Journal articles on the topic 'Universal Health Cover'
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1
Segal, Leonie. "HEALTH INSURANCE - UNIVERSAL COVER OR A SAFETY-NET? A CRITIQUE." Economic Papers: A journal of applied economics and policy 23, no. 2 (June 2004): 114–28. http://dx.doi.org/10.1111/j.1759-3441.2004.tb00358.x.
2
Marwick, C. "Report calls for universal health cover for all US citizens." BMJ 328, no. 7432 (January 17, 2004): 128—c—0. http://dx.doi.org/10.1136/bmj.328.7432.128-c.
3
Ortega, Adrianne. "… And Health Care for All: Immigrants in the Shadow of the Promise of Universal Health Care." American Journal of Law & Medicine 35, no. 1 (March 2009): 185–204. http://dx.doi.org/10.1177/009885880903500105.
Abstract:
President Obama’s ambitious universal health care plan aims to provide affordable and accessible health care for all. The plan to cover the estimated 46.5 million uninsured, however, ignores the over thirty million non-citizens living in the United States. If the United States passes universal health care coverage, Congress should repeal the prohibitions of the Welfare Reform Act, extend Medicaid coverage to non-citizens, and allow non-citizens to purchase employer-based insurance coverage.President Obama’s plan follows the lead of state universal health care legislation by retaining private, employer-sponsored insurance coverage and expanding the eligibility requirements of the Medicaid program. This strategy will not aid uninsured immigrants or overburdened states and hospitals, though, because current law excludes most non-citizens from nonemergency health care services.
4
Onarheim, Kristine Husøy, Andrea Melberg, Benjamin Mason Meier, and Ingrid Miljeteig. "Towards universal health coverage: including undocumented migrants." BMJ Global Health 3, no. 5 (October 2018): e001031. http://dx.doi.org/10.1136/bmjgh-2018-001031.
Abstract:
As countries throughout the world move towards universal health coverage, the obligation to realise the right to health for undocumented migrants has often been overlooked. With unprecedented millions on the move – including refugees, asylum seekers, internally displaced persons, and returnees – undocumented migrants represent a uniquely vulnerable subgroup, experiencing particular barriers to health related to their background as well as insecure living and working conditions. Their legal status under national law often restricts access to, and affordability of, healthcare services. While striving to ensure health for all, national governments face challenging priority setting dilemmas in deciding: who to include, which services to provide, and how to cover out-of-pocket expenses. Building on comparative experiences in Norway, Thailand and the United States – which reflect varied approaches to achieving universal health coverage – we assess whether these national approaches provide rights-based access to affordable essential healthcare services for undocumented migrants. To meet the shared Sustainable Development Goal on universal health coverage, the right to health must be realised for all persons – including undocumented migrants. To ensure universal health coverage in accordance with the right to health, governments must evaluate laws, regulations, policies and practices to evaluate: whether undocumented migrants are included, to which services they have access, and if these services are affordable. Achieving universal health coverage for everyone will require rights-based support for undocumented migrants.
5
Prakash, NS. "Strengthening the Health System in India through Ayushman Bharat (AB) - Prime Minister’s Jan Arogya Yojana (PM-JAY) - Core Areas to look in to for achieving Sustainable Development Goals (SDG)." Indian Journal of Community Health 32, no. 4 (December 31, 2020): 737–39. http://dx.doi.org/10.47203/ijch.2020.v32i04.022.
Abstract:
Background: Government of India flagged off a very big health scheme for poor in the name of ‘Ayushman Bharat’ (AB) with a huge increase in medical cover for poorer section of the society from Sep 2018. This covers secondary and tertiary hospitalization care to approximately 40% of the population. Objectives: As the scheme involves huge financial outlay, this paper attempts to evaluate performance and understand whether the core objectives are met on the lines of Universal Health. Methods: A exhaustive survey of related literatures and published data on the official web site of AB is made. Results: The scheme is reasonably successful in providing financial relief but need to look at areas concerning quality delivery. Conclusions: With the larger objective of ‘Universal Health’, the beneficiaries list need to be reviewed. The scheme should look at bringing down the out of pocket expenses.
