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Open Access
Article
Publication date: 17 April 2023

Noah Olasehinde, Uche Abamba Osakede and Abdulfatai Adekunle Adedeji

This study investigates the effect of user fees on access and waiting time in Nigeria. For access, the effect of user fees on both preventive and curative care; and the effect of…

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Abstract

Purpose

This study investigates the effect of user fees on access and waiting time in Nigeria. For access, the effect of user fees on both preventive and curative care; and the effect of user fees on waiting time at public healthcare facilities were examined. User fees are vital for the fiscal sustainability of healthcare provision for most African economies. Its imposition could debar healthcare access by the poor while its removal can reduce quality of care and induce longer waiting time.

Design/methodology/approach

The wave 3 of the Nigerian General Household Survey (2015/16) data was used for users of public health facilities. Access to healthcare was modelled using utilization data in a logistic regression model while waiting time was through the Negative Binomial Regression Model (NBRM).

Findings

The analyses showed significant effects of user fees on access to both preventive and curative care and on time spent waiting to make use of healthcare services. Individuals were able to access healthcare services regardless of amounts paid. Also, there was a non-negative effect of user fee imposition on waiting time.

Practical implications

Nigeria should improve healthcare facilities to address the enormous demand for healthcare services when designing policy for health sector.

Originality/value

This paper shows that even with the imposition of user fees, healthcare facilities could still not cater for the rising healthcare needs of the populace but cautioned that its abolition may not be a preferred option.

Details

International Journal of Health Governance, vol. 28 no. 2
Type: Research Article
ISSN: 2059-4631

Keywords

Content available
Article
Publication date: 29 August 2023

Inger Lise Teig, Kristine Bærøe, Andrea Melberg and Benedicte Carlsen

Unequal social conditions that provide people with unequal opportunities to live healthy lives are considered unjust and associated with “health inequity”. Governing power is…

Abstract

Purpose

Unequal social conditions that provide people with unequal opportunities to live healthy lives are considered unjust and associated with “health inequity”. Governing power is impacting people's lives through laws, policies and professional decisions, and can be used intentionally to combat health inequity by addressing and changing people's living- and working conditions. Little attention is paid to how these ways of exercising governing power unintentionally can structure further conditions for health inequity. In this paper, the authors coin the term “governance determinants of health” (GDHs). The authors' discussion of GDHs potential impact on health inequity can help avoid the implementation of governing strategies with an adverse impact on health equality. This paper aims to discuss the aforementioned objective.

Design/methodology/approach

The authors identify Governance Determinants of Health, the GDHs. GDHs refer to governance strategies that structurally impact healthcare systems and health equality. The authors focus on the unintended, blind sides of GDHs that maintain or reinforce the effects of socioeconomic inequality on health.

Findings

The power to organize healthcare is manifested in distinct structural approaches such as juridification, politicalization, bureaucratization and medical standardization. The authors explore the links between different forms of governance and health inequalities.

Research limitations/implications

The authors' discussion in this article is innovative as it seeks to develop a framework that targets power dynamics inherent in GHDs to help identify and avoid GDHs that may promote unequal access to healthcare and prompt health inequity. However, this framework has limitations as the real-world, blurred and intertwined aspects of governing instruments are simplified for analytical purposes. As such, it risks overestimating the boundaries between the separate instruments and reducing the complexity of how the GDHs work in practice. Consequently, this kind of theory-driven framework does not do justice to the myriad of peoples' complex empirical practices where GDHs may overlap and intertwine with each other. Nevertheless, this framework can still help assist governing authorities in imagining a direction for the impacts of GDHs on health equity, so they can take precautionary steps to avoid adverse impacts.

Originality/value

The authors develop and explore – and demonstrate – the relevance of a framework that can assist governing authorities in anticipating the impacts of GDHs on health inequity.

Details

International Journal of Health Governance, vol. 28 no. 4
Type: Research Article
ISSN: 2059-4631

Keywords

Book part
Publication date: 29 December 2023

Nirupama Patwardhan

The foremost objective of this chapter was to present an overview of the cooperative healthcare sector in Argentina by reviewing its brief history, components and the role these…

Abstract

The foremost objective of this chapter was to present an overview of the cooperative healthcare sector in Argentina by reviewing its brief history, components and the role these healthcare cooperatives play in the society. The second objective was to look at how these cooperatives have helped women and the local communities in which they operate.

This paper has used chiefly secondary data derived from various academic papers and official and government websites which publish cooperative sector-related information. The intention was to construct a concise yet detailed study that would be of help to other researchers in the field of healthcare cooperatives since the data related to Argentina is highly scattered and frequently found not up to date.

The research has found that health cooperatives in Argentina have aided in overcoming problems in the sector such as sectoral fragmentation, negligence and frequently inadequate standards of care management as well as operational and implementation failures that the private and government healthcare players have been accused of being fraught with. Furthermore, the cooperatives have frequently played a complementary or supplementary role rather than a competitive one with the private and government players.

Through the examples presented in this chapter, it is evident that health cooperatives in Argentina are making large impacts in the healthcare domain along with positively impacting women, marginalised and vulnerable sections of the society and the community. It only remains to be seen now how far this sector will grow in the future and how many more lives will be benefitted.

