Welfare Reform on the Web (February 2011): Healthcare - overseas

Can we make sense of multidisciplinary co-operation in primary care by considering routines and rules?

A.M.J. Elissen, A.J.A. van Raak and A.T.G. Paulus

Health and Social Care in the Community, vol. 19, 2011, p. 33-42

Although it is generally agreed that the complex health problems of chronically ill and elderly patients require care provision across organisational and professional boundaries, achieving widespread multidisciplinary co-operation in primary care has proved problematic. This study aimed to develop an explanation of the limited extent of multidisciplinary co-operation in primary healthcare in Limburg, the Netherlands by examining local providers' routines (patterns of behaviour) and the rules that shape them. Existing organisational rules appear to hamper change. Rather than promoting far-reaching multidisciplinary co-operation, these rules, particularly those on reimbursement, confirm the current practice of individual, monodisciplinary care delivery. They urge providers to engage in multidisciplinary co-operation as a subsidiary activity, which does not interfere with individual (reimbursed) activities.

Challenges to implementation of artemisinin combination therapy in Uganda

V. Batwala, P. Magnussen and F. Nuwaha

International Health, vol. 2, 2010, p. 262-268

In recent years the threat posed by failing, but inexpensive, anti-malarial drugs led to an international effort to replace them with more expensive artemisinin combination therapies (ACTs). Uganda launched an artemisinin combination therapy policy for the treatment of uncomplicated malaria in 2006, but little information is available regarding implementation. This paper describes the challenges to ACT policy implementation at rural public health centres in the Bushenyi and Iganga districts of Uganda. The major challenges identified in the study were: stock-outs in health centres, continued use of non-recommended antimalarials, lack of parasitological diagnosis, and problems with human resources.

Gaps in children's health insurance: magnitude, consequences, barriers and implications for policy and research

C.H. Brouse and C.E. Basch

International Journal of Health Promotion and Education, vol.48, no.4, 2010, p. 129-133

This paper considers how health insurance coverage influences the health status of children in the United States. Four topics are addressed. First, estimates of the number of children with no insurance or discontinuous coverage presented. Second, the consequences of being uninsured or having gaps in health insurance are considered. Third, a summary of the barriers to increasing the extent and continuity of children's health insurance is given. Fourth, the implications for policy and research are discussed.

Health care politics in the age of retrenchment

J. Jordan

Journal of Social Policy, vol. 40, 2011, p. 113-134

This study examines the impact of the era of welfare retrenchment which began with the oil-crisis induced recessions of the 1970s on the politics of health care. By examining the relative growth of the public and private health care sectors in 18 advanced industrial countries, the paper sheds light on the effect of the transition to retrenchment era politics on the role of partisanship in determining spending patterns. The analysis focused on whether the politics of retrenchment had reduced the impact of partisanship on healthcare policy. The results reveal that the partisan character of government no longer plays a significant role in determining changes in public responsibility for healthcare in the era of retrenchment. This suggests that the current period is characterised by general agreement across party lines on the broad parameters of the healthcare system.

Knowledge, skills and productivity in primary eye care among health workers in Tanzania: need for reassessment of expectations?

E. Byamukama and P. Courtright

International Health, vol.2, 2010, p. 247-252

Reducing blindness globally requires an appropriately skilled team of health professionals. In African countries there is general agreement that a primary eye care worker is a) employed as a full time health worker and b) includes eye care as only one component of a mix of health care activities. This study aimed to assess primary eye care knowledge, skills and productivity of workers at dispensaries in a district of Tanzania. Forty-nine health workers were assessed. There was poor understanding of basic ocular conditions and how to assess visual acuity. There was little association between having received training and the skills score. Findings suggest that a reassessment of the roles and responsibilities in primary eye care of dispensary health workers, and a review of training curriculum and teaching, and supervisory procedures may be needed.

New technologies and emerging spaces of care

M. Schillmeier and M. Domenech (editors)

Farnham: Ashgate, 2010

The book provides the latest practice-oriented qualitative research and innovative conceptual discussions of how health and health care systems are currently dealing with complex transformations and varied reforms. Exploring and analysing the social and cultural impact of new technologies, it examines the societal relevance of new assistive technologies for elderly and disabled people and the manner in which technological innovations configure and reconfigure institutionalized spaces of care. It addresses issues of social control, accountability, surveillance and disciplining; diverging patterns of inclusion and exclusion; new relations and subjectivities of patients and care givers; the relation between private and public forms of care; and the practices and concerns generated by new technologies at the individual as well as the societal level.

Poor countries with IMF loans 'divert aid from public health'

L. Elliott

The Guardian, Jan. 17th 2011, p. 22

Poor countries that borrow from the International Monetary Fund (IMF) are spending just one cent in every dollar received on health and on improving the medical care of their population, according to new research by Oxford University. The study, published in the International Journal of Health Services, found signs that the tough loans conditions imposed by the IMF were forcing poor countries to divert health aid to other uses.

Republicans set for fresh assault on Obama's healthcare reforms

D. Usborne

The Independent, Jan. 4th 2011, p. 19

Republicans in the House of Representatives will waste no time in asserting their agenda on Capitol Hill with a bill to repeal the most hard-fought achievement of the Obama's administration: the healthcare reform law.

(See also Times, Jan. 5th 2011, p. 27)

Towards healthy cities: comparing conditions for change

A. Otagaar, J. Klijs and L. Van Den Berg

Farnham: Ashgate, 2011

This book explores the conditions needed to make public and private investments in healthy cities most effective. The authors argue that three conditions are essential for such investments: citizen empowerment, corporate responsibility and a coordinated improvement of urban health conditions. Using an integrated approach to health in line with the Healthy Cities philosophy of the World Health Organization, case studies in Helsinki, Liverpool, London, Udine and Vancouver are not only used to demonstrate the relevance of these conditions, but also to show how actors in these cities are trying to meet them.

Urban health: global perspectives

D. Vlahov and others (editors)

Chichester: Wiley, 2010

In the twentieth century, the urban settings of the wealthy nations were largely associated with opportunity, accumulation of wealth, and better health than their rural counterparts. In the twenty-first century, demographic changes, globalization, and climate change are having important health consequences for wealthy nations and especially for low- and middle-income countries. The increasing concentration of poverty and significant inequalities between urban neighbourhoods and the physical and social environments in cities are important determinants of population health. In this book, experts identify the priority problems and outline solutions that can generate and sustain healthy urban environments.