Future Health Systems
Edited by Gerald Bloom and Hilary Standing
Social Science & Medicine - Volume 66, Issue 10, Pages 2067-2184 (May 2008)
“…The purpose of this Special Issue is to stimulate innovative thinking about health system development in low-income and transition countries. We believe that informed and engaged debate about this topic is greatly needed because we are approaching a period of major change in global health systems. In this introduction, we set out why future health systems will probably look very different and why it is particularly important to explore the possibilities now….”
“….Health systems in most parts of the world continue to be organised in ways that were essentially set in the early part of the 20th century in a few countries. In many low-income and transition countries, there is an increasing disconnection between these organisational forms and realities on the ground, yet debates and reform agendas concerning health systems largely proceed on a “business as usual” basis.
Health policy has tended to export models of how health systems should operate from the advanced market economies to low-income and transitional countries with little questioning of their appropriateness and adaptability.
This Special Issue has been compiled partly in response to dissatisfaction with the ideologically over-determined nature of some of the debate about health system development in low and middle-income countries. This often does not address the real situation. For example, debates about the roles of public and private providers have quite a different meaning in countries without the institutional framework to govern a market economy and where government has little capacity to regulate providers of health services. The lack of appropriately contextualised debate and language hampers national and international efforts to address major health challenges.
Health systems are social and political artefacts and can be organised differently.
Health systems, like other systems of producing social goods, are ways of producing and organising access to expert knowledge and the technologies that derive from it. There is nothing immutable about the way they are organised. Their failure, in many contexts, to serve the interests of the poor means we should also be exploring different ways of producing and delivering services rather than simply intensifying efforts to recreate existing ones
Content:
Future health systems: Why future? Why now?
Gerald Bloom, Hilary Standing
Markets, information asymmetry and health care: Towards new social contracts
Gerald Bloom, Hilary Standing, Robert Lloyd
.
The health professions and the performance of future health systems in low-income countries: Support or obstacle?
Gilles Dussault
.
Producing effective knowledge agents in a pluralistic environment: What future for community health workers?
H. Standing, A. Mushtaque R. Chowdhury
.
Scaling-up antiretroviral treatment in Southern African countries with human resource shortage: How will health systems adapt?
Wim Van Damme, Katharina Kober, Guy Kegels
.
Information and communications technology for future health systems in developing countries
Henry Lucas
.
Regulating
David H. Peters, V.R. Muraleedharan
.
Ownership, control, and contention: Challenges for the future of healthcare in Malaysia
Heng Leng CHEE
.
New therapeutic landscapes in Africa: Parental categories and practices in seeking infant health in the Republic of Guinea
Melissa A. Leach, James R. Fairhead, Dominique Millimouno, Alpha Ahmadou Diallo
From life insurance to safer sex – Reflections of a marketing man
Bruce Mackay
PDF (111 K)
Engaging citizens: Lessons from building
Andrea Cornwall, Alex Shankland
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