Can health systems be enhanced for optimal health services through disease-specific programs? – results of field studies in Viet Nam and Cambodia

2012 ◽  
Author(s):  
Yuriko Egami
Keyword(s):  
Health Services ◽  
Health Systems ◽  
Field Studies ◽  
Viet Nam ◽  
Optimal Health ◽  
Disease Specific

scholarly journals Assessing the effects of disease-specific programs on health systems: An analysis of the Bangladesh Lymphatic Filariasis Elimination Program’s impacts on health service coverage and catastrophic health expenditure

2021 ◽  
Vol 15 (11) ◽  
pp. e0009894
Author(s):  
Kimberly M. Koporc ◽  
David R. Hotchkiss ◽  
Charles F. Stoecker ◽  
Deborah A. McFarland ◽  
Thomas Carton
Keyword(s):  
Health Service ◽  
Health Services ◽  
Health System ◽  
Lymphatic Filariasis ◽  
Health Systems ◽  
Health Expenditures ◽  
Difference In Differences ◽  
Catastrophic Health Expenditures ◽  
Service Coverage ◽  
Disease Specific

This study presents a methodology for using tracer indicators to measure the effects of disease-specific programs on national health systems. The methodology is then used to analyze the effects of Bangladesh’s Lymphatic Filariasis Elimination Program, a disease-specific program, on the health system. Using difference-in-differences models and secondary data from population-based household surveys, this study compares changes over time in the utilization rates of eight essential health services and incidences of catastrophic health expenditures between individuals and households, respectively, of lymphatic filariasis hyper-endemic districts (treatment districts) and of hypo- and non-endemic districts (control districts). Utilization of all health services increased from year 2000 to year 2014 for the entire population but more so for the population living in treatment districts. However, when the services were analyzed individually, the difference-in-differences between the two populations was insignificant. Disadvantaged populations (i.e., populations that lived in rural areas, belonged to lower wealth quintiles, or did not attend school) were less likely to access essential health services. After five years of program interventions, households in control districts had a lower incidence of catastrophic health expenditures at several thresholds measured using total household expenditures and total non-food expenditures as denominators. Using essential health service coverage rates as outcome measures, the Lymphatic Filariasis Elimination Program cannot be said to have strengthened or weakened the health system. We can also say that there is a positive association between the Lymphatic Filariasis Elimination Program’s interventions and lowered incidence of catastrophic health expenditures.

scholarly journals Maintaining fair and efficient health care during the COVID-19 pandemic: Theoretical context and practical implications

2021 ◽  
Vol 24 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Charalampos Milionis ◽  
Maria Ntzigani ◽  
Stella Olga Milioni ◽  
Ioannis Ilias
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Systems ◽  
Human Life ◽  
Health Coverage ◽  
Maximum Benefit ◽  
Community Health Systems ◽  
Health Care Efficiency ◽  
Universal Health ◽  
Practical Implications

Coronavirus disease 2019 is a respiratory infection that has evolved to a pandemic with an enormous burden both on human life and health care. States throughout the world have pursued strategies to restrict the transmission of the virus in the community. Health systems have a crucial dual role as they are at the frontline of the fight against the pathogen and at the same time they must continue to offer emergency and routine health services. The provision of health care in the context of the COVID-19 pandemic finds certain barriers. The simultaneous protection of both universal health coverage and health care efficiency is a difficult task due to conflicting challenges of these two goals. Key actions need to be decided and implemented in the fields of health policy, operation of health services, and clinical interaction between health personnel and patients, so that health care continues to perform its mission in a sustainable manner. As the scientific community prepares for the widespread production and application of effective protective and therapeutic agents against COVID-19, it is vital for the general population to remain safe and for the health systems to survive. Allocation of resources and priority setting need to be applied fairly and efficiently for the achievement of the maximum benefit.

scholarly journals Mental Illness Inequalities by Multimorbidity, Use of Health Resources and Socio-Economic Status in an Aging Society

2021 ◽  
Vol 18 (2) ◽  
pp. 458
Author(s):  
Manuel García-Goñi ◽  
Alexandrina P. Stoyanova ◽  
Roberto Nuño-Solinís
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Services ◽  
Health Systems ◽  
Access To Health Care ◽  
Population Aging ◽  
Basque Country ◽  
International Comparisons ◽  
Health Resources ◽  
The Poor

