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International Health and Aid Policies

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  • 5 b/w illus. 20 tables
  • Page extent: 314 pages
  • Size: 234 x 156 mm
  • Weight: 0.54 kg

Library of Congress

  • Dewey number: 362.1
  • Dewey version: 22
  • LC Classification: RA441 .I565 2010
  • LC Subject headings:
    • Public health--International cooperation
    • World health
    • Poor--Medical care
    • Medically underserved areas
    • Medical care--Developing countries

Library of Congress Record

Paperback

 (ISBN-13: 9780521174268)

International Health and Aid Policies
Cambridge University Press
9780521174268 - International Health and Aid Policies - The Need for Alternatives - By Jean-Pierre Unger, Pierre De Paepe, Kasturi Sen and Werner Soors
Index

Index

access

assessing health policies by 153

Chile 101

China 126

reforms affect 123

study 127

Colombia 83, 85, 87, 247

conflict and 138

Costa Rica 76

definitions 199

divisionalized systems 172

drugs, improving 219–224

effect of neoliberal policy 247–249

equity and 125

free health care and 166

HIV/AIDS treatment 158

improving in LMICs 210

Ecuador 210–218

India 115

Lebanon 139–142, 149

LICs 161

LMICs 20–23, 159–160

managed care and 226, 227, 250

patient satisfaction and 202

poverty and 171

primary health care and 201

publicly oriented services 165, 178, 180

tuberculosis care 58, 59, 63

universal, according to need 178

universal, professional associations defend 250

universal, to comprehensive care

as aim 154, 155, 240, 251

disease control and 156

improving 240–241

USA 171, 247

user costs and 195

Western Europe 161

accountability 29

community and 168, 180

contracted out services 147

publicly oriented services 173

public providers 7

quality standards and 177

adhocracy, definition 172

advocacy in health policy 6

Africa

access to health care 21

AIDS, vertical programmes for care 51

compulsory insurance 10

disease-oriented approach 4

district health services 169, 193

doctrine informs aid policies 19

family medicine 202

history of health care 204

limitations of PHC strategy 11, 204

malaria

mortality 16

programmes 37–43

maternal mortality 17

minimal activities packages 188

mutual health organizations 169

population structure 42

rural, lack of private provision 38

staff incomes influence access 59

tuberculosis mortality 17

underfunding of public sector care 22

utilization 159

See under particular countries

age, utilization and 134

AHDR (Arab Human Development Report) 138

aid

agencies

See aid agencies

AIDS control 157

dependence on in India 119

GHIs central to 8

history 3–11

India 112

linked to trade 115, 117

mutual, associations 10, 149

policy

alternative 164

doctrine informing 3, 19, 28, 29, 153, 248

effect on health systems 247–252

failure of 16, 17, 29, 35, 164, 248

restricts public services 53, 160, 164

re-thinking 250

programmes, harmonization 11

support of public services 44

aid agencies

code of best practice for disease control 54

contracting in and 168

definition of access 199

DOTS and 63

influence on primary care 207

Lebanon 141

promote disease control by government 19

promote market approach 19, 30, 69, 72

Chile 97

Colombia 83, 91

India 112

promote public provision of disease control 18, 248

promote social insurance in LMICs 10

provide for refugees 143

recommendations cause two-tier systems 21

role in person-centredness 207

AIDS

control 155, 156, 157–159

India 113

integration 173

early detection 156

India 119

mortality, as MDG 17

vertical programmes for care 51

aims, health sector classified by 164

Alma Ata Declaration

WHO, 1978

primary health care 4, 17, 73, 189

approach

close-to-client, CMH 116, 117

market

aid agencies promote 19, 139

India 113

Arab countries.

See Mashreq and specific countries

Arab Human Development Report (AHDR) 138

Argentina, social security re-nationalized 249

Asia.

access to health care 21

disease-oriented approach 4

doctrine informs aid policies 19

history of health care 204

infant mortality 114

See under Particular countries

assessment, disease control programmes, Piot model in 38

asthma, essential clinical package 20

audit

publicly oriented services 172, 177

techniques 234–238

Australia, public–private partnerships 22

autonomy

adhocracy 173

divisionalized systems 172

for-profit sector 170

improving LMIC health sectors’ 240

indirect programmes 53

managerial

decentralization and 198

public hospitals 22–24, 185, 248

patients’ 23

effective care and 179, 202

family practice 180

publicly oriented services 178

professionals, managed care and 227, 228

Azerbaijan, health expenditure 89

Balint groups 230

Bamako Initiative 167, 219–220

barriers.

audit 234

care 59

China 135

class differences 180

cost 61, 133, 134, 167, 177

right to freedom from 177

flow, in health system 187

trade 116

See also obstacles

behaviour, health-seeking

Lebanon 140

malaria 37, 38

tuberculosis, poverty and 59

Belgium

contracting out 92

development agreement with Ecuador 212

health expenditure 92

interface flow process audit (IFPA) 236–238

publicly oriented health services 170

Benin

Bamako Initiative 168, 220

malaria 38

population structure 42

utilization 220

Bolivia, health care reform 97

Brazil

free health care 167

health expenditure 89, 92

planning 251

private sector profit in 21

breast milk, multinational companies and 4

Bretton Woods institutions 22, 30, 167, 248

See also World Bank, International Monetary Fund

Britain

Acheson Report 125

flow in health system 187

public services available 188

See also United Kingdom

budgets, inadequate, effects on health systems 20

burden of disease 8, 16

CMH view 116

concept drives policy 160

bureaucracy

Colombia 90

costs 159

divisionalized systems 172

India 112

indirect programmes by-pass 53

machine 165

policies lead to growth in 7, 248

professional 170–172

vertical programmes 51

Burkina Faso

malaria management 43

utilization 159

caesarean section, rates of

Costa Rica 77

driven by profit 21

CAFTA (Central American Free Trade Agreement) 74

Cameroun, efficiency 157

Canada

health expenditure 73

patient satisfaction 202

social insurance 74

welfare state evolution in 171

cancer

DCPs overlook 35

GHIs overlook 8

cardiovascular disease

burden and funding 17

DCPs overlook 35

care.

Chinese study of equity of 127

curative, delivery 188

holistic 186

managed 172, 248, 250, 225–228

definition 225

non-managed 4

strategies 189–193

See also health care

care, managed 29

Caribbean, inequality in 21

case management

acute respiratory infection 155

cost effectiveness 37

disease control procedure 52, 155

malaria 37–43

tuberculosis 59–60, 155

Central American Free Trade Agreement (CAFTA) 74

cerebrovascular disease

DCPs overlook 35

GHIs overlook 8

Chile 97–104

compared with Colombia and Costa Rica 24–27

divisionalized system 172

free health care 167

health expenditure 70

health indicators 70

China 123–135

access to health care 20

health expenditure 24, 92

PFIs 23

profit-making in state hospitals 23, 61

tuberculosis care 59, 61

CMH (Commission of Macroeconomics and Health) 6, 116, 117

coaching for professionals 172, 231

code of best practice, disease control 54

code of good practice

disease control 49

disease control

code of good practice 195–198

collapse, public health sector, LIC 28

Colombia 83–93

compared with Chile and Costa Rica 24–27

cost-effectiveness 160

education expenditure 78

efficiency 160

health expenditure 70, 78, 92, 93

health indicators 70, 77

human development indicators 77

reform of health sector 83–93, 248

results 20, 25

subcontracting of care 22

COMAC-HSR studies 126, 132

command, lines of, clarifying 54

Commission of Macroeconomics and Health.

