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Health policy and planning 16건

  1. [해외논문]   Resumenes en esta edición   SCIE SSCI


    Health policy and planning v.32 no.1 ,pp. S1 - S8 , 2017 , 0268-1080 ,

    초록

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  2. [해외논문]   Résuméés dans ce numéééro   SCIE SSCI


    Health policy and planning v.32 no.1 ,pp. F1 - F8 , 2017 , 0268-1080 ,

    초록

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    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  3. [해외논문]   International trade and determinants of price differentials of insulin medicine   SCIE SSCI

    Helble, Matthias , Aizawa, Toshiaki
    Health policy and planning v.32 no.1 ,pp. 1 - 10 , 2017 , 0268-1080 ,

    초록

    Empirical studies on pharmaceutical pricing across countries have found evidence that prices vary according to per capita income. These studies are typically based on survey data from a subset of countries and cover only one year. In this paper, we study the international trade and price of insulin by using detailed trade data for 186 importing countries from 1995 to 2013. With almost 12,000 observations, our study constitutes the largest comparative study on pharmaceutical pricing conducted so far. The large dataset allows us to uncover new determinants of price differentials. Our analysis shows that the international trade of insulin increased substantially over this time period, clearly outpacing the increasing prevalence of diabetes. Using the unit values of imports, we also study the determinants of price differentials between countries. Running various panel regressions, we find that the differences in prices across countries can be explained by the following factors: First, corroborating earlier studies, we find that per capita GDP is positively correlated with the unit price of insulin. Second, the price of insulin drugs originating from Organisation for Economic Co-operation and Development countries tends to be substantially higher than for those imported from developing countries. Third, more intense competition among suppliers leads to lower insulin prices. Fourth, higher out-of-pocket payments for health care are associated with higher prices. Finally, higher volumes and tariffs seem to result in lower unit prices.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  4. [해외논문]   Health system changes under pay-for-performance: the effects of Rwanda's national programme on facility inputs   SCIE SSCI

    Ngo, Diana K L (Department of Economics Occidental College, Fowler 223, 1600 Campus Rd, Los Angeles, CA 90041, USA ) , Sherry, Tisamarie B (Department of Medicine Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA ) , Bauhoff, Sebastian (Center for Global Development, 2055 L Street NW, Fifth Floor, Washington, DC 20036, USA)
    Health policy and planning v.32 no.1 ,pp. 11 - 20 , 2017 , 0268-1080 ,

    초록

    Pay-for-performance (P4P) programmes have been introduced in numerous developing countries with the goal of increasing the provision and quality of health services through financial incentives. Despite the popularity of P4P, there is limited evidence on how providers achieve performance gains and how P4P affects health system quality by changing structural inputs. We explore these two questions in the context of Rwanda’s 2006 national P4P programme by examining the programme’s impact on structural quality measures drawn from international and national guidelines. Given the programme’s previously documented success at increasing institutional delivery rates, we focus on a set of delivery-specific and more general structural inputs. Using the programme’s quasi-randomized roll-out, we apply multivariate regression analysis to short-run facility data from the 2007 Service Provision Assessment. We find positive programme effects on the presence of maternity-related staff, the presence of covered waiting areas and a management indicator and a negative programme effect on delivery statistics monitoring. We find no effects on a set of other delivery-specific physical resources, delivery-specific human resources, delivery-specific operations, general physical resources and general human resources. Using mediation analysis, we find that the positive input differences explain a small and insignificant fraction of P4P’s impact on institutional delivery rates. The results suggest that P4P increases provider availability and facility operations but is only weakly linked with short-run structural health system improvements overall.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  5. [해외논문]   Community midwifery initiatives in fragile and conflict-affected countries: a scoping review of approaches from recruitment to retention   SCIE SSCI

    Miyake, Sachiko (Department of Global Health and Development, London School of Hygiene and Tropical Medicine, Faculty of Public Health and Policy, London, UK ) , Speakman, Elizabeth M (Department of Global Health and Development, London School of Hygiene and Tropical Medicine, Faculty of Public Health and Policy, London, UK ) , Currie, Sheena (Jhpiego, Technical Leadership Office, Baltimore, Jhpiego, Baltimore, MD, USA ) , Howard, Natasha (Department of Global Health and Development, London School of Hygiene and Tropical Medicine, Faculty of Public Health and Policy, London, UK)
    Health policy and planning v.32 no.1 ,pp. 21 - 33 , 2017 , 0268-1080 ,