Background: Mental illness, multi-morbidity, and socio-economic inequalities are some of the main challenges for the public health system nowadays, and are further aggravated by the process of population aging. Therefore, it is widely accepted that health systems need to focus their strategies for confronting such concerns. With guaranteed access to health care services under universal coverage in many health systems, it is expected that all services be provided equally to patients with the same level of need. Methods: In this paper, we explore the existence of inequalities in the access to services of patients with mental illness taking into account whether they are multimorbid patients, their socioeconomic status, and their age. We take advantage of a one-year (2010–2011) database on individual healthcare utilization and expenditures for the total population (N = 2,262,698) of the Basque Country. Results: More comorbidity leads to greater inequality in prevalence, being the poor sicker, although with age, this inequality decreases. All health services are more oriented towards greater utilization of the poor and sicker, particularly in the case of visits to specialists and emergency care. Conclusions: Mental health inequalities in prevalence have been identified as being disproportionally concentrated in the least affluent areas of the Basque Country. However, inequalities in the utilization of publicly-provided health services present a pro-poor orientation. As this region has adopted a system-wide transformation towards integrated care, its mental health delivery model offers excellent potential for international comparisons and benchlearning.

scholarly journals Structural stigma and its impact on healthcare for consumers with borderline personality disorder: protocol for a scoping review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Pauline Klein ◽  
Alicia Kate Fairweather ◽  
Sharon Lawn ◽  
Helen Margaret Stallman ◽  
Paul Cammell
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Health Services ◽  
Health Systems ◽  
Scoping Review ◽  
Borderline Personality ◽  
Cochrane Library ◽  
Cultural Norms ◽  
International Literature ◽  
Institutional Policies

Abstract Background Structural stigma in health systems experienced by consumers diagnosed with Borderline Personality Disorder (BPD) is a widespread phenomenon that causes major health inequities and harm for this population. Structural stigma in this context relates to institutional policies, cultural norms, and organizational practices that limit consumers’ access to health services, quality of care, and capacity to achieve optimal health and well-being. BPD is a serious mental illness with high morbidity and mortality, characterized by instability in interpersonal relationships, self-image, and emotional and behavioral deregulation, which stem from significant traumatic childhood/life events, and/or biological etiologies. The objectives of this scoping review are to explore the international literature on structural stigma in healthcare systems specific to BPD, and to provide an overview of the impact of structural stigma on health services for BPD consumers and their carers/families. Methods This scoping review will follow the Joanna Briggs Institute (JBI) scoping review guidelines. We will search the following electronic databases (from inception onwards): MEDLINE, CINAHL, PsycINFO, Scopus, Cochrane Library, and JBI-Evidence databases. Grey literature will be identified through the Google search engine. We will include all types of literature in English, published and unpublished, including any study design, reviews, clinical practice guidelines, policy reports, and other documents. No restrictions on publication date of sources of evidence will be applied. International literature should examine structural stigma associated with BPD in any healthcare setting such as, outpatients, inpatients, primary health care, or community-based facilities. Two reviewers will independently screen all titles, abstracts, and full-text citations. Quality appraisal of the included sources of evidence will be assessed using the Mixed Methods Appraisal Tool (MMAT) 2018 version. Data analysis will involve quantitative (e.g., frequencies) and qualitative (e.g., thematic analysis) methods. Discussion This review is anticipated to enhance both identification and understanding of those structures in health systems (i.e., institutional policies, cultural norms, and practices) that manifest and perpetuate stigma experienced by consumers with BPD and their carers/families. The findings can be used to inform future research, policy, and practice relating to stigma reduction strategies that can be adopted to improve the provision of BPD-responsive services and care for this population. Systematic review registration Open Science Framework (https://osf.io/bhpg4).

Maternal health services in China’s western rural areas: uptake and correlates

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Chengfang Liu ◽  
Linxiu Zhang ◽  
Yaojiang Shi ◽  
Huan ZHOU ◽  
Alexis Medina ◽  
...  
Keyword(s):  
Public Health ◽  
Maternal Health ◽  
Health Services ◽  
Health Systems ◽  
Uptake Rate ◽  
Rural Areas ◽  
Design Methodology ◽  
Maternal Health Services ◽  
Western China ◽  
Public Health Systems

Purpose Many public health systems have struggled with the dual questions of (1) why the uptake rate of maternal health services is low among some subpopulations; and (2) how to raise it. The objective of this study is to assess the uptake rate of a new set of maternal health services in poor rural areas of China. Design/methodology/approach The analysis is based on the survey responses of women’s representatives and village cadres from almost 1000 villages in June 2012 as part of a wide-scale public health survey in Sichuan, Gansu and Yunnan provinces in the western part of China. Findings We find that the uptake rate of maternal health services (including in-hospital delivery, antenatal care visits and post-partum care visits) in poor rural areas of western China are far below average in China, and that the rates vary across provinces and ethnic groups. Our analyses demonstrate that distance, income, ethnicity and availability appear to be systematically correlated with low uptake rates of all maternal health services. Demand-side factors seem to be by far the most important sources of the differences between subpopulations. We also find that there is potential for creating a Conditional Cash Transfer program to improve the usage of maternal health services. Originality/value We believe that our results will contribute positively to the exploration of answers to the dual questions that many public health systems have struggled with (1) why the uptake rate of maternal health services is low among some subpopulations; and (2) how to raise it.