Details

World Healthcare Cooperatives: Challenges and Opportunities
Type: Book
ISBN: 978-1-80455-775-4

Keywords

Book part
Publication date: 15 April 2024

M. Rezaul Islam

This chapter embarks on a cross-Asian comparison to glean valuable insights from various regions and religious contexts. By examining family planning practices and challenges in…

Abstract

This chapter embarks on a cross-Asian comparison to glean valuable insights from various regions and religious contexts. By examining family planning practices and challenges in different parts of Asia, valuable lessons are uncovered that can inform policies, programs, and initiatives aimed at achieving family planning-related sustainable development goals (SDGs). The complexities and nuances of family planning across diverse cultural, social, and religious landscapes are delved into, shedding light on both common threads and unique challenges faced by marginalized communities. Through this comparative analysis, the aim is to contribute to a holistic understanding of family planning in Asia and provide actionable recommendations to enhance access, equity, and outcomes in pursuit of family planning-related SDGs.

Details

Family Planning and Sustainable Development in Bangladesh: Empowering Marginalized Communities in Asian Contexts
Type: Book
ISBN: 978-1-83549-165-2

Keywords

Book part
Publication date: 4 December 2023

Zarjina Tarana Khalil and Samira Rahman

Although healthcare and healthy living are integral to the Sustainable Development Goals (SDGs) for 2030, the coronavirus epidemic has dealt a devastating blow to these efforts…

Abstract

Although healthcare and healthy living are integral to the Sustainable Development Goals (SDGs) for 2030, the coronavirus epidemic has dealt a devastating blow to these efforts. As governments and policymakers were compelled to shift their focus to lockdowns, sustenance, procurement, and distribution of vaccines, the momentum for health initiatives slowed, and the already fragile health systems of emerging markets were subjected to additional shocks. However, in many underserved regions of the globe, the introduction of technology has greatly facilitated the distribution and adoption of healthcare services.

This chapter highlights mini-cases from four emerging nations: Bangladesh, Nigeria, Vietnam, and the Philippines. Although the countries are emerging, each one of them are in a distinct stage of development and face a unique set of healthcare-related challenges. The chapter showcases how four different organizations based in these countries leveraged the use of technology to take healthcare services to underserved populations. In doing so, they addressed the key challenges of imparting healthcare: geographic accessibility, availability, financial accessibility, and acceptability.

This chapter concludes with a discussion of the implications of expanding healthcare industries leading to increased healthcare waste. To prevent mass population exposure to hazardous substances, the emergence of intelligent healthcare waste collection and disposal systems will be an absolute necessity. Hence, with the development of healthcare services, governments and policymakers need to mechanize smart waste management systems to safeguard humans, animals, and the environment.

Details

Fostering Sustainable Businesses in Emerging Economies
Type: Book
ISBN: 978-1-80455-640-5

Keywords

Book part
Publication date: 29 December 2023

Samaya Pillai, Manik Kadam, Madhavi Damle and Pankaj Pathak

Healthcare is indispensable for any civilisation to attain a good quality of life and well-being on both mental and physical levels. The healthcare domain primarily falls under…

Abstract

Healthcare is indispensable for any civilisation to attain a good quality of life and well-being on both mental and physical levels. The healthcare domain primarily falls under pharma, medical, biotechnology, and nursing. Also, other fields may be aligned with these primary fields. Healthcare amasses the contemporary trends and knowledge of upcoming techniques to improve healthcare processes. The practitioners are primarily doctors, nurses, specialists and health professionals, hospital administrators, and health insurance.

It is a fundamental attribute needed for any society to attain good quality of life and well-being in mental and physical health. It is a fundamental right of people to receive good healthcare where drug treatment and hospitalization are available at a nominal cost, as a requirement of today’s modern era. There appears to be a significant disparity in the availability of good healthcare in rural areas compared to urban in India. Even though we enter the digital era with the facilities offered in Industry 4.0 and other advanced technologies brings about a significant change of overall processing within healthcare systems. During the pandemic of COVID-19, there has been digital transformation with success globally. Healthcare cooperatives are a new norm to support the healthcare systems globally. The chapter discusses Gampaha healthcare cooperative and reviews Ayushman Sahakar scheme in India. The reforms require time to evolve.

Article
Publication date: 15 February 2024

Williams E. Nwagwu

This study was carried out to examine the volume and annual growth pattern of research on e-health literacy research, investigate the open-access types of e-health literacy…

Abstract

Purpose

This study was carried out to examine the volume and annual growth pattern of research on e-health literacy research, investigate the open-access types of e-health literacy research and perform document production by country and by sources. The study also mapped the keywords used by authors to represent e-health literacy research and performed an analysis of the clusters of the keywords to reveal the thematic focus of research in the area.

Design/methodology/approach

The research was guided by a bibliometric approach involving visualization using VosViewer. Data were sourced from Scopus database using a syntax that was tested and verified to be capable of yielding reliable data on the subject matter. The analysis in this study was based on bibliographic data and keywords.