    초록

    Background: Birth assisted by skilled health workers is one of the most effective interventions for reducing maternal and neonatal mortality. Fragile and conflict-affected states and situations (FCAS), with one-third of global maternal deaths, face significant challenges in achieving skilled care at birth, particularly in health workforce development. The importance of community-level midwifery services to improve skilled care is internationally recognized, but the literature on FCAS is limited. This review aimed to examine community midwifery (CMW) approaches, from recruitment to retention, in FCAS. Methods: This scoping review design adapted Arksey and O'Malley's six-stage framework. Data collection included systematic searching of seven databases, purposive hand-searching of reference lists and web sites, and stakeholder engagement for additional information. Potential sources were screened against inclusion and exclusion criteria. Included sources were appraised for methodological quality using the McGill University Mixed Methods Appraisal Tool. Data were analysed thematically, using deductive (i.e. cadre definition, recruitment, education, deployment and retention) and inductive coding (i.e. capacity, gender and insecurity). Results: Twenty-three sources were included, of 2729 identified, discussing community midwifery programmes in six FCAS (i.e. eight for Sudan, six for Afghanistan, three each for Mali and Yemen, two for South Sudan and one for Somalia). Source quality was relatively poor, and cadre definitions were context dependent. Major enablers for effective CMW programmes were community linkages and acceptance, while barriers included inappropriate recruitment, non-standardized education, weak supportive environment, political insecurity and violence. Conclusions: While community engagement and acceptance were crucial, CMW programmes were weakened by inappropriate recruitment and training, lack of support and general insecurity. Further research and implementation evidence is needed to aid policy-makers, donors and implementing agencies in developing and implementing effective CMW programmes in FCAS.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  6. [해외논문]   Who bears the cost of 'informal mhealth'? Health-workers' mobile phone practices and associated political-moral economies of care in Ghana and Malawi   SCIE SSCI

    Hampshire, Kate (Department of Anthropology, Durham University, Durham DH1 3LE, UK ) , Porter, Gina (Department of Anthropology, Durham University, Durham DH1 3LE, UK ) , Mariwah, Simon (Department of Geography and Regional Planning, University of Cape Coast, Ghana, ) , Munthali, Alister (Centre for Social Research, University of Malawi ) , Robson, Elsbeth (Department of Geography, Environment and Earth Sciences, University of Hull, UK ) , Owusu, Samuel Asiedu (Department of Population and Health, University of Cape Coast, Ghana ) , Abane, Albert (Department of Geography and Regional Planning, University of Cape Coast, Ghana, ) , Milner, James (Centre for Social Research, University of Malawi)
    Health policy and planning v.32 no.1 ,pp. 34 - 42 , 2017 , 0268-1080 ,

    초록

    Africa’s recent communications ‘revolution’ has generated optimism that using mobile phones for health (mhealth) can help bridge healthcare gaps, particularly for rural, hard-to-reach populations. However, while scale-up of mhealth pilots remains limited, health-workers across the continent possess mobile phones. This article draws on interviews from Ghana and Malawi to ask whether/how health-workers are using their phones informally and with what consequences. Health-workers were found to use personal mobile phones for a wide range of purposes: obtaining help in emergencies; communicating with patients/colleagues; facilitating community-based care, patient monitoring and medication adherence; obtaining clinical advice/information and managing logistics. However, the costs were being borne by the health-workers themselves, particularly by those at the lower echelons, in rural communities, often on minimal stipends/salaries, who are required to ‘care’ even at substantial personal cost. Although there is significant potential for ‘informal mhealth’ to improve (rural) healthcare, there is a risk that the associated moral and political economies of care will reinforce existing socioeconomic and geographic inequalities.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  7. [해외논문]   A composite indicator to measure universal health care coverage in India: way forward for post-2015 health system performance monitoring framework   SCIE SSCI

    Prinja, Shankar (School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India ) , Gupta, Rakesh (Office of Chief Minister, Government of Haryana, Chandigarh 160012, India ) , Bahuguna, Pankaj (School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India ) , Sharma, Atul (School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India ) , Kumar Aggarwal, Arun (School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India ) , Phogat, Amit (National Rural Health Mission, Department of Health and Family Welfare, Panchkula - 134109, Haryana, India ) , Kumar, Rajesh (School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India)
    Health policy and planning v.32 no.1 ,pp. 43 - 56 , 2017 , 0268-1080 ,

