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Open Access
Article
Publication date: 23 March 2020

Yara Ahmed, Racha Ramadan and Mohamed Fathi Sakr

This paper aims to evaluate the progressivity of health-care financing in Egypt by assessing all five financing sources individually and then combining them to analyze the equity…

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Abstract

Purpose

This paper aims to evaluate the progressivity of health-care financing in Egypt by assessing all five financing sources individually and then combining them to analyze the equity of the whole financing system.

Design/methodology/approach

Lorenz dominance analysis and Kakwani progressivity index were applied on data from 2010/2011 Household Income, Expenditure, and Consumption Survey and the National Health Accounts 2011 using Stata to evaluate the progressivity of each source of health-care finance and the financing system overall.

Findings

The data show that Egypt’s health-care system, which is largely financed by out-of-pocket (OOP) payments, is slightly regressive, with an overall Kakwani index of −0.079. The overall regressive effect was the result of three regressive sources (OOP payments, an earmarked cigarette tax and direct taxes), one proportional finance source (social health insurance) and two slightly progressive sources (indirect taxes and private health insurance). This shows that the burden of financing health care falls more on the poor. These results signal the need for reform of health-care financing in Egypt to reduce dependence on OOP payments to achieve more equitable financing.

Originality/value

The paper seeks to augment the literature on health-care financing in Egypt by calculating specific progressivity estimates for all five sources of financing the Egyptian health-care system and analyzing the overall equity of this financing system. It will, therefore, provide a benchmark for monitoring the equity of finance in the Egyptian health-care system in future studies and allow one to assess the impact of implemented financing reforms in the future on the level of progressivity of health system financing.

Details

Journal of Humanities and Applied Social Sciences, vol. 3 no. 1
Type: Research Article
ISSN: 2632-279X

Keywords

Open Access
Book part
Publication date: 6 May 2019

Mitch Blair, Mariana Miranda Autran Sampaio, Michael Rigby and Denise Alexander

The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might be…

Abstract

The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might be different from those directed at adults and considered how these models might be appraised. The project took the multiple and interrelated dimensions of primary care and simplified them into a conceptual framework for appraisal. A general description of the models in existence in all 30 countries of the EU and EEA countries, focusing on lead practitioner, financial and regulatory and service provision classifications, was created. We then used the WHO ‘building blocks’ for high-performing health systems as a starting point for identifying a good system for children. The building blocks encompass safe and good quality services from an educated and empowered workforce, providing good data systems, access to all necessary medical products, prevention and treatments, and a service that is adequately financed and well led. An extensive search of the literature failed to identify a suitable appraisal framework for MOCHA, because none of the frameworks focused on child primary care in its own right. This led the research team to devise an alternative conceptualisation, at the heart of which is the core theme of child centricity and ecology, and the need to focus on delivery to the child through the life course. The MOCHA model also focuses on the primary care team and the societal and environmental context of the primary care system.

Details

Issues and Opportunities in Primary Health Care for Children in Europe
Type: Book
ISBN: 978-1-78973-354-9

Keywords

Open Access
Article
Publication date: 28 May 2021

Chanapong Rojanaworarit and Sarah El Bouzaidi

This article analyzes deficiencies in public health services for international migrant workers (IMWs) during the COVID-19 pandemic and provides a policy brief for improvement of…

Abstract

Purpose

This article analyzes deficiencies in public health services for international migrant workers (IMWs) during the COVID-19 pandemic and provides a policy brief for improvement of the public health system.

Design/methodology/approach

A COVID-19 outbreak that initially clustered in IMWs and further contributed to the resurgence of the disease across Thailand in December 2020 was analyzed to address the deficiencies in public health services based on the framework of the 10 Essential Public Health Services (EPHS). The EPHS framework was also applied to develop policy options and recommendations in the subsequent policy brief.

Findings

This outbreak unveiled unique challenges that make IMWs more vulnerable to COVID-19. The public health system, challenged by the COVID-19 outbreak among IMWs, manifested deficiencies in the planning and implementation of all essential services. Delayed detection of the outbreak along with the lack of policy accommodating undocumented IMWs and the lack of equitable access to testing and treatment for COVID-19 resulted in the transmission of the disease that harmed the public at large.