See CMH

Commission on Social Determinants of Health 201

commitments, health sector classified by 164

commodification

care 12, 16, 29, 164, 248

managed care and 228

communication

key to public sector development 251

patient–practitioner 166, 195, 202, 210

one-way in vertical programmes 51, 204

person-centred care 206

strategies to improve 229

staff–community, improvement of access and 217

community

associations, providers of care 10, 38

disease control 18–19

health facility as part of 185

health workers

Senegal 223

lobbying government 167

medicine 180

quality of care and 186

participation

Alma Ata Conference 189

Bamako Initiative 219

Colombia 84

drugs management 215, 216

health centre level 190

publicly oriented services 165, 167, 169, 178, 182, 189, 207, 251

public services 4, 7, 27, 49, 72, 216, 219

self-help 168

support of public services 173, 213, 217

Senegal 221

competition

among providers, WHO report and 6

between vertical programmes 166

contracting out and 92

drug prices and 8

for staff 250

due to income 20

health provision, managed 26

managed, Colombia’s policy of 84, 89

public–private, Chile’s policy of 97

compliance

drug

malaria 39–42, 43

Piot model considers 38

patient-centred care 48

conditions

migration and 173, 247

staff, affect motivation 170

conflict, effects of

health care 139

health services 138

Lebanon 148–149

Congo, DSPs 8

consultancy, GHIs and 8

continuity of care 185

disease control and 52

effectiveness and 179

patient satisfaction and 202

payment structure and 167, 223

utilization and 53

contracting in 27

Costa Rica 73–75

contracting out 23, 92, 248

Costa Rica 73, 78

disease control programmes 196

disease specific programmes 35

health care 83

Colombia 83, 90–91

India 113

Lebanon 140, 147–148

Mashreq countries 138

COPD (chronic obstructive long disease)

poor environment and 114

WB essential clinical package 20

corporations.

finance health care 115

gain market access 117, 249

policies backed by 248

See also multinational companies

corruption

lack of regulation 27

practices, obstacles to care 215

Costa Rica 69–80

compared with Chile and Colombia 24–27

divisionalized system 172

first-line services 190

free health care 167

health expenditure 73

public services 24

cost-effectiveness 153

case management, malaria 37

Colombia 160

DALY and QALY 160

essential clinical package and 187

integrated programmes 51–52

Lebanon 150

malaria interventions 37, 45

PPM-DOTS 61

Selective Primary Health Care and 49

WHO report and 6

costing, unrealistic, effects on health systems 20

costs

administrative

Chile 103

Colombia 90

DSPs 157

private insurance 215

balanced with quality of care 179

China 123

Colombia 90, 93

comprehensive care vs. vertical programmes 167

control, managed care and 225, 227–228

Costa Rica 75

efficiency and 118

health care

private vs. public 23, 75

HIV/AIDS programmes 157–159

integrated programmes and 51

Lebanon 145, 147–148, 150

managed care 29

of DSPs, reducing 29

operating, health services 157

opportunity 54, 215

PPM-DOTS 59–61

patients’

cause poverty 159

Chile 100

China 124, 126, 131, 134

Colombia 86, 88–89

Ecuador 211

generic drugs and 220

improving access and 215, 217

insurance 215

Lebanon 143–148

Mashreq countries 138

reducing 167

tuberculosis 61

planning and 189

PPM- DOTS 61

transaction

DSPs 157

private insurance 215

coverage

Africa, mutual health organizations 169

Canada 171

Chile 100

Colombia 83–87, 91

Costa Rica 76

Lebanon 146, 148–150, 146–147

New Zealand 171

planning and 190

Sweden 171

UK 171

USA 171

critique, WHO, of liberal economic governance 28

Cuba

free health care 167

public services 24

cure rates

disease control activities and 53, 61

malaria in Africa 40–43

Piot model estimates 38, 40

DALY 160

Danish International Development Agency (DANIDA) 112

death.

See mortality

decentralization

causes segmentation 29

Colombia 84

malaria and 88

community participation and 169

DCPs and 161

globalization and 119

primary care 191

Alma Ata Conference 189

vertical programmes and 197

WB promotes 123

decision making

clinical

audit 236–237

managed care and 227, 228

techniques to improve 228

managerial 244

delivery

policy determines 153

publicly oriented services 165

standards 176–182

demand

-based projects

donor agencies promote 112

community 186–187, 191

essential clinical package and 204

managed care and 226

publicly oriented organizations respond to 164

quality of care and 201

supplier-induced 7, 134, 141

utilization and 127

vertical programmes ignore 51

democracy

European welfare states and 171

in LMICs, Western politicians and 173

democratizing the health sector 168–169, 181, 251

Bamako Initiative 219

demography, Lebanon 142

deontology, medical 176, 181, 228, 249, 251

Department for International Development.

See DFID

detection

access and 224

early

AIDS 156

malaria 43, 156

tuberculosis 156

rates, integration and 20, 48, 52, 89, 195

tuberculosis 57–58, 60, 63

utilization and 53

development

community 168

economic, health improvement, a strategy for 6

funding failure 116

health sector 177

human

Arab countries 138

Chile 102, 103

Costa Rica 26, 69, 70, 77–78

India 109–111, 119

person-centred care 206

professional 172

public services, community 173

re-thinking 250

strategies for publicy oriented health services 165–181

sustainable 169

devolution, effect of 29

DFID (Department for International Development)

