Health Equity: 06/23/10

Wednesday, June 23, 2010

[EQ] 10 best resources on: health workers in developing countries

10 best resources on: health workers in developing countries

Karen A Gre´pin 1 and William D Savedoff

1 Assistant Professor, Robert F. Wagner Graduate School of Public Service, ew York University, New York, NY

2 Senior Partner, Social Insight, Portland, ME, USA.

Available online at: http://bit.ly/bHAveF

KEY MESSAGES

· Until recently researchers and policymakers paid little attention to the role of health workers in developing countries but a new generation of studies are providing a fuller understanding of these issues using more sophisticated data and research tools.

· Recent research highlights the value of viewing health workers as active agents in dynamic labour markets who are faced with many competing incentives and constraints.

· Newer studies have provided greater insights into human resource requirements in health, the motivations and behaviours of health workers, and health worker migration. We are encouraged by the progress but believe there is a need for even more, and higher quality, research on this topic.

Our goal in this essay is not so much to present the ‘10 best’ resources on health workers, which would be presumptuous to say the least, but rather to introduce this new generation of research by highlighting a number of good research articles that demonstrate this trend.

These articles share a growing awareness that the number and quality of health workers engaged in health care services is influenced by more than government decisions about spending and deployment. They encompass the behaviour of private practitioners and nongovernmental organizations; people who seek health care; and health workers themselves as they make choices about their training, employment, location and work effort, all within a context defined by the broader labour market, politics and culture.

This is why recent research is often framed within the perspective of labour market analysis even if it emerges from fields like political science, sociology, anthropology, public administration and business management.

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
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[EQ] A systematic review of the evidence on integration of targeted health interventions into health systems

A systematic review of the evidence on integration of targeted health interventions into health systems

Rifat Atun,1, Thyra de Jongh, 2 Federica Secci, 3 Kelechi Ohiri 4 and Olusoji Adeyi 4,5

1 Professor of International Health Management, Imperial College London, UK, 2 Researcher, Centre for Health Management, Imperial College London, UK, 3 Doctoral Researcher, Centre for Health Management, Imperial College London, UK, 4 Health Specialist, Human Development Network, World Bank, Washington, DC, USA and 5 Coordinator of Public Health Programs, Human Development Network, World Bank, Washington, DC, USA

Available online at: http://bit.ly/8Y1zrv

“……..A longstanding debate on health systems organization relates to benefits of integrating health programmes that emphasize specific interventions into mainstream health systems to increase access and improve health outcomes.

This debate has long been characterized by polarization of views and ideologies, with protagonists for and against integration arguing the relative merits of each approach. However, all too frequently these arguments have not been based on hard evidence. The presence of both integrated and non-integrated programmes in many countries suggests there may be benefits to either approach, but the relative merits of integration in various contexts and for different interventions have not been systematically analysed and documented.

In this paper we present findings of a systematic review that explores a broad range of evidence on:
(i) the extent and nature of the integration of targeted health programmes that emphasize specific interventions into critical health systems functions,
(ii) how the integration or non-integration of health programmes into critical health systems functions in different contexts has influenced programme success,
(iii) how contextual factors have affected the extent to which these programmes were integrated into critical health systems functions.

Our analysis shows few instances where there is full integration of a health intervention or where an intervention is completely non-integrated. Instead, there exists a highly heterogeneous picture both for the nature and also for the extent of integration. Health systems combine both non-integrated and integrated interventions, but the balance of these interventions varies considerably…………”

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[EQ] How the Performance of the U.S. Health Care System Compares Internationally

Mirror, Mirror on the Wall:
How the Performance of the U.S. Health Care System Compares Internationally, 2010 Update

Karen Davis, Cathy Schoen, and Kristof Stremikis
Commonwealth Fund June 2010

Available online PDF [34p.] at: http://bit.ly/bPSyNT

Chartpack (859K PPT)
Chartpack (274K PDF)

Despite having the most costly health system in the world, the United States consistently underperforms on most dimensions of performance, relative to other countries.

This report—an update to three earlier editions—includes data from seven countries and incorporates patients' and physicians' survey results on care experiences and ratings on dimensions of care. Compared with six other nations—Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom—the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives.

Newly enacted health reform legislation in the U.S. will start to address these problems by extending coverage to those without and helping to close gaps in coverage—leading to improved disease management, care coordination, and better outcomes over time.

Interactive tool:

http://www.commonwealthfund.org/usr_doc/site_docs/slideshows/MirrorMirror/MirrorMirror.html

Other New International Resources

· Health Care Abroad and Reform at Home: The latest podcast from the Fund's "New Directions in Health Care" series examines the costs of providing medical services in other parts of the world and considers how health care reform might change the bottom line in this country.

· International Profiles of Health Care Systems: These overviews, covering Australia, Canada, Denmark, England, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the U.S., provide detailed information for each nation on health insurance coverage and benefits, health system financing, delivery system organization, quality assurance mechanisms, efforts to improve efficiency and control costs, and recent innovations and reforms.

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