Contemporary trends in book publishing, “supported” by the imposition of online communication by means of information technologies, necessitated a complete change in the vision and presentation of the media in general, and for specialized periodicals in particular. The destiny of specialized publications follows the line of visual transformation of other publications. Although slower, this process is also observed in Bulgarian periodicals, incl. journals in the field of medicine and social care. The transition has been smooth, initially involving a long co-existence of both print and online editions, leading to a complete transition of e-editions.
{"title":"Current trends in the visual transformation of periodic publications in the field of medicine and social care","authors":"V. Terziev, S. Vasileva","doi":"10.47696/adved.202118","DOIUrl":"https://doi.org/10.47696/adved.202118","url":null,"abstract":"Contemporary trends in book publishing, “supported” by the imposition of online communication by means of information technologies, necessitated a complete change in the vision and presentation of the media in general, and for specialized periodicals in particular. The destiny of specialized publications follows the line of visual transformation of other publications. Although slower, this process is also observed in Bulgarian periodicals, incl. journals in the field of medicine and social care. The transition has been smooth, initially involving a long co-existence of both print and online editions, leading to a complete transition of e-editions.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129178843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The COVID-19 pandemic has impacted the lives of individuals living in the U.S. in a variety of ways. The combination of various effects caused by the pandemic and social distancing measures (SDMs) are likely to jointly determine individual health outcomes like body weight during the pandemic. In this paper, we use data from the 2018-2020 waves of the Behavioral Risk Factor Surveillance System (BRFSS) to estimate the COVID-19 pandemic’s effect on Body Mass Index (BMI) and the probability of obesity among adults living in the U.S. We use the introduction of initial COVID-19 lockdown as an indicator of when individuals’ lifestyles were likely changed by the pandemic, controlling for indicators of the economy reopening post-initial-lockdown, the contemporaneous presence of other social distancing measures, and the state COVID-19 cases per 1000 individuals. We estimate the overall effects of interest within a difference-in-differences (DID) framework, relying on the plausibly exogenous timing of COVID-19 lockdown initiation. We find a statistically significant association between the COVID-19 lockdown and body weight, with the initial lockdown leading to a 0.18 unit increase in BMI and 1.4 percentage point increase in the probability of obesity. Results for an event study suggest that adults experienced a temporary decrease in body weight in the first month of lockdown, then an increase in body weight as the time since lockdown progressed. Our findings are robust to a variety of sensitivity analysis and falsification tests. We find that COVID-19 lockdown’s effects on body weight was larger and more stable among men, non-white adults, individuals with lower levels of educational attainment, and adults living in more densely populated states. Analyzing the potential mechanisms driving our effects, while we did not find significant effects of COVID-19 on BRFSS-defined variables such as physical activity and mentally unhealthy days, we find that COVID-19 potentially impacted adult diets with increases in Google search intensity for the terms of food delivery and some specific high calorie foods. Similarly, we find that individuals may have engaged in more sedentary behaviors during the pandemic as implied by increased Google search intensity for most major video streaming platforms. Our study provides valuable results for researchers, policy makers, and other interested stakeholders concerned with the pandemic’s potential impacts on body weight.