Originality/value

The comprehensive analysis of the deficiencies in public health services for IMWs enabled a clear description of problems that could be further prioritized by relevant stakeholders. The policy brief provides policymakers with evidence-based recommendations for improving public health services for IMWs during the COVID-19 pandemic and beyond.

Details

Journal of Health Research, vol. 36 no. 5
Type: Research Article
ISSN: 0857-4421

Keywords

Open Access
Article
Publication date: 8 March 2023

Louise Holly, Shannon Thom, Mohamed Elzemety, Beatrice Murage, Kirsten Mathieson and Maria Isabel Iñigo Petralanda

This paper introduces a new set of equity and rights-based principles for health data governance (HDG) and makes the case for their adoption into global, regional and national…

3497

Abstract

Purpose

This paper introduces a new set of equity and rights-based principles for health data governance (HDG) and makes the case for their adoption into global, regional and national policy and practice.

Design/methodology/approach

This paper discusses the need for a unified approach to HDG that maximises the value of data for whole populations. It describes the unique process employed to develop a set of HDG principles. The paper highlights lessons learned from the principle development process and proposes steps to incorporate them into data governance policies and practice.

Findings

More than 200 individuals from 130 organisations contributed to the development of the HDG principles, which are clustered around three interconnected objectives of protecting people, promoting health value and prioritising equity. The principles build on existing norms and guidelines by bringing a human rights and equity lens to HDG.

Practical implications

The principles offer a strong vision for HDG that reaps the public good benefits of health data whilst safeguarding individual rights. They can be used by governments and other actors as a guide for the equitable collection and use of health data. The inclusive model used to develop the principles can be replicated to strengthen future data governance approaches.

Originality/value

The article describes the first bottom-up effort to develop a set of principles for HDG.

Details

International Journal of Health Governance, vol. 28 no. 3
Type: Research Article
ISSN: 2059-4631

Keywords

Open Access
Article
Publication date: 5 November 2020

Wanapa Naravage, Marc van der Putten, Anja Krumeich, Luca Falqui and Rodger Doran

The pledge of the 2030 Agenda for Sustainable Development is “to leave no one behind.” However, there are significant groups of people who are at risk of being left behind. The…

956

Abstract

Purpose

The pledge of the 2030 Agenda for Sustainable Development is “to leave no one behind.” However, there are significant groups of people who are at risk of being left behind. The health and social issues facing prisoners are well known, but past initiatives to address them through international development initiatives have failed to gain widespread support. The purpose of this paper is to advocate for inclusion of prison health care in current international development frameworks such as Universal Health Coverage and the 2030 Sustainable Development Goals.

Design/methodology/approach

This is a commentary paper.

Findings

The governments of most countries have accepted both the 2030 Agenda for Sustainable Development and Universal Health Coverage as frameworks for future national development planning. Including prison health care in these frameworks will provide a powerful platform for those advocating for better prison health services and will allow governments wary of offending public opinion to make significant changes to the way prisons are managed. Providing better prison health care services will not only lead to better long-term population health outcomes overall but will also contribute to achieving the 2030 Agenda aspiration to “leave no-one behind.”

Originality/value

This paper provides a discussion of current international development guidance and identifies that prison health care is not sufficiently recognized as an essential contributor to achieving the sustainable development goals.

Details

Journal of Health Research, vol. 36 no. 1
Type: Research Article
ISSN: 0857-4421

Keywords

Open Access
Article
Publication date: 27 August 2020

Heba Nassar, Hala Sakr, Asmaa Ezzat and Pakinam Fikry

This paper aims to evaluate the technical efficiency of the health-care systems in 21 selected middle-income countries during the period (2000–2017) and determine the source of…

3137

Abstract

Purpose

This paper aims to evaluate the technical efficiency of the health-care systems in 21 selected middle-income countries during the period (2000–2017) and determine the source of inefficiency whether it is transient (short run) or persistent (long run).

Design/methodology/approach

The study uses the stochastic frontier analysis technique through employing the generalized true random effects model which overcomes the drawbacks of the previously introduced stochastic frontier models and allows for the separation between unobserved heterogeneity, persistent inefficiency and transient inefficiency.

