Cardona C and Bishai D (2018) The slowing pace of life expectancy gains since 1950, BMC Public Health, 18(1), 151, DOI: 10.1186/s12889-018-5058-9
New technological breakthroughs in biomedicine should have made it easier for countries to improve life expectancy at birth (LEB). This paper measures the pace of improvement in the decadal gains of LEB, for the last 60-years adjusting for each country’s starting point of LEB.
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There is a growing appreciation and recognition of the role of the private sector in the development of better health systems and the improvement of healthcare worldwide.
This Health Policy and Planning supplement reflects contributions to a Symposium of the Health Systems Global Private Sector in Health Thematic Working Group during the 9th World Congress on Health Economics, held in Sydney in July 2013. Members of the PSIH TWG that convened the Symposium included FHS members David Bishai (JHBSPH) and Gerry Bloom (IDS), and was generously supported by Rockefeller, Gates, USAID, AusAid (DFAT), and DFID.
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Complex and dynamic public health problems require a different approach: an emphasis on the value of people. People who own the problem can anticipate the most likely social obstacles to its resolution, and their participation is essential to maintain an evolving strategy that can institutionalize an approach to the problem.
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This paper presents a system dynamics computer simulation model to illustrate unintended consequences of apparently rational allocations to curative and preventive services.
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In 2009 the government of China identified an essential drugs policy as one of five priority areas for health system reform. Since then, a national essential drugs policy has been defined, along with plans to implement it. As a large scale social intervention, the policy will have a significant impact on various local health actors. This paper uses the lens of complex adaptive systems to examine how the policy has been implemented in three rural Chinese counties. Using material gathered from interviews with key actors in county health bureaus and township health centers, we illustrate how a single policy can lead to multiple unanticipated outcomes. The complexity lens applied to the material gathered in interviews helps to identify relevant actors, their different relationships and policy responses and a new framework to better understand heterogeneous pathways and outcomes. Decision-makers and policy implementers are advised to embrace the complex and dynamic realities of policy implementation. This involves developing mechanisms to monitor different behaviors of key actors as well as the intended outcomes and unintended consequences of the policy.
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Dr David Bishai gives an introduction complex adaptive systems and their application to health systems modelling and strengthening.
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The presentation by Dr David Bishai was given at the First Complex Adaptive Systems Training Workshop for CNHDRC, which was held in Beijing, China, from 18-19 July. It outlines the origins of complex adaptive systems thinking in social sciences.
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Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing independent private sector providers; social franchises of private providers; non-government organization (NGO) providers; and government providers on these three factors.
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We reviewed existing literature on private sector initiatives that have shown effectiveness in improving maternal and neonatal health. The private sector constitutes a significant proportion of delivery services for women in developing countries and it also plays a key role in family planning, abortion, nutrition, and antenatal care. We primarily address maternal health outcomes and include interventions that improve neonatal health outcomes where they are included in the study design or interventional strategy alongside maternal outcomes. We do not review evidence that addresses neonatal outcomes alone, as this would go beyond the scope of this paper.
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This paper discusses the economic rationale for innovative service models in private sector health care delivery. Social franchising and other business models of health care delivery secure cooperation between providers, and coordinating agencies in order to improve quality, access, and efficiency of primary health care (PHC) in the private sector.
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Uganda implemented health sector reforms to make services more accessible to the population. An assessment of the likely impact of these reforms is important for informing policy. This paper describes the changes in utilization of health services that occurred among the poor and those in rural areas between 2002/3 and 2005/6 and associated factors.
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The goal of this paper is to examine the ways in which public and private sectors can cooperate to improve the quality and accessibility of primary healthcare (PHC) to the poor in developing countries.
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In The Lancet today, Stephen Lim and colleagues compare officially reported estimates of coverage with diphtheria, tetanus, and pertussis vaccine (DTP3) to estimates based on household survey data.1 With close to 600 surveys from 193 countries, this definitive study confirms that the correlation between mothers' reports and official reports is not good.
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Objective: To determine the cost-effectiveness of prenatal iron supplementation and misoprostol use as interventions to prevent maternal mortality in home births in rural India.
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