Pub Date : 2020-02-01DOI: 10.31124/advance.11787264.v1
E. Osafo, Robert M. Yawson
Quality of healthcare delivery is a long-standing issue that concerns every individual member or group in society. The purpose of this paper is to identify problems with HRD functions in healthcare delivery and to suggest ways to improve and sustain quality healthcare delivery in Ghana. Using the FOCOS Orthopedic Hospital as a case study, data were collected using a qualitative research design. The following HRD functions: Program effectiveness, operating efficiency, service quality, financial stability, long versus short–term impact, tangible impact, client satisfaction, community support, publicity, employee satisfaction and commitment to the organization, trust in leadership, and altruism assessed as core indicators of high performance at the organization level, as well as the epitome of quality healthcare delivery. The results indicated that these factors presented different levels of importance to employees of FOCOS. However, there is universal agreement that the composite of these HRD functions and contextual performance indicators enhance quality healthcare delivery. FOCOS’ adherence to best practices in healthcare delivery presents a case for future research to adopt the culture espoused by FOCOS to help bridge gaps in healthcare delivery in Ghana. Unlike the traditional sectoral reforms that characterize healthcare delivery in Ghana, this paper proposes a holistic approach to culture change in healthcare delivery.
{"title":"An Empirical Case for Culture Change in Healthcare Delivery","authors":"E. Osafo, Robert M. Yawson","doi":"10.31124/advance.11787264.v1","DOIUrl":"https://doi.org/10.31124/advance.11787264.v1","url":null,"abstract":"Quality\u0000of healthcare delivery is a long-standing issue that concerns every individual\u0000member or group in society. The purpose of this paper is to identify problems with\u0000HRD functions in healthcare delivery and to suggest ways to improve and sustain\u0000quality healthcare delivery in Ghana. Using the FOCOS Orthopedic\u0000Hospital as a case study, data were collected using a qualitative\u0000research design. The following HRD functions: Program effectiveness, operating efficiency, service quality, financial stability, long versus short–term\u0000impact, tangible impact, client satisfaction, community support, publicity, employee satisfaction and\u0000commitment to the organization, trust in leadership, and altruism assessed as core\u0000indicators of high performance at the organization level, as well as the\u0000epitome of quality healthcare delivery. The results indicated that these\u0000factors presented different levels of importance to employees of FOCOS. However,\u0000there is universal agreement that the composite of these HRD functions and\u0000contextual performance indicators enhance quality healthcare delivery. FOCOS’\u0000adherence to best practices in healthcare delivery presents a case for future\u0000research to adopt the culture espoused by FOCOS to help bridge gaps in healthcare\u0000delivery in Ghana. Unlike the traditional sectoral reforms that characterize\u0000healthcare delivery in Ghana, this paper proposes a holistic approach to\u0000culture change in healthcare delivery.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133826635","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}
Dr. Catriona Planel-Ratna, Dr. Thanika Devi Juwaheer
The purpose of this paper is to investigate patient fear and the factors that could possibly trigger this phenomenon in Mauritian`s private healthcare settings. A mixed-methods approach was considered to fulfilling the research aim. The research sample comprised 27 healthcare professionals and 411 private healthcare customers (patients). A scale with 11 patient fear attributes and one open-ended question were used in quantitative and qualitative data collection respectively. Descriptive statistics, One-way ANOVA and Grounded Theory method were used to analyze the data. The results reveal that patient fear is a reality and an underestimated aspect of care in Mauritian`s private healthcare settings. Major factors causing patient fear to arise are the cost of the treatment, the ability to pay the bill and the treatment outcome among others. Properly understanding those factors and adjusting the service delivery accordingly were considered to be crucial in effectively managing patient fear, however other results suggest that such fear is instead being exploited by private healthcare organizations. Patients are becoming increasingly aware that their fears are even in certain cases being triggered or aggravated by private healthcare professionals in an attempt to convince them to purchase more services quickly and expensively. Consequently, other important aspects of care such as patient trust and patient compliance were found to be adversely affected. Moreover statistically significant differences in the degree of fear between patients of different age groups and income groups were also obtained. The study acts as a guide to ensure that the best measures to efficiently manage patient fear throughout the healthcare delivery can be determined and applied thus ensuring to deal with better-informed patients in an honest, fair and trustworthy manner. For instance results highlight the importance for healthcare providers to preserve human touch when dealing with patients in an effort to alleviate their fears and create reasonably positive experiences irrespective of the treatment outcome. Results following One-Way ANOVA analysis and Tukey HSD post hoc test exposed the difference in degree of fear between patients based on simple factors such as age group or income group. This implies that healthcare providers should ensure that they develop and adopt different approaches to handle patient fear effectively and not attempt to develop and adopt a ‘one size fits all’ approach. Moreover that the 'fear handling mechanism' established is ingrained in their service culture not only to prevent adverse effects on other vital aspects of care including patient trust and patient compliance but also and mostly to optimize the patient journey. The study also attempts to increase awareness about patient fear in private healthcare settings by exposing the major factors that normally trigger this phenomenon as well as the most common fear-related behaviors. The study moreove
