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

Canada: a land of missed opportunity for addressing the social determinants of health

T. Bryant and others

Health Policy, vol.101, 2011, p. 44-58

The first 25 years of universal public health insurance in Canada saw major reductions in income-related health inequalities as regards conditions amenable to medical treatment, such as asthma and appendicitis. For Canada, the next challenge in tackling health inequalities lies in addressing the social determinants of health. Unfortunately, recent social policy initiatives in several areas have not been supportive of the reduction of health inequalities. Canada's track record in this regard has been poor since the 1980s in five areas: the overall redistributive impact of tax and transfer policies; the reduction of family and child poverty; housing policy; early childhood education and care; and urban health policy.

Firms asked to give 5m for jab project

S. Lister

The Times, July 8th 2011, p. 9

In order to encourage greater support from the private sector to help meet the budget targets of the Global Alliance for Vaccines, 20 of the UK's top businesses have been asked by the Government to give 5 million each to global efforts to improve childhood vaccination which will then be matched by government funds. Glaxo SmithKline suggested that big business, including the pharmaceutical industry, needed to put the world's most urgent health needs before profits. GSK itself has cut the cost of its vaccine against diarrhoeal disease, the second biggest killer of children under 5, to 1.50 a dose in Third World countries- just 5% of its 30 Western market price.

Health policies for migrant populations in three European countries: England, Italy and Spain

M.-L. Vzquez and others

Health Policy, vol.101, 2011, p. 70-78

This article presents a comparative analysis of health policies for immigrants in three European Union countries with different traditions with regard to immigration, namely England, Italy and Spain. Different models of immigrant integration in receiving countries seem to condition the health policy approach. England and Spain propose actions to address immigrants' healthcare needs, while in Italy the development of specific strategies is limited. However, in England inequalities in health and access to healthcare persist in relation to immigrants despite decades of policy initiatives. This suggests that policy formulation needs to be accompanied by careful implementation and evaluation. Moreover, to prevent immigrants being excluded from the healthcare system, countries should consider two kinds of policies: those that address the needs of recently arrived immigrants and those that address the needs of an ethnically diverse population.

Healthy mothers, healthy children: does maternal demand for antenatal care matter for child health in Nepal?

N. Halim, A.K. Bohara and X. Ruan

Health Policy and Planning, vol.26, 2011, p. 242-256

Nepal's Safe Motherhood Programme has failed to deliver expected gains in maternal and child health, with continued low use of antenatal services, high maternal mortality and common chronic malnutrition. This study shows that education, both maternal and paternal, increases routine antenatal care use and that child health improves as a result. In the face of strict patriarchal gender norms, religious and cultural health practices, efforts should be made to involve husbands in the process of maternal care utilisation as well as focusing on female education and raising women's status.

Is demand-side financing equity enhancing? Lessons from a maternal health voucher scheme in Bangladesh

S. Ahmed and M.M. Khan

Social Science and Medicine, vol. 72, 2011, p. 1704-1710

Despite the capacity expansion of healthcare facilities, access to maternal health services has remained low in developing countries, especially for poorer sections of the community, due to relatively high out-of-pocket expenses. In recent years, in order to reduce financial barriers to access, maternal health voucher schemes have been introduced in a number of low-income countries, including Bangladesh. However, little is known about the impact of such demand-side financing schemes on healthcare service utilisation and health outcomes. This study used a relatively large household survey to examine the effects of the Bangladesh maternal health voucher programme on maternal health service use in a poor rural community. Results showed that, once the financial barriers to access were removed, maternal health service utilisation by the poor increased rapidly.

Ownership change and the rise of a for-profit hospital industry in Germany

T. Klenk

Policy Studies, vol. 32, 2011, p. 263-275

The 2008/09 financial crisis has had a severe impact on hospitals. Hospitals have high investment needs due to technological developments and population ageing at a time when financial support from the public authorities is declining. In Germany, public subsidies for inpatient services declined by 34.48% between 1998 and 2008. In these circumstances, the German hospital sector has become attractive to private investors, particularly as the ageing population promises stable growth. Private hospital companies, venture capitalists, financial investors and strategic investors (medical engineering and pharmaceutical companies) have entered the market. Public authorities have welcomed the new actors as they have promised smart solutions for indebted communities withdrawing from funding responsibilities. As a result, the share of hospitals with a private legal form has risen sharply in recent years.

Patients satisfied with e-prescribing in Sweden: a survey of nationwide implementation

T. Hammar and others

Journal of Pharmaceutical Health Services Research, vol. 2, 2011, p. 97-105

It has been suggested that the introduction of electronically transmitted prescriptions will improve safety, quality, efficiency and cost-effectiveness. However, the introduction of new technology may create problems as well as solving them. In Sweden, 70% of prescriptions are transmitted electronically, and since 2005 it has been possible for patients to store their valid prescriptions in the Online Prescription Repository. Patients can now access their prescriptions via the Internet. This has opened up new services such as mail order prescriptions. Previous research has shown that Swedish prescribers and pharmacists value e-prescribing and consider it safe, convenient and time-saving. This study evaluate Swedish patients' attitudes to e-prescribing using data from a nationwide survey. Results showed that the vast majority of patients had positive attitudes to e-prescribing and electronic storage of prescriptions, but improvements were still needed in user education and information.

Prospects for regulated competition in the health care system: what can China learn from Russia's experience?

W. Xu and others

Health Policy and Planning, vol.26, 2011, p. 199-209

China is considering directions for the reform of its malfunctioning healthcare system, with competition between both insurers and providers being one of the options under consideration. In 1993 Russia implemented legislation to stimulate regulated competition in the healthcare sector. The subsequent progress and lessons learned can inform the future evolution of the Chinese system. In Russia, competition is still lacking among both insurers and providers, which is not surprising since most, if not all, of the necessary pre-conditions for regulated competition are lacking. The experience of Russia demonstrates to Chinese policymakers that necessary pre-conditions, such as consumer choice, contracting freedom and appropriate government regulation, must be in place for regulated competition to succeed, and implementation strategies must be carefully considered.

UN resolution on the prevention and control of non-communicable diseases: an opportunity for global action

H.M. Mamudu, J.S. Yang and T.E. Novotny

Global Public Health, vol.6, 2011, p. 347-353

In May 2010 the UN General Assembly unanimously adopted a resolution on non-communicable diseases that called for a series of high level meetings to address their control and prevention. This paper highlights the growing global burden of non-communicable diseases, provides a brief historical background to the adoption of the UN resolution and argues that it provides a new opportunity for improved international collaboration to address the problem.

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