6
Musa, Nighat. "Universal Health Coverage; A Way Forward." Journal of Gandhara Medical and Dental Science 9, no. 2 (April 7, 2022): 1. http://dx.doi.org/10.37762/jgmds.9-2.318.
Abstract:
Universal health coverage means every person has access to quality health care without suffering financial hardships. The basis of universal health coverage lies in the primary health care concept, which was envisioned way back in 1978, as mentioned in Alma Ata Declaration1. The "World Health Report" published by the World Health Organization (WHO) in 2008 structures primary health care reforms in four groups. One of the crucial reforms was universal coverage reform to improve health equity2. WHO and UNICEF in 2018 documented how primary health care will be in the 21st century? The approach was towards universal health coverage and sustainable development goals. Sustainable development goals were to be achieved by 2030, and they were a continuation of millennium development goals 2000–20153. The resolution on Transforming our world: the 2030 Agenda for Sustainable Development adopted the target of universal health coverage by 2030, including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines for all4. Currently, many developing nations do not have access to health services. About 100 million people are pushed into extreme poverty each year because of out-of-pocket spending on health. To make health for all, we need individuals and communities to have high-quality health services to take care of their families health. Skilled health workers providing quality, people-centred care and policy-makers should be committed to investing in universal health coverage. Universal health coverage should be based on intense, people-centred primary health care. Good health systems are rooted in the communities they serve. They focus not only on preventing and treating disease and illness but also on helping to improve well-being and quality of life5. Pakistan, the developing country, is struggling to provide good quality health services, mostly availed from the out-of-pocket expenditure.
Both private and public sector hospitals were trying to deliver health services, but poor people failed to have access to many services due to poverty. To overcome this obstacle and address indicator 3.8 of SDGs, the current government developed a five-year program to improve the targeted population's health by increasing their access to quality health services. The initiative will also reduce poverty, as the government will cover most of their health budget through the "Sehat Sahulat Program". The program was part of the National vision to ensure Universal Health Coverage (UHC) for all Pakistani families. No one is denied quality healthcare services only because of financial constraints. Initially, it was piloted in selected four districts of Khyber Pakhtunkhwa, which was later extended to all over the province. Currently, 7.2 million families are getting free in-patient health care services, and the program's annual cost is 18 billion. It was a bold initiative of the current government, which helped improve access to UHC, thus addressing one of the sustainable development goals6,7.
7
Ha, Phan Thi Thuy, and Trinh Van Tung. "Strategies For Mobilizing Economic Resources to Cover Healthcare Costs for Poor Households in Vinh City, Nghe An Province." International Journal of Religion 5, no. 11 (June 27, 2024): 2177–88. http://dx.doi.org/10.61707/hhvedf22.
Abstract:
Based on qualitative and quantitative data collected from the research project "Differences in Access to Healthcare Services among the Population during the Implementation of Universal Health Insurance Policies" (Case study in Vinh City, Nghe An Province), this paper explores strategies used by poor households to mobilize economic resources to cover their healthcare costs. It also highlights the difficulties these households face in mobilizing economic resources. What strategies have they chosen to meet their expectations, and what are the outcomes of these mobilization efforts? Despite significant efforts, poor households are still considered fragile beneficiaries in the context of implementing universal health insurance policies in Vietnam nowadays.
8
Forst, Linda. "SS46-02 NETWORKING FOR WORKERS' HEALTH IN THE AMERICAS." Occupational Medicine 74, Supplement_1 (July 1, 2024): 0. http://dx.doi.org/10.1093/occmed/kqae023.0275.