{"title":"Fear in Healthcare Settings, Myth or Reality: A Case Study of the Private Healthcare Sector in Mauritius","authors":"Dr. Catriona Planel-Ratna, Dr. Thanika Devi Juwaheer","doi":"10.2139/ssrn.3524791","DOIUrl":"https://doi.org/10.2139/ssrn.3524791","url":null,"abstract":"The purpose of this paper is to investigate patient fear and the factors that could possibly trigger this phenomenon in Mauritian`s private healthcare settings. A mixed-methods approach was considered to fulfilling the research aim. The research sample comprised 27 healthcare professionals and 411 private healthcare customers (patients). A scale with 11 patient fear attributes and one open-ended question were used in quantitative and qualitative data collection respectively. Descriptive statistics, One-way ANOVA and Grounded Theory method were used to analyze the data. The results reveal that patient fear is a reality and an underestimated aspect of care in Mauritian`s private healthcare settings. Major factors causing patient fear to arise are the cost of the treatment, the ability to pay the bill and the treatment outcome among others. Properly understanding those factors and adjusting the service delivery accordingly were considered to be crucial in effectively managing patient fear, however other results suggest that such fear is instead being exploited by private healthcare organizations. Patients are becoming increasingly aware that their fears are even in certain cases being triggered or aggravated by private healthcare professionals in an attempt to convince them to purchase more services quickly and expensively. Consequently, other important aspects of care such as patient trust and patient compliance were found to be adversely affected. Moreover statistically significant differences in the degree of fear between patients of different age groups and income groups were also obtained. The study acts as a guide to ensure that the best measures to efficiently manage patient fear throughout the healthcare delivery can be determined and applied thus ensuring to deal with better-informed patients in an honest, fair and trustworthy manner. For instance results highlight the importance for healthcare providers to preserve human touch when dealing with patients in an effort to alleviate their fears and create reasonably positive experiences irrespective of the treatment outcome. Results following One-Way ANOVA analysis and Tukey HSD post hoc test exposed the difference in degree of fear between patients based on simple factors such as age group or income group. This implies that healthcare providers should ensure that they develop and adopt different approaches to handle patient fear effectively and not attempt to develop and adopt a ‘one size fits all’ approach. Moreover that the 'fear handling mechanism' established is ingrained in their service culture not only to prevent adverse effects on other vital aspects of care including patient trust and patient compliance but also and mostly to optimize the patient journey. The study also attempts to increase awareness about patient fear in private healthcare settings by exposing the major factors that normally trigger this phenomenon as well as the most common fear-related behaviors. The study moreove","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127119959","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}
Where regulatory systems overlap, courts and scholars often focus on the undesirable aspects of the overlap — the ways in which systems conflict. One such context involves the regulation of prescription drugs and medical devices by the FDA’s premarket evaluation processes and by state common-law tort and products liability actions. FDA regulation and state common law are often described as separate, conflicting regulatory systems. This Article challenges that description by proposing a model in which FDA premarket evaluation and state common law function as a single regulatory system.This model brings order to the Supreme Court’s seemingly inconsistent medical products preemption cases, permitting the Court’s decisions in Medtronic v. Lohr, Riegel v. Medtronic, Wyeth v. Levine, PLIVA v. Mensing, and other cases to be understood as having created an emergent, coherent, multilayered regulatory system that calibrates the requirements imposed by each layer to the deficit in information about the risk of each product category. The model also provides a strong critique of scores of recent lower court preemption decisions involving “combination products,” a new product category whose members consist of both a new drug and a high-risk device. In finding common law actions preempted, these courts claim to have faithfully applied Riegel’s holding. But using the model developed here, it is clear that courts have disrupted the calibrated regulatory system, allowing thousands or millions of people in the United States to be exposed to dangerous products whose risks have not been well characterized. Using the combination products decisions as a cases study, the model also highlights the far-reaching effects that even small changes to any one input may have on the function of an emergent system and the field that it regulates.
