Showing papers on "International health published in 1995"

The Imperative of Health: Public Health and the Regulated Body

Abstract: Governing the Masses The Emergence of the Public Health Movement Technologies of Health Contemporary Health Promotion and Public Health Taming Uncertainty Risk Discourse and Diagnostic Testing Communicating Health The Mass Media and Advertising in Health Promotion Bodies, Pleasures and the Practices of the Self

Community health workers: integral members of the health care work force.

Abstract: As the US health care system strives to function efficiently, encourage preventive and primary care, improve quality, and overcome nonfinancial barriers to care, the potential exists for community health workers to further these goals. Community health workers can increase access to care and facilitate appropriate use of health resources by providing outreach and cultural linkages between communities and delivery systems; reduce costs by providing health education, screening, detection, and basic emergency care; and improve quality by contributing to patient-provider communication, continuity of care, and consumer protection. Information sharing, program support, program evaluation, and continuing education are needed to expand the use of community health workers and better integrate them into the health care delivery system.

What Makes Women Sick - Gender and the Political Economy of Health

Abstract: In Sickness and in Health - Safe Sex? - Regulating Reproduction - A Labour of Love - Hazards of Hearth and Home - Waged Work and Well-Being - Abusing Women - Women's Movements for Health - The Global Politics of Women's Health

Society and health

Abstract: 1. Introduction 2. Family Pathways to Child Health 3. Community and Health 4. Race and Health: A Multidimensional Approach to Afrrican American Health 6. Explanations for Social Inequities in Health 7. Political Economy and Health 9. The Cultural Frame: Context and Meaning in the Construction of Health 10. The Role of Medical Care in Determining Health: Creating an Inventory of Benefits 11. Thinking Strategically about Society and Health

Choice matters: enrollees' views of their health plans

Abstract: Prologue: Despite the failure of government to act on comprehensive health system reform, the US, health care system is undergoing rapid and profound changes. Managed care plans continue to gain a foothold throughout the country. The security of many Americans' health care rises and falls with the fortunes of the U.S. economy, both here and abroad, because health care coverage is inextricably linked to employment status. Public programs such as Medicare and Medicaid are under unprecedented scrutiny by lawmakers intent on balancing the federal budget by sharply reducing their growth rates. Amid these changes, it is critical for health policymakers to know how Americans perceive their health care system and their coverage. The survey reported in this paper is an attempt to fill the information gap. Conducted by The Commonwealth Fund in 1994, the managed care survey examines the experiences with managed care by families who have employer health coverage in Boston, Los Angeles, and Miami. Karen Davis is presi...

The Health of Adults in the Developing World: A Summary

Abstract: This booklet summarizes the main points of the full length publication of the same name. It provides the salient points discussed concerning health sector resources in developing countries. The concept of adult health, as discussed, includes all major health conditions, communicable, noncommunicable, or injuries. It includes the poor, wealthy, urban, rural, employed, unemployed, men and women. The booklet defines adults as those aged between fifteen through fifty-nine years. The booklet summarizes the key findings based on already available data and identifies areas for further research and makes recommendations for action. The recommendations are that governments reduce expenditures on inefficient and inequitable adult health care and free resources for the implementation of cost effective interventions, many of which are preventive.

The Sociology of Health, Illness, and Health Care: A Critical Approach

Abstract: Extremely student friendly and completely up to date, THE SOCIOLOGY OF HEALTH, ILLNESS, AND HEALTH CARE: A CRITICAL APPROACH, 6e delivers a comprehensive, cutting-edge overview that exposes the ethical dilemmas of modern health care and challenges readers to think analytically. Offering a sociological perspective on current topics, its unique critical perspective enables you to question your previously held beliefs about health and illness. Dr. Weitz's thorough discussions of health and medicine emphasize the effects of power and how social forces create illness, affect our ideas about the meaning of illness and disability, structure health care institutions, and impact the work and social position of health care workers. While the text focuses on health within the United States, it also examines global health care issues.

The World Health Report 1995: bridging the gaps.