    초록

    Background There is limited work done on developing methods for measurement of universal health coverage. We undertook a study to develop a methodology and demonstrate the practical application of empirically measuring the extent of universal health coverage at district level. Additionally, we also develop a composite indicator to measure UHC. Methods A cross-sectional survey was undertaken among 51 656 households across 21 districts of Haryana state in India. Using the WHO framework for UHC, we identified indicators of service coverage, financial risk protection, equity and quality based on the Government of India and the Haryana Government’s proposed UHC benefit package. Geometric mean approach was used to compute a composite UHC index (CUHCI). Various statistical approaches to aggregate input indicators with or without weighting, along with various incremental combinations of input indicators were tested in a comprehensive sensitivity analysis. Findings The population coverage for preventive and curative services is presented. Adjusting for inequality, the coverage for all the indicators were less than the unadjusted coverage by 0.1–6.7% in absolute term and 0.1–27% in relative term. There was low unmet need for curative care. However, about 11% outpatient consultations were from unqualified providers. About 30% households incurred catastrophic health expenditures, which rose to 38% among the poorest 20% population. Summary index (CUHCI) for UHC varied from 12% in Mewat district to 71% in Kurukshetra district. The inequality unadjusted coverage for UHC correlates highly with adjusted coverage. Conclusion Our paper is an attempt to develop a methodology to measure UHC. However, careful inclusion of others indicators of service coverage is recommended for a comprehensive measurement which captures the spirit of universality. Further, more work needs to be done to incorporate quality in the measurement framework.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  8. [해외논문]   Effect of primary health care reforms in Turkey on health service utilization and user satisfaction   SCIE SSCI

    Hone, Thomas (Department of Primary Care and Public Health, Imperial College London, London SW7 2AZ, UK ) , Gurol-Urganci, Ipek (Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK ) , Millett, Christopher (Department of Primary Care and Public Health, Imperial College London, London SW7 2AZ, UK ) , Basara, Berrak (General Directorate of Health Service Research, Ministry of Health, Ankara, 06430, Republic of Turkey ) , Akdağ (Minister for Health, Ministry of Health, Ankara, 06420, Republic of Turkey ) , , Recep (Department of Global Health and Population, Harvard School of Public Health, Harvard University, Boston, MA 02115, USA) , Atun, Rifat
    Health policy and planning v.32 no.1 ,pp. 57 - 67 , 2017 , 0268-1080 ,

    초록

    Strengthening primary health care (PHC) is considered a priority for efficient and responsive health systems, but empirical evidence from low- and middle-income countries is limited. The stepwise introduction of family medicine across all 81 provinces of Turkey (a middle-income country) between 2005 and 2010, aimed at PHC strengthening, presents a natural experiment for assessing the effect of family medicine on health service utilization and user satisfaction. The effect of health system reforms, that introduced family medicine, on utilization was assessed using longitudinal, province-level data for 12 years and multivariate regression models adjusting for supply-side variables, demographics, socio-economic development and underlying yearly trends. User satisfaction with primary and secondary care services was explored using data from annual Life Satisfaction Surveys. Trends in preferred first point of contact (primary vs secondary, public vs. private), reason for choice and health services issues, were described and stratified by patient characteristics, provider type, and rural/urban settings. Between 2002 and 2013, the average number of PHC consultations increased from 1.75 to 2.83 per person per year. In multivariate models, family medicine introduction was associated with an increase of 0.37 PHC consultations per person ( P  < 0.001), and slower annual growth in PHC and secondary care consultations. Following family medicine introduction, the growth of PHC and secondary care consultations per person was 0.08 and 0.30, respectively, a year. PHC increased as preferred provider by 9.5% over 7 years with the reasons of proximity and service satisfaction, which increased by 14.9% and 11.8%, respectively. Reporting of poor facility hygiene, difficulty getting an appointment, poor physician behaviour and high costs of health care all declined ( P  < 0.001) in PHC settings, but remained higher among urban, low-income and working-age populations.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  9. [해외논문]   Incidence and determinants of hysterectomy in a low-income setting in Gujarat, India   SCIE SSCI

    Desai, Sapna (Dept of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine. Keppel St, London WC1E 7HT, UK ) , Campbell, Oona MR (Dept of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine. Keppel St, London WC1E 7HT, UK ) , Sinha, Tara (Self Employed Women's Association (SEWA) Health) , Mahal, Ajay (Chanda Niwas, Nr Ellis Bridge, Ahmedabad 380006, Gujarat India, ) , Cousens, Simon (Nossal Institute for Global Health, University of Melbourne, Carlton VIC 3053, Australia )
    Health policy and planning v.32 no.1 ,pp. 68 - 78 , 2017 , 0268-1080 ,