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Abstract The Pan American Health Organization (PAHO) Workers' Health team promotes workers' health equity in the Americas by providing technical assistance to strengthen regulatory frameworks and the leadership of the health sector; promote workers' health and the development of safe, productive and healthy workplaces; prevent and register diseases, injuries and deaths at work; achieve access to universal healthcare and support critical economic sectors related to workers' health. PAHO collaborates with a broad range of stakeholders to implement the Plan of Action on Workers' Health 2015-2025, using a Health in All Policies approach, responding to national, regional and global priorities for workers' health, and contributing to the achievement of the Sustainable Development Goals (SDGs) 1, 3, and 8. This presentation will cover the activities of the WHO Collaborating Centres for Occupational Health in the PAHO region / Region of the Americas (AMRO).
9
Al Dahdah, Marine, and Rajiv K. Mishra. "Smart Cards for All: Digitalisation of Universal Health Coverage in India." Science, Technology and Society 25, no. 3 (April 26, 2020): 426–43. http://dx.doi.org/10.1177/0971721820912920.
Abstract:
In less than ten years, India has launched colossal biometric databases. One among them is related to the first ‘free’ health coverage scheme offered by the government of India: the Rashtriya Swasthya Bima Yojna (RSBY). Based on a public–private partnership between government and private companies, RSBY national scheme was launched in 2008, as a first step towards universal health coverage in a country where households endorse 70% of health expenses. The first phase of RSBY offers to cover ₹30,000 ($600) of inpatient expenses per year for five members of a below poverty line household and is now piloted in several Indian States to include outpatient expenses and above poverty line families too. RSBY relies exclusively on a centralised digital artefact to function, made visible by the ‘RSBY Smart Card’, a chip enabled plastic card containing personal data of individual and their family counting and conditioning the granting of health services to them; thus, no smart card means no health coverage. Till date 120 million Indians have been registered in the RSBY database. This article analyses how health accessibility is crafted under the RSBY scheme by questioning two central dimensions of this data-driven digital health scheme: the smart card technology and the public–private partnership, whereas RSBY scheme promises health coverage for all, its digital infrastructures may complicate access to health services, and reveal new patterns of exclusion of individuals. Thus, we will detail how smartcards technologies and private providers condition access to health care in India.
10
Kipo-Sunyehzi, Amogre Ayanore, Dzidzonu, and Ayalsuma Yakubu. "Ghana’s Journey towards Universal Health Coverage: The Role of the National Health Insurance Scheme." European Journal of Investigation in Health, Psychology and Education 10, no. 1 (October 1, 2019): 94–109. http://dx.doi.org/10.3390/ejihpe10010009.
Abstract:
: Background: the main aim of the study is to find if the National Health Insurance Scheme (NHIS) in Ghana is achieving universal health coverage (UHC) or not. The study gives the trajectories of health policies in Ghana and their implications on long term health financing. NHIS in Ghana was implemented in 2004, with the aim of increasing subscribers’ access to health care services and reduce financial barriers to health care. On equity access to healthcare, it addresses two core concerns: (1) enrolling particular groups (persons exempted from annual premium payments) and (2) achieving UHC for all citizens and persons with legal residence. It utilizes a multifactor approach to the conceptualization of UHC. The research question: is Ghana’s NHIS on course to deliver or achieve universal health coverage? Methods: we used qualitative methods. In doing so, the study engaged participants in in-depth interviews, focus group discussions and direct observations of participants in their natural settings, like hospitals, clinics, offices and homes, with purposive and snowball techniques. This data triangulation approach aims to increase the reliability and validity of findings. Results: the empirical evidence shows NHIS performed relatively well in enrolling more exempt groups (particular groups) than enrolling all persons in Ghana (UHC). The biggest challenge for the implementation of NHIS from the perspectives of health insurance officials is inadequate funding. The health insurance beneficiaries complained of delays during registrations and renewals. They also complained of poor attitude of some health insurance officials and health workers at facilities. Conclusions: both health insurance officials and beneficiaries emphasized the need for increased public education and for implementers to adopt a friendly attitude towards clients. To move towards achieving UHC, there is a need to redesign the policy, to move it from current voluntary contributions, to adopt a broad tax-based approach to cover all citizens and persons with legal residence in Ghana. Also, to adopt a flexible premium payment system (specifically ‘payments by installation’ or ‘part payments’) and widen the scope of exempt groups as a way of enrolling more into the NHIS.