{"title":"Emergent Regulatory Systems and Their Challenges: The Case of Combination Medical Products","authors":"George Horvath","doi":"10.2139/ssrn.3427826","DOIUrl":"https://doi.org/10.2139/ssrn.3427826","url":null,"abstract":"Where regulatory systems overlap, courts and scholars often focus on the undesirable aspects of the overlap — the ways in which systems conflict. One such context involves the regulation of prescription drugs and medical devices by the FDA’s premarket evaluation processes and by state common-law tort and products liability actions. FDA regulation and state common law are often described as separate, conflicting regulatory systems. This Article challenges that description by proposing a model in which FDA premarket evaluation and state common law function as a single regulatory system.This model brings order to the Supreme Court’s seemingly inconsistent medical products preemption cases, permitting the Court’s decisions in Medtronic v. Lohr, Riegel v. Medtronic, Wyeth v. Levine, PLIVA v. Mensing, and other cases to be understood as having created an emergent, coherent, multilayered regulatory system that calibrates the requirements imposed by each layer to the deficit in information about the risk of each product category. The model also provides a strong critique of scores of recent lower court preemption decisions involving “combination products,” a new product category whose members consist of both a new drug and a high-risk device. In finding common law actions preempted, these courts claim to have faithfully applied Riegel’s holding. But using the model developed here, it is clear that courts have disrupted the calibrated regulatory system, allowing thousands or millions of people in the United States to be exposed to dangerous products whose risks have not been well characterized. Using the combination products decisions as a cases study, the model also highlights the far-reaching effects that even small changes to any one input may have on the function of an emergent system and the field that it regulates.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131089550","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}
S. Burris, Katie Moran-McCabe, Nadya Prood, K. Blankenship, Angus Corbett, A. Gutman, Bethany Saxon
This report is the fifth in a series of reports exploring the role of law in housing equity and innovative uses of law to improve health equity through housing. The reports are based on extensive literature scans and semi-structured interviews with people who are taking action in housing policy and practice. The full series includes: Report I: A Vision of Health Equity in Housing; Report II: Legal Levers for Health Equity in Housing: A Systems Approach; Report III: Health Equity in Housing: Evidence and Evidence Gaps; Report IV: Creative People and Places Building Health Equity in Housing; Report V: Governing Health Equity in Housing; and Report VI: Health Equity through Housing: A Blueprint for Systematic Legal Action. This report focuses on governance – the coordination of many actors from many levels, including policymakers, citizens, businesses, and other individuals and organizations – as an approach to the challenge of achieving health equity in housing. In this report, we tell the story of Oak Park, Illinois: a suburb of Chicago that rewrote the housing script to establish a lasting integrated and successful community. We extract lessons learned from Oak Park, and explore its use of governance to experiment and learn, and build health equity in housing.
{"title":"Governing Health Equity in Housing","authors":"S. Burris, Katie Moran-McCabe, Nadya Prood, K. Blankenship, Angus Corbett, A. Gutman, Bethany Saxon","doi":"10.2139/ssrn.3501675","DOIUrl":"https://doi.org/10.2139/ssrn.3501675","url":null,"abstract":"This report is the fifth in a series of reports exploring the role of law in housing equity and innovative uses of law to improve health equity through housing. The reports are based on extensive literature scans and semi-structured interviews with people who are taking action in housing policy and practice. The full series includes: Report I: A Vision of Health Equity in Housing; Report II: Legal Levers for Health Equity in Housing: A Systems Approach; Report III: Health Equity in Housing: Evidence and Evidence Gaps; Report IV: Creative People and Places Building Health Equity in Housing; Report V: Governing Health Equity in Housing; and Report VI: Health Equity through Housing: A Blueprint for Systematic Legal Action. This report focuses on governance – the coordination of many actors from many levels, including policymakers, citizens, businesses, and other individuals and organizations – as an approach to the challenge of achieving health equity in housing. In this report, we tell the story of Oak Park, Illinois: a suburb of Chicago that rewrote the housing script to establish a lasting integrated and successful community. We extract lessons learned from Oak Park, and explore its use of governance to experiment and learn, and build health equity in housing.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133734444","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}
Cities attract both more physicians and healthier people, but whether these two facts are causally related is yet to be determined, as many variables are correlated with both the physician concentration and health outcomes. This paper uses unidentifiable claims data from New Hampshire and treatment-effects analysis to address this question and finds that access to an additional physician per 10,000 residents leads to 4.5 saved lives per 100,000 residents. Using aggregate data and an instrumental-variable approach where I use the procedures carried out across areas joint with the policy-set reimbursement fees to instrument for the number of care providers, I show that these results generalize to the US as a whole. The results are robust to many specifications, to variations in the type of care providers considered, and to variations in how the instrument is constructed.