Findings

Persistent efficiency is lower than the transient efficiency; hence, there are more efficiency gains that can be made by the selected countries by adopting long-term policies that aim at reforming the structure of the health-care system in the less efficient countries such as South Africa and Russia. The most efficient countries are Vietnam, Mexico and China which adopted a social health insurance that covers almost the whole population with the aim of increasing access to health-care services. Also, decentralization in health-care has assisted in adopting health-care policies that are suitable for both the rural and urban areas based on their specific conditions and health-care needs. A key success in the implementation of the adopted long-term policies by those countries is the continuous monitoring and evaluation of their outcomes and comparing them with the predefined targets and conducting any necessary modifications to ensure their movement in the right path to achieve their goals.

Originality/value

Although several studies have evaluated the technical efficiency both across and within countries using non-parametric (data envelopment analysis) and parametric (stochastic frontier analysis) approaches, to the best of the authors’ knowledge, this is the first attempt to evaluate the technical efficiency of selected middle-income countries during the period (2000–2017) using the generalized true random effects stochastic frontier analysis model.

Details

Review of Economics and Political Science, vol. 5 no. 4
Type: Research Article
ISSN: 2356-9980

Keywords

Open Access
Article
Publication date: 19 January 2024

Roosa Amanda Lambin and Milla Nyyssölä

Mainland Tanzania has seen two decades of significant social policy reforms and transformations in its social and economic structures, whilst the country continues to grapple with…

413

Abstract

Purpose

Mainland Tanzania has seen two decades of significant social policy reforms and transformations in its social and economic structures, whilst the country continues to grapple with persisting gender inequalities. This article examines Tanzania's social policy developments from a gender perspective. The authors analyse the level, reach and quality of social policy delivery to working-age women across the areas of health policy, social protection and employment policy during 2000–2021.

Design/methodology/approach

The article draws on qualitative research deploying the scoping review method. The data consist of diverse secondary materials, including academic publications, government policy documents, relevant statistics and other types of “grey” literature.

Findings

Tanzania has made significant advancements in the legal frameworks around welfare provision and has instituted increasingly gender-responsive government policy plans. The health and social protection sectors, in particular, have witnessed the introduction of large-scale measures expanding social policy implementation. However, social policy delivery remains two-tiered, with differences in provisions for women in the formal and informal sectors.

Originality/value

Social policy delivery and implementation have increased and diversified in Sub-Saharan Africa (SSA) during the new millennium, with a growing integration of gender-specific policy objectives. However, limited social policy scholarship has focused on the gendered effects of broader social policy models in SSA. The article remedies the concomitant knowledge gaps by examining various social policies and their impacts on working-age women in Mainland Tanzania. The authors also engage with the theoretical welfare regime literature and present an analytical framework for gender-sensitive assessment of emerging social policy models in the Global South.

Details

International Journal of Sociology and Social Policy, vol. 44 no. 13/14
Type: Research Article
ISSN: 0144-333X

Keywords

Open Access
Book part
Publication date: 6 May 2019

Paul Kocken, Eline Vlasblom, Gaby de Lijster, Helen Wells, Nicole van Kesteren, Renate van Zoonen, Kinga Zdunek, Sijmen A. Reijneveld, Mitch Blair and Denise Alexander

There is considerable heterogeneity between primary care systems that have evolved in individual national cultural environments. Models of Child Health Appraised (MOCHA) studied…

Abstract

There is considerable heterogeneity between primary care systems that have evolved in individual national cultural environments. Models of Child Health Appraised (MOCHA) studied how the transfer of models or their individual components can be achieved across nations, using examples of combinations of settings, functions, target groups and tracer conditions. There are many factors that determine the feasibility of successful transfer of these from one setting to another, which must be recognised and taken into account. These include the environment of the care system, national policy-making and contextual means of directing population behaviour – in the form of penalties and incentives, which cannot be assessed or expected to work by means of rational actions alone. MOCHA developed a list of criteria to assess transferability, summarised in a population characteristics, intervention content, environment and transfer (PIET-T) process. To explore the process and means of transferability, we obtained consensus statements from the researchers on optimum model scenarios and conducted a survey of stakeholders, professionals and users of children’s primary care services that involved three specific health topics: vaccination coverage in infants, monitoring of a chronic or complex condition and early recognition of mental health problems. The results give insight into features of transferability – such as the availability and the use of guidelines and formal procedures; the barriers and facilitators of implementation and similarities and differences between model practices and the existing model of child primary care in the country. We found that successful transfer of an optimal model is impossible without tailoring the model to a specific country setting. It is vital to be aware of the sensitivity of the population and environmental characteristics of a country before starting to change the system of primary care.

