It could eventually change social attitudes about what constitutes ethical behaviour by health workers. We seek to understand how and why ToCs were applied and to clarify how they facilitate the implementation of iterative intervention designs and stakeholder engagement in health systems research and strengthening. Making Health Markets Work addresses the challenge of improving health markets so that they better meet the needs of the poor. It uses one county hospital to illustrate how pressures to increase revenue, combined with distortionary pricing policies, have led to cost increases. The implication is that it is not possible to apply standard or single interventions across countries, as approaches proven to work well in one context will not necessarily work well elsewhere. This paper, attempts to provide insights into the functioning of the informal transport markets in facilitating access to maternal health care. Under the Mutual Learning component, work was undertaken with thought leaders from the rising powers to systematise an approach to mutual learning that allowed for learning exchanges with a range of policy actors.
The book documents the problems associated with unregulated health markets and presents innovative approaches that have emerged to address them. The Economics of Social Franchising for Health in Low and Middle Income Countries David Bishai and Claire Champion 12. This book is ideal reading for researchers and students in public health, development studies, public policy and administration, health economics, medical anthropology, and science and technology studies. However, less than 40% of expenditure is on public health services and three quarters of that is on acute care hospitals. This review paper considers access and use of antibiotics in these countries from a complex adaptive system perspective. This enables actors to learn their roles and responsibilities and the appropriate responses to new incentive structures.
There is a general agreement that the outcome of an intervention depends a great deal on the way that a large number of agents respond. The paper concludes that policy-makers need to better understand the objectives, incentives and potential adaptive behaviors of the agents when they implement interventions to improve antibiotic use and reduce the risk of emergence of resistant organisms. No significant association was observed between the use of electronic devices for health information seeking and socio demographic variables probably due to low use of electronic platforms for seeking health information. A cross-sectional survey was performed to identify households affected by major illness for further in-depth interviews. For each month in 1993, 100 outpatient records were randomly selected from each county hospital and 50 from each health center for review.
The hugeness of China, and the variation in conditions in different jurisdictions present very substantial challenges to reformers, and militate against adopting one-size-fits-all policy solutions. Four of the six countries identified stakeholders in addition to the guidelines, while some of the stakeholder categories were not identified by countries. It argues that restructuring the health sector is complex and there is a risk of failure. Hafizur Rahman and Smisha Agarwal 5. This presents a major challenge in Africa, where an economic downturn is projected in a number of resource-dependent countries, such as Mozambique and Guinea Bissau and where countries such as Sierra Leone have weakened health systems. Since the first democratic elections in 1994 the government has been under enormous pressure to diminish disparities between population groups in access to health services. The effort to bring order to these chaotic markets is almost certain to become one of the greatest challenges in global health.
In other words, what are the unique ethical challenges when researchers engage with host communities for longer periods 10 years or more , and what special considerations does this time commitment generate when applying ethical principles to these kinds of studies? Many Asian countries are in the midst of multiple interconnected social, economic, demographic, technological, institutional and environmental transitions. Background: There is substantial evidence that ill-health is a major cause of impoverishment in developing countries. Healthcare systems are increasingly recognised as complex, in which a range of non-linear and emergent behaviours occur. Evidence of the Effects of Market-Based Innovations and International Initiatives to Improve the Performance of Private Providers Claire Champion, Gerald Bloom and David Peters 10. Many governments of low and middle-income countries are under pressure to increase access to safe, effective and affordable health services.
This underlines the need for the government to fund a substantial share of health expenditure out of general revenues, particularly in poor localities. Over the past few decades, there has been increasing attention focused on the ethics of health research, particularly in low- and middle-income countries. Further, it documents how the Ministry of Health viewed its role as both an advocate for the interests of health facilities and health workers and as the agency responsible for ensuring that government health system objectives were met. It outlines a framework th. In early 1997 a new government policy identified health prepayment as a major potential source of rural health finance. Innovations in information technologies and in low cost diagnostics are creating important new opportunities for achieving this.
Since the economic reforms were instituted in the late 1970s, the financing and delivery of rural health services have seen many changes, some positive, others not. Although a number of intermediate transport initiatives have been used in some developing countries, available evidence reveals a dearth of local knowledge on the effect of these rural informal transport mechanisms on access to maternal health care services, the cost of implementing such schemes and their scalability. The creation of such systems requires sustained efforts to strengthen state oversight of the health sector and to build effective partnerships for public health and service delivery. There is extensive literature on the digital divide which suggests that access and use of technological innovations are influenced by socio-demographic traits such as gender, age, education, income, rural-urban disparity etc. These tended to be constrained in the options available.
This book documents the problems associated with unregulated health markets and presents innovative approaches that have emerged to address them. However, they also encourage overuse of antibiotics and behaviour likely to encourage the emergence of resistance. This paper provides a review of the research-policy interface in low-income countries and proposes a conceptual framework, followed by directions for empirical approaches. Other countries can learn from China's experience by taking a systematic approach to the formulation and implementation of strategies for health sector reform. This book is ideal reading for researchers and students in public health, development studies, public policy and administration, health economics, medical anthropology, and science and technology studies. The average cost per prescription in township health centers was equal to 5. The effort to bring order to these chaotic markets is almost certain to become one of the greatest challenges in global health.
Rural households in India rely extensively on informal biomedical providers, who lack valid medical qualifications. We conclude with a proposal for long-term approaches to the institutionalisation of accountability processes and the strategic galvanising of a broader range of partners to work towards Universal Health Coverage, as both a metric and a mechanism of achieving greater health equity. The article describes the impact of China's health sector reform on relatively small hospitals in rural counties. This has substantially increased the availability of health-related goods and services in all but the most remote localities, but it has created problems with safety, efficiency and cost. It also describes how health sector managers are creating regulations to influence the performance of their facility. In spite of the fact that average health expenditure was almost 5% of household income in 1988, there was evidence of lack of access. The three themes are Social justice who wins or loses from disease and how health policy is focused , Politics how health and disease responses are framed, both locally and internationally and Governance how health policies are defined, and how health technologies are regulated and controlled.
We frame our discussion around two country case studies with which we are familiar, namely China and South Africa and discuss the implications for conducting 'embedded' research. Background: This paper explores the evolution of schemes for rural finance in China as a case study of the long and complex process of health system development. This will involve additional funding of primary health service services, particularly in underserved localities. A large majority of China's rural population were members of health prepayment schemes in the 1970's. Conclusions: Making Health Markets Work Better for Poor People Gerald Bloom, Barun Kanjilal, Henry Lucas, David P.