11
HaGani, Neta, Samah Hayek, Jalal Tarabeia, Mohammad Yehia, and Manfred S. Green. "Fear of catastrophic health expenditures and unrealistic expectations from supplementary health insurance: ethnic differences." International Health 11, no. 4 (November 9, 2018): 283–89. http://dx.doi.org/10.1093/inthealth/ihy089.
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Abstract Background In Israel, the whole population is covered by comprehensive universal health insurance. Despite that, most of the population purchases supplementary health insurance (SHI). It has been shown that individuals purchase more health insurance and preventive medicine when they are uncertain of their state of health, while a majority may not fully understand basic concepts in their health insurance coverage. The purpose of this study was to examine the role of fear of catastrophic health expenditures and unrealistic expectations in purchasing SHI, which does not cover expenses for life-threatening illnesses. Methods A cross-sectional survey was conducted among random samples of 814 Jews and 800 Arabs in Israel. A structured questionnaire was administered by telephone using random digit dialling. Log-linear regression was used to identify factors associated with reasons for purchasing SHI and expectations from SHI. Results The most common reason for purchasing SHI was fear of catastrophic health-related expenditures (41%). The most important service expected from SHI was ‘cancer medications’ (mean 4.68 [standard deviation 0.87]). Differences in the reasons for purchasing SHI and in expectations from SHI were found according to population group, age, gender and education. Conclusions Consumers’ misconceptions and fear of catastrophic health expenditures are major factors leading to the purchase of SHI, despite universal health coverage. Improved and accessible information should help consumers make informed decisions as to whether or not to purchase SHI.
12
Blaauw, D., C. Chambers, T. Chirwa, N. Duba, L. Gwyther, K. Hofman, L. London, et al. "Introducing an Ethics Framework for health priority-setting in South Africa on the path to universal health coverage." South African Medical Journal 112, no. 3 (March 1, 2022): 240–44. http://dx.doi.org/10.7196/samj.2022.v112i3.16278.
Abstract:
Background. South Africa (SA) has embarked on a process to implement universal health coverage (UHC) funded by National Health Insurance (NHI). The 2019 NHI Bill proposes creation of a health technology assessment (HTA) body to inform decisions about which interventions NHI funds will cover under UHC. In practice, HTA often relies mainly on economic evaluations of cost-effectiveness and budget impact, with less attention to the systematic, specific consideration of important social, organisational and ethical impacts of the health technology in question. In this context, the South African Values and Ethics for Universal Health Coverage (SAVE-UHC) research project recognised an opportunity to help shape the health priority-setting process by providing a way to take account of multiple, ethically relevant considerations that reflect SA values. The SAVE-UHC Research Team developed and tested an SA-specific Ethics Framework for HTA assessment and analysis. Objectives. To develop and test an Ethics Framework for use in the SA context for health priority-setting. Methods. The Framework was developed iteratively by the authors and a multidisciplinary panel (18 participants) over a period of 18 months, using the principles outlined in the 2015 NHI White Paper as a starting point. The provisional Ethics Framework was then tested with multi-stakeholder simulated appraisal committees (SACs) in three provinces. The membership of each SAC roughly reflected the composition of a potential SA HTA committee. The deliberations and dedicated focus group discussions after each SAC meeting were recorded, analysed and used to refine the Framework, which was presented to the Working Group for review, comment and final approval. Results. This article describes the 12 domains of the Framework. The first four (Burden of the Health Condition, Expected Health Benefits and Harms, Cost-Effectiveness Analysis, and Budget Impact) are commonly used in HTA assessments, and a further eight cover the other ethical domains. These are Equity, Respect and Dignity, Impacts on Personal Financial Situation, Forming and Maintaining Important Personal Relationships, Ease of Suffering, Impact on Safety and Security, Solidarity and Social Cohesion, and Systems Factors and Constraints. In each domain are questions and prompts to enable use of the Framework by both analysts and assessors. Issues that arose, such as weighting of the domains and the availability of SA evidence, were discussed by the SACs. Conclusions. The Ethics Framework is intended for use in priority-setting within an HTA process. The Framework was well accepted by a diverse group of stakeholders. The final version will be a useful tool not only for HTA and other priority-setting processes in SA, but also for future efforts to create HTA methods in SA and elsewhere.