Details

Issues and Opportunities in Primary Health Care for Children in Europe
Type: Book
ISBN: 978-1-78973-354-9

Keywords

Open Access
Book part
Publication date: 6 May 2019

Mitch Blair and Denise Alexander

Equity is an issue that pervades all aspects of primary care provision for children and as such is a recurring theme in the Models of Child Health Appraised project. All European…

Abstract

Equity is an issue that pervades all aspects of primary care provision for children and as such is a recurring theme in the Models of Child Health Appraised project. All European Union member states agree to address inequalities in health outcomes and include policies to address the gradient of health across society and target particularly vulnerable population groups. The project sought to understand the contribution of primary care services to reducing inequity in health outcomes for children. We focused on some key features of inequity as they affect children, such as the importance of good health services in early childhood, and the effects of inequity on children, such as the higher health needs of underprivileged groups, but their generally lower access to health services. This indicates that health services have an important role in buffering the effects of social determinants of health by providing effective treatment that can improve the health and quality of life for children with chronic disorders. We identified common risk factors for inequity, such as gender, family situation, socio-economic status (SES), migrant or minority status and regional differences in healthcare provision, and attempted to measure inequity of service provision. We did this by analysing routine data of universal primary care procedures, such as vaccination, age at diagnosis of autism or emergency hospital admission for conditions that can be generally treated in primary care, against variables of inequity, such as indicators of SES, migrant/ethnicity or urban/rural residency. In addition, we focused on the experiences of child population groups particularly at risk of inequity of primary care provision: migrant children and children in the state care system.

Details

Issues and Opportunities in Primary Health Care for Children in Europe
Type: Book
ISBN: 978-1-78973-354-9

Keywords

Open Access
Article
Publication date: 25 October 2022

Janice Kathleen Moodley, Bianca Rochelle Parry and Marie Claire Van Hout

The menstrual health and menstrual hygiene management (MHM) of incarcerated women remains relatively low on the agenda of public health interventions globally, widening the…

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Abstract

Purpose

The menstrual health and menstrual hygiene management (MHM) of incarcerated women remains relatively low on the agenda of public health interventions globally, widening the inequitable access of incarcerated women to safe and readily available menstrual health products (MHP). The COVID-19 pandemic has adversely impacted on the MHM gains made in various development sectors in the global North and South, through its amplification of vulnerability for already at-risk populations. This is especially significant to developing countries such as South Africa where the incarcerated female population are an often-forgotten minority.

Design/methodology/approach

This viewpoint highlights the ignominious silence of research and policy attention within the South African carceral context in addressing MHM. The ethical and political implications of such silences are unpacked by reviewing international and local literature that confront issues of inequality and equitable access to MHP and MHM resources within incarcerated contexts.

Findings

Structural inequalities in various contexts around the world have exacerbated COVID-19 and MHM. Within the prison context in South Africa, women face multiple layers of discrimination and punishment that draw attention to the historical discourses of correctional facilities as a site of surveillance and discipline.

Research limitations/implications

This study acknowledges that while this viewpoint is essential in rising awareness about gaps in literature, it is not empirical in nature.

Practical implications

The authors believe that this viewpoint is essential in raising critical awareness on MHM in carceral facilities in South Africa. The authors hope to use this publication as the theoretical argument to pursue empirical research on MHM within carceral facilities in South Africa. The authors hope that this publication would provide the context for international and local funders, to assist in the empirical research, which aims to roll out sustainable MHP to incarcerated women in South Africa.

Social implications

The authors believe that this viewpoint is the starting point in accelerating the roll out of sustainable MHP to incarcerated females in South Africa. These are females who are on the periphery of society that are in need of practical interventions. Publishing this viewpoint would provide the team with the credibility to apply for international and national funding to roll out sustainable solutions.

Originality/value

It is hoped that the gaps in literature and nodes for social and human rights activism highlighted within this viewpoint establish the need for further participatory research, human rights advocacy and informed civic engagement to ensure the voices of these women and their basic human rights are upheld.

Details

International Journal of Prisoner Health, vol. 19 no. 3
Type: Research Article
ISSN: 1744-9200

Keywords

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