{"title":"Physician Workforce Effect on Health","authors":"Elena Falcettoni","doi":"10.2139/ssrn.3493192","DOIUrl":"https://doi.org/10.2139/ssrn.3493192","url":null,"abstract":"Cities attract both more physicians and healthier people, but whether these two facts are causally related is yet to be determined, as many variables are correlated with both the physician concentration and health outcomes. This paper uses unidentifiable claims data from New Hampshire and treatment-effects analysis to address this question and finds that access to an additional physician per 10,000 residents leads to 4.5 saved lives per 100,000 residents. Using aggregate data and an instrumental-variable approach where I use the procedures carried out across areas joint with the policy-set reimbursement fees to instrument for the number of care providers, I show that these results generalize to the US as a whole. The results are robust to many specifications, to variations in the type of care providers considered, and to variations in how the instrument is constructed.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130741508","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 begins with discussing how Coca-Cola paved its way from a rip off of Vin-Mariani (wine-cocoa luxury drink popular in the 18th century) to a global beverage brand, through diplomatic strategies, political lobbying, the formation of powerful allies and other strategies through covert operations acclimatized as per changing political landscapes. Moving on to how Coca-Cola avoids one of biggest posing risks to its business which is deleterious effects on health especially amongst children, by funding scientific research projects and warping scientific integrity to suit its propaganda by banking upon its influential power. It also talks about the cost-effective strategy adopted by Coca-Cola by making a switch from Sugar to High Fructose Corn Sugar, baring the bigger picture behind it. It highlights the hegemonic strength of a transnational corporation having a pervasive influence to change health mindsets amongst the world population, underpinning the need to bring about a change.
{"title":"Crisis and Coca-Cola","authors":"Megha Chauhan","doi":"10.2139/ssrn.3664678","DOIUrl":"https://doi.org/10.2139/ssrn.3664678","url":null,"abstract":"This paper begins with discussing how Coca-Cola paved its way from a rip off of Vin-Mariani (wine-cocoa luxury drink popular in the 18th century) to a global beverage brand, through diplomatic strategies, political lobbying, the formation of powerful allies and other strategies through covert operations acclimatized as per changing political landscapes. Moving on to how Coca-Cola avoids one of biggest posing risks to its business which is deleterious effects on health especially amongst children, by funding scientific research projects and warping scientific integrity to suit its propaganda by banking upon its influential power. It also talks about the cost-effective strategy adopted by Coca-Cola by making a switch from Sugar to High Fructose Corn Sugar, baring the bigger picture behind it. It highlights the hegemonic strength of a transnational corporation having a pervasive influence to change health mindsets amongst the world population, underpinning the need to bring about a change.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130605110","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 this study we used the variation in the c-section rate following a health reform in Iran, to identify the causal effect of cesarean delivery on health outcomes of the neonates as well as the effect of supply and demand side on the use of this procedure. By lowering the cost of vaginal delivery, increasing the wages of performing doctors and defining a quota for the maximum rate of annual cesarean delivery, the cesarean rate in Iran among first birth young women decreased from 48% to 33% in less than 3 years. We showed that the main driving force of this reduction is supply side incentives. We also showed that cesarean significantly increases the probability of infant's death by 5% and decreases the Apgar score by 10%.
