MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Health Policy and Planning' source. Thu, 09 Feb 2012 10:12:55 +0100 http://www.medworm.com/index.php?rid=5531374&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F76%3Frss%3D1 A lack of good quality evidence on the effect of alternative social policies in low- and middle-income countries has been recently underlined and the value of randomized trials increasingly advocated. However, it is also acknowledged that randomization is not always feasible or politically acceptable. Analyses using longitudinal data series before and after an intervention can also deliver robust results and such data are often reasonably easy to access. Using the example of evaluating the impact on utilization of a change in health financing policy, this article explains how studies in the literature have often failed to address the possible biases that can arise in a simple analysis of routine longitudinal data. It then describes two possible statistical approaches to estimate impact in ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5531374 Wed, 21 Dec 2011 05:00:00 +0100 5531374 http://www.medworm.com/index.php?rid=5531373&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F69%3Frss%3D1 This study was carried out to explore pregnant women’s experiences of, and views on, the policies for opt-out, and couple HIV testing, and to understand how the policy implementation could be improved in order to increase access to prevention of mother-to-child-transmission (PMTCT) services. The study was conducted at three ANC health facilities at different levels of care in rural eastern Uganda. Data were collected through sit-in observations during ANC and 18 semi-structured interviews with pregnant women receiving ANC, and thereafter analysed using latent content analysis. Pregnant women who received ANC from facilities that provided HIV testing on-site perceived HIV testing as compulsory without actually fully realizing the benefits of HIV testing and PMTCT. No referral for HIV ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5531373 Wed, 21 Dec 2011 05:00:00 +0100 5531373 http://www.medworm.com/index.php?rid=5531372&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F60%3Frss%3D1 Conclusions Community mobilization for local selection of trainees achieved significantly higher employment levels of trained midwives in high-risk rural communities than usual selection methods, without compromising quality of skills. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5531372 Wed, 21 Dec 2011 05:00:00 +0100 5531372 http://www.medworm.com/index.php?rid=5531371&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F52%3Frss%3D1 Conclusions This experience from Madagascar is among the first evidence from sub-Saharan Africa documenting the feasibility, effectiveness and acceptability of CBD services for injectable contraceptives. This evidence influenced national and global policy makers to recommend expansion of the practice. CBD of injectables is an example of effective task shifting of a clinical practice as a means of extending services to underserved populations without further burdening clinicians. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5531371 Wed, 21 Dec 2011 05:00:00 +0100 5531371 http://www.medworm.com/index.php?rid=5531370&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F42%3Frss%3D1 Conclusion The adoption of the concept of task shifting can substantially reduce the expected number of health care providers otherwise needed to close mental health service gaps at primary health care level in South Africa at minimal cost and may serve as a model for other middle-income countries. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5531370 Wed, 21 Dec 2011 05:00:00 +0100 5531370 http://www.medworm.com/index.php?rid=5531369&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F32%3Frss%3D1 Improved understanding of how to advance national nutrition policy is critical to ensure greater policy investments in nutrition. We used a participant-observer, change-agent model to prospectively study why and how national nutrition policy advanced in Vietnam between 2006 and 2008. Our goal was to understand strategies used, factors that shaped policy advancement, and the interaction of strategies with factors in this context. Data were collected using questionnaires, informant interviews, programme visits, document reviews and documentation of key events. For analysis, we created a chronology of events, examined strategies and actions used and their results by event, coded interviews and summarized findings using a well-known framework for policy analysis. Our analysis shows that the fo... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5531369 Wed, 21 Dec 2011 05:00:00 +0100 5531369 http://www.medworm.com/index.php?rid=5531368&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F19%3Frss%3D1 Undernutrition is the single largest contributor to the global burden of disease and can be addressed through a number of highly efficacious interventions. Undernutrition generally has not received commensurate attention in policy agendas at global and national levels, however, and implementing these efficacious interventions at a national scale has proven difficult. This paper reports on the findings from studies in Bangladesh, Bolivia, Guatemala, Peru and Vietnam which sought to identify the challenges in the policy process and ways to overcome them, notably with respect to commitment, agenda setting, policy formulation and implementation. Data were collected through participant observation, documents and interviews. Data collection, analysis and synthesis were guided by published concep... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5531368 Wed, 21 Dec 2011 05:00:00 +0100 5531368 http://www.medworm.com/index.php?rid=5531367&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F11%3Frss%3D1 Conclusions Our study established time standards in minutes for each MCH activity promised by the NRHM, which could be applied elsewhere in India by government planners and civil society advocates. Our calculations indicate significant numbers of new health workers are required to deliver the services promised by the NRHM. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5531367 Wed, 21 Dec 2011 05:00:00 +0100 5531367 http://www.medworm.com/index.php?rid=5531366&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F8%3Frss%3D1 (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5531366 Wed, 21 Dec 2011 05:00:00 +0100 5531366 http://www.medworm.com/index.php?rid=5531365&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F1%3Frss%3D1 Across low- and middle-income countries on the one hand, and high-income countries on the other, there is confusion in the terminology relating to the study of health services and health systems. This commentary discusses health policy and systems research (HPSR) methods, drawing on the health services research literature and on recent work on HPSR. An earlier version of the text was written to contribute to discussions at a meeting organized by the Alliance for Health Policy and Systems Research, an agency set up in 1998 to promote and support such research in low- and middle-income countries. The paper comments on the field of HPSR methods, suggests priorities and identifies challenges facing the field of HPSR. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5531365 Wed, 21 Dec 2011 05:00:00 +0100 5531365 http://www.medworm.com/index.php?rid=5353802&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_2%2Fii104%3Frss%3D1 Removing user fees could improve service coverage and access, in particular among the poorest socio-economic groups, but quick action without prior preparation could lead to unintended effects, including quality deterioration and excessive demands on health workers. This paper illustrates the process needed to make a realistic forecast of the possible resource implications of a well-implemented user fee removal programme and proposes six steps for a successful policy change: (1) analysis of a country's initial position (including user fee level, effectiveness of exemption systems and impact of fee revenues at facility level); (2) estimation of the impact of user fee removal on service utilization; (3) estimation of the additional requirements for human resources, drugs and other inputs, an... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5353802 Tue, 25 Oct 2011 04:00:00 +0100 5353802 http://www.medworm.com/index.php?rid=5353801&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_2%2Fii92%3Frss%3D1 Conclusion Both pilot and nationwide data indicated that curative care utilization increased following fee removal, without differential changes in quality. Concerns raised by non-governmental organizations, health workers and community leaders over the effects of lost revenue and increased utilization require continued effort to raise revenues, monitor health worker and patient perceptions, and carefully manage health facility performance. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5353801 Tue, 25 Oct 2011 04:00:00 +0100 5353801 http://www.medworm.com/index.php?rid=5353800&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_2%2Fii84%3Frss%3D1 This article examines the latest policy, which was introduced in January 2009: free delivery care across the country. The study objective was to understand the effects of the policy on health facilities. Study methods included structured forms to retrieve financial and activity data from national, district and facility records (comparing 10 months before implementation with 10 months after). These were supplemented by semi-structured interviews with key informants at different levels of the health system. Findings include that utilization of services (at the facilities visited) continues to rise, with caesareans proportionate to the general growth in deliveries. Funds for the free delivery policy (‘Aama’) are found to be adequate to cover the main costs of services, with some s... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5353800 Tue, 25 Oct 2011 04:00:00 +0100 5353800 http://www.medworm.com/index.php?rid=5353799&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_2%2Fii72%3Frss%3D1 This article questions the effectiveness of the current national policy, and the effectiveness of reducing the cost of drugs only (i.e. partial subsidies) or providing malaria tests and drugs free for under-5s, without abolishing other related fees. National and international budgets, in particular those that target health systems strengthening, could be used to complement existing subsidies and be directed towards effective abolition of user fees. This would contribute to increasing the impact of interventions on population health and, in turn, the effectiveness of aid. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5353799 Tue, 25 Oct 2011 04:00:00 +0100 5353799 http://www.medworm.com/index.php?rid=5353798&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_2%2Fii63%3Frss%3D1 In May 2006, the President of Burundi announced the removal of user fees in all health centres and hospitals for children under 5 and women giving birth. As other studies also point out, the policy was adopted extremely suddenly, without much reflection on its ultimate aims and on the operational dimension of its implementation. From the perspective of a frontline manager, this paper provides a descriptive case study of the abolition of user fees in the Muramvya District and a first-hand account of the effects of the sudden reform in the management of a district and a district hospital. The analysis highlights the challenges that the district and hospital teams faced. The main issues were: the reduction of financial flows, which prevented the possibility of investments and caused frequent ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5353798 Tue, 25 Oct 2011 04:00:00 +0100 5353798 http://www.medworm.com/index.php?rid=5353797&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_2%2Fii52%3Frss%3D1 This article examines the case of Rwanda, a country which has championed innovative health care financing policies. Between 2000 and 2007, Rwanda has improved financial access for the poor, increased utilization of health services and reduced out-of-pocket payments for health care. Poor groups’ utilization has increased for all health services, sometimes dramatically. Use of assisted deliveries, for example, increased from 12.1% to 42.7% among the poorest quintile; payments at the point of delivery have also been reduced; and catastrophic expenditures have declined. Part of these achievements is likely linked to innovative health financing policies, particularly the expansion of micro-insurance (‘mutuelles’) and performance-based financing. The paper concludes that the Rw... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5353797 Tue, 25 Oct 2011 04:00:00 +0100 5353797 http://www.medworm.com/index.php?rid=5353796&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_2%2Fii41%3Frss%3D1 Inadequate health financing is one of the major challenges health systems in low-income countries currently face. Health financing reforms are being implemented with an increasing interest in policies that abolish user fees. Data from three nationally representative surveys conducted in Uganda in 1999/2000, 2002/03 and 2005/06 were used to investigate the impact of user fee abolition on the attainment of universal coverage objectives. An increase in illness reporting was noted over the three surveys, especially among the poorer quintiles. An increase in utilization was registered in the period immediately following the abolition of user fees and was most pronounced in the poorest quintile. Overall, there was an increase in utilization in both public and private health care delivery sectors... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5353796 Tue, 25 Oct 2011 04:00:00 +0100 5353796 http://www.medworm.com/index.php?rid=5353795&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_2%2Fii30%3Frss%3D1 Conclusions This ambitious policy expresses a strong political commitment but has not been adequately supported by international partners. Despite relatively tight administrative controls, health workers have figured out how to take advantage of the system. Some of the policy's instruments should be reviewed and clarified to improve its effectiveness. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5353795 Tue, 25 Oct 2011 04:00:00 +0100 5353795 http://www.medworm.com/index.php?rid=5353794&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_2%2Fii16%3Frss%3D1 In this study, we review recent reforms in six sub-Saharan African countries: Burkina Faso, Burundi, Ghana, Liberia, Senegal and Uganda. The review describes the processes and strategies through which user fee removal reforms have been implemented and tries to assess them by referring to a good practice hypotheses framework. The analysis shows that African leaders are willing to take strong action to remove financial barriers met by vulnerable groups, especially pregnant women and children. However, due to a lack of consultation and the often unexpected timing of the decision taken by the political authorities, there was insufficient preparation for user fee removal in several countries. This lack of preparation resulted in poor design of the reform and weaknesses in the processes of polic... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5353794 Tue, 25 Oct 2011 04:00:00 +0100 5353794 http://www.medworm.com/index.php?rid=5353793&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_2%2Fii5%3Frss%3D1 Several authors have stressed the fact that many policy reforms fail because of poor formulation or implementation. On the other hand, the health financing literature provides little guidance to policy makers in low-income countries on how to implement a health care financing reform in ways that enhance its chance of achieving policy objectives, even less so for a user fee removal reform. This paper presents the framework used for a multi-country review of the policy process of removing user fees in six sub-Saharan African countries. The review aimed at developing operational guidance for health managers involved in user fee removal reform. Drawing broadly on Walt and Gilson's ‘health policy analysis triangle’ (context—actor—process—content), we focused partic... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5353793 Tue, 25 Oct 2011 04:00:00 +0100 5353793 http://www.medworm.com/index.php?rid=5353792&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_2%2Fii1%3Frss%3D1 (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5353792 Tue, 25 Oct 2011 04:00:00 +0100 5353792 http://www.medworm.com/index.php?rid=5342194&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F6%2F518%3Frss%3D1 Conclusions It is possible to direct the flow of patients to EDs and rationalize the use of resources, making it possible for patients to be admitted to EDs best able to care for them. These findings are especially relevant to emergency situations, but also to non-emergent situations in which control of patient flow may be required. Direct communication with the public is recommended to minimize the implementation time of directives regarding patient flow. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5342194 Sat, 22 Oct 2011 04:00:00 +0100 5342194 http://www.medworm.com/index.php?rid=5342193&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F6%2F508%3Frss%3D1 Although logic models are now touted as an important component of health promotion planning, implementation and evaluation, there are few published manuscripts that describe the process of logic model development, and fewer which do so with community involvement, despite the increasing emphasis on participatory research. This paper describes a process leading to the development of a logic model for a youth mental health promotion intervention using a participatory approach in a Palestinian refugee camp in Beirut, Lebanon. First, a needs assessment, including quantitative and qualitative data collection was carried out with children, parents and teachers. The second phase was identification of a priority health issue and analysis of determinants. The final phase in the construction of the l... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5342193 Sat, 22 Oct 2011 04:00:00 +0100 5342193 http://www.medworm.com/index.php?rid=5342192&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F6%2F496%3Frss%3D1 Conclusions An increase in the average number of ANC visits has been achieved among Oportunidades beneficiaries. An indirect effect is the increased selection of a physician/nurse for delivery care among young women living in localities with greater exposure time to Oportunidades. Disadvantaged women in Mexico (indigenous women) continue to have less access to skilled delivery care. Developing countries must develop strategies to increase access and use of skilled obstetric care for marginalized women. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5342192 Sat, 22 Oct 2011 04:00:00 +0100 5342192 http://www.medworm.com/index.php?rid=5342191&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F6%2F485%3Frss%3D1 Objective To understand the Iranian health financing system and provide lessons for policy makers about achieving universal coverage. Methods Twenty-five interviewees from seven major health insurance companies were selected for a qualitative study in 2007. Using a semi-structured interview, three main tasks of the health financing system (revenue collection, risk pooling and purchasing) were investigated. A framework method was applied for the data analysis. Results The results of the study show the following seven major obstacles to universal coverage: unknown insured rate; regressive financing and non-transparent financial flow; fragmented and non-compulsory system; non-scientifically designed benefit package; non-health-oriented and expensive payment system; uncontrolled demands; and a... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5342191 Sat, 22 Oct 2011 04:00:00 +0100 5342191 http://www.medworm.com/index.php?rid=5342190&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F6%2F471%3Frss%3D1 Strengthening good governance and preventing corruption in health care are universal challenges. The Karnataka Lokayukta (KLA), a public complaints agency in Karnataka state (India), was created in 1986 but played a prominent role controlling systemic corruption only after a change of leadership in 2001 with a new Lokayukta (ombudsman) and Vigilance Director for Health (VDH). This case study of the KLA (2001–06) analysed the:Scope and level of poor governance in the health sector; KLA objectives and its strategy; Factors which affected public health sector governance and the operation of the KLA. We used a participatory and opportunistic evaluation design, examined documents about KLA activities, conducted three site visits, two key informant and 44 semi-structured interviews and ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5342190 Sat, 22 Oct 2011 04:00:00 +0100 5342190 http://www.medworm.com/index.php?rid=5342189&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F6%2F464%3Frss%3D1 Trying to determine how best to allocate resources in health care is especially difficult when resources are severely constrained, as is the case in all developing countries. This is particularly true in South Africa currently where the HIV epidemic adds significantly to a health service already overstretched by the demands made upon it. This paper proposes a framework for determining how best to allocate scarce health care resources in such circumstances. This is based on communitarian claims. The basis of possible claims considered include: the need for health care, specified both as illness and capacity to benefit; whether or not claimants have personal responsibility in the conditions that have generated their health care need; relative deprivation or disadvantage; and the impact of se... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5342189 Sat, 22 Oct 2011 04:00:00 +0100 5342189 http://www.medworm.com/index.php?rid=5342188&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F6%2F453%3Frss%3D1 Conclusions Rapid improvements in drug availability in the late 1990s in Russia are a probable consequence of a more liberalized pharmaceutical sector and an improved pharmacy network, whilst later improvements in affordability may relate to expanded health care insurance coverage and economic recovery after the 1998 crash. A significant minority still finds prescription costs problematic, notably poorer and sick individuals, with inequalities apparently widening. Non-monetary determinants of affordability indicate its partly subjective nature, however. Ongoing research into access is needed, due to recent national changes in prescription drug subsidies, and into doctor- and patient-related influences on access and prescribing for individual conditions. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5342188 Sat, 22 Oct 2011 04:00:00 +0100 5342188 http://www.medworm.com/index.php?rid=5342187&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F6%2F445%3Frss%3D1 This article presents a qualitative description of an early post-conflict policy process in southern Sudan, which represented an opportunity to test these boundaries. The methodology of provision of technical assistance to the MoH in the formulation of a human resource plan is reviewed. Initial objectives are compared with the results accomplished. Shortcomings are discussed and recommendations for technical assistance programmes in similar contexts are provided. Between October 2005 and May 2006, World Health Organization advisers supported the MoH in conducting a human resources assessment to lay the grounds for a human resources development plan. The study employed three consultants, ten data collectors and entailed questionnaires, field visits, interviews and a review of literature. Th... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5342187 Sat, 22 Oct 2011 04:00:00 +0100 5342187 http://www.medworm.com/index.php?rid=5342186&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F6%2F441%3Frss%3D1 (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5342186 Sat, 22 Oct 2011 04:00:00 +0100 5342186 http://www.medworm.com/index.php?rid=5153513&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F5%2F429%3Frss%3D1 The concentration index is the most commonly used measure of socio-economic-related health inequality. However, a critical constraint has been that it is just a measure of inequality. Equity is an important goal of health policy but the average level of health also matters. In this paper, we explore evidence of both these crucial dimensions—equity (inequality) and efficiency (average health)—in child health indicators by adopting the recently developed measure of the extended concentration index on the National Family Health Survey (NFHS-3) data from India. An increasing degree of inequality aversion is used to measure health inequalities as well as achievement in the following child health indicators: under-2 child mortality, full immunization coverage, and prevalence of under... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153513 Wed, 17 Aug 2011 23:00:00 +0100 5153513 http://www.medworm.com/index.php?rid=5153512&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F5%2F423%3Frss%3D1 The attitude of pregnant women to a new antenatal care model with four antenatal visits (focused antenatal care) is examined using a cross-sectional survey in Enugu, Nigeria. Only 20.3% of the parturients desired a change to the new model. Parturients who defaulted from antenatal care three or more times, those dissatisfied with their current antenatal care, senior civil servants and parturients who received secondary school education or less most commonly desired a change to the new model (P < 0.05). Default from antenatal care and dissatisfaction with current antenatal care were most predictive of the desire for change in multiple logistic regression analysis. The most common reasons for desiring the change were convenience (65.1%) and cost considerations (24.1%). Reasons given for th... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153512 Wed, 17 Aug 2011 23:00:00 +0100 5153512 http://www.medworm.com/index.php?rid=5153511&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F5%2F413%3Frss%3D1 This study assessed fidelity and reinvention in the implementation of a community-based control strategy for Aedes aegypti control. The intervention was implemented in 16 study areas in La Lisa, a municipality of Havana, Cuba. Its major components were: organization & management, capacity-building, community work and surveillance. A participatory assessment of process data was performed to determine whether the components and subcomponents were implemented, not-implemented or modified. Frequencies were tabulated over all circumscriptions (lowest level of local government) and the average was calculated for the four components. Spearman Rank correlation coefficients were calculated to explore the relationships between components. In addition, semi-structured interviews were conducted wi... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153511 Wed, 17 Aug 2011 23:00:00 +0100 5153511 http://www.medworm.com/index.php?rid=5153510&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F5%2F405%3Frss%3D1 The Framework Convention on Tobacco Control (FCTC) is an exemplar result of global health diplomacy, based on its global reach (binding on all World Health Organization member nations) and its negotiation process. The FCTC negotiations are one of the first examples of various states and non-state entities coming together to create a legally binding tool to govern global health. They have demonstrated that diplomacy, once consigned to interactions among state officials, has witnessed the dilution of its state-centric origins with the inclusion of non-governmental organizations (NGOs) in the diplomacy process. To engage in the discourse of global health diplomacy, NGO diplomats are immediately presented with two challenges: to convey the interests of larger publics and to contribute to inter... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153510 Wed, 17 Aug 2011 23:00:00 +0100 5153510 http://www.medworm.com/index.php?rid=5153509&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F5%2F395%3Frss%3D1 Health worker training is a key component of the integrated management of childhood illness (IMCI). However, training coverage remains low in many countries. We conducted in-depth case studies in two East African countries to examine the factors underlying low training coverage 10 years after IMCI had been adopted as policy. A document review and in-depth semi-structured interviews with stakeholders at facility, district, regional/provincial and national levels in two districts in Kenya (Homa Bay and Malindi) and Tanzania (Bunda and Tarime) were carried out in 2007–08. Bunda and Malindi achieved higher levels of training coverage (44% and 25%) compared with Tarime and Homa Bay (5% and 13%). Key factors allowing the first two districts to perform better were: strong district leadershi... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153509 Wed, 17 Aug 2011 23:00:00 +0100 5153509 http://www.medworm.com/index.php?rid=5153508&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F5%2F385%3Frss%3D1 Conclusions Our study identifies problems in how health care systems in LMICs adopt new, expensive medical technologies, and suggests that a set of innovative approaches and policy instruments are needed in order to balance the institutional and professional desire to practise a modern and expensive medicine in a context of health inequalities and basic health needs. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153508 Wed, 17 Aug 2011 23:00:00 +0100 5153508 http://www.medworm.com/index.php?rid=5153507&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F5%2F373%3Frss%3D1 The relevance and importance of research for understanding policy processes and influencing policies has been much debated, but studies on the effectiveness of policy theories for predicting and informing opportunities for policy change (i.e. prospective policy analysis) are rare. The case study presented in this paper is drawn from a policy analysis of a contemporary process of policy debate on legalization of abortion in Indonesia, which was in flux at the time of the research and provided a unique opportunity for prospective analysis. Applying a combination of policy analysis theories, this case study provides an analysis of processes, power and relationships between actors involved in the amendment of the Health Law in Indonesia. It uses a series of practical stakeholder mapping tools ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153507 Wed, 17 Aug 2011 23:00:00 +0100 5153507 http://www.medworm.com/index.php?rid=5153506&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F5%2F366%3Frss%3D1 Conclusions The findings suggest that this combined economic and health intervention was cost-effective in its trial phase and highly cost-effective in scale-up. These estimates are probably conservative, as they do not include the health and development benefits of the intervention beyond IPV reduction. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153506 Wed, 17 Aug 2011 23:00:00 +0100 5153506 http://www.medworm.com/index.php?rid=5153505&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F5%2F357%3Frss%3D1 Despite the high prevalence of mental illness, mental health remains a low priority in Africa. There has been no investigation of the views of stakeholders in Africa on why this is and what can be done. This paper reports a comparison of the views of stakeholders in Ghana, South Africa, Uganda and Zambia, focusing on the priority given to mental health by the government at the national and regional/province levels. We conducted semi-structured interviews with key stakeholders and used a two-stage approach to analysis: firstly framework analysis in each study country, followed by comparative analysis of the country data. Mental health was largely considered a low priority at national and regional/provincial levels in all four countries. We identified nine factors affecting the priority of m... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153505 Wed, 17 Aug 2011 23:00:00 +0100 5153505 http://www.medworm.com/index.php?rid=5153522&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_1%2Fi72%3Frss%3D1 Global financing for the HIV response has reached unprecedented levels in recent years. Over US$10 billion were mobilized in 2007, an effort credited with saving the lives of millions of people living with HIV (PLHIV). A relatively unexamined aspect of the global HIV response is the role of the private sector in financing HIV/AIDS services. As the nature of the response evolves from emergency relief to long-term sustainability, understanding current and potential contributions from the private sector is critical. This paper examines trends in private sector financing, management and resource consumption related to HIV/AIDS in five sub-Saharan African countries, with a particular emphasis on the effects of recently scaled-up donor funding on private sector contributions. We analysed Nationa... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153522 Mon, 04 Jul 2011 23:00:00 +0100 5153522 http://www.medworm.com/index.php?rid=5153521&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_1%2Fi63%3Frss%3D1 Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing (1) independent private sector providers; (2) social franchises of private providers; (3) non-government organization (NGO) providers; and (4) government providers on these three factors. Franchised private clinics have higher quality than non-franchised private clinics in both countries. In Pakistan, the costs per client and the proportion of poorest clients showed no differences between franchised a... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153521 Mon, 04 Jul 2011 23:00:00 +0100 5153521 http://www.medworm.com/index.php?rid=5153520&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_1%2Fi53%3Frss%3D1 The principal-agent problem in health care asserts that providers, being the imperfect agents of patients, will act to maximize their profits at the expense of the patients’ interests. This problem applies especially where professional regulations are lacking and incentives exist to directly link providers’ actions to their profits, such as a fee-for-service payment system. The current analysis tests for the existence of the principal-agent problem in the private health market in Vietnam by examining the prescribing patterns of private providers. I show that: (1) private providers were able to induce demand by prescribing more drugs than public providers for a similar illness and patient profile; (2) private providers were significantly more likely to prescribe injection drugs ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153520 Mon, 04 Jul 2011 23:00:00 +0100 5153520 http://www.medworm.com/index.php?rid=5153519&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_1%2Fi45%3Frss%3D1 There has been a dramatic spread of market relationships in many low- and middle-income countries. This spread has been much faster than the development of the institutional arrangements to influence the performance of health service providers. In many countries poor people obtain a large proportion of their outpatient medical care and drugs from informal providers working outside a regulatory framework, with deleterious consequences in terms of the safety and efficacy of treatment and its cost. Interventions that focus only on improving the knowledge of these providers have had limited impact. There is a considerable amount of experience in other sectors with interventions for improving the performance of markets that poor people use. This paper applies lessons from this experience to the... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153519 Mon, 04 Jul 2011 23:00:00 +0100 5153519 http://www.medworm.com/index.php?rid=5153518&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_1%2Fi30%3Frss%3D1 In spite of all efforts to build national health services, health systems of many low-income countries are today highly pluralistic. Households use a vast range of public and private health care providers, many of whom are not controlled by national health authorities. Experts have called on Ministries of Health to re-establish themselves as stewards of the entire health system. Modern stewardship will require national and decentralized health authorities to have an overall view of their pluralistic health system, especially of the components outside the public sector. Little guidance has been provided so far on how to develop such a view. In this paper, we explore whether household surveys could be a source of information. The study builds on secondary data analysis of a household survey ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153518 Mon, 04 Jul 2011 23:00:00 +0100 5153518 http://www.medworm.com/index.php?rid=5153517&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_1%2Fi20%3Frss%3D1 This study illustrates the importance of trust as a unique concept that can affect people’s choice of health care providers in a low-income country. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153517 Mon, 04 Jul 2011 23:00:00 +0100 5153517 http://www.medworm.com/index.php?rid=5153516&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_1%2Fi13%3Frss%3D1 Conclusions on criteria for selecting NGOs for providing basic health care could guide other governments choosing to contract for such services. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153516 Mon, 04 Jul 2011 23:00:00 +0100 5153516 http://www.medworm.com/index.php?rid=5153515&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_1%2Fi4%3Frss%3D1 The authors conducted a literature review on the role of the private sector in low- and middle-income countries. The review indicated that relatively few studies have researched the role of the private sector in immunization service delivery in these countries. The studies suggest that the private sector is playing different roles and functions according to economic development levels, the governance structure and the general presence of the private sector in the health sector. In some countries, generally low-income countries, the private for-profit sector is contributing to immunization service delivery and helping to improve access to traditional EPI vaccines. In other countries, particularly middle-income countries, the private for-profit sector often acts to facilitate early adoption ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153515 Mon, 04 Jul 2011 23:00:00 +0100 5153515 http://www.medworm.com/index.php?rid=5153514&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2Fsuppl_1%2Fi1%3Frss%3D1 (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=5153514 Mon, 04 Jul 2011 23:00:00 +0100 5153514 http://www.medworm.com/index.php?rid=4950567&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F4%2F349%3Frss%3D1 This paper investigates the effect of health-related expenditure on household welfare in Albania, Bosnia and Herzegovina, Montenegro, Serbia and Kosovo, all of which have undertaken major health sector reform. Two methodologies are used: (i) the incidence and intensity of ‘catastrophic’ health care expenditure, and (ii) the effect of out-of-pocket payments on poverty headcount and poverty gap measures. Data are drawn from the most recent Living Standards and Measurement Surveys, 2000–05. While our analyses are not without their limitations, and the lack of comparability across instruments precludes a direct comparison across countries, there is no doubt that health expenditure contributes substantially to the impoverishment of households—increasing the incidence of ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4950567 Mon, 20 Jun 2011 23:00:00 +0100 4950567 http://www.medworm.com/index.php?rid=4950566&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F4%2F338%3Frss%3D1 This article examines how policy decisions regarding mental health and wellbeing were incorporated into the national agenda in the years which followed. The study reveals the policy shifts, contextual influences and players responsible. The Solomon Islands’ experience reflects incremental change, built upon longstanding but modest concern with mental health and social welfare issues, reinforced by advocacy from the small mental health team. Armed conflict and ethnic tensions from 1998 to 2003 promoted wider recognition of unmet mental health needs and psychosocial problems. Additional impetus was garnered through the positioning of key health leaders, some of whom were trained in public health. Working together, with an understanding of culture and politics, and drawing on external s... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4950566 Mon, 20 Jun 2011 23:00:00 +0100 4950566 http://www.medworm.com/index.php?rid=4950565&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F4%2F327%3Frss%3D1 Community case management (CCM) as applied to child survival is a strategy that enables trained community health workers or volunteers to assess, classify, treat and refer sick children who reside beyond the reach of fixed health facilities. The Nicaraguan Ministry of Health (MOH) and Save the Children trained and supported brigadistas (community health volunteers) in CCM to improve equitable access to treatment for pneumonia, diarrhoea and dysentery for children in remote areas. In this article, we examine the policy landscape and processes that influenced the adoption and implementation of CCM in Nicaragua. Contextual factors in the policy landscape that facilitated CCM included an international technical consensus supporting the strategy; the role of government in health care provision ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4950565 Mon, 20 Jun 2011 23:00:00 +0100 4950565 http://www.medworm.com/index.php?rid=4950564&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F4%2F316%3Frss%3D1 Significant scale-up of donors’ investments in health systems strengthening (HSS), and the increased application of harmonization mechanisms for jointly channelling donor resources in countries, necessitate the development of a common framework for tracking donors’ HSS expenditures. Such a framework would make it possible to comparatively analyse donors’ contributions to strengthening specific aspects of countries’ health systems in multi-donor-supported HSS environments. Four pre-requisite factors are required for developing such a framework: (i) harmonization of conceptual and operational understanding of what constitutes HSS; (ii) development of a common set of criteria to define health expenditures as contributors to HSS; (iii) development of a common HSS classi... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4950564 Mon, 20 Jun 2011 23:00:00 +0100 4950564 http://www.medworm.com/index.php?rid=4950563&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F4%2F307%3Frss%3D1 This study illustrates dissonance between global expectations and local realities of the delivery of HIV-testing interventions. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4950563 Mon, 20 Jun 2011 23:00:00 +0100 4950563 http://www.medworm.com/index.php?rid=4950562&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F4%2F298%3Frss%3D1 Conclusions Male circumcision programmes should be tailored to accommodate variations in the determinants of demand across the target population. We find that circumcision’s protective effect against HIV acquisition in men is the only determinant to be found consistently across all ethnic groups in Johannesburg. We also find that concerns over condom avoidance may have been overstated. This said, male circumcision strategies should reinforce a range of HIV prevention strategies, including condom use, as we find evidence that whites may view circumcision as a means to avoid condom use. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4950562 Mon, 20 Jun 2011 23:00:00 +0100 4950562 http://www.medworm.com/index.php?rid=4950561&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F4%2F288%3Frss%3D1 The Global Financial Crisis (GFC) of 2008/2009 was the largest economic slowdown since the Great Depression. It undermined the growth and development prospects of developing countries. Several recent studies estimate the impact of economic shocks on the poor and vulnerable, especially women and children. Infant and child mortality rates are still likely to continue to decline, but at lower rates than would have been the case in the absence of the GFC. Asia faces special challenges. Despite having been the fastest growing region in the world for decades, and even before the current crisis, this region accounted for nearly 34% of global deaths of children under 5, more than 40% of maternal deaths and 60% of newborn deaths. Global development goals cannot be achieved without much faster and d... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4950561 Mon, 20 Jun 2011 23:00:00 +0100 4950561 http://www.medworm.com/index.php?rid=4950560&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F4%2F275%3Frss%3D1 Conclusion Although there are documented interventions among IPPs, there are few good quality studies. Strategies that change the market conditions for IPPs—by changing incentives and accountability—appear more likely to succeed than those that depend on building individual capacities of IPPs. Understanding the effectiveness of these and other strategies will also require more rigorous research designs that assess contextual factors and document outcomes over longer periods. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4950560 Mon, 20 Jun 2011 23:00:00 +0100 4950560 http://www.medworm.com/index.php?rid=4740647&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F3%2F266%3Frss%3D1 This paper empirically identifies cross-price elasticities of betel nut and cigarette consumption in Taiwan based on the Central Bureau of Statistics demand model. It compares reduction of cigarette consumption as a result of the proposed Betel Nut Health Tax with reduction of betel nut consumption as a result of the Tobacco Health and Welfare Taxes levied in 2002 and 2006, in order to determine which tax is most effective. Results from a simulated comparative analysis indicate that the Betel Nut Health Tax reduces cigarette consumption to a much greater extent than the Tobacco Health and Welfare Taxes reduce betel nut consumption. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4740647 Tue, 19 Apr 2011 23:00:00 +0100 4740647 http://www.medworm.com/index.php?rid=4740646&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F3%2F257%3Frss%3D1 Discussion While promoting breastfeeding is a must for all women, to maximize its benefits for child survival and health, additional efforts are needed to reach poorly educated and rural women with little access to health care. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4740646 Tue, 19 Apr 2011 23:00:00 +0100 4740646 http://www.medworm.com/index.php?rid=4740645&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F3%2F242%3Frss%3D1 Nepal’s Safe Motherhood Programme has failed to deliver expected gains in maternal and child health. Nepalese mothers and their children continue to dispense with (or be denied) antenatal care, experience high maternal mortality rates and suffer chronic malnutrition. We address the correlates and consequences of antenatal care utilization in Nepal by applying two-stage least squares, binomial logit and Heckman selection bias estimates to data drawn from the Nepal Health and Demographic Surveys of 1996 and 2001. Results indicate that maternal education, even at low levels, significantly increases the use of antenatal care; paternal education plays a more important role in the use of routine antenatal care than the conventional wisdom suggests; and when mothers use routine professional... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4740645 Tue, 19 Apr 2011 23:00:00 +0100 4740645 http://www.medworm.com/index.php?rid=4740644&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F3%2F233%3Frss%3D1 As a result of the increasing number of orphans in sub-Saharan Africa, numerous programmes have been initiated to facilitate the care and support of orphaned and vulnerable children. This paper reports on a community-based capital cash transfer initiative in Kenya and explores its role in building orphan competent and supportive communities through its participatory project cycle. Using a mixture of individual and group interviews, 300 orphaned children and 110 adults involved in this initiative were interviewed using open-ended questions. A thematic analysis of the data revealed that many of the communities participating in this programme had become more united and active in the support of orphaned children following the mobilization of much needed economic, political and social support r... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4740644 Tue, 19 Apr 2011 23:00:00 +0100 4740644 http://www.medworm.com/index.php?rid=4740643&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F3%2F223%3Frss%3D1 Conclusion: The strengths and limitations of any measure of SEP depend on the context and purpose for which it is being used. In these data, the wealth index was strongly influenced by community infrastructure, whereas the subjective SEP measures were not, perhaps allowing analyses using them to disentangle household and community influences. Several subjective measures also corresponded to dollar-a-day poverty more strongly than the wealth index. Subjective measures may therefore be preferable to the wealth index in some circumstances, although they have their own set of potential biases. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4740643 Tue, 19 Apr 2011 23:00:00 +0100 4740643 http://www.medworm.com/index.php?rid=4740642&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F3%2F210%3Frss%3D1 Conclusions Contextualization of WHO-CHOICE using local data provides health decision-makers with more sound economic evidence for policy debates on prioritizing health interventions to reduce cardiovascular diseases in Vietnam. When used, cost-effectiveness analysis could increase efficiency in allocating scare resources. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4740642 Tue, 19 Apr 2011 23:00:00 +0100 4740642 http://www.medworm.com/index.php?rid=4740641&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F3%2F199%3Frss%3D1 As China explores new directions to reform its health care system, regulated competition among both insurers and providers of care might be one potential model. The Russian Federation in 1993 implemented legislation intended to stimulate such regulated competition in the health care sector. The subsequent progress and lessons learned over these 17 years can shed light on and inform the future evolution of the Chinese system. In this paper, we list the necessary pre-conditions for reaping the benefits of regulated competition in the health care sector. We indicate to what extent these conditions are being fulfilled in the post-reform Russian and current Chinese health care systems. We draw lessons from the Russian experience for the Chinese health care system, which shares a similar economi... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4740641 Tue, 19 Apr 2011 23:00:00 +0100 4740641 http://www.medworm.com/index.php?rid=4740640&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F3%2F187%3Frss%3D1 The pursuit of the Millennium Development Goals and advancing the ‘global health agenda’ demand the achievement of health impact at scale through efficient investments. We have previously offered that sustainability—a necessary condition for successful expansion of programmes—can be addressed in practical terms. Based on benchmarks from actual child survival projects, we assess the expected impact of translating pro-sustainability choices into investment strategies. We review the experience of Save the Children US in Guinea in terms of investment, approach to sustainability and impact. It offers three benchmarks for impact: Entry project (21 lives saved of children under age five per US$100 000), Expansion project (37 LS/US$100k), and Continuation project (100 LS/US... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4740640 Tue, 19 Apr 2011 23:00:00 +0100 4740640 http://www.medworm.com/index.php?rid=4488075&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F2%2F183%3Frss%3D1 (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4488075 Wed, 16 Feb 2011 00:00:00 +0100 4488075 http://www.medworm.com/index.php?rid=4488074&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F2%2F174%3Frss%3D1 Benefit incidence analysis (BIA) considers who (in terms of socio-economic groups) receive what benefit from using health services. While traditionally BIA has focused on only publicly funded health services, to assess whether or not public subsidies are ‘pro-poor’, the same methodological approach can be used to assess how well the overall health system is performing in terms of the distribution of service benefits. This is becoming increasingly important in the context of the growing emphasis on promoting universal health systems. To conduct a BIA, a household survey dataset that incorporates both information on health service utilization and some measure of socio-economic status is required. The other core data requirement is unit costs of different types of health service. ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4488074 Wed, 16 Feb 2011 00:00:00 +0100 4488074 http://www.medworm.com/index.php?rid=4488073&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F2%2F163%3Frss%3D1 Conclusion The interpretive framework links the concept of outreach to the poor and enhancing equity to rationing health services at a particularly opportune moment in Iran. However, using windows of opportunity to implement a major policy change, if it results in sacrifices in planning and preparedness, may harm the policy and the future success in achieving its objectives. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4488073 Wed, 16 Feb 2011 00:00:00 +0100 4488073 http://www.medworm.com/index.php?rid=4488072&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F2%2F157%3Frss%3D1 Conclusions This study indicates that lower COC is associated with increased hospital admissions and ED visits, even in a health care system that lacks a referral arrangement framework. This suggests that improving the COC is beneficial both for patients and for the health care system. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4488072 Wed, 16 Feb 2011 00:00:00 +0100 4488072 http://www.medworm.com/index.php?rid=4488071&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F2%2F142%3Frss%3D1 The AIDS pandemic in sub-Saharan Africa puts increasing pressure on the buffer capacity of low- and middle-income households without access to health insurance. This paper examines the relationship between health shocks, insurance status and health-seeking behaviour. It also investigates the possible mitigating effects of insurance on income loss and out-of-pocket health expenditure. The study uses a unique dataset based on a random sample of 1769 households and 7343 individuals living in the Greater Windhoek area in Namibia. The survey includes medical testing for HIV infection which allows for the explicit analysis of HIV-related health shocks. We find that the economic consequences of health shocks can be severe for uninsured households even in a country with a relatively well-developed... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4488071 Wed, 16 Feb 2011 00:00:00 +0100 4488071 http://www.medworm.com/index.php?rid=4488070&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F2%2F133%3Frss%3D1 This study estimates the price and income elasticities of demand for ITNs using nationally representative household survey data and actual consumer choices, in the context of a national scheme to provide vouchers for subsidized nets to pregnant women in Tanzania. Under this distribution system, the estimated price elasticity of demand for subsidized ITNs equals –0.12 and the income elasticity estimates range from zero to 0.47, depending on household socio-economic status. The model also shows a substantial decline in short-term ITN purchases for women whose household received a free ITN. These findings suggest that if the Tanzanian government continues to use a mixed public–private model to distribute ITNs, increasing the consumer subsidy alone will not dramatically improve IT... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4488070 Wed, 16 Feb 2011 00:00:00 +0100 4488070 http://www.medworm.com/index.php?rid=4488069&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F2%2F124%3Frss%3D1 This article discusses the linkages of these events and the effects on Mexican nurses and the development of the profession. The findings have implications for nursing human resources policy-making and trade in services. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4488069 Wed, 16 Feb 2011 00:00:00 +0100 4488069 http://www.medworm.com/index.php?rid=4488068&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F2%2F115%3Frss%3D1 In this study, we examine the relationship between AIDS orphans’ care arrangement and their psychosocial well-being among a sample of AIDS orphans in rural China. A total of 296 children who lost both parents to AIDS participated in the study, including 176 in orphanages, 90 in kinship care and 30 in community-based group homes. All participants completed a cross-sectional survey assessing their traumatic symptoms, physical health and schooling. Data reveal that the AIDS orphans in group homes reported the best outcomes in three domains of psychosocial well-being, followed by those in the orphanages and then the kinship care. The differences in psychosocial well-being among the three groups of children persist after controlling for key demographic characteristics. The findings sugges... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4488068 Wed, 16 Feb 2011 00:00:00 +0100 4488068 http://www.medworm.com/index.php?rid=4488067&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F2%2F105%3Frss%3D1 Thailand implemented a Universal Coverage Scheme (UCS) of national health insurance in April 2001 to finance equitable access to health care. This paper compares inequalities in health service use before and after the UCS, and analyses the trend and determinants of inequality. The national Health and Welfare Surveys of 2001 and 2005 are used for this study. The concentration index for use of ambulatory care among the population reporting a recent illness is used as a measure of health inequality, decomposed into contributing demographic, socio-economic, geographic and health insurance determinants. As a result of the UCS, the uninsured group fell from 24% in 2001 to 3% in 2005 and health service patterns changed. Use of public primary health care facilities such as health centres became ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4488067 Wed, 16 Feb 2011 00:00:00 +0100 4488067 http://www.medworm.com/index.php?rid=4488066&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F2%2F93%3Frss%3D1 Vulnerable groups are often not covered by health insurance schemes. Strategies to extend coverage in these groups will help to address inequity. We used the existing literature to summarize the options for expanding health insurance coverage, describe which countries have tried these strategies, and identify and describe evaluation studies. We included any report of a policy or strategy to expand health insurance coverage and any evaluation and economic modelling studies. Vulnerable populations were defined as children, the elderly, women, low-income individuals, rural population, racial or ethnic minorities, immigrants, and those with disability or chronic diseases. Forty-five databases were searched for relevant documents. The authors applied inclusion criteria, and extracted data using... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4488066 Wed, 16 Feb 2011 00:00:00 +0100 4488066 http://www.medworm.com/index.php?rid=4286904&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F1%2F83%3Frss%3D1 This article analyses the nature of power relationships between urban hospital practitioners and other groups of actors involved in the implementation of public health policies in India, and the effects of enacting different strategies to strengthen implementation, in the context of these balances of power. It is based on an empirical research study conducted over 18 months in five Indian cities involving 61 in-depth interviews with medical practitioners and policy actors, and an interpretivist analytical approach. An issue case study—of the implementation of national HIV testing guidelines—was used to focus the interviews on specific events and phenomena. Respondents’ accounts revealed that practitioners in both private and government hospitals tended to successfully res... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286904 Thu, 23 Dec 2010 00:00:00 +0100 4286904 http://www.medworm.com/index.php?rid=4286903&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F1%2F73%3Frss%3D1 The objective of this empirical study was to understand the perspectives and attitudes of policy-makers towards the use and impact of research in the health sector in low- and middle-income countries. The study used data from 83 semi-structured, in-depth interviews conducted with purposively selected policy-makers at the national level in Argentina, Egypt, Iran, Malawi, Oman and Singapore. The interviews were structured around an interview guide developed based on existing literature and in consultation with all six country investigators. Transcripts were processed using a thematic-analysis approach. Policy-makers interviewed for this study were unequivocal in their support for health research and the high value they attribute to it. However, they stated that there were structural and info... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286903 Thu, 23 Dec 2010 00:00:00 +0100 4286903 http://www.medworm.com/index.php?rid=4286902&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F1%2F63%3Frss%3D1 This paper explores the nature and type of policy transfer promoted by global health partnerships to facilitate access to medication in Cameroon and the associated implementation challenges. Using concepts from policy transfer, multi-level governance and the politics of scale, the paper conceptualizes the social spaces (global-national-local linkages) through which global health policies are negotiated as transcalar networks. The framework is used to analyse policy documents, technical and media reports and journal articles focusing on two global health partnerships (GHPs)—Roll Back Malaria and the Accelerating Access Initiative—in Cameroon. Both GHPs helped to create the national Malaria and HIV/AIDS programmes in Cameroon, respectively. Global policies are negotiated through ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286902 Thu, 23 Dec 2010 00:00:00 +0100 4286902 http://www.medworm.com/index.php?rid=4286901&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F1%2F53%3Frss%3D1 Volunteers are increasingly being relied upon to provide home-based care for people living with AIDS in South Africa and this presents several unique challenges specific to the HIV/AIDS context in Africa. Yet it is not clear what motivates people to volunteer as home-based caregivers. Drawing on the functional theory on volunteer motivations, this study uses data from qualitative interviews with 57 volunteer caregivers of people living with HIV/AIDS in six semi-rural South African communities to explore volunteer motivations. Findings revealed complex motivations underlying volunteering in AIDS care. Consistent with functional theorizing, most of the volunteers reported having more than one motive for enrolling as volunteers. Of the 11 categories of motivations identified, those relating t... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286901 Thu, 23 Dec 2010 00:00:00 +0100 4286901 http://www.medworm.com/index.php?rid=4286900&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F1%2F43%3Frss%3D1 Low-income volunteers constitute a major part of AIDS care workforces in sub-Saharan Africa, yet little research has been conducted to determine how poverty and insecurity among volunteers impact their wellbeing and the sustainability of the AIDS treatment programmes they support. This paper presents longitudinal ethnographic and epidemiological research documenting how the 2008 food crisis in Addis Ababa affected AIDS care volunteers’ care relationships and motivations. Ethnographic results highlight the distress and demotivation that rising food costs created for caregivers by contributing to their own and their care recipients’ experiences of food insecurity and HIV-related stigmatization. Epidemiological results underscore a high prevalence of food insecurity (approximately... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286900 Thu, 23 Dec 2010 00:00:00 +0100 4286900 http://www.medworm.com/index.php?rid=4286899&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F1%2F33%3Frss%3D1 Conclusions Several factors and groups influence resource allocation in KwaDukuza. Although formal economic and epidemiologic information is sometimes used, in most cases other factors are more important for resource allocation decision-making. These other factors should be considered in any attempts to improve the resource allocation processes. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286899 Thu, 23 Dec 2010 00:00:00 +0100 4286899 http://www.medworm.com/index.php?rid=4286898&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F1%2F25%3Frss%3D1 It is now more than 2 years since the Ministry of Health and Family Welfare of the Government of Bangladesh implemented the Maternal Health Voucher Scheme, a specialized form of demand-side financing programme. To analyse the early lessons from the scheme, information was obtained through semi-structured interviews with stakeholders at the sub-district level. The analysis identified a number of factors affecting the efficiency and performance of the scheme in the program area: delay in the release of voucher funds, selection criteria used for enrolling pregnant women in the programme, incentives created by the reimbursement system, etc. One of the objectives of the scheme was to encourage market competition among health care providers, but it failed to increase market competitiveness in th... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286898 Thu, 23 Dec 2010 00:00:00 +0100 4286898 http://www.medworm.com/index.php?rid=4286897&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F1%2F12%3Frss%3D1 In this paper we examine whether Brazil, Russia and India have similar financing patterns to those observed globally. We assess how national health allocations compare with epidemiological estimates for burden of disease. We identify the major causes of burden of disease in each country, as well as the contribution HIV/AIDS, tuberculosis and malaria make to the total burden of disease estimates. We then use budgetary allocation information to assess the alignment of funding with burden of disease data. We focus on central government allocations through the Ministry of Health or its equivalent. We found that of the three cases examined, Brazil and India showed the most bias when it came to financing HIV/AIDS over other diseases. And this occurred despite evidence indicating that HIV/AIDS (a... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286897 Thu, 23 Dec 2010 00:00:00 +0100 4286897 http://www.medworm.com/index.php?rid=4286896&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F26%2F1%2F1%3Frss%3D1 In Africa, user fees constitute a financial barrier to access to health services. Increasingly, international aid agencies are supporting countries that abolish such fees. However, African decision-makers want to know if eliminating payment for services is effective and how it can be implemented. For this reason, given the increase in experiences and the repeated requests from decision-makers for current knowledge on this subject, we surveyed the literature. Using the scoping study method, 20 studies were selected and analysed. This survey shows that abolition of user fees had generally positive effects on the utilization of services, but at the same time, it highlights the importance of implementation processes and our considerable lack of knowledge on the matter at this time. We draw les... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286896 Thu, 23 Dec 2010 00:00:00 +0100 4286896 http://www.medworm.com/index.php?rid=4286913&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2Fsuppl_1%2Fi58%3Frss%3D1 Nepal, with a concentrated HIV epidemic and high burden of tuberculosis (TB) and malaria, was perceived to have immensely benefited from grants by the Global Fund to Fight AIDS, Tuberculosis and Malaria in addressing the three diseases, amounting to total approved funding of US$80 million. This paper looks at the interaction and integration of Global Fund-supported programmes and national health systems. A mixed method ‘case study’ approach based on the Systemic Rapid Assessment Toolkit (SYSRA) was used to systematically analyse across the main health systems functional domains. The Country Coordinating Mechanism has been credited with providing the stewardship in attracting additional resources and providing oversight. The involvement of civil society for delivering key HIV an... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286913 Thu, 21 Oct 2010 00:00:00 +0100 4286913 http://www.medworm.com/index.php?rid=4286912&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2Fsuppl_1%2Fi53%3Frss%3D1 As part of a series of case studies on the interactions between programmes supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria and health systems, we assessed the extent of integration of national HIV, tuberculosis (TB) and malaria programmes with the general health system, the integration of the Global Fund-portfolios within the national disease programmes, and system-wide effects on the health system in Thailand. The study relied on a literature review and 34 interviews with key stakeholders using the Systemic Rapid Assessment Toolkit and thematic analysis. In Thailand, the HIV, TB and malaria programmes’ structures and functions are well established in the general health care system, with the Department for Disease Control and the Ministry of Public Health’s... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286912 Thu, 21 Oct 2010 00:00:00 +0100 4286912 http://www.medworm.com/index.php?rid=4286911&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2Fsuppl_1%2Fi48%3Frss%3D1 In Papua New Guinea, investment by the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) has played an important role in scaling up the response to HIV and tuberculosis (TB). As part of a series of case studies on how Global Fund-supported programmes interact with national health systems, we assessed the nature and extent of integration of the Global Fund portfolios within the national HIV and TB programmes, the integration of the HIV and TB programmes within the general health system, and system-wide effects of Global Fund support in Papua New Guinea. The study relied on a literature review and 30 interviews with key stakeholders using the Systemic Rapid Assessment Toolkit and thematic analysis. Global Fund-supported activities were found to be largely integrated, or a... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286911 Thu, 21 Oct 2010 00:00:00 +0100 4286911 http://www.medworm.com/index.php?rid=4286910&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2Fsuppl_1%2Fi43%3Frss%3D1 The Global Fund to Fight AIDS, Tuberculosis and Malaria has played an important role in financing the response to HIV/AIDS and tuberculosis (TB) in Indonesia. As part of a series of case studies, we assessed the nature and extent of integration of Global Fund portfolios into the national HIV and TB programmes, integration of the HIV and TB programmes within the general health system, and system-wide effects of Global Fund support on the health care system in Indonesia. The study relied on a literature review and interviews with 22 key informants using the Systemic Rapid Assessment Toolkit and thematic analysis. Global Fund programmes in Indonesia are highly vertical and centralized, in contrast with the decentralized nature of the Indonesian health system. Consequently, there is more integ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286910 Thu, 21 Oct 2010 00:00:00 +0100 4286910 http://www.medworm.com/index.php?rid=4286909&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2Fsuppl_1%2Fi37%3Frss%3D1 In Lao PDR, investment by the Global Fund to Fight AIDS, Tuberculosis and Malaria has played an important role in scaling up the response to HIV and tuberculosis (TB). As part of a series of case studies on how Global Fund-supported programmes interact with national health systems, we assessed the nature and extent of integration of the Global Fund portfolios within the national HIV and TB programmes, the integration of the HIV and TB programmes within the general health system, and system-wide effects of Global Fund support in Lao PDR. The study relied on a literature review and 35 interviews with key stakeholders using the Systemic Rapid Assessment Toolkit and thematic analysis. In Lao PDR, the HIV and TB programmes remain vertical and mostly weakly integrated with the general health sys... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286909 Thu, 21 Oct 2010 00:00:00 +0100 4286909 http://www.medworm.com/index.php?rid=4286908&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2Fsuppl_1%2Fi32%3Frss%3D1 This case study on Vietnam aims to generate empirical evidence on the relative merits of integration of two priority health interventions, HIV/AIDS and tuberculosis (TB), into six functions of the wider health system: stewardship and governance, service delivery, demand generation, monitoring and evaluation, planning, and financing. Selective documentary reviews and 25 qualitative, semi-structured interviews were conducted in early 2009 in Hanoi, Hai Duong province, Chih Linh district and Hoang Tien commune with informants from international, national and sub-national agencies steering or managing the HIV/AIDS and TB programmes and from health facilities providing HIV/AIDS and TB services. Data collected were collated and evaluated against 25 elements of integration. Each element of integr... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286908 Thu, 21 Oct 2010 00:00:00 +0100 4286908 http://www.medworm.com/index.php?rid=4286907&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2Fsuppl_1%2Fi21%3Frss%3D1 Attempts to comparatively analyse large-scale communicable disease control programmes have, for the most part, neglected the wider health system contexts within which the programmes lie. In addition, many evaluations of the integration of vertical disease control programmes into health systems have focused on single case studies or on a limited number of cases, or, when large numbers of cases were drawn upon, have been presented as a compendium of monographs rather than a systematic cross-national comparison. One reason for this may be that appropriate theories and tools for comparative health systems analysis are rare and difficult to formulate. In this paper we propose a conceptual framework and an analytical methodology which might be used to comparatively analyse a series of case studi... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286907 Thu, 21 Oct 2010 00:00:00 +0100 4286907 http://www.medworm.com/index.php?rid=4286906&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2Fsuppl_1%2Fi4%3Frss%3D1 The HIV/AIDS, tuberculosis and malaria pandemics pose substantial challenges globally and to health systems in the countries they affect. This demands an institutional approach that can integrate disease control programmes within health and social care systems. Whilst integration is intuitively appealing, evidence of its benefits remains uncertain and evaluation is beset by lack of a common understanding of what it involves. The aim of this paper is to better define integration in health systems relevant to communicable disease control. We conducted a critical review of published literature on concepts, definitions, and analytical and methodological approaches to integration as applied to health system responses to communicable disease. We found that integration is understood and pursued i... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286906 Thu, 21 Oct 2010 00:00:00 +0100 4286906 http://www.medworm.com/index.php?rid=4286905&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2Fsuppl_1%2Fi1%3Frss%3D1 (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4286905 Thu, 21 Oct 2010 00:00:00 +0100 4286905 http://www.medworm.com/index.php?rid=4084909&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F6%2F529%3Frss%3D1 Contrary to what many may expect, this article argues that Brazil did a better job than the USA when it came to responding to HIV/AIDS. Because of the Brazilian government’s concern about its international reputation and the partnerships it has forged with international donors and civil society, the government has been committed to strengthening decentralization processes by introducing both formal and informal re-centralization measures that strengthen health policy devolution, while effectively targeting the biggest at-risk groups. The US, in contrast, has not achieved these objectives, due to its lack of interest in increasing its international reputation and its focus on bi-lateral aid rather than investing in domestic policy. The paper closes by explaining the lessons that Brazi... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4084909 Tue, 19 Oct 2010 23:00:00 +0100 4084909 http://www.medworm.com/index.php?rid=4084908&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F6%2F523%3Frss%3D1 This paper provides an empirical evaluation of adult HIV prevalence rates, foreign aid for HIV/AIDS programmes, and the amount of government spending on health care. It finds that there exists a statistically significant relationship between adult HIV prevalence rates and the amount of foreign funding for HIV/AIDS programmes, suggesting that need does in fact play some role in the allocation of HIV aid. It suggests there may be an additive relationship between foreign and domestic health spending, where governments turn the funding of their AIDS programmes over to foreign donors and instead put their own monies toward other parts of the health care system. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4084908 Tue, 19 Oct 2010 23:00:00 +0100 4084908 http://www.medworm.com/index.php?rid=4084907&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F6%2F510%3Frss%3D1 Conclusions This regime analysis allows us to understand the evolution, etiology and eventualities of the global health security regime, which is essential for national and international health policymakers, practitioners and academics to know where and how to act effectively in preparation for tomorrow’s challenges. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4084907 Tue, 19 Oct 2010 23:00:00 +0100 4084907 http://www.medworm.com/index.php?rid=4084906&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F6%2F505%3Frss%3D1 The International Health Regulations (2005) [IHR(2005)] represent a potentially revolutionary change in global health governance. The use of the regulations by the World Health Organization (WHO) to respond to the outbreak of pandemic influenza A 2009-H1N1 highlights the importance of the regulations to protecting global health security. As the 2009-H1N1 pandemic illustrated, the IHR(2005) have provided a more robust framework for responding to public health emergencies of international concern (PHEICs), through requiring reporting of serious disease events, strengthening how countries and WHO communicate concerning health threats, empowering the WHO Director-General to declare the existence of PHEICs and to issue temporary recommendations for responding to them, and requiring countries no... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4084906 Tue, 19 Oct 2010 23:00:00 +0100 4084906 http://www.medworm.com/index.php?rid=4084905&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F6%2F495%3Frss%3D1 This article questions both of those assumptions. It argues that even within the Security Council, HIV/AIDS’ status as a bona fide threat to international peace and security is not entirely secure. Despite the fact that the Resolution was adopted unanimously, there is considerable doubt over the extent to which the Council members were persuaded that HIV/AIDS is genuinely a threat to international peace and security. Furthermore, the Council's subsequent actions suggest a retreat from the issue. The article moves on to examine statements made in and by some of the other key UN System bodies grappling with HIV/AIDS. Focusing in particular on the General Assembly, the Economic and Social Council and UNAIDS, it is argued that the international security framing of HIV/AIDS has not genera... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4084905 Tue, 19 Oct 2010 23:00:00 +0100 4084905 http://www.medworm.com/index.php?rid=4084904&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F6%2F486%3Frss%3D1 This article assesses the role and significance of the Biological Weapons Convention (BWC) with respect to infectious disease surveillance and response to outbreaks. Increasingly, the BWC is being used as a platform for addressing infectious disease threats arising naturally as well as traditional concerns about malicious dissemination of pathogenic microorganisms. The latter have long had a place on the security agenda, but natural disease outbreaks too are now being partially ‘securitized’ through the use of the BWC as a forum for exchanging information and ideas on disease surveillance and response. The article focuses on two prominent issues discussed at recent meetings of BWC member states: enhancing capacity for disease surveillance and response; and responding to allegat... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4084904 Tue, 19 Oct 2010 23:00:00 +0100 4084904 http://www.medworm.com/index.php?rid=4084903&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F6%2F476%3Frss%3D1 This article analyses how the ‘securitization’ of highly pathogenic avian influenza (H5N1) contributed to the rise of a protracted international virus-sharing dispute between developing and developed countries. As fear about the threat of a possible human H5N1 pandemic spread across the world, many governments scrambled to stockpile anti-viral medications and vaccines, albeit in a context where there was insufficient global supply to meet such a rapid surge in demand. Realizing that they were the likely ‘losers’ in this international race, some developing countries began to openly question the benefits of maintaining existing forms of international health cooperation, especially the common practice of sharing national virus samples with the rest of the international... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4084903 Tue, 19 Oct 2010 23:00:00 +0100 4084903 http://www.medworm.com/index.php?rid=4084902&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F6%2F467%3Frss%3D1 This article seeks to examine the Vietnamese government’s response to the epidemics of avian influenza and Human immunodeficiency virus. Both diseases have been recognized at different times as threats to international security and both are serious infectious disease problems in Vietnam. Yet, the character of the central government’s response to these two epidemics has been starkly different. How and why this disparity in policy approaches occurs depends largely on the epidemiological, economic and political context in which they occur. Although epidemiological factors are frequently explored when discussing disease as a security issue, seldom are the political, social and economic characteristics of the state invoked. These dimensions, and their interaction with the epidemiol... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4084902 Tue, 19 Oct 2010 23:00:00 +0100 4084902 http://www.medworm.com/index.php?rid=4084901&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F6%2F454%3Frss%3D1 In conclusion, the article argues that alternatives to securitization, such as viewing health as a global public good, would require a prior commitment to risk management within affected states. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4084901 Tue, 19 Oct 2010 23:00:00 +0100 4084901 http://www.medworm.com/index.php?rid=4084900&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F6%2F447%3Frss%3D1 In the closing decade of the 20th century the myriad challenges posed by infectious disease in a globalized environment began to be re-conceptualized as threats to national and human security. The most widely applied model for identifying and responding to such threats is securitization theory, as proposed by the Copenhagen School. Although its analytical framework is generally accepted, its utility remains contested; especially in non-European and non-state settings. The papers in this special edition have several aims: (1) to analyse ways by which Asian states and international organizations have identified health challenges as security threats, (2) to draw upon the securitization model as a way of understanding the full extent to which these states and international organizations have r... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=4084900 Tue, 19 Oct 2010 23:00:00 +0100 4084900 http://www.medworm.com/index.php?rid=3906354&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F5%2F437%3Frss%3D1 Conclusion Improvements in the purchasing power of the population, and the strategy of private hospitals in this highly competitive market to generate revenue from the poorer quintiles by offering different pricing options, have reduced the observed rich–poor divide in the consumption of inpatient treatment from this sector. However, while this gap in utilization has closed, the burden of out-of-pocket expenditure is higher among the poor. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3906354 Thu, 26 Aug 2010 09:13:45 +0100 3906354 http://www.medworm.com/index.php?rid=3906353&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F5%2F427%3Frss%3D1 This article investigates trends in out-of-pocket payments for health care using the results of a series of nationally representative household surveys conducted over the period 2001–2007, when the reforms were being rolled out. The analysis shows that there has been a significant improvement in financial access to health care amongst the population. The proportion paying state providers for consultations fell between 2004 and 2007. As a result of the introduction of co-payments for hospital care, fewer inpatients report making payments to medical personnel, but when they are made, payments are high, especially to surgeons and anaesthetists. However, although financial access for outpatient care has improved, the burden of health care payments amongst the poor remains significant. (S... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3906353 Thu, 26 Aug 2010 09:13:45 +0100 3906353 http://www.medworm.com/index.php?rid=3906352&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F5%2F419%3Frss%3D1 Conclusion Out-of-pocket health payments remain a severe burden for rural households. Financial protection from the NCMS was limited. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3906352 Thu, 26 Aug 2010 09:13:45 +0100 3906352 http://www.medworm.com/index.php?rid=3906351&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F5%2F406%3Frss%3D1 There is increasing pressure for reduction of user fees, but this can have adverse effects by decreasing facility-level funds. To address this, direct facility funding (DFF) was piloted in Coast Province, Kenya, with health facility committees (HFCs) responsible for managing the funds. We evaluated the implementation and perceived impact 2.5 years after DFF introduction. Quantitative data collection at 30 public health centres and dispensaries included a structured interview with the in-charge, record reviews and exit interviews. In addition, in-depth interviews were conducted with the in-charge and HFC members at 12 facilities, and with district staff and other stakeholders. DFF procedures were well established: HFCs met regularly and accounting procedures were broadly followed. DFF made ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3906351 Thu, 26 Aug 2010 09:13:45 +0100 3906351 http://www.medworm.com/index.php?rid=3906350&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F5%2F393%3Frss%3D1 Conclusions Variability in immunization coverage across districts highlights the limitations of using nationally aggregated indicators. If district data are to be used in monitoring and planning immunization programmes as intended by decentralization, heterogeneity in their validity must be reduced. The authors recommend: (1) strengthening administrative data systems; (2) implementing indicators that are insensitive to population mobility; (3) integrating surveys into monitoring processes at the subnational level; (4) actively promoting the use of coverage information by local personnel and district-level staff. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3906350 Thu, 26 Aug 2010 09:13:45 +0100 3906350 http://www.medworm.com/index.php?rid=3906349&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F5%2F384%3Frss%3D1 This article presents the results of an evaluation of the free delivery and caesarean policy (FDCP) in Senegal. The policy was introduced into five poor regions in 2005 and in 2006 was extended at regional hospital level to all regions apart from the capital (Dakar). The evaluation was carried out in 2006–7. There were four research components, all focused on selected facilities and districts within the five FDCP regions: a financial analysis of expenditure on the policy and wider health financing in the five regions and nationally; 54 key informant interviews from national down to facility level; 10 focus group discussions and 8 in-depth interviews; and analysis based on clinical record extraction of 761 major obstetric interventions. The evaluation found significant implementation ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3906349 Thu, 26 Aug 2010 09:13:45 +0100 3906349 http://www.medworm.com/index.php?rid=3906348&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F5%2F372%3Frss%3D1 Conclusions Both IRS and ITNs have a place in integrated malaria vector management, but pro-IRS interests and ideas slowed or prevented the uptake of ITNs. Policy makers needed more than evidence from trials to change from the time-honoured IRS strategy that they perceived was working. Those intending to promote new policies such as ITNs should examine the interests and ideas motivating key stakeholders and their own institutions, and identify where shifts in thinking or coalitions among the like-minded may be possible. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3906348 Thu, 26 Aug 2010 09:13:45 +0100 3906348 http://www.medworm.com/index.php?rid=3906347&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F5%2F363%3Frss%3D1 Over the last decade development assistance for health has more than doubled. This increase provides an unprecedented opportunity to scale up health services, and in doing so, achieve the health Millennium Development Goals. However, sustaining scaling up will in turn require sustainable donor support until domestic health financing can substitute for it. The provision of long-term predictable finance is of particular concern in health because the bulk of costs are recurrent and many interventions require sustained, multi-year support to be successful. This is also true for health systems strengthening efforts. As the bulk of new aid resources flow through Global Health Partnerships (GHPs), their ability to make long-term commitments is critical to health systems development. In order to ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3906347 Thu, 26 Aug 2010 09:13:45 +0100 3906347 http://www.medworm.com/index.php?rid=3906346&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F5%2F352%3Frss%3D1 Home-based care (HBC) programmes in low- and middle-income countries have evolved over the course of the past two decades in response to the HIV epidemic and wider availability of antiretroviral therapy (ART). Evidence is emerging from small-scale and well-resourced studies that ART delivery can be effectively incorporated within HBC programmes. However, before this approach can be expanded, it is necessary to consider the lessons learned from implementing routine HBC programmes and to assess what conditions are required for their roll-out in the context of ART provision. In this paper, we review the literature on existing HBC programmes and consider the arguments for their expansion in the context of scaling up ART delivery. We develop a framework that draws on the underlying rationale fo... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3906346 Thu, 26 Aug 2010 09:13:45 +0100 3906346 http://www.medworm.com/index.php?rid=3906345&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F5%2F349%3Frss%3D1 (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3906345 Thu, 26 Aug 2010 09:13:45 +0100 3906345 http://www.medworm.com/index.php?rid=3906344&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F5%2F346%3Frss%3D1 (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3906344 Thu, 26 Aug 2010 09:13:45 +0100 3906344 http://www.medworm.com/index.php?rid=3906343&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F5%2F343%3Frss%3D1 (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3906343 Thu, 26 Aug 2010 09:13:45 +0100 3906343 http://www.medworm.com/index.php?rid=3682805&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F4%2F334%3Frss%3D1 Conclusions This study found that both the cure rate and average length of treatment for cured cases improved significantly after the implementation of the P4P on TB programme in Taiwan. Compared with non-P4P hospitals, P4P hospitals had significantly better treatment outcomes. Patients’ age, income level, the physician density of a patient’s place of residence, and whether the hospital has joined the P4P on TB programme are factors affecting the treatment outcomes of TB patients in Taiwan. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3682805 Tue, 22 Jun 2010 05:12:42 +0100 3682805 http://www.medworm.com/index.php?rid=3682804&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F4%2F328%3Frss%3D1 Conclusion Out-of-pocket expenditure on child hospitalization places a considerable burden on poor families. Our findings justify a closer scrutiny of how this expenditure could be reduced, particularly through the provision of adequate food for both children and caretakers and through reducing stock-outs of essential medicines. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3682804 Tue, 22 Jun 2010 05:12:42 +0100 3682804 http://www.medworm.com/index.php?rid=3682803&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F4%2F319%3Frss%3D1 This study examined these components of referral of injured patients in a representative sample of health centres (HCs) and referral hospitals (RHs) in Cambodia. We analysed data from a survey carried out in 80 HCs and 17 RHs by interview or mailed questionnaire from December 2006 to April 2007. Collected information on referral included the presence of referral guidelines for injured patients, distance of referral, commonly used transportation and its cost, communication with receiving facilities, and fast-tracking at receiving facilities. Formal referral systems were not functioning well in some areas (insufficient communication and underutilization of ambulances), and informal systems were frequently involved (patient transfer by taxi or referral by community volunteers, and treatment b... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3682803 Tue, 22 Jun 2010 05:12:41 +0100 3682803 http://www.medworm.com/index.php?rid=3682802&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F4%2F311%3Frss%3D1 We present a simple descriptive study of maternal health care utilization among ethnic minority women in a remote region of China. Factors that affect women obtaining care and their decision-making are explored. Results show that utilization of maternal health care services is associated with a range of social, economic, cultural and geographic factors as well as the policies of the state and the delivery of services. Utilization is not necessarily increased through easy access to a health facility. We identify potential for improving utilization through developing the role of village-based health care workers, expanding mobile antenatal care clinics and changing the way township hospital services are provided and funded. This would include modifications to rural health insurance schemes. ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3682802 Tue, 22 Jun 2010 05:12:41 +0100 3682802 http://www.medworm.com/index.php?rid=3682801&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F4%2F300%3Frss%3D1 Background Despite the realized importance of unsafe abortion as a global health problem, reliable data are difficult to obtain, especially in countries where abortion is illegal. Estimates for most developing countries are based on limited and incomplete sources of data. In Mexico, studies have been undertaken to improve estimates of induced abortion but the determinants of unsafe abortion have not been explored. Methods We analysed data from the 2006 Mexican National Demographic Survey. The sample comprises 14 859 reported pregnancies in women between 15 and 55 years old, of which 966 report having had an abortion in the 5 years preceding the survey. We use logistic regression to explore the relationship between unsafe abortion and various socio-economic and demographic characteristics. ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3682801 Tue, 22 Jun 2010 05:12:41 +0100 3682801 http://www.medworm.com/index.php?rid=3682800&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F4%2F292%3Frss%3D1 This article presents an analysis of the first four rounds of countries’ funding applications. These requested funding for a variety of health system initiatives that reflected country-specific requirements, and were not limited to improving immunization coverage. Analyses identified a dominance of operational-level health service provision activities, and an absence of interventions related to demand and financing. While the proposed activities are only now being implemented, the results of this study provide evidence that the open application process employed by the HSS window has led to a shift in analysis and planning—from the programmatic to the systemic—in the countries whose applications have been approved. However, the proposed responses to identified constraints ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3682800 Tue, 22 Jun 2010 05:12:41 +0100 3682800 http://www.medworm.com/index.php?rid=3682799&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F4%2F283%3Frss%3D1 This article examines the relationships between health system characteristics and the HIV response in Russia, the country which towards the end of the Soviet period had the world’s highest ratios of doctors and hospital beds to population and yet struggled to address the growing threat of HIV/AIDS. Methods The study is based on semi-structured qualitative interviews with policy-makers and senior health care managers in two Russian regions, and a review of published and unpublished sources on health systems and HIV in Russia. Findings We identified a number of factors associated with the system’s failure to address the epidemic. We argue that these factors are not unique to HIV/AIDS. The features of the wider health system within which the HIV response was set up influenced the ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3682799 Tue, 22 Jun 2010 05:12:41 +0100 3682799 http://www.medworm.com/index.php?rid=3682798&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F4%2F272%3Frss%3D1 This paper assesses the extent of the financial burden due to out-of-pocket payments for health care incurred by people living with HIV (PLHIV) and the effect of this burden on their financial capacity. Data were collected in a cross-sectional survey of 353 PLHIV from three cities in Indonesia (Jakarta, Jogjakarta and Merauke). Respondents in Jakarta were sampled from one hospital and one non-governmental organization working with PLHIV. In Jogjakarta and Merauke, all HIV patients on antiretroviral therapy (ART) who came to selected hospitals during the interview period were asked to participate in the survey. The survey collected data on the frequency and extent of payments for HIV-related care, with answers cross-checked against medical records. Results show that PLHIV had different burd... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3682798 Tue, 22 Jun 2010 05:12:41 +0100 3682798 http://www.medworm.com/index.php?rid=3682797&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F4%2F262%3Frss%3D1 Although universal access to quality health services is a primary policy goal of the Government of Vietnam (GOVN), economic restructuring and privatization of health services have been associated with emerging inequities in access to care. A GOVN programme for socio-economic development known as Program 135 (P135) designates communes known to be relatively poor as priority localities for development resources. Under this programme, basic curative and preventive health services, including some prescription drugs, are provided free of charge at commune health centres (CHCs). In an effort to improve the quality of care provided at CHCs, the national Ministry of Health (MOH) has implemented a set of national benchmarks for commune health care, which defines a minimum configuration of equipment... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3682797 Tue, 22 Jun 2010 05:12:41 +0100 3682797 http://www.medworm.com/index.php?rid=3682796&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F4%2F253%3Frss%3D1 Conclusions Special efforts must be made to improve quality of care in the public sector. Poor and black women should be actively encouraged to start antenatal care early in pregnancy so that they can fully benefit from it. There is a need for regular monitoring of antenatal attendances and quality of care with an equity lens, in order to assess how different social groups are benefiting from progress in health care. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3682796 Tue, 22 Jun 2010 05:12:41 +0100 3682796 http://www.medworm.com/index.php?rid=3479024&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F3%2F248%3Frss%3D1 (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3479024 Sat, 17 Apr 2010 05:16:37 +0100 3479024 http://www.medworm.com/index.php?rid=3479023&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F3%2F237%3Frss%3D1 Conclusion Insurance for the poor appeared to be relatively effective in protecting households from catastrophic payments. However, it is not sufficient only to cover the very poor; the non-poor can also suffer catastrophic payments and they are only protected because hospital rules over who qualifies have been relaxed. Although the association between insurance and expenditure for obstetric care was important, it was not clear that this represents over-provision of services but rather that it reflected previously inadequate treatment given to those unable to pay. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3479023 Sat, 17 Apr 2010 05:16:37 +0100 3479023 http://www.medworm.com/index.php?rid=3479022&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F3%2F230%3Frss%3D1 Conclusion The expressed WTP results indicate a high demand for zinc in childhood diarrhoea management in this rural community of Bangladesh. Safety net measures and targeted communication activities specifically aimed at the poor and less educated population could be beneficial to achieve more equitable use of zinc as part of the standard treatment with oral rehydration solution in childhood diarrhoea management. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3479022 Sat, 17 Apr 2010 05:16:37 +0100 3479022 http://www.medworm.com/index.php?rid=3479021&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F3%2F219%3Frss%3D1 Conclusions The survey revealed low procurement prices but poor availability in the public sector. Various policy adjustments could increase the availability of essential medicines and reduce their prices for the low income population. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3479021 Sat, 17 Apr 2010 05:16:37 +0100 3479021 http://www.medworm.com/index.php?rid=3479020&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F3%2F209%3Frss%3D1 This article examines socio-economic determinants and inequality of health care utilization in Ecuador. Despite health reform efforts in Latin America, drastic socio-economic inequalities persist across the region, including Ecuador. Almost a third of Ecuador's population lack regular access to health services, while more than two-thirds have no health insurance and insufficient resources to pay for health care services. Using Andersen's model of health care utilization behaviour, relevant variables were selected from the 2004 National Demographic and Maternal & Child Health Survey (ENDEMAIN) household survey. Four outcomes were assessed: use of preventive services, number of curative visits, hospitalization, and use of antiparasitic medicines. Adjusting for various predisposing, enabl... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3479020 Sat, 17 Apr 2010 05:16:37 +0100 3479020 http://www.medworm.com/index.php?rid=3479019&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F3%2F197%3Frss%3D1 Contracting non-governmental organizations (NGOs) has been shown to increase health service delivery output considerably over relatively short time frames in low-income countries, especially when applying performance-related pay as a stimulus. A key concern is how to manage the transition back to government-operated systems while maintaining health service delivery output levels. In this paper we describe and analyse the transition from NGO-managed to government-managed health services over a 3-year period in a health district in Cambodia with a focus on the level of health service delivery. Data are derived from four sources, including cross-sectional surveys and health management and financial information systems. The transition was achieved by focusing on all the building blocks of the ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3479019 Sat, 17 Apr 2010 05:16:37 +0100 3479019 http://www.medworm.com/index.php?rid=3479018&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F3%2F186%3Frss%3D1 Conclusions There are high levels of institutional and contextual complexity at country level that require a more focused global response by GAVI to the governance challenges of institutions and partners implementing GHIs at the country level. ICCs should be maintained and strengthened in the more pluralistic context of an ‘immunization coordination system’ that is represented by the wider health sector, regulatory authorities, and civil society and private sector interests. Managing through systems, rather than being over-reliant on committees, will broaden participation in implementation and, in doing so, expand the reach of immunization and maternal and child health care services in developing countries. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3479018 Sat, 17 Apr 2010 05:16:37 +0100 3479018 http://www.medworm.com/index.php?rid=3479017&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F3%2F171%3Frss%3D1 Hitherto, the story of HIV/AIDS in South Africa is, to a large extent, one of lost opportunities. Whereas the country has one of the worst epidemics in the world, consecutive national AIDS strategies have been repeatedly marked by failure over almost three decades. Understandably, South Africa’s most recent HIV/AIDS policy, the HIV & AIDS and STI Strategic Plan for South Africa, 2007–2011 (NSP), has been greeted with general acclaim. However, what are its real prospects of success against the backdrop of the repeated failures of the past? The first objective of this review is to systematically identify the core reasons for past policy failures. Using a comprehensive analytical framework, this article presents a systematic review of the literature on postapartheid AIDS polic... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3479017 Sat, 17 Apr 2010 05:16:37 +0100 3479017 http://www.medworm.com/index.php?rid=3272315&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F2%2F162%3Frss%3D1 Conclusions The Long-Term Therapeutic Groups Index was successfully developed. Variability in number of primary care visits can be predicted by LTTGI-based models. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3272315 Mon, 15 Feb 2010 13:23:08 +0100 3272315 http://www.medworm.com/index.php?rid=3272314&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F2%2F155%3Frss%3D1 Conclusion Economic status and place of residence amongst other factors matter in peoples’ WTP for CBHI membership. Consumer awareness has to be created about the benefits of CBHI, especially in rural areas, and the amount to be paid has to be augmented with other means of financing (e.g. government and/or donor subsidies) to ensure success and sustainability of CBHI schemes. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3272314 Mon, 15 Feb 2010 13:23:08 +0100 3272314 http://www.medworm.com/index.php?rid=3272313&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F2%2F145%3Frss%3D1 Conclusions A well-designed CHI scheme has the potential to improve access to hospital care, even for vulnerable sections of the community—the poorest, individuals with pre-existing conditions like diabetes and hypertension, and pregnant women. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3272313 Mon, 15 Feb 2010 13:23:08 +0100 3272313 http://www.medworm.com/index.php?rid=3272312&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F2%2F135%3Frss%3D1 This study compares changes in the utilization of outpatient curative services from 2004 to 2005 between the different approaches for contracting-out services to non-governmental service providers, contracting-in technical assistance at public sector facilities, and public sector facilities that did not use contracting. We find that both contracting-in and contracting-out approaches are associated with substantial double difference increases in service use from 2004 to 2005 compared with non-contracted facilities. The double difference increase in contracting-out facilities for outpatient visits is 29% (P < 0.01), while outpatient visits from female patients increased 41% (P < 0.01), use by the poorest quintile increased 68% (P < 0.01) and use by children aged under 5 years incre... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3272312 Mon, 15 Feb 2010 13:23:08 +0100 3272312 http://www.medworm.com/index.php?rid=3272311&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F2%2F125%3Frss%3D1 Conclusions Managers should monitor supervision, understand the evolving influences on supervision, and use their resources and authority to both promote supervision and remove impediments to supervision. Support from leaders can be crucial, thus donors and politicians should help make supervision a true priority. As with front-line clinicians, supervisors are health workers who need support. We emphasize the importance of research to identify effective and affordable strategies for improving supervision frequency and quality. (ClinicalTrials.gov number NCT00510679.) (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3272311 Mon, 15 Feb 2010 13:23:08 +0100 3272311 http://www.medworm.com/index.php?rid=3272310&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F2%2F112%3Frss%3D1 Conclusions Despite rigorous programmatic effort, reaching neonates within the first 2 days after birth remained a challenge, and parental compliance with referral recommendation was limited, particularly among young neonates. To optimize potential impact, community postnatal surveillance must be coupled with skilled attendance at delivery, and/or a worker skilled in recognition of neonatal illness must be placed in close proximity to the community to allow for rapid case management to avert early deaths. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3272310 Mon, 15 Feb 2010 13:23:08 +0100 3272310 http://www.medworm.com/index.php?rid=3272309&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F2%2F104%3Frss%3D1 We present an analytical framework which enables deconstruction of the term integration into multiple facets, each corresponding to a critical health system function. Our conceptual framework builds on theoretical propositions and empirical research in innovation studies, and in particular adoption and diffusion of innovations within health systems, and builds on our own earlier empirical research. It brings together the critical elements that affect adoption, diffusion and assimilation of a health intervention, and in doing so enables systematic and holistic exploration of the extent to which different interventions are integrated in varied settings and the reasons for the variation. The conceptual framework and the analytical approach we propose are intended to facilitate analysis in eva... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3272309 Mon, 15 Feb 2010 13:23:08 +0100 3272309 http://www.medworm.com/index.php?rid=3272308&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F2%2F101%3Frss%3D1 (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3272308 Mon, 15 Feb 2010 13:23:08 +0100 3272308 http://www.medworm.com/index.php?rid=3272307&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F2%2F99%3Frss%3D1 (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3272307 Mon, 15 Feb 2010 13:23:08 +0100 3272307 http://www.medworm.com/index.php?rid=3272306&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F2%2F97%3Frss%3D1 (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3272306 Mon, 15 Feb 2010 13:23:08 +0100 3272306 http://www.medworm.com/index.php?rid=3272305&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F2%2F85%3Frss%3D1 The term ‘scaling up’ is now widely used in the international health literature, though it lacks an agreed definition. We review what is meant by scaling up in the context of changes in international health and development over the last decade. We argue that the notion of scaling up is primarily used to describe the ambition or process of expanding the coverage of health interventions, though the term has also referred to increasing the financial, human and capital resources required to expand coverage. We discuss four pertinent issues in scaling up the coverage of health interventions: the costs of scaling up coverage; constraints to scaling up; equity and quality concerns; and key service delivery issues when scaling up. We then review recent progress in scaling up the covera... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3272305 Mon, 15 Feb 2010 13:23:08 +0100 3272305 http://www.medworm.com/index.php?rid=3118026&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F1%2F70%3Frss%3D1 It has been suggested that medicines are unaffordable in low-income countries and that world manufacturing and trade policies are responsible for high prices. This research investigates medicine prices in urban Mozambique with the objective of understanding how prices are formed and with what public health implications. The study adopts an economic framework and uses a combination of quantitative and qualitative methods to analyse local pharmaceutical prices and markets. The research findings suggest that: (a) local mark-ups are responsible for up to two-thirds of drugs’ final prices in private pharmacies; (b) statutory profit and cost ceilings are applied unevenly, due to lack of government control and collusion among suppliers; and (c) the local market appears to respond effectivel... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3118026 Thu, 24 Dec 2009 13:10:55 +0100 3118026 http://www.medworm.com/index.php?rid=3118025&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F1%2F61%3Frss%3D1 Conclusions Our findings emphasize the importance of meaningful consumer involvement in the development of national medicines policies, and strategic campaigns targeting consumers and prescribers regarding the quality of generic and essential medicines. Where consumers perceive free or generic medicines as inferior, this could significantly undermine attempts to implement national medicines policies aimed to improve access to medicines. (Source: Health Policy and Planning) Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3118025 Thu, 24 Dec 2009 13:10:54 +0100 3118025 http://www.medworm.com/index.php?rid=3118024&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F1%2F50%3Frss%3D1 The study assessed the impact of an EPI (Expanded Programme on Immunization) intervention package, implemented within the existing service-delivery system, to improve the child immunization coverage in urban slums of Dhaka, Bangladesh. This intervention trial used a pre- and post-test design. An intervention package was tested from September 2006 to August 2007 in two urban slums. The intervention package included: (a) an extended EPI service schedule; (b) training for service providers on valid doses and management of side-effects; (c) a screening tool to identify immunization needs among clinic attendants; and (d) an EPI support group for social mobilization. Data were obtained from random sample surveys, service statistics and qualitative interviews. Analysis of quantitative data was ba... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3118024 Thu, 24 Dec 2009 13:10:54 +0100 3118024 http://www.medworm.com/index.php?rid=3118023&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F1%2F39%3Frss%3D1 This study investigates barriers and opportunities that exist for TFA policy development in low- and middle-income countries, through a literature review of international TFA policy and stakeholder analysis. Previous national policy responses have mostly been in developed countries. Voluntary reduction of TFA by the food industry, following food labelling and/or consumer lobbying, has been the approach in several countries but with varying levels of success, and resulting in major differences in formulation of products between countries. Canada and New York have now moved from voluntary to mandatory approaches. Only three countries have regulated the TFA content of food. Common factors for successful TFA reduction include increased consumer and political awareness of the health impacts of ... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3118023 Thu, 24 Dec 2009 13:10:54 +0100 3118023 http://www.medworm.com/index.php?rid=3118022&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F1%2F28%3Frss%3D1 Insecticide-treated nets (ITNs) are effective in substantially reducing malaria transmission. Still, ITN coverage in sub-Saharan Africa (SSA) remains extremely low. Policy makers are concerned with identifying the most suitable delivery mechanism to achieve rapid yet sustainable increases in ITN coverage. Little is known, however, on the comparative costs of alternative ITN distribution strategies. This paper aimed to fill this gap in knowledge by developing such a comparative cost analysis, looking at the cost per ITN distributed for two alternative interventions: subsidized sales supported by social marketing and free distribution to pregnant women through antenatal care (ANC). The study was conducted in rural Burkina Faso, where the two interventions were carried out alongside one anoth... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3118022 Thu, 24 Dec 2009 13:10:54 +0100 3118022 http://www.medworm.com/index.php?rid=3118021&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F1%2F15%3Frss%3D1 Evidence-informed decisions can strengthen health systems. Literature suggests that engaging policymakers and other stakeholders in research priority-setting exercises increases the likelihood of the utilization of research evidence by policymakers. To our knowledge, there has been no previous priority-setting exercise in health policy and systems research in countries of the Middle East and North Africa (MENA) region. This paper presents the results of a recent research priority-setting exercise that identified regional policy concerns and research priorities related to health financing, human resources and the non-state sector, based on stakeholders in nine low and middle income countries (LMICs) of the MENA region. The countries included in this study were Algeria, Egypt, Jordan, Lebano... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3118021 Thu, 24 Dec 2009 13:10:54 +0100 3118021 http://www.medworm.com/index.php?rid=3118020&cid=s_31276_51_f&fid=31276&url=http%3A%2F%2Fheapol.oxfordjournals.org%2Fcgi%2Fcontent%2Fshort%2F25%2F1%2F1%3Frss%3D1 A longstanding debate on health systems organization relates to benefits of integrating health programmes that emphasize specific interventions into mainstream health systems to increase access and improve health outcomes. This debate has long been characterized by polarization of views and ideologies, with protagonists for and against integration arguing the relative merits of each approach. However, all too frequently these arguments have not been based on hard evidence. The presence of both integrated and non-integrated programmes in many countries suggests there may be benefits to either approach, but the relative merits of integration in various contexts and for different interventions have not been systematically analysed and documented. In this paper we present findings of a system... Health Policy and Planning journals http://www.medworm.com/rss/comments.php?id=3118020 Thu, 24 Dec 2009 13:10:54 +0100 3118020