attitude to GHIs 8

demand-based projects 112

diabetes

audit 234

Costa Rica 76

neglected 35

diagnosis

mother’s, in child malaria 38, 44

Piot model considers 38

tuberculosis 59, 60

diagonal organization, Mexico 10

diarrhoea 117

avoidable child mortality 25, 88, 114

mortality, MDG 17

disease

burden 8, 17

CMH view 116

concept drives policy 160

cardiovascular, burden and funding 17

cerebrovascular, GHIs overlook 8

eradication

malaria 4

programmes 196

smallpox 4

neglected 29, 35, 155

-oriented approach 4

specific programmes (DSPs) 8

compete for staff

comprehensive care in 115

diagonal organization and 10

disintegration of health systems 11

funding 156

IHP and 11

impact on health systems 27, 28, 29, 195

integration 52

limitations 35

promotion of 16

running costs 156–159

weaknesses 156

See also disease control

disease control

aid policies

aim 19

effect on 3, 16, 18, 69

assessment of programmes 38

barriers to care affect 134

biomedical model and 117

code of best practice 54

code of good practice 49, 195–198

Colombia 84, 88–89

difficulties with 155–159

failure 35

GHIs for 8, 19

effect on health systems 19

health policies aim 3, 248

integrated 51

integration 37–38, 44, 48, 54, 161, 195–198

Costa Rica 76

effects 89

publicly oriented services 173

integration between programmes 49

integration with essential clinical package 204

interventions, integration of 18

management 181–182

policies for 7, 53, 83

political support 30

programme performance 16–18, 44, 205

programmes 49

Colombia 83

effect on care delivery 48–55, 76, 196

India 113

standardization in 166

public sector role focused on 22, 83, 160, 166, 248

India 113

separated from curative care 6, 7, 83

specialists 51

strategies 52

tuberculosis 57–63

World Bank strategy 5, 83

district, health services based on 169, 191

divisionalized systems 172

organizing strategy 222

Senegal 220–222

divisionalized systems 172

doctrine

informing aid policies 3, 11, 19, 28, 29, 248

informing health reform in Chile 97

donors

code of best practice for disease control 54

funding for drugs 219

impact on health systems 51

Mashreq countries 138

indirect programmes popular with 53

influence health care policy 5, 114, 117, 201

China 123

promote demand-based projects 112

DOTS Expansion Working Group 63

dracunculiasis 4

drug

companies

influence health policy 30

WHO confronts 4

resistance 57

China 123

malaria 37, 43, 45

tuberculosis 60, 62

drugs

access improved

Ecuador 215

Senegal 219–224

corporate aid 117

essential 159, 167, 220, 223

Bamako Initiative 219–220

improving access 219–224

policy in publicly oriented services 179

expenditure on, Lebanon 144–146, 150

prices, GHIs and 8

DSPs (disease specific programmes).

See under disease

economic growth

Americas 70

Chile 98, 102, 103

China 126

Costa Rica 70

health and 116

health planning and 119

India 109–111, 116, 119

MDGs linked to 116

promotion by health investment 116

economics, effects on access to health care 21

Ecuador

health care reform 97

improving access 210–218

patient–practitioner communication 204

education.

income and 125

See also training

effectiveness 118

aid, study 11

Costa Rican system 75

efficiency and 179

Lebanon 150

planning to maximize 184–193

pre-conditions 179

publicly oriented services 177

treatment, early detection and 156

efficacy 118

efficiency 118

aid policies and 28

assessing health policies by 153

Chilean reforms and 102

Colombia 160

Colombia’s health reforms affect 91

community participation and 169

Costa Rican system 75, 77

effectiveness and 179

experts’ definition 118

for-profit providers and 23, 49

India 113

integrated programmes 52

malaria treatment 43

managed care and 225, 227

notion of 118

planning to maximize 184–193

PPM-DOTS 61

professional bureaucracy and 170

publicly oriented services 178, 179

USA 171, 179

variability in 157

vertical programmes 51

Egypt

family medicine 202

emergencies

vertical programmes in 18, 50

England.

definition of good general practice 202

patient satisfaction 202

See also Britain, United Kingdom

Enhanced Structural Adjustment Facilities (ESAFs) affect health care provision 22

environment, quality of, mortality and 114

epidemics

control 160

politicians support 30

vertical programmes in 18, 50

epidemiology

smallpox 4

vertical programmes in 18, 50

equity

Alma Ata Conference 189

assessing health policies by 153

Chile 101–102

China 123, 126

study 127

Colombia 84–87

Costa Rican policy 69, 74, 76, 78

India 110, 114, 120

inequality and, ECuity projects 126

notion of 118, 125

primary health care and 201

publicly oriented services and 178

standards of 119

USA 171

eradication

malaria 4

programmes 196

smallpox 4

ESAFs (Enhanced Structural Adjustment Facilities) affect health care provision 22

essential

clinical package 5, 20, 187, 204

drugs 159, 167, 220, 223

Bamako Initiative 219–220

improving access 219–224

policy in publicly oriented services 179

health care 119

ethics 181

health care delivery and 249

health care policy and 251

standards for publicly oriented services and 176

use of professionals according to 166

Europe.

creation of welfare states 171

Eastern, health facilities 21

health systems, Bismarckian 170

public services defended 249

Western

contracting out 27

health expenditure 24, 92

poor people’s access to care 92

See under particular countries

European Union (EU)

2002 approach to health aid 7

IHP and 11

evaluation

health services 153

improving access and 212, 215

in divisionalized health systems 172, 191

staff, Costa Rica 75

techniques 234–238

evidence-based

aid policy 93, 248

medicine

effective care and 179

publicly oriented services 177

practice, dominated by profitability 21

expenditure

catastrophic health 247

Chile 100

Colombia 25, 78, 89

Costa Rica 25, 78

education

Colombia 78

Costa Rica 78

Mexico 78

health

Canada 171

causes poverty 159

Chile 98–101, 103

China 124, 131, 132–135

Colombia 78, 83, 89–91

comparisons between countries 92

Costa Rica 69, 70, 73, 78

Ecuador 78, 210

high-income countries 73

Latin America 69

Lebanon 142–143, 147–148

LICs 167

Mexico 78

New Zealand 171

Senegal 220

Sweden 171

UK 171

USA 171

managed care and 226

public

health effects of 22, 26

LMIC 24

USA 179

exploitation of poor, India 120

facilities

Chile 98

co-management 168, 181

Costa Rica 74

disproportionate provision, Lebanon 141, 150

efficient use of 184–185, 188–189

Lebanon 149

Senegal 220

territorial responsibility 188

family medicine 179

family medicine, person-centred care 201–207

family planning

India 119

informal provision 43

integration 173

World Bank strategy 5

fees.

See costs, income

finance overruns, effects on health systems 20

financing.

See funding

first-line health services

audit 236

Costa Rica 73, 75

DCPs and 53

hospitals 23, 185

Colombia 90

primary care strategy 190

scope 187

flow patient, in health systems 187, 191

audit by analysis of 238

managed care and 227

food, India 111, 116

for-profit providers

autonomous public hospitals act as 23

contracting out to 23

Costa Rica 73, 78

disease control 19

focus of some 164

incentives 9, 62

Lebanon 140, 141, 147

policy to use 19, 49, 69, 83

publicly oriented services, standards for 178–180

regulation 28, 57

WHO report and 6

for-profit sectors, characteristics 170

fragmentation 117, 118

conflict and 148

health care delivery 55, 57, 88

Chile 104

health services 248

India 113

Lebanon 139, 140, 148

financing 146

overcoming 164

responsibilities, decentralization and 88

France

contracting out 92

health expenditure 92

Free Trade Agreement, subsidy of health care and 35

funding

Chile 98

China 123–125

Chinese study of 127

Colombia 84, 89–91

corporate sector provides 115, 117

cuts, reduced access 53

difficulties 54

drugs, Bamako Initiative 167

DSPs 156

focus on 153

globalization and 119

health care, aid policy and 30

HIV/AIDS programmes 156–159, 247

improving access and, Ecuador 217

Lebanon 139–142, 145, 147–148

LMICs 167

Senegal 220–221

strategies 241

vertical programmes 50

GATS

effect on health services 6, 249

influence on health services 30, 35, 83, 114, 115, 187

gender

discrimination in health care, India 115

sensitivity, in care delivery 178

Germany

contracting out 92

health expenditure 92

GFATM (Global Fund to Fight AIDS, TB and Malaria) 19

IHP and 11

polyvalent care and 44

Ghana

malaria programmes 39, 42

regulation in 28

GHIs (Global Health Initiatives)

categories 8

CMH and 116

definition of ‘access’ 199

disease control programmes and 8

impact on LMIC health services 28

resist policy change 248

GHPs (Global Health Programmes) impact on LMIC health services 8

Global Fund to Fight AIDS, TB and Malaria.