{"title":"The Effects of COVID-19 Lockdown on Bodyweight Status and Lifestyle Behaviors Among US Adults: Evidence from the Behavioral Risk Factor Surveillance System 2018-2020","authors":"Jaesang Sung, W. Davis, Qihua Qiu","doi":"10.2139/ssrn.3930402","DOIUrl":"https://doi.org/10.2139/ssrn.3930402","url":null,"abstract":"The COVID-19 pandemic has impacted the lives of individuals living in the U.S. in a variety of ways. The combination of various effects caused by the pandemic and social distancing measures (SDMs) are likely to jointly determine individual health outcomes like body weight during the pandemic. In this paper, we use data from the 2018-2020 waves of the Behavioral Risk Factor Surveillance System (BRFSS) to estimate the COVID-19 pandemic’s effect on Body Mass Index (BMI) and the probability of obesity among adults living in the U.S. We use the introduction of initial COVID-19 lockdown as an indicator of when individuals’ lifestyles were likely changed by the pandemic, controlling for indicators of the economy reopening post-initial-lockdown, the contemporaneous presence of other social distancing measures, and the state COVID-19 cases per 1000 individuals. We estimate the overall effects of interest within a difference-in-differences (DID) framework, relying on the plausibly exogenous timing of COVID-19 lockdown initiation. We find a statistically significant association between the COVID-19 lockdown and body weight, with the initial lockdown leading to a 0.18 unit increase in BMI and 1.4 percentage point increase in the probability of obesity. Results for an event study suggest that adults experienced a temporary decrease in body weight in the first month of lockdown, then an increase in body weight as the time since lockdown progressed. Our findings are robust to a variety of sensitivity analysis and falsification tests. We find that COVID-19 lockdown’s effects on body weight was larger and more stable among men, non-white adults, individuals with lower levels of educational attainment, and adults living in more densely populated states. Analyzing the potential mechanisms driving our effects, while we did not find significant effects of COVID-19 on BRFSS-defined variables such as physical activity and mentally unhealthy days, we find that COVID-19 potentially impacted adult diets with increases in Google search intensity for the terms of food delivery and some specific high calorie foods. Similarly, we find that individuals may have engaged in more sedentary behaviors during the pandemic as implied by increased Google search intensity for most major video streaming platforms. Our study provides valuable results for researchers, policy makers, and other interested stakeholders concerned with the pandemic’s potential impacts on body weight.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"645 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133216798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pranav Pattatathunaduvil, Dikshya Upadhyaya, M. Prapti, Aastha Ghimire, A. Shah, P. Aryal, Sailor Alfonzo, Sarthak Bhattarai, Dara Macareno, Navaneeth M S, Aarya Moharir, M. Sharma
The study primarily focuses on assessing how effective are current services and policies at addressing and improving child health in Nepal. More than 45% of children perish before the age of 5, and the neonatal and infant mortality rates have persisted as an issue over the last decade (Humanium, n.d.). The study is divided into three phases with the first one using the 2015 Nepal Health Facility Survey data to conduct a statistical comparison of clinical pediatric services available in hospitals in high-income areas versus low-income areas. The second phase is based on a field survey assessing the mental health services available for infants, early teens, and adolescents. The third phase of this study would employ statistical analysis of Nepal Health Facility Survey 2016 data to measure the impact of several government-supported policies and the link between distance to a health facility and child health outcomes. All three phases will involve a literature review of innovative policies and services worldwide that boost child health. Our study results are expected to reveal a significant disparity in child pediatrics between higher and lower-income districts, a substantial negative impact of distance from a health facility, and disruptive approaches that could be implemented in healthcare services and government policy.
{"title":"An Analysis of Nepal’s Clinical Pediatric Services and Policies to Address Child Mortality","authors":"Pranav Pattatathunaduvil, Dikshya Upadhyaya, M. Prapti, Aastha Ghimire, A. Shah, P. Aryal, Sailor Alfonzo, Sarthak Bhattarai, Dara Macareno, Navaneeth M S, Aarya Moharir, M. Sharma","doi":"10.2139/ssrn.3920788","DOIUrl":"https://doi.org/10.2139/ssrn.3920788","url":null,"abstract":"The study primarily focuses on assessing how effective are current services and policies at addressing and improving child health in Nepal. More than 45% of children perish before the age of 5, and the neonatal and infant mortality rates have persisted as an issue over the last decade (Humanium, n.d.). The study is divided into three phases with the first one using the 2015 Nepal Health Facility Survey data to conduct a statistical comparison of clinical pediatric services available in hospitals in high-income areas versus low-income areas. The second phase is based on a field survey assessing the mental health services available for infants, early teens, and adolescents. The third phase of this study would employ statistical analysis of Nepal Health Facility Survey 2016 data to measure the impact of several government-supported policies and the link between distance to a health facility and child health outcomes. All three phases will involve a literature review of innovative policies and services worldwide that boost child health. Our study results are expected to reveal a significant disparity in child pediatrics between higher and lower-income districts, a substantial negative impact of distance from a health facility, and disruptive approaches that could be implemented in healthcare services and government policy.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"45 54","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120875396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Community Mental Health Act of 1963 established Community Mental Health Centers (CMHCs) across the country with the goal of providing continuous, comprehensive, community-oriented care to people suffering from mental illness. Despite this program being considered a failure by most contemporary accounts, the World Health Organization advocates for a transition from the institutionalization of the mentally ill to a system of community-centered care. In this paper, we construct a novel dataset documenting the rollout of CMHCs from 1971 to 1981 to identify the effect of establishing a CMHC on county level mortality rates, focusing on causes of death related to mental illness. Though we find little evidence that access to a CMHC impacted mortality rates in the white population, we find large and robust effects for the non-white population, with CMHCs reducing suicide and homicide rates by 8% and 14%, respectively. CMHCs also reduced deaths from alcohol in the female non-white population by 18%. These results suggest the historical narrative surrounding the failure of this program does not represent the non-white experience and that community care can be effective at reducing mental health related mortality in populations with the least access to alternative treatment options.