scholarly journals Effort to Fulfill Female Convicts’ Rights to Health and Clothing at Sigli Class Iib Correctional Facility for Women

2021 ◽  
Vol 21 (2) ◽  
pp. 237
Author(s):  
Mustafa Hasan
Keyword(s):  
Health Services ◽  
Government Regulation ◽  
Descriptive Analysis ◽  
Correctional Facility ◽  
Detention Center ◽  
Health Card ◽  
Optimal Health ◽  
Female Convicts ◽  
Class Iib ◽  
The Right

Article 14 Paragraph (1) letter d of Law Number 12 Year 1995 concerning Corrections. The right to health services and the right to adequate clothing are often neglected and have not been fully implemented properly. The purpose of this research is to find out and explain the fulfilment of the rights to health and clothing of female convicts at the Sigli Class IIB Correctional Facility for Women. This research method is an empirical juridical method by using a descriptive analysis approach. The results of the study showed that the fulfilment of the rights to health and clothing has not been implemented optimally pursuant to what is mandated by law, and Article 14 Paragraph (2) of Government Regulation Number 32 Year 1999 concerning Terms and Procedures for the Implementation of the Rights of Correctional Inmates. To ensure optimal health services, at least one doctor must be provided. However, in this case it is not yet available at the Sigli Class IIB Correctional Facility for Women. One of the efforts made by the correctional facility is to collaborate with the local government to check the health of correctional inmates at least 1 (one) time in 1 (one) month and it is recorded in a health card. As for clothing need, it has been given partly to female convicts, but has not been given in full due to the lack of budget given to the Sigli Correctional Facility for Women. The responsibility of the state is to finance the fulfilment of the rights that have been regulated in the law, for example in the provision of health and clothing rights in a Correctional Facility, the facility shall have at least a doctor, nurses, clinics and medicines sufficient to support health facility in the Correctional Facility or Detention Center.

Unlocking Trust in Community Health Systems: Lessons from the Lymphatic Filariasis Morbidity Management and Disability Prevention Pilot Project in Luangwa District, Zambia

2021 ◽  
Author(s):  
Joseph M. Zulu ◽  
Patricia Maritim ◽  
Adam Silumbwe ◽  
Hikabasa Halwiindi ◽  
Patricia Mubita ◽  
...  
Keyword(s):  
Focus Group ◽  
Health Services ◽  
Lymphatic Filariasis ◽  
Health Systems ◽  
Disability Prevention ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Community Health Systems ◽  
Referral Systems ◽  
Depth Interviews

Background: Surgery for hydrocele is commonly promoted as part of morbidity management and disability prevention (MMDP) services for lymphatic filariasis (LF). However, uptake of these surgeries has been suboptimal owing to several community level barriers that have triggered mistrust in such services. This study aimed at documenting mechanisms of unlocking trust in community health systems (CHS) in the context of a LF hydrocele management project that was implemented in Luangwa District, Zambia. Methods: Qualitative data was collected through in-depth interviews and focus group discussions (n=45) in February 2020 in Luangwa District. Thirty-one in-depth interviews were conducted with hydrocele patients, CHWs, health workers, traditional leaders and traditional healers. Two focus group discussions were also conducted with CHWs who had been involved in project implementation with seven participants per group. Data was analyzed using a thematic analysis approach. Results: The use of locally appropriate communication strategies, development of community driven referral systems, working with credible community intermediaries as well as strengthening health systems capacity through providing technical and logistical support enhanced trust in surgery for hydrocele and uptake of the surgeries. Conclusion: Implementation of community led communication and referral systems as well as strengthening health services are vital in unlocking trust in health systems as such mechanisms trigger authentic partnerships, including mutual respect and recognition in the CHS. The mechanisms also enhance confidence in health services among community members.

Developing High Quality Public Health Services Across the Union That Are Equally Accessible to All

2018 ◽  
pp. 1924-1947
Author(s):  
Androutsou Lorena ◽  
Androutsou Foulvia
Keyword(s):  
Public Health ◽  
Health Services ◽  
Member State ◽  
Health Systems ◽  
Quality Standards ◽  
Decision Makers ◽  
Public Health Services ◽  
High Quality ◽  
The Public ◽  
European Health

Health systems are facing greater demands and challenges. Access to all with high-quality standards has been a key challenge for the European health systems, however, they are engaged to take care of the rights of those in need. This article aims to identify public health areas and values. It offers many opportunities to help policy and decision makers to write “policy briefs” and to clearly outline the rationale for action. It will pursuit to enhance local capacities and skills to plan, implement, evaluate and sustain system improvements. There is a need both at Member State and European levels to support the public health services to shape the future of health and healthcare.

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