See GFATM

Global Health Initiatives.

See GHIs

Global Public Private Partnerships (GPPPs) 115, 117

globalization

health planning and 119

profit and 139

GOBI programme, UNICEF 49

governance

clinical, concept 234

CMH and 116

economic, impacts on health systems 28

Indian reform and 114

government

code of best practice for disease control 54

disease control 18, 83

funding 167

Ecuador 217

health sector autonomy and 240

Senegal 220–221

health expenditure

Ecuador 210

publicly oriented health services 168

WHO report and 6

World Bank strategy and 5

health facilities

Africa 38

publicy oriented health sector 165

influence on privatization 30

plans, in China 123

reforms

Chile 97–104

regulation by

LMICs 170, 172

regulation of private sector 9, 19, 27, 57

Chile 98, 99, 103

Colombia 91

disease control and 196

patients’ costs and 61

WB attitude to 9

regulation of private sector 91–92

patients’ costs and 61

role 19

China 134

Colombia 84, 88

Colombia’s health reforms 91

India 113

Lebanon 139, 148, 150

trade agreement and 6

vertical programmes and 51, 57, 62

WHO report and 6

GPPPs (Global Public Private Partnerships) 115

Great Britain.

See Britain, United Kingdom

Greece, patient satisfaction 202

Guinea

malaria 38

population structure 42

health

care.

See care, health care

fundamental right to 251

policy

effect on health systems 247–252

international 3

proposed 251

re-thinking 250

poverty and 247

primary health care and 201

professionals.

See staff, health professionals

public, market economics and 118–119

sector, integrated, publicly oriented 164–174

services

democratization 168

effect of neoliberal policy 247–249

for the poor, WB strategy for 5

India 112–113

integrated 3, 6, 20, 37–38, 44

Lebanon 145, 150

market economics and 118

need for integrated 18

organization, audit of 233–238

output in Costa Rica 76

training in policy and provision 240–245

services, first-line

audit 236

Costa Rica 73, 75

DCPs and 53

hospitals 23, 90, 185

scope 187

system

criteria for 186

integrated local 169

notion of 118

systems

Bismarckian 170

collapse in LIC 28

district 169, 172, 191

effect of aid policy 40–44, 247–252

integrated 184–187

management 244

strengthening 155, 157, 184, 197, 210, 248

vertical 142

workers, village 190

health care

access to in LMICs 20

antenatal, Costa Rica 76

child, Costa Rica 76

comprehensive 155–161, 184

access 240–241

family medicine 202

improving access 210–218

universal, as aim 154, 155, 251

WB attitude to 248

Costa Rica 72–77

curative 51

disease control and 155

focus on in Lebanon 147

improving access 210–218

integrating with preventive 18, 50, 186

preventive care and 204, 224

privatization 49, 141, 249

delivery, disease control programmes and 48–55

free 166

general

effect on of aid policies 3

integrated with disease control 52, 173

separated from disease control 6, 7, 16, 44

history of state provision 10

holistic 230

patient-centred 48, 177

disease control and 52, 54

integrated 54

professional associations defend 250

publicly oriented services 179

polyvalent 35

disease control programmes and 44, 156

integration 48, 54

preventive

Costa Rica 75, 76

curative dominated by 204

integrating with curative 18, 223

neglected in Lebanon 141, 147, 150

primary

aid strategy 4

Alma Ata Declaration 49

strengthening person-centred care 201

See also Primary, Secondary

Health Maintenance Organizations (HMOs) 226

health professionals

associations 250

attitude to audit 234

audit, role in 238

autonomy, managed care and 227, 228

competition for 22

Costa Rica 74, 75

DCPs demotivate 53

disease control programmes 197

human resource policy 44

lobbying government 167

motivation 169, 172, 205, 206, 213, 217

patient-centred care 48

professional bureaucracy and 170–171

publicly oriented health services 166, 168

publicly oriented services 178

optimizing care 179

role in holistic care 230

skills

loss of 29

status 29, 182, 206

tensions between 54

training in service policy and provision 240–245

health-seeking behaviour

Lebanon 140

malaria 37, 38

tuberculosis, poverty and 59

helminthiasis, interventions 52

Hippocratic principles

health care and 166

staff

motivation and 170

HIV prevalence, Africa 42

HIV/AIDS

burden and funding 16

funding for programmes 156–159, 247

programmes

relative size 8

HMOs (Health Maintenance Organizations) 226

hospital

care, general, aid policies and 16

functions, reorientation 190–193

hospitals

audit 236, 237

Colombia 84

Costa Rica 74, 76

efficient use of 185

India 115

NGO, integration 189

patient-centred care in 230

public

managerial autonomy 22–24, 185, 248

support for 44

publicly oriented health care 166

Senegal 220, 222

housing, India 112, 113

hypertension

audit 234

Costa Rica 76

ICC (International Commission of Commerce) 115

ICPD (International Conference on Population and Development) 116

IFIs (International Financing Institutions), privatization and 22

IHP (International Health Partnership) 11

IMF (International Monetary Fund)