{"title":"The Effect of 'Failed' Community Mental Health Centers on Non-White Mortality","authors":"Mallory Avery, Jessica LaVoice","doi":"10.2139/ssrn.3893645","DOIUrl":"https://doi.org/10.2139/ssrn.3893645","url":null,"abstract":"The Community Mental Health Act of 1963 established Community Mental Health Centers (CMHCs) across the country with the goal of providing continuous, comprehensive, community-oriented care to people suffering from mental illness. Despite this program being considered a failure by most contemporary accounts, the World Health Organization advocates for a transition from the institutionalization of the mentally ill to a system of community-centered care. In this paper, we construct a novel dataset documenting the rollout of CMHCs from 1971 to 1981 to identify the effect of establishing a CMHC on county level mortality rates, focusing on causes of death related to mental illness. Though we find little evidence that access to a CMHC impacted mortality rates in the white population, we find large and robust effects for the non-white population, with CMHCs reducing suicide and homicide rates by 8% and 14%, respectively. CMHCs also reduced deaths from alcohol in the female non-white population by 18%. These results suggest the historical narrative surrounding the failure of this program does not represent the non-white experience and that community care can be effective at reducing mental health related mortality in populations with the least access to alternative treatment options.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132776483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In examining how badly the United States bungled its COVID-19 pandemic response, it is worth going back to the commemorations of the 100th anniversary of the 1918 flu pandemic. Author after author cautioned that the next pandemic would overwhelm the United States health system and that the demand for hospital beds, treatments, and medical staff would quickly outstrip supply. These prescient predictions from just two years ago. Why, when the risks were so obvious and so clearly understood, were they ignored? In answering that question there is blame enough to go around. The American public increasingly refused vaccines for communicable diseases, resisted spending for health research, and elected anti-science candidates. Those elected officials in turn failed to take obvious steps to ward off an entirely foreseeable disaster. Some of these developments are new(ish), relating to the specifics of the current political climate. Yet what is most striking is how readily official responses fell into virtually the same patterns that stymied effective pandemic response in 1918, and how structural racism predicted which communities would be hardest hit and least served by government responses. Instead of learning from the mistakes of the 1918 pandemic we have largely repeated them. This paper traces some of the threads of complacency, hubris, isolationism, and distrust that got in the way both times, and draws some broader lessons we must learn about American political culture before the pandemic next time.
{"title":"This Great Catastrophe: Bungling Pandemics from 1918 to Today","authors":"Rebecca M. Bratspies","doi":"10.2139/ssrn.3891108","DOIUrl":"https://doi.org/10.2139/ssrn.3891108","url":null,"abstract":"In examining how badly the United States bungled its COVID-19 pandemic response, it is worth going back to the commemorations of the 100th anniversary of the 1918 flu pandemic. Author after author cautioned that the next pandemic would overwhelm the United States health system and that the demand for hospital beds, treatments, and medical staff would quickly outstrip supply. These prescient predictions from just two years ago. Why, when the risks were so obvious and so clearly understood, were they ignored? In answering that question there is blame enough to go around. The American public increasingly refused vaccines for communicable diseases, resisted spending for health research, and elected anti-science candidates. Those elected officials in turn failed to take obvious steps to ward off an entirely foreseeable disaster. Some of these developments are new(ish), relating to the specifics of the current political climate. Yet what is most striking is how readily official responses fell into virtually the same patterns that stymied effective pandemic response in 1918, and how structural racism predicted which communities would be hardest hit and least served by government responses. Instead of learning from the mistakes of the 1918 pandemic we have largely repeated them. This paper traces some of the threads of complacency, hubris, isolationism, and distrust that got in the way both times, and draws some broader lessons we must learn about American political culture before the pandemic next time.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123635449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper has conducted a literature review of the international scenario of the local governance and covid19 (including best practices) followed by an empirical examination of risk perception and state of local governance in the two most populous states in India (UP and Bihar) with a joint population of over 300 million. Plenty of work during COVID 19 suggests multiple problems, solutions and best local practices. However, very little is known about linkages between pandemic, its community perception and local response mechanism in high population countries having scarce resources. The result of logistic regression (N=2041) shows non-migrants and females perceive no risk of COVID despite having heard of Corona, showing a perception and behavioural issue that requires special local governing attention in such societies. Further, analysis reveals infection rate is high in the districts where complete elected council is not present and are only governed by chiefs of the villages. In such a deficient state of local governance, the COVID problem could be handled by community policing instead of totally relying on strict lockdown.
