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Publications

Filtering by Category: 2011

Do we have the right models for scaling up health services to achieve the Millennium Development Goals?

Future Health Systems

There is widespread agreement on the need for scaling up in the health sector to achieve the Millennium Development Goals (MDGs). But many countries are not on track to reach the MDG targets. The dominant approach used by global health initiatives promotes uniform interventions and targets, assuming that specific technical interventions tested in one country can be replicated across countries to rapidly expand coverage. Yet countries scale up health services and progress against the MDGs at very different rates. Global health initiatives need to take advantage of what has been learned about scaling up.
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卫生服务提供体系创新:公立医院法人化 (中文版)

Future Health Systems

《卫生服务提供体系创新:公立医院法人化》系世界银行经济学家对多个发达国家(地区)和发展中国家(地区)的公立医院改革进行研究的一项成果。《卫生服务提供体系创新:公立医院法人化》清晰地提出了公立医院的改革目的,阐述了其改革的理论基础,提出了分析、评价公立医院改革的基本框架。强调只有外部环境和内部治理的制度安排相互作用和协调一致,公立医院的改革才能成功。《卫生服务提供体系创新:公立医院法人化》利用原苏东地区和拉丁美洲地区的综述及九个国家(地区)案例研究的数据,对公立医院组织变革的全球经验进行了比较分析。作者通过系统、翔实的资料和深入的分析向读者展示了英国、新西兰、澳大利亚、中国香港、马来西亚、新加坡、突尼斯、印度尼西亚和厄瓜多尔等九个国家(地区)的公立医院改革的鲜活案例。《卫生服务提供体系创新:公立医院法人化》对公立医院改革的研究者和实践者大有裨益。
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FHS Podcast 2: A visit to Kabul

Future Health Systems

In the second podcast from Future Health Systems, Jeff Knezovich visits the FHS Afghanistan team in Kabul to find out what sort of research they're currently undertaking, what challenges they face in attempting research in an insecure environment, and what it's like living and working in difficult security situations. He interviews Kojo, Melissa Roach and Anubhav Agarwal, who tell him about the community scorecard that FHS is in the process of piloting in several provinces in Afghanistan.
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Building Informed Trust: Injection Practices in Cambodia

Future Health Systems

Dr Sachiko Ozawa from JHSPH presents recent findings from a study on trust in health systems and injection rates in Cambodia to the Health System Reform in Asia conference in Hong Kong in December 2012. She notes that the average Cambodian receives six injections/year, and that trained medical practitioners often feel pressure to give shots and IVs as patients will often turn to informal providers if they don't.
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Regulatory challenges associated with the rapid spread of health markets

Future Health Systems

Dr Barun Kanjilal of IIHMR gives an overview of the regulatory challenges associated with the rapid spread of health markets in India to the Health System Reform in Asia conference held in Hong Kong in early December 2011. He notes in particular the important role that informal providers have played in delivering health services in the wake of government reforms.
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Understanding informal markets: The roles and perspectives of RMPs in West Bengal and Karnataka, India

Future Health Systems

Dr Asha George of JHSPH presents work on the role of informal health care providers in India at the Health System Reform in Asia conference held in December 2011 in Hong Kong. She compares West Bengal and Karnataka -- two states with very different health profiles -- providing both qualitative and quantitative insights into how and why the poor use poorly trained rural medical practitioners as their first port of call when accessing health services.
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Removing user fees for basic health services: a pilot study and national roll-out in Afghanistan

Future Health Systems

User fees for primary care tend to suppress utilization, and many countries are experimenting with fee removal. Studies show that additional inputs are needed after removing fees, although well-documented experiences are lacking. This study presents data on the effects of fee removal on facility quality and utilization in Afghanistan, based on a pilot experiment and subsequent nationwide ban on fees.
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Association between health workforce capacity and quality of care for children under five in Afghanistan

Future Health Systems

This presentation by Dr Anbrasi Edward at the 28th ISQua conference in Hong Kong was informed by a study to determine the association between health workforce capacity and quality of care in primary care facilities providing a basic package of health services (BPHS) in Afghanistan.
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Can community health workers increase coverage of reproductive health services?

Future Health Systems

Health services were severely affected during the many years of instability and conflict in Afghanistan. In recent years, substantial increases in the coverage of reproductive health services have been achieved, yet absolute levels of coverage remain very low, especially in rural areas. One strategy for increasing use of reproductive health services is deploying community health workers (CHWs) to promote the use of services within the community and at health facilities. Results show that presence of a female CHW in the community is associated with higher use of modern contraception, antenatal care services and skilled birth attendants but presence of a male CHW is not. Community-level random effects were also significant.
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Understanding pathways for scaling up health services through the lens of complex adaptive systems

Future Health Systems

Despite increased prominence and funding of global health initiatives, efforts to scale up health services in developing countries are falling short of the expectations of the Millennium Development Goals. Arguing that the dominant assumptions for scaling up are inadequate, we propose that interpreting change in health systems through the lens of complex adaptive systems (CAS) provides better models of pathways for scaling up.
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FHS Podcast 1: Complexity, complexity, complexity

Future Health Systems

In this first podcast from Future Health Systems, Jeff Knezovich finds out what complexity science is, and how a complex adaptive systems approach can help scale up health systems interventions. We find out from Ben Ramalingam about the history of complexity science, while Professor David Peters explains a few key concepts of complex adaptive systems.
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Heterogeneity in Self-Assessed Health Status Among the Elderly in India

Future Health Systems

The authors examine the observed heterogeneity in self-assessed health (SAH) among the aged in India using data on health and living conditions of the elderly in India from the 60th Round of National Sample Survey (2004-2005). Results indicate that almost one fourth of the old in India rate their health as poor.
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Economic burden of care for chronic diseases of poor rural households in China

Future Health Systems

Henry Lucas of IDS briefly presents work on the burden of chronic diseases for the rural poor in China at the 2011 iHEA conference. The study, led by Ding Shijun for the POVILL programme, showed that, where inpatient care did not involve surgery, the cost of outpatient care for chronic diseases was similar -- but not covered by insurance.
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Villagers’ evaluation of a community-based health insurance scheme in Thmar Pouk, Cambodia

Future Health Systems

There is growing international evidence that the effectiveness of health services stems primarily from the extent to which the incentives facing providers and consumers are aligned with "better health" objectives. Efficiency in health service provision requires that providers and consumers have incentives to use healthcare resources in ways that generate the maximum health gains. Equity in at least one sense requires that consumers requiring the same care are treated equally, irrespective of their ability to pay. Efficiency in the use of health services requires that consumers are knowledgeable about the services on offer and which are most appropriate to their needs. Although these principles are enshrined in the design of every health system in the world, they have proven extremely difficult to apply in practice. Healthcare providers have financial obligations to their families as well as professional obligations to their patients. Health service consumers generally lack information about both their health and health services so that they under-consume or over-consume healthcare.
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FHS Inception Phase Report

Future Health Systems

The Inception Phase for the second phase of the Future Health Systems Research Program Consortium lasted from January-August 2011. This report summarizes the progress made during that time and lays out a plan of action for the next five years of work. In particular, the report summarizes progress made on research (including different analytical frameworks, themes and methodologies), management, capacity development, policy influence and research uptake and monitoring and evaluation of the program. Full annexes are available upon request.
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