devolution promoted by 29

Enhanced Structural Adjustment Facilities (ESAFs) 22

India 110

promote for-profit health care 69

recommends privatization 74, 97

immunization

Colombia 88

Costa Rica 76

World Bank strategy 5

incentives

managed care and 225, 227

perverse 5, 62, 185

China 123

to over-treat 103, 104, 148, 179

China 135

income

as purpose of health service 165

equity and 125

Chinese study 127

ECuity projects 126

inequality

Costa Rica 78, 101

India 110

Lebanon 143

staff 44

China 124, 185

choice of patients and 59, 185

competition due to 20, 22, 54, 250

Costa Rica 75

motivation and 169, 182, 206, 250

over-consumption and 179–180, 223

publicly oriented services 169, 182

UK 169

India 109–120

free health care 167

health services 112–113

PFIs 23

PPM-DOTS programmes 59–62

public services 24

regulation in 28

welfare cutbacks 111

indicators

conditions

Ecuador 212

infant mortality 25

cost-effectiveness, DALY and QALY 160

equity, Latin America 70

health care

Chile 102, 103

China 132, 134

Colombia 77, 83, 88–89

Costa Rica 77–78

Ecuador 211

HICs 171

India 114–115

Latin America 70

Lebanon 142

Mexico 77

perinatal and maternal mortality 25

human development

Colombia 77

Costa Rica 77

Mexico 77

performance, Costa Rica 74

socio-economic, Lebanon 143

indirect programmes 53–54, 197

Indonesia, health expenditure 92

inequality

China 123

equity and 118, 125

ECuity projects 126

India 120

Lebanon 139, 140, 146, 150

LMICs

politics and 172

mortality and 125

social

access to health care 21, 118

infection

acute respiratory

avoidable child mortality 25, 88, 114

burden and funding 16

GHIs overlook 8

WB essential clinical package 20

bacterial, child deaths in Africa and 3

sexually transmitted

assessment of control programmes 38

informal provision of health care 44

informal provision of health care

malaria 37, 42, 43

innovation

GHIs and 8

insurance

managed care compared with 226

private

Chile 97–104

Ecuador 215

Lebanon 140, 144, 149

obstacles 215

social

Ecuador 211, 217

Lebanon 147, 150

LMICs 10

Mexico, Plan Oportunidades 10

USA 171

social and private 249

Chile 24, 25, 26, 74, 97–104

China 124, 129, 130, 133–134, 135

Colombia 24, 25, 26, 74, 83, 84–87, 91

Costa Rica 27, 72, 73, 74, 78

India 113

Integrated Management of Childhood Illnesses programme 42

integration

Alma Ata Conference 189

among disease control programmes 49

health care and disease control 3, 18, 20, 37–38, 44, 48, 50, 54

Costa Rica 76

cost-effectiveness 51, 52

costs and 156–159

feasibility 48

India 119

limitations 205

planning of 196

publicly oriented services 165, 173

World Bank report and 5, 204

health services 26

Costa Rica 72

India 113

health systems 184–187

by harmonization 11

NGOs, in national planning 189

interface flow process audit 234, 235–239

International Commission of Commerce (ICC) 115

International Conference on Population and Development (ICPD) 116

International Financing Institutions (IFIs), privatization and 22

International Health Partnership (IHP) 11

International Monetary Fund.

intervention area, choice of 8

See IMF

interventions, environmental, for disease control 52

investment

health

corporate 116

promotes economic development 6

India 119

Italy, IHP and 11

Ivory Coast, malaria 38

Jordan

divisionalized system 172

doctrine informing aid policies 19

Kakwani index 132

Kenya, malaria case management 39, 40–43

Latin America

access to health care 21

doctrine informing aid policies 19

family medicine 202, 204

free health care 167

health expenditure 24

privatization of health care 22

Lebanon 138–151

Le Grand index 132

health expenditure 89

PFIs 23

subcontracting of health care in 22

Lesotho, free health care 167

levels of care, specificity 186

life expectancy

Chile 102

Costa Rica 25, 69, 77

disease control programmes and 205

economic growth and 125

gains due to medical care 240

LMICs (low and middle income countries)

access to health care 20–23, 159–160

contracting out 27

disease control policy in 16

effect of aid policy on health systems 40–44

family medicine 201–207

improving access 210

medical training 205–206

patient-centred care 48

policies for 7, 19

effects of neoliberal 30

primary health care 201–207

public services 206

regulation of health services 9

selective primary health care 204

World Bank strategy for health provision 5

loan conditions, enforcement 22

long route monitoring of health provision 7

lymphatic filariasis

interventions 52

machine bureaucracies 165, 173

malaria

burden 16

control 155

decline 88

India 113

integration 37, 44

early detection 156

incidence, Costa Rica 76

India 113

interventions 37, 45

mortality 247

MDG 17

poor environment and 114

Mali

Bamako Initiative 167

family medicine 205

malaria programmes 45, 37–43

malnutrition 117

managed care 29, 172, 225–228, 245, 250

definition 225

management

adhocracy 173

by objectives 20, 53, 181

case

acute respiratory infection 155

disease control procedure 52, 155

malaria 37–43

tuberculosis 59–61, 155

co-, Bamako Initiative promoted 219

contracting out 92

costs of, Colombia 90

decentralized 191–193

district health systems 44

district systems 191

Ecuador 217

improving access and 217

organizing strategy 222

drugs access, improving 219–224

drugs, co-, community and professionals 215, 216, 219, 222

health funding

Chile 98

Colombia 84

health services

Costa Rica 76

determined by policy 153

training 240–245

health systems 244

holistic, of patient 186

indirect programmes 53

integrated services 50

integration of disease control programmes 197

machine bureaucracies 166

patient-centred care 48

PPM-DOTS 58, 60

primary care

improving 206

public health 240–245

publicly oriented services 166, 168–169

co-, users and professionals 164, 165, 168–169, 178, 189

standards 165, 176–182

public services

co-, users and professionals 219

regulation of 27

weak, in Senegal 220

MAP (Minimal Activities Package) 187

disease control and 196

market

approach

aid agencies promote 19, 139

India 113

-based systems, ethical principles and 178, 181

corporate access to through aid 117

deficiencies, remediation 7, 10

economics and public health 118–119

failure, WB and 114

-oriented reforms in China 123

values, provision of aid and 5, 112

vertical programmes provide 114

Mashreq, The 138

maternal care

contracting out 35

maternity care

public health expenditure and 22

MDGs (Millennium Development Goals) 17, 116

approach 53

effect of staff competition 9

failure 35

IHP and 11

stalled 155, 156, 249

measles 4

Costa Rica 76

Mexico

expenditure

education 78

health 70, 78

health indicators 70, 77

human development indicators 77

regulation in 28

migration, conditions in LMICs and 173, 247

Millennium Development Goals.

See MDGs

Minimal Activities Package.