Abstract: Overall the global health status has improved. Life expectancy at birth has increased to 65 years. Infant mortality has decreased to 62/1000 live births. Population growth has been projected to fall rapidly (1.7% in 1990-1995 to 1% in 2020-2025). By the year 2000 poliomyelitis will likely be eradicated and leprosy neonatal tetanus and measles will likely be eliminated. Nevertheless great disparities in health status between countries and among population groups within countries remain. During the last decade gaps between the developing and least developed countries in life expectancy at birth and infant mortality have widened. Situations exacerbating these gaps and making it more difficult to manage health and welfare services are rapid urbanization and an increase in international refugees and internally displaced persons. Immunization coverage is falling in some countries. Chronic diseases common to the aged are on the rise. World Health Organization (WHO) governing bodies called on WHO to conduct annual assessments of the world health status and of needs and to publish WHOs priorities for international action to improve global health status and to secure essential quality health services. The priorities for international action include: allocating resources to countries and population groups who have not yet achieved the global targets for Health for All by the Year 2000 improving labor productivity by improving the health of the workforce and of school children and by ensuring that the poor have access to primary health care improving equity of access to health itself and not only to health care and strengthening the capabilities of WHO member nations in epidemiological surveillance and emergency management in the context of sustainable development. The sections of the Report include status of world health WHOs contribution to world health and charting the future.

Risk contracts in managed mental health care

Abstract: Prologue: The term risk contracting has become a familiar part of the vocabulary and the landscape of managed care. Risk contracting refers to an arrangement whereby the cost or claims risk for an ...

Health policy in less developed countries: past trends and future directions.

Abstract: Health policies worldwide have changed dramatically in the last few decades. We reflect upon these changes, highlight current trends and identity key issues and challenges as the year 2000 approaches. The article comprises five sections: (i) comments on concepts of health and of policy; (ii) historical developments which have influenced policy; (iii) discussion of the context within which health policies in low income countries are formulated and implemented, including macropolitical and macroeconomic developments, health needs and determinants, financing, approaches to health planning and priority setting, and the key international health policy actors; (iv) an overview of the content of current health policy proposals in less developed countries which considers the financing, organization and management of health systems and (v) a concluding section which identifies key issues for the coming years. The recent World Bank Development Report, Investing in Health (1993) and other health sector reform efforts, form the backdrop for this discussion.

The effects of access to health care on infant mortality in Indonesia.

Abstract: This paper examines the impact of access to health facilities and personnel on infant and child mortality in Indonesia. Demographic and Health Survey data are combined with village-level censuses of infrastructure collected by the Central Bureau of Statistics. Because the village-level data are available from two points in time, it is possible to analyse the effects on mortality risks within the village of changes in access to health care. Factors about villages that might affect both access to health care and mortality risks are held constant. Adding a maternity clinic to a village decreases the odds of infant mortality by almost 15 per cent, in comparison to the risk before the clinic was added. An additional doctor reduces the odds by about 1.7 per cent.

De Facto Mental Health Services in the Rural South

Abstract: Health care reform efforts highlighted the continuing scarcity of mental health services for the rural poor. Most mental health services are provided in the general medical sector, a concept first described by Regier and colleagues in 1978 as the de facto mental health service system, rather than through formal mental health specialist services. The de facto system combines specialty mental health services with general medical services such as primary care and nursing home care, ministers and counselors, self-help groups, families, and friends. The nature of the de facto system in rural areas with large minority populations remains largely unknown due to minimal available data. This article examines the availability, accessibility, and use of mental health services in the rural South and the applicability of the de facto model to rural areas. The critical need for data necessary to inform changes in health care relative to rural mental health service delivery is emphasized.

Public Health Informatics: How Information-Age Technology Can Strengthen Public Health

Abstract: The combination of the burgeoning interest in health, health care reform and the advent of the Information Age, represents a challenge and an opportunity for public health. If public health’s effectiveness and profile are to grow, practitioners and researchers will need reliable, timely informati6n with which to make information-driven decisions, better ways to communicate, and improved tools to analyze and present new knowledge. “Public Health Informatics” (PHI) is the science of applying Information- Age technology to serve the specialized needs of public health. In this paper we define Public Health Informatics, outline specific benefits that may accrue from its widespread application, and discuss why and how an academic discipline of public health informatics should be developed. Finally, we make specific recommendations for actions that government and academia can take to assure that public health professionals have the systems, tools, and training to use PHI to advance the mission of public health.

