Plus. I reflected with both professionals and patients on what happened during 40 Primary Care Plus consultations. By presenting and analyzing three of these consultations, I foreground what is rendered invisible with the triple aim: improvisations, surprises and habits unfolding in practice. With exnovation, health care innovations can provide fertile soil for creating new forms of sustainable care that can help prevent the impending exhaustion of health care systems.


2018 ◽  
Author(s):  
Christina Østervang ◽  
Lene Vedel Vestergaard ◽  
Karin Brochstedt Dieperink ◽  
Dorthe Boe Danbjørg

BACKGROUND In cancer settings, relatives are often seen as a resource as they are able to support the patient and remember information during hospitalization. However, geographic distance to hospitals, work, and family obligations are reasons that may cause difficulties for relatives’ physical participation during hospitalization. This provided inspiration to uncover the possibility of telehealth care in connection with enabling participation by relatives during patient rounds. Telehealth is used advantageously in health care systems but is also at risk of failing during the implementation process because of, for instance, health care professionals’ resistance to change. Research on the implications for health care professionals in involving relatives’ participation through virtual presence during patient rounds is limited. OBJECTIVE This study aimed to investigate health care professionals’ experiences in using and implementing technology to involve relatives during video-consulted patient rounds. METHODS The design was a qualitative approach. Methods used were focus group interviews, short open interviews, and field observations of health care professionals working at a cancer department. The text material was analyzed using interpretative phenomenological analysis. RESULTS Field observational studies were conducted for 15 days, yielding 75 hours of observation. A total of 14 sessions of video-consulted patient rounds were observed and 15 pages of field notes written, along with 8 short open interviews with physicians, nurses, and staff from management. Moreover, 2 focus group interviews with 9 health care professionals were conducted. Health care professionals experienced the use of technology as a way to facilitate involvement of the patient’s relatives, without them being physically present. Moreover, it raised questions about whether this way of conducting patient rounds could address the needs of both the patients and the relatives. Time, culture, and change of work routines were found to be the major barriers when implementing new technology involving relatives. CONCLUSIONS This study identified a double change by introducing both new technology and virtual participation by relatives at the same time. The change had consequences on health care professionals’ work routines with regard to work load, culture, and organization because of the complexity in health care systems.


2008 ◽  
Vol 24 (5) ◽  
pp. 1159-1161 ◽  
Author(s):  
Claudia Travassos

The Introduction outlines this issue's special Forum on equity in access to health care, including three Articles and a Postscript. The Forum represents a continuation of the debates raised during a seminar organized by the Oswaldo Cruz Foundation in the city of Rio de Janeiro, Brazil, in 2006, in collaboration with UNICEF, UNDP, World Bank, the WHO Special Program for Research and Training in Tropical Diseases, and the United Nations Research Institute for Social Development. The authors approach health care access and equity from a comprehensive and contemporaneous perspective, introducing a new conceptual framework for access, in which information plays a central role. Trust is proposed as an important value for an equitable health care system. Unethical practices by health administrators and health care professionals are highlighted as hidden critical aspects of inequities in health care. As a whole, the articles represent a renewed contribution for understating inequalities in access, and for building socially just health care systems.


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