See MAP

minimal package of activities 49

mission

defines publicly oriented services 177

health professionals, professional bureaucracy and 170

publicly oriented services 165

monitoring

contracting out 92

Global Monitoring Report (GMR) 116

health provision

Costa Rica 74

long route 7

integrated programmes 51

PPM-DOTS programme 58, 60, 61

morbidity

Colombia 88

control 52

India 115, 116

utilization and 127

Morocco, family medicine 202

mortality

AIDS 156, 247

avoidable

access and 159

policy failure and 247

tracer pathology 25, 88

certification as indicator of health care

Colombia 87

child 247

Colombia 25, 88

Lebanon 150

MDG 155

public health expenditure and 22

Colombia 88

diarrhoea 247

income and 125

India 116

infant 247

Chile 102

China 126

Colombia 77

Costa Rica 25, 70, 77, 78

Ecuador 212

India 114

indicator of conditions 25, 88, 114

Mashreq countries 138

MDGs 17

Mexico 77

public health expenditure and 22

malaria 156, 247

maternal 171, 247

Canada 171

Chile 102

Colombia 25

Costa Rica 78

Ecuador 211

factors affecting 157

India 114

indicator of health care 25

Mashreq countries 138

MDG 155

MDGs 17

New Zealand 171

Sweden 171

USA 171

perinatal

Colombia 88

Costa Rica 26, 78

indicator of health care 25, 88

pneumonia-specific 247

Costa Rica 78

reduction, public care delivery and 167

refugees 247

tuberculosis 247

tuberculosis-specific 156

Costa Rica 78

motivation

patients’, Piot model considers 38, 42

staff

Costa Rica 75

DCPs and 53

divisionalized systems 172

improvement 206

improvement of access and 213, 217

in publicly oriented services 169, 180

increasing 250

managed care and 227, 228, 250

PPM-DOTS programme 58

multinational companies

finance health provision 115, 117

globalization aids 119

India as market for 114

neoliberalism advocates healthcare provision by 5

policies backed by 248

WHO confronts 4

mutual

aid associations 10

community care 180

Lebanon 149

lobbying government 167

health organizations

neoliberal policy promotes 169

solidarity networks 181

Namibia, utilization in 39

need

defined by professionals 186, 187, 191

for care 127

human, health care satisfies 154

priorities and 177, 178

publicly oriented organisations respond to 164

treatment related to 128

needs

basic, universal right to have them met 178

learning, for professionals 172

unexpressed 118

neglected diseases 29, 35, 155

neoliberalism

attitudes to international health policy 5, 18, 139, 210

Chilean health reforms 97–104

effects on health systems 247

impacts on health systems 28–30, 68, 141, 153, 185

training 205

promotes mutual health organisations 169

regulation and 27

welfare provision and 171, 172

Netherlands, The

flow in health system 187

IHP and 11

New Zealand

health expenditure 73

welfare state evolution in 171

NGOs

activities

GHIs and 8

CMH and 116, 117

contracting out to 23

definition of ‘access’ 199

disease control 18

case management 38

integration in national planning 189

Lebanon 141, 144, 147, 149–150

operate as public services 206

PPM-DOTS programme 58, 60

publicly oriented services 165, 177, 181

regulation 28

socially motivated care promotion 249

Nicaragua, family medicine training 205

Nigeria, health expenditure 92

non-governmental providers

funding from Government

World Bank strategy 5

Norway, IHP and 11

not-for-profit

health services

DCPs and 54, 195

World Bank and 69

providers

Lebanon 140, 147

publicly oriented services 165, 176

WHO report and 6

nutrition

India 115

targeted, World Bank strategy 5

obstacles.

to care

commercial insurance and 215

improving access and 216

to policy change 248

See also barriers

onchocerciasis 4, 156

interventions 52

organization

diagonal, Mexico 10

model 172

outcome

patient

health system structure and 235

integration and 51

person-centredness and 203

output

DCPs 51

health systems

Chile 25

Costa Rica 25, 26, 71, 73, 76

PPM-DOTS 57

programmatic 161, 166

publicly oriented services 176

outreach, vertical programmes for 18, 50

Oxfam view on aid programmes 48

Panama

health expenditure 70

health indicators 70

Pan American Health Organization (PAHO) return to PHC 11, 184

pandemic, fear of influences choice of intervention area 8

Papua New Guinea, regulation in 27

Paris Declaration 2005 11

patents, drug 159

patient-centred care 48, 177, 229

disease control and 52, 54

effective care and 179

hospitals 230

integrated 54

professional associations defend 250

publicly oriented services 179

See also person-centered care development in first-line services

patronage, lack of regulation 27

penalties

non-compliance 9

performance

-based pay 250

health service planning and 153

health system structure and 235

primary care, management and 206

person-centred care 201–207

See also patient-centered care

Philippines, Southern, doctrine informing aid policies 19

Piot operational model, malaria programmes in Mali 37–43, 45

plague, India 113

planning

district system 191

principles 184–193

publicly oriented services 251

pneumonia 117

mortality 247

Costa Rica 78

MDG 17

Poland, avoidable deaths 240

policy

aid

alternative 164

doctrines informing 3, 19, 28, 29, 153, 248

effect on health systems 247–251

factors affecting implementation 3

failure of 16, 17, 29, 35, 164, 248

restricts public services 53, 160, 164

re-thinking 250

change

China 127

person-centredness and 207

resisted 248

WHO 29

democratic rights and, European welfare states 171

disease control, failure of 7

health

Bismarckian 10, 98

Chile 97

China 134, 123–125

Colombia 84–93

colonial 4, 204

Costa Rican 69, 71, 78, 79, 72–74

doctrines underlying 3

effect on health systems 247–251

heterodox 69, 80, 153

India 113, 114, 119–120

national, improving access and 217

poor and 93

Principles for publicly oriented 153–154

proposed 251

public, making 240–241

reforms and, in China 123–125, 127

reforms and, in India 113, 114

Senegalese, lessons from 223

-induced inefficiency 171

maker, regulator as 7

makers 153

elite as 172

European welfare states 171

LMICs 172

welfare concept 171

politics of 118

pricing 23

protectionist, India 109

public health, making 240–241

publicly oriented integrated health sector 164–174

regulation required by 9

re-thinking 250

return to PHC 11

social-and-democratic 168, 173, 164–165

stakeholders lobbying government 167

polio, India 114

poliomyelitis 4

politicians

responsibility for trade agreements 249

Western, awareness in 173

politics

effects on health and development

India 109, 112, 119–120

Lebanon 139–142, 150

international, of health investment 114–115

of knowledge 117

poor

policy created for in USA 171

policy defined by in European welfare states 171

See also poverty

population-base, facilities 189

poverty

Ecuador 212

health and 116, 118, 247

China 134

health care and 171

Lebanon 143, 150

political instability and 173

reduction

Chile 27, 102, 103

India 110

refugees 143

PPM-DOTS 57–63

PPM-HIV-AIDS 62

PPM-malaria 62

practice

best

disease control 54

family medicine 202–207

good, disease control 49, 195–198

pregnancy, privatisation of care 19

pre-payment associations 181

preventive health services.

See also health care

prices

China 124

drugs

corporate aid 117

GHIs and 8

Senegal 223

primary care

for-profit approach prioritises 24

India 113, 115

public provision, results in 24

primary health care.

Alma Ata Conference 4, 17, 49, 73, 189

Chile 100

concept and strategy 189–193

Costa Rica 72, 74, 76

distorted by DCPs 53

ethics and standards 177

evidence and guidance support 201

international policies change 119

Lebanon 147, 149

limitations in Africa 11

LMICs 201–207

return to 11, 184

strategies to improve 206–207

Primary Health Care (PHC).

See primary health care

See under World Health Organization

See under World Health Organization and health care

principles

ethical 173

ethical, health systems 176–182

good practice of disease control 195–198

Hippocratic 166, 170

planning 184–193

public health management 241

priorities

ill-defined 54

public disease control

Minimal Activities Package 187

priority setting 160–161

according to need 177, 178

aid policies 16

district level 224

effects on health systems 20

WHO report and 6

private provision of health care

Chile 97, 103, 104

Costa Rica 73, 75, 78

India 115

influenced by profit 21

LMICs 206

publicly funded 19

Chile 100

Colombia 84

efficiency in 179

Lebanon 139, 148, 149, 150

publicly oriented services 165, 177

regulation 196

tuberculosis 58

vs. public

aid policies and 4–7, 18, 21, 29

Costa Rica 79

disease control 18, 19, 62

India 113–114

Lebanon 139–142, 144, 146–151

malaria 37

tuberculosis 57–63

privatization 16, 29, 248

agencies attitudes to 18, 30, 83, 97

Chile 24, 97

China 124

Colombia 24, 83, 84, 91

curative care 49

GATS and 30, 249

globalization and 119

health education and research 245

impact on health systems in LMICs 28

India 110, 113–114, 115, 119

Lebanon 139

market deficiencies and 10

Mashreq countries 138

public sector funding and 22, 30

regulation and 7, 9

India 114

product focus of GHIs 8

productivity, labour, disease eradication to improve 6

professionals, health.