Cost Recovery in Public Health Services in Sub-Saharan Africa

Abstract: Many developing countries are currently reforming their health care systems and are experimenting with various mechanisms for delivering and financing health care. One such mechanism has been the introduction of cost recovery for health services. As part of its training program for the health sector, EDI's Human Resources Development Division felt it would be useful to do a survey of cost recovery schemes, particularly in sub-Saharan Africa, and to analyze the objectives, processes, and results of different approaches. This book summarizes the findings of that study. It is designed mainly for health policymakers and senior health care managers in sub-Saharan Africa and will be used in EDI seminars on health financing and health sector reform in that region. The study consists of two parts: theoretical and conceptual models that might be employed to implement user charges; and a review of recent cost recovery experiences in Africa.

The politics of agenda setting in international health: child health versus adult health in developing countries.

Abstract: Policy change is a political process. Political analysis is therefore necessary to understand how and why policies change. Noting that the politics of setting the international health policy agenda are poorly understood the author compares such politics with regard to child health and adult health along the following political streams: organizational symbolic economic scientific and politician politics. This approach is a modified version of Kingdons garbage can model of how public policy agendas are set. The five political streams were all found to long favor child health over adult health as an issue on the international health policy agenda. In the early 1990s however the World Bank has asserted greater influence on the agenda than before with a concerted effort to shift the focus from child health to adult health and to give greater attention to the preventive aspects of adult health in poor countries.

Building healthy communities.

Abstract: Sigmond eloquently detailed in his article his vision for the future of American health care. And while the specific details of community care networks may vary by community--as well as the local and national experiences that lead to their creation--Sigmond is exactly correct in his assertion that community coordination of health care services is the solution to what has become a very competitive, complex health industry. Imagine the history of health care in America plotted on a trend chart. You can start the clock running at the emergence of what we consider to be the modern-day hospital. You will later see the advent of today's insurance models, regulatory systems, and government involvement. And at the far right of the graph, you will see the recent flutter of activity as managed care and other new ideas begin to influence the course of health care in our country. Health care's history does not fit on a one-dimensional time line. Its history is one of sharp upward swings (advancements) and long plateaus (the new status quo) as each new program, each new medical or economic revelation pushes the complexity of our health care system up a notch. As the complexity has grown, so have both the demands on our system and our understanding of its capabilities. As Sigmond indicates, we are now at the foothill of another upward thrust in the evolution of American health care. It may be a turbulent climb, but the next plateau holds his vision of a truly community-based, collaborative health care delivery system that, for the first time, will direct resources at the very points at which health is created. Most hospitals and health systems seem to be caught in a rather awkward position as they try to navigate between two very conflicting realities. On the one hand, we seem to be caught up in a "middle game," which is marked by a rapidly growing investment in developing an integrated delivery system (IDS) based on a heavy-competition model. Huge investments are going toward acquisitions of physician practices, development of risk-bearing managed care products, and PHO arrangements with our medical staffs. Concurrently, we are keeping the other eye on the "end game," which is a more collaborative, cooperative approach to developing healthy communities and being more accountable for the health status of a defined population. As we navigate between these two points, it places great stress on organizations, boards, and medical staff leadership to create a vision for the future and develop successful delivery models. The Future Four There are basically four new premises that underpin the movement toward developing healthy communities and new models of care for those we serve. The first premise is that health care cannot be reformed from the top; it can only be reformed at the grassroots, or the bottom part of our health care system. "One size fits all" solutions from Washington, DC, or our state capitols seldom take into account the complexity, diversity, and unique characteristics of our communities. In order to be successful, grassroots models with empowering initiatives at the local community level are the only models that will be sustainable in the future. Unfortunately, these are models with which we have little experience to date. Doctors and acute care hospitals do not create health. Rather, health is created and nurtured (or abused) by our home environment, by our neighborhoods, by the places we spend our time, and by the decisions each of us makes every day for ourselves. Therefore, to succeed in creating greater health and improving the quality of life, we must have greater impact and leverage resources at these crucial points in our communities, families, and neighborhoods that largely determine our health status. Much of the central planning in Washington and the state capitols across the country cannot begin to address health status with the precision of a true grassroots effort, which is many times more responsive to local needs and the interests of people who make local health care decisions on a daily basis. …

Urban health in developing countries : progress and prospects

Abstract: Urbanization and health in developing countries - a review of trends linkages for urban health - the community and agencies features and determinants of urban health organizing and managing urban health services research on urban health financing urban health services WHO support for urban health development urban health and the World Bank UNICEF's activities in urban health USAID's experience in urban health GTZ'a experience NGO's - between municipalities and communities view from the slums of Asia action and research - progress and prospects.