{"title":"Community Perception of COVID-19 and Local Response Mechanism in India","authors":"M. Singh","doi":"10.2139/ssrn.3878318","DOIUrl":"https://doi.org/10.2139/ssrn.3878318","url":null,"abstract":"This paper has conducted a literature review of the international scenario of the local governance and covid19 (including best practices) followed by an empirical examination of risk perception and state of local governance in the two most populous states in India (UP and Bihar) with a joint population of over 300 million. Plenty of work during COVID 19 suggests multiple problems, solutions and best local practices. However, very little is known about linkages between pandemic, its community perception and local response mechanism in high population countries having scarce resources. The result of logistic regression (N=2041) shows non-migrants and females perceive no risk of COVID despite having heard of Corona, showing a perception and behavioural issue that requires special local governing attention in such societies. Further, analysis reveals infection rate is high in the districts where complete elected council is not present and are only governed by chiefs of the villages. In such a deficient state of local governance, the COVID problem could be handled by community policing instead of totally relying on strict lockdown.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133277180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Johannes G. Jaspersen, Andreas Richter, Casey G. Rothschild, Roxane Steinacker
It is well known that health insurance coverage increases the demand for health services. However, evidence on the effects of this increased demand on the structure and capacity of the health services market is relatively scarce. We analyze the effects of a reform in the German social health insurance system which caused exogenous variation in coverage for services across different geographic regions. A formal model predicts that the reform led to an immediate decline in demand for services and that it decreased the market capacity in the long run. Our empirical analysis provides strong support for these predictions. We show that the reform was welfare improving under standard assumptions and discuss possible market frictions which could weaken or reverse these conclusions about welfare. Our study informs the ongoing policy debate about the effects of insurance coverage on the societal costs for health care.
{"title":"Moral Hazard and Market Capacity: Evidence from a Natural Experiment in Germany","authors":"Johannes G. Jaspersen, Andreas Richter, Casey G. Rothschild, Roxane Steinacker","doi":"10.2139/ssrn.3868938","DOIUrl":"https://doi.org/10.2139/ssrn.3868938","url":null,"abstract":"It is well known that health insurance coverage increases the demand for health services. However, evidence on the effects of this increased demand on the structure and capacity of the health services market is relatively scarce. We analyze the effects of a reform in the German social health insurance system which caused exogenous variation in coverage for services across different geographic regions. A formal model predicts that the reform led to an immediate decline in demand for services and that it decreased the market capacity in the long run. Our empirical analysis provides strong support for these predictions. We show that the reform was welfare improving under standard assumptions and discuss possible market frictions which could weaken or reverse these conclusions about welfare. Our study informs the ongoing policy debate about the effects of insurance coverage on the societal costs for health care.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131813869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The role of informal carers in long-term care sheds light on the struggle related to population ageing and the increasing incidence of chronic disease. However, despite the increasing number of informal carers, most of them experienced the burden of caregiving. Since various policies have been implemented across countries to support informal carers, their attitude toward support services should be addressed. This research consisted of investigating how formal home care affected the utilisation of support services by informal carers. Data used stemmed from the 2015 Survey Capacite Aide et Ressources des Seniors ("CARE menage") collected in France; and the National Health and Aging Trends Survey (NHATS) with the National Survey of Caregiving (NSOC) in the United States of America (U.S.). Andersen's health behavioural model of support services utilisation provided a conceptual framework for investigating predisposing, enabling, and need variables associated with informal carers services use. We used a probit model for econometrics modelling. We also checked for the endogeneity of formal care. A sample of N = 4,866 in France and N = 1,060 in the U.S. informal carers and care recipients' dyads were used in the study. In France, the care recipients' formal care utilisation does not influence the carer support service use. Comparatively, in the United States, formal care significantly increases the respite services utilisation by informal carers. This study provides important implications for Long-Term Care (TLC) dedicated to health policy, for an optimal trade-off between informal and formal care use, bearing in mind health system specificities. First, countries may spend more funds in innovative support programs in access to care, because some carers may have difficulties in accessing and using support services. Secondly, to provide and foster information campaigns to raise awareness concerning the utilisation of various existing health services, to improve social welfare..