{"title":"The Health Outcomes of Cesarean Section","authors":"H. Pilvar","doi":"10.2139/ssrn.3473002","DOIUrl":"https://doi.org/10.2139/ssrn.3473002","url":null,"abstract":"In this study we used the variation in the c-section rate following a health reform in Iran, to identify the causal effect of cesarean delivery on health outcomes of the neonates as well as the effect of supply and demand side on the use of this procedure. By lowering the cost of vaginal delivery, increasing the wages of performing doctors and defining a quota for the maximum rate of annual cesarean delivery, the cesarean rate in Iran among first birth young women decreased from 48% to 33% in less than 3 years. We showed that the main driving force of this reduction is supply side incentives. We also showed that cesarean significantly increases the probability of infant's death by 5% and decreases the Apgar score by 10%.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"143 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131716592","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 Office of the United States Trade Representative released its annual Special 301 Report this April and India continues to be on the Priority Watch List for a record 27th time. The USTR through its annual report identifies those countries, which it considers to be having inadequate intellectual property (IP) protection for US industries, including pharmaceutical industries. The Report, every year as a custom, demands stringent IP standards and enforcement in third world countries to undermine the competitors of these US behemoths. The Special 301 Report, driven majorly by demands from lobbyists for multinational pharmaceutical corporations, is the most effective mechanism that the US government employs to pressure countries like India to amend their laws and policies to favour US industries at the cost of not only the local industry but also right to health of people. The US initiate retaliatory action(s) against such countries via trade sanctions in the form of prohibitory tariffs, which causes countries on the list to be wary of the annual report. Further, it provides for a range of country listings, remedies and possible investigations to strong-arm other countries to surrender to US demands.
今年4月，美国贸易代表办公室(Office of The United States Trade Representative)发布了年度《特别301报告》(Special 301 Report)，印度创纪录地第27次被列入“重点观察名单”。美国贸易代表办公室通过其年度报告确定了那些它认为对美国工业(包括制药业)知识产权保护不足的国家。该报告每年都要求第三世界国家实施严格的知识产权标准和执法，以削弱这些美国巨头的竞争对手。特别301报告主要是由跨国制药公司说客的要求推动的，是美国政府用来向印度等国家施加压力的最有效的机制，迫使它们修改法律和政策，以有利于美国工业，不仅以当地工业为代价，而且以人民的健康权为代价。美国以禁止性关税的形式对这些国家采取贸易制裁的报复行动，这使得名单上的国家对年度报告保持警惕。此外，它还规定了一系列国家名单、补救措施和可能的调查，以迫使其他国家屈服于美国的要求。
{"title":"US Pressure and Changing Dynamics of India’s Patent Policy","authors":"Roshan John","doi":"10.2139/ssrn.3450523","DOIUrl":"https://doi.org/10.2139/ssrn.3450523","url":null,"abstract":"The Office of the United States Trade Representative released its annual Special 301 Report this April and India continues to be on the Priority Watch List for a record 27th time. The USTR through its annual report identifies those countries, which it considers to be having inadequate intellectual property (IP) protection for US industries, including pharmaceutical industries. The Report, every year as a custom, demands stringent IP standards and enforcement in third world countries to undermine the competitors of these US behemoths. \u0000 \u0000The Special 301 Report, driven majorly by demands from lobbyists for multinational pharmaceutical corporations, is the most effective mechanism that the US government employs to pressure countries like India to amend their laws and policies to favour US industries at the cost of not only the local industry but also right to health of people. The US initiate retaliatory action(s) against such countries via trade sanctions in the form of prohibitory tariffs, which causes countries on the list to be wary of the annual report. Further, it provides for a range of country listings, remedies and possible investigations to strong-arm other countries to surrender to US demands.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127639289","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}
Background: Uganda’s government embraced private provision of social services including health care. The involvement of private providers is an indicator that the public facilities are not sufficient enough to meet the high demands of the ever-increasing population. This has been done through partnership arrangements. This paper discusses the impact of Public-Private Partnership (PPP) on health care outcomes of the local population and opportunities for improving health outcomes, challenges facing private providers in a low-income setting like Uganda. Methodology: This was a qualitative study, data were collected using qualitative methods in January 2017 through interview (using semi-structured questions) at Ruharo Mission Hospital (RMH) administration, health workers, district health office and used a structured questionnaire for patients/clients. This was a nascent study, with a sample size of 22 respondents. The hospital has three departments; Organized Useful Rehabilitation Services (OURS), General Medical Services (GMS) and Eye Department (ED). All the departments of the hospital were represented in this study. Results: The hospital is a Church of Uganda founded, and runs a budget of 5 billion shillings ($ 1,351,351.4) annually, has multiple sources of funding including PHC funding annually and that, health services were delivered adequately to clients. Much as some services were accessed at no costs, other services like eye treatment were found expensive on the side of clients. The hospital’s hybrid mode of delivering health services through outreaches and facility-based services was cherished, however it had no ambulance and relied only on a hospital van. Conclusions and Recommendations: Our study concludes that if private providers are supported under the partnership arrangement, they can adequately deliver services to the clients and decongest the public facilities. We recommend that the government devote more funds to support the hospital through employing more sub-seconded staff, procuring medicines, and ambulances to enable it to subsidize services especially eye treatment and other services not supported under the partnership.