    초록

    Hysterectomy is a leading reason for use of health insurance amongst low-income women in India, but there are limited population-level data available to inform policy. This paper reports on the findings of a mixed-methods study to estimate incidence and identify predictors of hysterectomy in a low-income setting in Gujarat, India. The estimated incidence of hysterectomy, 20.7/1000 woman- years (95% CI: 14.0, 30.8), was considerably higher than reported from other countries, at a relatively low mean age of 36 years. There was strong evidence that among women of reproductive age, those with lower income and at least two children underwent hysterectomy at higher rates. Nearly two-thirds of women undergoing hysterectomy utilized private hospitals, while the remainder used government or other non-profit facilities. Qualitative research suggested that weak sexual and reproductive health services, a widespread perception that the post-reproductive uterus is dispensable and lack of knowledge of side effects have resulted in the normalization of hysterectomy. Hysterectomy appears to be promoted as a first or second-line treatment for menstrual and gynaecological disorders that are actually amenable to less invasive procedures. Most women sought at least two medical opinions prior to hysterectomy, but both public and private providers lacked equipment, skills and motivation to offer alternatives. Profit and training benefits also appeared to play a role in some providers’ behaviour. Although women with insecure employment underwent the procedure knowing the financial and physical implications of undergoing a major surgery, the future health and work security afforded by hysterectomy appeared to them to outweigh risks. Findings suggest that sterilization may be associated with an increased risk of hysterectomy, potentially through biological or attitudinal links. Health policy interventions require improved access to sexual and reproductive health services and health education, along with surveillance and medical audits to promote high-quality choices for women through the life cycle.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  10. [해외논문]   Has India's national rural health mission reduced inequities in maternal health services? A pre-post repeated cross-sectional study   SCIE SSCI

    Vellakkal, Sukumar (Center for Chronic Diseases and Injuries, Public Health Foundation of India, Gurgaon, Haryana, Postal code 122002, India ) , Gupta, Adyya (Center for Chronic Diseases and Injuries, Public Health Foundation of India, Gurgaon, Haryana, Postal code 122002, India ) , Khan, Zaky (Center for Chronic Diseases and Injuries, Public Health Foundation of India, Gurgaon, Haryana, Postal code 122002, India ) , Stuckler, David (Department of Sociology, University of Oxford, Oxford, OX1 3UQ, United Kingdom ) , Reeves, Aaron (Department of Sociology, University of Oxford, Oxford, OX1 3UQ, United Kingdom ) , Ebrahim, Shah (Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine 15-17 Tavistock place, London, WC1H 9SH, United Kingdom ) , Bowling, Ann (Department of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom ) , Doyle, Pat (Department of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom)
    Health policy and planning v.32 no.1 ,pp. 79 - 90 , 2017 , 0268-1080 ,

    초록

    Background: In 2005, India launched the National Rural Health Mission (NRHM) to strengthen the primary healthcare system. NRHM also aims to encourage pregnant women, particularly of low socioeconomic backgrounds, to use institutional maternal healthcare. We evaluated the impacts of NRHM on socioeconomic inequities in the uptake of institutional delivery and antenatal care (ANC) across high-focus (deprived) Indian states. Methods: Data from District Level Household and Facility Surveys (DLHS) Rounds 1 (1995–99) and 2 (2000–04) from the pre-NRHM period, and Round 3 (2007–08), Round 4 and Annual Health Survey (2011–12) from post-NRHM period were used. Wealth-related and education-related relative indexes of inequality, and pre-post difference-in-differences models for wealth and education tertiles, adjusted for maternal age, rural-urban, caste, parity and state-level fixed effects, were estimated. Results: Inequities in institutional delivery declined between pre-NRHM Period 1 (1995–99) and pre-NRHM Period 2 (2000–04), but thereafter demonstrated steeper decline in post-NRHM periods. Uptake of institutional delivery increased among all socioeconomic groups, with (1) greater effects among the lowest and middle wealth and education tertiles than highest tertile, and (2) larger equity impacts in the late post-NRHM period 2011–12 than in the early post-NRHM period 2007–08. No positive impact on the uptake of ANC was found in the early post-NRHM period 2007–08; however, there was considerable increase in the uptake of, and decline in inequity, in uptake of ANC in most states in the late post-NRHM period 2011–12. Conclusion: In high-focus states, NRHM resulted in increased uptake of maternal healthcare, and decline in its socioeconomic inequity. Our study suggests that public health programs in developing country settings will have larger equity impacts after its almost full implementation and widest outreach. Targeting deprived populations and designing public health programs by linking maternal and child healthcare components are critical for universal access to healthcare.

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