An Introduction to Community Health

Abstract: An Introduction to Community Health, Seventh Edition, has been updated to reflect the latest trends and statistics in community health. With an emphasis on developing the knowledge and skills necessary for a career in health education, this best-selling introductory text covers such topics as epidemiology, community organization, program planning, minority health, health care, mental health, environmental health, drugs, safety, and occupational health. Short scenarios, key terminology, marginal definitions, and web activities are included in each chapter to make this an accessible and reader-friendly resource for the beginning community health student.

The role of private medical practitioners and their interactions with public health services in Asian countries.

Abstract: This paper aims to review the role of private practitioners and their interactions with public health services in developing countries, focusing largely on the Asian region. Evidence on the distribution of health facilities, manpower, health expenditures and utilization rates shows that private practitioners are significant health care providers in many Asian countries. Limited information has been published on interactions between public and private providers despite their co-existence. Issues related to enforcement of regulations, human resources, patient referrals and disease notifications, are examined.

Ethical climate in health care organizations.

Abstract: An organization's policies, procedures and practices on ethical issues can influence the amount of risk nurses will take in voicing their opinions about patient care issues. While the concepts of organizational climate and culture are frequently referred to, the concept of ethical climate is relatively new.

Health Promotion: Theory and Practice

Abstract: Introduction.- PART 1: THEORY Introduction and History.- Some Basics Principles.- The Determinants of Health.- Uncovering Cause.- What Governments Can Do.- Principles of Education .- Health Behaviours and Behavioural Change.- PART 2: NECESSARY SKILLS Influencing Policy Makers and Managers.- Planning Health Promotion at a Local Level .- Evaluation of Health Promotion.- Putting Health Education into Practice.- Health Promotion Materials.- PART 3: SPECIFIC SETTINGS Health Promotion in Schools J. Harvey.- Health Promotion in Hospitals.- Health Promotion in General Practice.- Health Promotion in the Community.- Health Promotion in the Workplace M. Bamford.- Health Promotion in the Health City.- Working with National Campaigns J. Chambers.- Index.

Country report. Kenya.

Abstract: Kenya has an estimated population of 27 million GNP per capita of US$300 and life expectancy of 54 years. Levels of mortality have declined in the country since it became independent in 1963 but Kenya still claims one of the highest rates of population growth in the world. The high population growth rate has affected the general socioeconomic status of the country. Malaria acute respiratory infections diarrhea and AIDS are the most important causes of morbidity and mortality. An inequitable and partial distribution of health services lack of adequate public information and education about health underfunding in key areas of promotive and preventive health services mismanagement of public health services public sector budgetary constraints in the financing of health facility and service expansion shortages of drugs and vaccines and a high infant mortality rate are other factors which affect the populations health status. National health policy is to increase the emphasis upon maternal and child health and family planning services increase health service coverage and accessibility in rural areas further consolidate urban and rural curative and preventive/promotive services and reduce the population growth rate to 3.0% by 1994. Central strategy is to strengthen community-based health care as a basic component of primary health care in which community participation in environmental health activities and the prevention of disease are the major foci as contained in national policies and goals. Nongovernmental organizations (NGO) will launch health initiatives and there will be AIDS programs. Closer collaboration with NGOs has also strengthened the foci with health promotion programs targeted at specific community groups. Networks such as Kenyas Health Education Network bring together professionals involved in health promotion to share experiences and expertise.

Sustaining primary health care

Abstract: Analyzing the dimensions of the struggle for effective health care in the developing countries, this study demonstrates how current governmental and donor agency policies in such countries as Uganda, Ghana, Nepal, Pakistan and Vietnam have failed to develop efficient systems. The author argues against the current emphasis on decentralization and privatization, and outlines a framework for a long-term approach that should bring benefits and improvements in health care.