{"title":"Public-Private Partnership in Health Care and Its Impact on Health Outcomes: Evidence from Ruharo Mission Hospital in South Western Uganda","authors":"Justus Asasira, Frank Ahimbisibwe","doi":"10.2139/ssrn.3450562","DOIUrl":"https://doi.org/10.2139/ssrn.3450562","url":null,"abstract":"Background: Uganda’s government embraced private provision of social services including health care. The involvement of private providers is an indicator that the public facilities are not sufficient enough to meet the high demands of the ever-increasing population. This has been done through partnership arrangements. This paper discusses the impact of Public-Private Partnership (PPP) on health care outcomes of the local population and opportunities for improving health outcomes, challenges facing private providers in a low-income setting like Uganda. Methodology: This was a qualitative study, data were collected using qualitative methods in January 2017 through interview (using semi-structured questions) at Ruharo Mission Hospital (RMH) administration, health workers, district health office and used a structured questionnaire for patients/clients. This was a nascent study, with a sample size of 22 respondents. The hospital has three departments; Organized Useful Rehabilitation Services (OURS), General Medical Services (GMS) and Eye Department (ED). All the departments of the hospital were represented in this study. Results: The hospital is a Church of Uganda founded, and runs a budget of 5 billion shillings ($ 1,351,351.4) annually, has multiple sources of funding including PHC funding annually and that, health services were delivered adequately to clients. Much as some services were accessed at no costs, other services like eye treatment were found expensive on the side of clients. The hospital’s hybrid mode of delivering health services through outreaches and facility-based services was cherished, however it had no ambulance and relied only on a hospital van. Conclusions and Recommendations: Our study concludes that if private providers are supported under the partnership arrangement, they can adequately deliver services to the clients and decongest the public facilities. We recommend that the government devote more funds to support the hospital through employing more sub-seconded staff, procuring medicines, and ambulances to enable it to subsidize services especially eye treatment and other services not supported under the partnership.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130972831","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}
Equitable health services are the rights of every human being and citizen, including disability community groups such as those contained in the The Constitution of the Republic of Indonesia of 1945 and 17 goals SDGs UN. One of the efforts made by the government is the establishment of regional regulations that can provide a legal protection for people with disabilities at the regional level. Local regulation no. 2 of 2017 concerning health for persons with disabilities of Surabaya is one of the example of regulation for disabilities people in regional level. This study explain the implementation of health services for people with disabilities in Surabaya based on local regulation no. 2 of 2017 using the concept of collaborative governance. The method used in this study was interviews with stakeholders, observation, and literature review. Results from this study indicate that there are health facilities and services that have been established by Surabaya City Government and private parties such as the establishment of disability service centers, service rooms for family with disabilities children, disabled child development foundations, "Suroboyo Bus" disabled-friendly buses, etc.
{"title":"Collaborative Governance in Administering Health for People With Disabilities (Case Study in Surabaya City)","authors":"Wardatul Yunita Tikasari, Nisrina Nurika Agustin","doi":"10.2139/ssrn.3497278","DOIUrl":"https://doi.org/10.2139/ssrn.3497278","url":null,"abstract":"Equitable health services are the rights of every human being and citizen, including disability community groups such as those contained in the The Constitution of the Republic of Indonesia of 1945 and 17 goals SDGs UN. One of the efforts made by the government is the establishment of regional regulations that can provide a legal protection for people with disabilities at the regional level. Local regulation no. 2 of 2017 concerning health for persons with disabilities of Surabaya is one of the example of regulation for disabilities people in regional level. This study explain the implementation of health services for people with disabilities in Surabaya based on local regulation no. 2 of 2017 using the concept of collaborative governance. The method used in this study was interviews with stakeholders, observation, and literature review. Results from this study indicate that there are health facilities and services that have been established by Surabaya City Government and private parties such as the establishment of disability service centers, service rooms for family with disabilities children, disabled child development foundations, \"Suroboyo Bus\" disabled-friendly buses, etc.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124550871","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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