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The health sectors in many low-and middle-income countries have been characterized in recent years by extensive private sector activity. This has been complemented by increasing public?private linkages, such as the contracting-out of selected services or facilities, development of new purchasing arrangements, franchising and the introduction of vouchers. Increasingly, however, experience with the private sector has indicated a number of problems with the quality, price and distribution of private health services, and thus led to a growing focus on the role of government in regulation. This paper presents the existing network of regulations governing private activity in the health sectors of Tanzania and Zimbabwe, and their appropriateness in the context of emerging market realities. It draws on a comparative mapping exercise reviewing the complexity of the variables currently being regulated, the level of the health system at which they apply, and the specific instruments being used. Findings indicate that much of the existing regulation occurs through legislation. There is still very much a focus on the 'social' rather than 'economic' aspects of regulation within the health sector. Recent changes have attempted to address aspects of private health provision, but some very key gaps remain. In particular, current regulations in Tanzania and Zimbabwe: (1) focus on individual inputs rather than health system organizations; (2) aim to control entry and quality rather than explicitly quantity, price or distribution; and (3) fail to address the market-level problems of anti-competitive practices and lack of patient rights. This highlights the need for additional measures to promote consumer protection and address the development of new private markets such as for health insurance or laboratory and other ancillary services.
Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.
Increasing recognition of the impact that globalisation may be having on public health has led to widespread concern about the risks arising from emerging and re-emerging diseases, environmental degradation and demographic change. This book argues that health policy making is being affected by globalisation and that these effects are, in turn, contributing to the kind of global health issues being faced today. The book explores how the actors, context, processes and content of health policy are changing as a result of globalisation, raising concerns about growing differences in who can influence health policy, what priorities are set, what interventions are deemed appropriate and ultimately who enjoys good and bad health. Bringing together a distinguished, international group of contributors, this book covers a comprehensive range of topics and geographic regions and will be invaluable for all those interested in health, social and public policy and globalisation.
Until the start of the new century, efforts to strengthen health systems focused solely on the public sector and health programs overseen by public bodies. The private sector was sidelined in certain countries and even banned in others. At the same time, some private-sector stakeholders readily adapted themselves to this special situation so as to avoid becoming part of a structured health system.This volume notes profound changes in health care around the world in two areas. The stakeholders involved in the health sector are increasing in number and diversifying as a result of the development of the private sector. They are also responding to a process of democratization and decentralization. These developments have been paralleled by greater functional differentiation. Various stakeholders are increasingly specializing in particular areas of the health system: service delivery, procurement, management, financing, and regulation.The interdependence of health stakeholders becomes more evident along with the increased complexity of delivery systems as these respond to changing demand. There is a compelling need to forge relationships. Such relationships are in fact emerging in developed countries and, more recently, in developing countries. They may be informal, but are increasingly organized and structured.
Safeguarding the Health Sector in Times of Macroeconomic Instability presents the results of an international initiative to document the effects of how health systems in the developing world have responded to macroeconomic austerity and adjustment measures. Are these systems flexible and resilient to changes or are they rigid? In which circumstances and under which conditions do health systems respond favourably or unfavourably? What are the success stories? Country studies from Burkina Faso, Zimbabwe, India, Thailand, Mexico, and Colombia discuss lessons learned and identify policy measures for safeguarding the health sector. This book provides a fresh look at the relationships between. macroeconomic policy and interventions, health sector reform, and the health system in general, presenting new and detailed observations to inform policy choices within the health-care sector worldwide. It is unique in its focus on health systems and services (including financing, quality, accessibility, and utilization), rather than on health status. It will be of interest to academics, researchers, and students studying or active in health sciences and international development studies; professionals and practitioners in donor organizations, development organizations, and NGOs worldwide; and policy advisors and decision-makers in the health-care sector.
"The analysis of the distributional impact of policy reforms on the well-being or welfare of different stakeholder groups, particularly on th e poor and vulnerable, has an important role in the elaboration and implementation of poverty reduction strategies in developing countries. In recent years this type of work has been labeled as Poverty and Social Impact Analysis (PSIA) and is increasingly implemented to promote evidence-based policy choices and foster debate on policy reform options. While information is available on the general approach, techniques, and tools for distributional analysis, each sector displays a series of specific characteristics. These have implications for the analysis of distributional impacts, including the types of impacts and transmission channels that warrant particular attention, the tools and techniques most appropriate, the data source typically utilized, and the range of political economy factors most likely to affect the reform process. This volume provides an overview of the specific issues arising in the analysis of the distributional impacts of policy and institutional reforms in selected sectors. Each chapter offers guidance on the selection of tools and techniques most adapted to the reforms under scrutiny, and offers examples of applications of these approaches. This is a companion to the first volume, which offers guidance on trade, monetary and exchange rate policy, utility provision, agricultural markets, land policy, and education."
Beginning with a look into simple models of supply and demand within health care, this key text moves on to techniques of cost-benefit analysis, and then compares differing health care systems around the world. Featuring an array of case studies based on systems from around the world, the book successfully bridges the divide between the insurance-based system employed in the United States, the publicly-funded options more common in Europe and Canada, and the mixed arrangements characteristic of most developing countries. This informative textbook, essential for students on the ever-growing number of health economics courses internationally, will also be useful in other areas, such as public health studies, medicine and health science.
In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.
The regulation of health practitioners is an essential strategy to minimize instances of patient harm in health services by enabling access to practitioners who meet minimum criteria for patient safety. Although the models of regulation vary, regulatory functions include the following: defining and enforcing education standards; defining the minimum levels for competence and conduct of health practitioners; investigating complaints and enforcing discipline; and informing the public about regulated practitioners. Health practitioner regulation also has the potential to advance other health system priorities and objectives, such as workforce availability, equitable distribution and improved performance. This guidance aims to inform the design, reform and implementation of health practitioner regulation and to strengthen regulatory systems and institutions. It highlights the contemporary issues in health practitioner regulation, discusses challenges in implementing regulatory policies and articulates policy considerations for the design, reform and implementation of regulation. Finally, it highlights evidence gaps and identifies a research agenda.
This work provides a complete up-to-date guide and introduction to the increasingly important role of social policy in the context of development processes and practice.