See health professionals, staff

profit.

as purpose of health service 164, 178

care influenced by need for 21, 62, 89, 103, 185

ethics and 116

globalisation and 139

margins 23

secondary and tertiary care

India 113

See for-profit, not-for-profit

programme officers, role of 197

programmes

indirect 53–54, 197

integrated 51–53, 54

vertical 10, 18, 35, 50

Alma Ata Conference 190

as market 114

characteristics 166

Colombia 88–89

disadvantages 51

donor-driven 117

impact on health systems 28, 45, 48–55, 197

India 113

integration 54, 205

non-integrated 3, 4, 5, 6, 7

running costs 156–159

weakness of 156

Public Finance Initiatives (PFIs) 23

public health

methods 160

notion of 118

training 240–245

publicly oriented

public provision of health care

arguments for 22, 35

Chile 97, 100, 103

community participation in managing 4

Costa Rica 72–79

efficiency in 179

European welfare states created 171

focused on disease control 22, 83, 160, 205, 248

Hippocratic principles and 166

India 113

India 112–114

Lebanon 140, 141, 144, 145

LMICs 206

policy, for private sector calls for 159

publicly oriented services 165, 177

re-thinking development 250

tuberculosis 63

vs. private

aid policies and 4–7, 18, 21, 29, 83

Costa Rica 79

disease control 18, 19, 49, 83

Lebanon 146–151

malaria 37

tuberculosis 60, 61–63

WB attitude to 248

public services

Bamako Initiative 219–220

comprehensive care, improving access 210

LMICs 206

managed care 227

strategies to improve 206

publicly oriented

definition 164

services

balancing 251

developing 251

drug access 219–224

ethics and standards 176–182

family medicine 202

principles of planning 184–193

strategies to improve 206, 219–224

training in policy and provision 240–245

public–private

cooperation

Costa Rica 75

health service delivery 6

PPM–DOTS 57–63

partnerships (PPP) 23

disease control 19

GHIs 8

global 114–115, 117

hospital leasing 22

India 112, 113

PPM-DOTS 62

WHO and WB promote 83

purchaser–provider split 11, 226, 248

Chile 103

Colombia 24, 84

purchasing, strategic 11

QALY 160

quality

care

assessing health policies by 153

audit 234–238

community care and 186, 190

community support and 168, 173

demand and 201

family medicine 202

improvement programmes 234

integration and 205

managed care and 227, 250

strategies to improve 206–207

services, managed care and 225, 226

standards, publicly oriented services 165, 176–182

rationalization

drug access, strategy 222–224

health care, effects of 205, 217

managed care and 226, 228

treatment 178, 179

Bamako Initiative and 219

Senegal 220–222

reform

delivery

family medicine as part of 202

health service 83

advocated in WHO report 6

Chile 97–104

Colombia 83–93, 248

results of 6, 20, 67

health services, Europe 92

managed care in 225

reforms

China

policy lessons from 127

China 123–125

health investment as cutting edge 116

India 109–114

attitudes to 120

Lebanon 139–142, 146, 150

Senegal 220–222

refugees

death toll 247

internal, Colombia 91

Palestinian in Lebanon 143

regulation

autonomous hospitals 23

Colombia 90, 91

contracting out 27

globalization and 119

government

LMICs 21, 27, 170, 172

government, of private sector 9, 57, 91–92, 248

Chile 98, 99, 103

Colombia 91

India 114

trade agreements and 6

WHO report and 6

World Bank strategy 5

government, of public sector, to 7

LMICs 9, 21

of private practitioners 60

MICs 9

policies require 9, 248

relationships

key to public sector development 251

patient–practitioner

disease control 156

family medicine 180, 202

improvement of access and 213

person-centred care 206

strategies to improve 229

staff–community

improvement of access and 213, 217

staff–community in community care 185

improvement of access and 217

research and development, GHIs and 8

research, privatization of 245

resistance

drug 57

China 123

malaria 37, 43, 45

tuberculosis 60, 61, 62

right

democratic, to health care

European welfare states and 171

health care as universal 154, 176, 177, 247, 251

WHO 161

Rockefeller Foundation 10

Selective Primary Health Care 4, 6

sanctions

bad treatment, opposition to 60

non-compliance 9

SAP (Structural Adjustment Programmes)

affect access to health care 21, 59

affect health care provision 22, 91

India 109, 115, 116

India 109, 111, 112, 119

satisfaction

job 206

patient

patient-centred care 48

person-centredness and 203

quality of care and 202

schistosomiasis 156

interventions 52

school health, World Bank strategy 5

secondary care provision, for-profit approach limits 23

segmentation 29, 155, 249

Chile 100

overcoming 164

Selective Primary Health Care 4, 49, 73, 119, 204

Senegal 220

improving drug access 219–224

sensitivity, drug, Piot model considers 38

sexually transmitted disease

control programmes, assessment of 38

informal provision of health care 43

shigellosis

burden and funding 16

GHIs overlook 8

shopkeepers

provision of health care by

malaria 37, 39, 42, 43

training for 43, 44

short route, monitoring of health provision 7

skills

expanding 250

loss of clinical 29

training 48

variability in LMICs 228

sleeping sickness, control programmes

assessment of 38

smallpox eradication 4, 50

social

-and-democratic policy 168, 164–165, 173

basis to health policy 154

commitment

Costa Rica 25, 77

publicly oriented health care and 167, 168

determinants of health, ignored 118

insurance 249

Chile 24, 25, 26, 97, 97–103, 104

China 124, 129, 130, 133–134, 135

Colombia 24, 25, 26, 84–87, 91

Costa Rica 27, 69, 72, 73, 74, 78

Ecuador 211, 217

India 113

Lebanon 147

LMICs 10

Mexico, Plan Oportunidades 10

USA 171

justice, concept 154

pluralism

health institutions 173

lack of in LMICs 172

policy, European welfare states and 171

protection

European welfare states 171

LMICs 10

privatisation justified by 11

security

concept 10

re-nationalised 249

solidarity 154, 187

Chile 98, 100, 101

CMH strategy and 117

Colombia 84, 86

community 168

Costa Rica 27, 73, 76, 78

Costa Rican policy 69

European welfares states and 104, 171

international 187

meeting needs and 178

mutual, networks 181

payment structure and 167

Ecuador 217

publicly oriented services 173

ruling elite and 93

USA 171

South Africa

contracting out 23, 92

regulation in 28

South America.