{"title":"Does the Formal Home Care Provided to Old-Adults Persons Affect Utilization of Support Services by Informal Carers? An Analysis of the French CARE and the U.S. NHATS/NSOC Surveys","authors":"W. Guets","doi":"10.2139/ssrn.3769126","DOIUrl":"https://doi.org/10.2139/ssrn.3769126","url":null,"abstract":"The role of informal carers in long-term care sheds light on the struggle related to population ageing and the increasing incidence of chronic disease. However, despite the increasing number of informal carers, most of them experienced the burden of caregiving. Since various policies have been implemented across countries to support informal carers, their attitude toward support services should be addressed. This research consisted of investigating how formal home care affected the utilisation of support services by informal carers. Data used stemmed from the 2015 Survey Capacite Aide et Ressources des Seniors (\"CARE menage\") collected in France; and the National Health and Aging Trends Survey (NHATS) with the National Survey of Caregiving (NSOC) in the United States of America (U.S.). Andersen's health behavioural model of support services utilisation provided a conceptual framework for investigating predisposing, enabling, and need variables associated with informal carers services use. We used a probit model for econometrics modelling. We also checked for the endogeneity of formal care. A sample of N = 4,866 in France and N = 1,060 in the U.S. informal carers and care recipients' dyads were used in the study. In France, the care recipients' formal care utilisation does not influence the carer support service use. Comparatively, in the United States, formal care significantly increases the respite services utilisation by informal carers. This study provides important implications for Long-Term Care (TLC) dedicated to health policy, for an optimal trade-off between informal and formal care use, bearing in mind health system specificities. First, countries may spend more funds in innovative support programs in access to care, because some carers may have difficulties in accessing and using support services. Secondly, to provide and foster information campaigns to raise awareness concerning the utilisation of various existing health services, to improve social welfare..","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127490824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Nigerian health system is weak and has been evolving over the years with misplaced priorities and the focus on health inputs rather than outputs. The design and adoption of several policies have contributed little to strengthening the health system towards improvement in health outcomes. Available evidence on the Nigerian health system from 1960 to 2019 was reviewed. Decentralization and fragmentation of the health system with duplication of responsibilities among the three tiers of government have affected effective health service delivery and accountability. The national health insurance scheme has provided health insurance coverage to less than five per cent of the population. Nigeria is also faced with health workforce crisis with no end in sight. While some modest gains and improvements have been recorded over the decades, maternal mortality, child mortality, immunization coverage, access to basic health services and life expectancy remain poor. Nigeria needs to strengthen its health system.
{"title":"Towards Health System Strengthening: A Review of the Nigerian Health System From 1960 to 2019","authors":"Bolaji Samson Aregbeshola","doi":"10.2139/ssrn.3766017","DOIUrl":"https://doi.org/10.2139/ssrn.3766017","url":null,"abstract":"The Nigerian health system is weak and has been evolving over the years with misplaced priorities and the focus on health inputs rather than outputs. The design and adoption of several policies have contributed little to strengthening the health system towards improvement in health outcomes. Available evidence on the Nigerian health system from 1960 to 2019 was reviewed. Decentralization and fragmentation of the health system with duplication of responsibilities among the three tiers of government have affected effective health service delivery and accountability. The national health insurance scheme has provided health insurance coverage to less than five per cent of the population. Nigeria is also faced with health workforce crisis with no end in sight. While some modest gains and improvements have been recorded over the decades, maternal mortality, child mortality, immunization coverage, access to basic health services and life expectancy remain poor. Nigeria needs to strengthen its health system.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133290188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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