Findings

A total number of 1,176 documents were produced during 2006 and 2022. The majority of the documents (18.90%) were published based on hybrid open-access processes, and the USA has the highest contributions. The Journal of Medical Internet Research is the venue for most of the documents on the subject. The 1,176 documents were described by 5,047 keywords, 4.29 keywords per document, and the keywords were classified into five clusters that aptly capture the thematic structure of research in the area.

Research limitations/implications

e-Health literacy has experienced significant growth in research production from 2006 to 2022, with an average of 69 documents per year. Research on e-health literacy initially had low output but began to increase in 2018. The majority of e-health literacy documents are available through open access, with the USA being the leading contributor. The analysis of keywords reveals the multifaceted nature of e-health literacy, including access to information, attitudes, measurement tools, awareness, age factors and communication. Clusters of keywords highlight different aspects of e-health literacy research, such as accessibility, attitudes, awareness, measurement tools and the importance of age, cancer, caregivers and effective communication in healthcare.

Practical implications

This study has practical implications for health promotion. There is also the element of patient empowerment in which case patients are allowed to take an active role in their healthcare. By understanding their health information and having access to resources that help them manage their conditions, patients can make informed decisions about their healthcare. Finally, there is the issue of improved health outcomes which can be achieved by improving patients' e-health literacy. Visualisation of e-health literacy can help bridge the gap between patients and healthcare providers, promote patient-centered care and improve health outcomes.

Originality/value

Research production on e-Health literacy has experienced significant growth from 2006 to 2022, with an average of 69 documents per year. Many e-health literacy documents are available through open access, and the USA is the leading contributor. The analysis of keywords reveals the nature of e-health literacy, including access to information, attitudes, measurement tools, awareness and communication. The clusters of keywords highlight different aspects of e-health literacy research, such as accessibility, attitudes, awareness, measurement tools and the importance of age, cancer, caregivers, and effective communication in healthcare.

Details

Kybernetes, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0368-492X

Keywords

Book part
Publication date: 7 February 2024

Clair Reynolds Kueny, Alex Price and Casey Canfield

Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower…

Abstract

Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.

Details

Research and Theory to Foster Change in the Face of Grand Health Care Challenges
Type: Book
ISBN: 978-1-83797-655-3

Keywords

Book part
Publication date: 29 December 2023

Raj Krishna and Kumar Mukul Choudhary

Post COVID-19 crisis, healthcare has become a priority for every government. Furthermore, the pandemic has also made us realise why do we need an affordable healthcare delivery…

Abstract

Post COVID-19 crisis, healthcare has become a priority for every government. Furthermore, the pandemic has also made us realise why do we need an affordable healthcare delivery service at the grassroots level. As a result, the Government of India has come out with the Ayushman Sahakar scheme. This scheme has been launched by the Union Government with an aim to assist the cooperatives in the creation of healthcare infrastructure in this country. It is pertinent to note that the cooperatives in the last few years have transformed rural areas and have pushed them out of poverty. As a result, it will be interesting to see the impact cooperatives will have in the field of healthcare.

The authors in this work have discussed the history of healthcare cooperatives in India. After this, the authors have analysed the government schemes and legal provisions which regulate the functioning of healthcare cooperatives in this country. In the next part, the authors studied the Ayushman Sahakar scheme. The authors have discussed the features of the scheme and the impact it has generated in the field of healthcare. Lastly, the author has discussed the challenges which healthcare cooperatives face in this country and how we can overcome those challenges.

Details

World Healthcare Cooperatives: Challenges and Opportunities
Type: Book
ISBN: 978-1-80455-775-4

Keywords

Book part
Publication date: 29 December 2023

Khushbu Thadani and Mansi Patnaik

The public healthcare system faces challenges and limitations regarding the supply and delivery of healthcare services. The private healthcare system is expensive and only…

Abstract

The public healthcare system faces challenges and limitations regarding the supply and delivery of healthcare services. The private healthcare system is expensive and only affordable for some. Due to the increasing population, developing countries face a greater degree of demand–supply mismatch. The existing healthcare services in developing countries need to be more sustainable due to high out-of-pocket expenditures and low-income levels. The research design used in this chapter is a case study approach based on qualitative data. The study focuses on two objectives: (1) to have a detailed understanding of the nature of healthcare cooperatives in Spain and their contribution to meeting healthcare requirements; and (2) to make suggestions and recommendations for an improved and sustainable healthcare cooperative for developing countries. Inspired by the healthcare cooperative model of Spain and keeping in mind the ground reality of the lack of healthcare facilities and services accessible and affordable in developing countries, the authors have developed a conceptual framework with the foundation of an insurance cooperative. The Spain Model is sustainable for developing countries as it serves the interest of all income brackets, not leaving the low-income population behind. Concepts like cooperative worker insurance embedded in the model can ensure that the beneficiaries receive timely and good quality health services at an affordable price. It empowers individuals by allowing them to make small amounts of investments as premiums to secure a hopeful future for a healthy life.

Details

World Healthcare Cooperatives: Challenges and Opportunities
Type: Book
ISBN: 978-1-80455-775-4

Keywords

1 – 10 of over 5000