underfunding of public sector care 22

See under particular countries

Soviet Union

access to health care 20

patient satisfaction 202

specificity, principle of 186

planners overlook 190

stability, political

health care and 159

poverty threatens 173

staff.

competition for 22

disease control programmes and 196

DSPs 8

private sector and 22

DCPs demotivate 53, 205

efficient use of 52

human resource policy 44

income 44

loss of skills 29

motivation 23, 206

improvement of access and 213, 217

increasing 250

managed care and 227, 228, 250

PPM-DOTS 60

role in holistic care 230

status 29

Costa Rica 75

See also health professionals

stakeholders

ethics code 176

socially motivated care promotion 249

standardization

clinical practice, managed care and 227, 228

standards

best practice in family medicine 202–207

clinical, machine bureaucracies 165

quality, publicly oriented services 165, 176–182

status

health professionals 29, 182, 206

utilization of health care and 125, 126

stewardship as government role 57, 178, 189, 196

WHO defines 6, 62, 83

stigma

access influenced by, tuberculosis 60

public provision carries in Lebanon 140

Structural Adjustment Programmes.

See SAP

subsidy

disease control, health care delivery and 44

private sector 117

public

Chile 100

GATS and 30, 35, 83, 249

India 114

Lebanon 140, 141, 145, 146–147, 148, 149, 150

WHO report and 6

supplier-induced demand 7, 134

Lebanon 141

support

community, of public services, quality of care and 168, 173

of health professionals 172

sustainability

disease control 196

drug supply 210, 219

DSPs 159

funding 167

PPM-DOTS programme 60

problems with

effects on health systems 20

Sweden

divisionalized system 172

health expenditure 73

social insurance 74

Swedish International Development Cooperation Agency (SIDA)

demand-based projects 112

Tanzania, malaria programmes 39, 42

Tavistock Group 176

taxation, health care funding 30

territorial responsibility, facilities 188

Thailand

family medicine 202

for-profit approach influences care in 24

tracer

pathologies 25, 88

audit 238

patient’s career as, for audit 234, 235–238

trade

agreements.

effect on health services 6, 74, 114, 115, 117, 119

politicians responsibility for 249

See also GATS, Free Trade

GHIs and 8

training

clinical

LMICs 205–206

informal providers 43

in public health 240–245

in-service 44

hospital role in 190

patient-centred care 48

person-centred care 206

supports clinical decision-making 228–230

medical

Costa Rica 75

deterioration 29

India 112

person-centredness in 203, 205, 206

professional bureaucracy and 170

to meet Hippocratic ideal 166

PPM-DOTS programme 58

standards influence care 205

treatment

audit 236–238

discrepancies, effects on health systems 20

outcome rates, tuberculosis 59, 63

rates

Colombia 87, 91

Piot model and 40, 44

Piot model estimates 38

related to need 128

saving life vs. reducing morbidity 161

tuberculosis 60

tuberculosis

Chile 102

control 19, 155

assessment of programmes 38

barriers to care and 134

contracting out 35, 88

India 113

early detection 156, 196

incidence

Colombia 88

mortality 247

Costa Rica 26, 78

MDG 17

prevalence

Africa 42

Colombia 25, 77, 88

Costa Rica 77

Mexico 77

targets for control 57, 58

WB essential clinical package 20

Tunisia, family medicine 202

two-tier provision of care

Chile 104

Colombia 84, 86

result of aid policy 21

Uganda

‘free’ health care 167

health facilities 21

malaria programmes 39, 42

underfunding, public sector, encourages private 22

UNICEF

Bamako Initiative 167, 219–220

GOBI programme 49

Selective Primary Health Care 4, 73

United Kingdom.

audit 234

clinical governance concept 234

divisionalized system 172

health expenditure 92

IHP and 11

PFIs 23

professionals pay 169

public services defended 249

See also Britain, England

United Nations Children’s Fund (UNICEF)

IHP and 11

United Nations Programme on HIV and AIDS (UNAIDS), Joint

2007 report 157

IHP and 11

United Nations Research Institute for Social Development (UNRISD) 4

United Nations supports corporate provision 115

United States of America

attitude to Primary Health Care aid 4

audit in 234

health care

reform 97

health expenditure 73, 89, 93

administrative costs 91

insurance industry lobbied 249

managed care 226

poor people’s access to care 93

residual welfare 171

withholds WHO contribution 4

Uruguay, free health care 167

users

co-manage health services 4, 27, 164, 165, 178

co-manage health services 168–169

participation

divisionalized systems 172

utilization

Africa 38, 159

malaria 39, 42

Bamako Initiative and 168

Benin 220

Chile 25, 102

China 126

study 127

Colombia 87

control of and managed care 226

Costa Rica 76

demand and 127

disease control activities and 48, 53, 196

Ecuador 212

India 115

inequity and 126

Lebanon 144

Senegal 222

status and 125

vector control, vertical programmes for 18, 50

Venezuela

free health care 167

health expenditure 70

health indicators 70

vertical health care organisation.

Lebanon 142

See under programmes

Vietnam

efficiency 157

family medicine 202

health expenditure 24, 89

village health workers 190

water, India 112, 113

welfare, residual, USA 171

workload, planning and 189

World Bank (WB)

1987 report 4

1993 report 5, 6, 97, 248

DALY and QALY 160

1993 report, Minimal Activities Package 187

1996 discussion paper 5

1997 report 5

1997 Strategy Paper 5

2004 report 7

Costa Rica and Cuba 70

2005 report 116

Chile health reforms 97

Chinese policy influenced by 123, 127

competes with WHO 5

devolution promoted by 29

essential clinical package 5, 20, 187, 204

IHP and 11

indirect programmes 53

influences WHO 6, 248

minimal package of activities 49

presents Chile as model 104

private health insurance 74

promotes for-profit health care 69, 83, 97

Mashreq countries 138

public–private partnerships 22, 83, 114, 115

Structural Adjustment Programmes (SAP) 21, 22, 91

India 110, 112

withholds funds from Costa Rica 74

World Health Assembly tuberculosis control targets 57

World Health Organization (WHO)

1996 definition integrated programmes 49

2000 report 6

2001 report 6

2008 commission 28

2009 statement 28

Alma Ata Conference 4, 17, 49, 73, 189

appraisal of MDG compliance 17

Bamako Initiative 167, 219–220

competes with WB 5

GPPPs and 116

Health for All 155

Health for All concept 4, 6, 123

IHP and 11

Macroeconomic and Health Commission Report 22

malaria control 37

mortality and poor environment 114

policy change 29, 73, 155

Primary Health Care 123

return to 4, 11, 16, 201

promoted decentralization 169, 191

promote privatization 83

selective primary health care 73

tuberculosis 57, 62, 63

view of governance and health systems 28

World Health Organization (WHO):

right to health in constitution 251

World Trade Organization (WTO)

influence on health services 30, 83, 115

Yugoslavia, patient satisfaction 202

Zambia

internal brain drain 250

subcontracting of health care 22

Zimbabwe

contracting out 92

free health care 167

regulation in 28

role of hospitals 185




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