13
Mustikasari, Aidha Puteri. "BPJS Kesehatan Memberikan Jaminan Kesehatan Terhadap Pasien Atau Masyarakat." Yustitiabelen 7, no. 2 (December 17, 2021): 146–54. http://dx.doi.org/10.36563/yustitiabelen.v7i2.304.
Abstract:
Abstrak. Kepesertaan BPJS Kesehatan pada tahun 2020 tidak akan mencakup 90% penduduk Indonesia, namun rencana Universal Health Care Implementation (UHC) telah direncanakan sejak tahun sebelumnya. Di masa pandemi Covid, sejumlah besar status kepesertaan BPJS Kesehatan dicabut karena terlambat, padahal masyarakat membutuhkan layanan kesehatan dan asuransi dengan kondisi yang ada. Kajian ini bersifat norma deskriptif , dibahas dalam konteks kepesertaan BPJS kesehatan, dan cukup menggunakan prinsip asuransi dengan hanya memberikan jaminan kepada peserta, tetapi negara mengikuti kewajiban UUD 1945 yaitu memberikan jaminan kesehatan dan pelayanan kepada warga negara. Untuk mendukung keberadaan jaminan kesehatan universal, Indonesia perlu menerapkan formulir kepesertaan dan sanksi untuk ketentuan wajib peserta jaminan sosial yang efektif dan efisien.
Abstract. BPJS Health membership in 2020 will not cover 90% of Indonesia's population, but the Universal Health Care Implementation (UHC) plan has been planned since the previous year. During the Covid pandemic, a large number of BPJS Health membership statuses were revoked because they were late, even though people needed health services and insurance with the existing conditions. This study is descriptive in nature, discussed in the context of BPJS health participation, and it is sufficient to use the insurance principle by only providing guarantees to participants, but the state follows the obligations of the 1945 Constitution, namely to provide health insurance and services to citizens. To support the existence of universal health insurance, Indonesia needs to implement an effective and efficient membership form and sanctions for mandatory provisions for social security participants.
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Khanal, Geha Nath, and Bhagawan Regmi. "Social Protection in Health: Characteristics and Coverage of Health Insurance Programme in Nepal." Journal of Social Protection 1 (December 1, 2020): 27–42. http://dx.doi.org/10.3126/jsp.v1i0.38209.
Abstract:
The agenda of social protection has become very popular in recent years. Several social protection programs in healthcare are designed to increase the healthcare coverage, ensure financial protection and enhance the scope and quality of services and access to medicines which ultimately paves the way for universal health coverage. The national health insurance programme (NHIP) is one of the approaches implemented in Nepal to cover healthcare expenditure. This paper discusses the gradual development of the health insurance programme in Nepal and the key features of NHIP that have been implemented since 2016. It further highlights the implementation status of NHIP, the milestones it covered, and the role of political parties in implementing NHIP in Nepal. Furthermore, the paper discusses the challenges associated with enrollment of formal and non-formal sectors, the mismatch between geographical coverage and the number of service contact points, and commitment from the political parties for effective implementation of NHIP. It seeks major implementation reforms to ensure effective implementation of NHIP.
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Szarek-Iwaniuk, Patrycja, Agnieszka Dawidowicz, and Adam Senetra. "Methodology for Precision Land Use Mapping towards Sustainable Urbanized Land Development." International Journal of Environmental Research and Public Health 19, no. 6 (March 18, 2022): 3633. http://dx.doi.org/10.3390/ijerph19063633.
Abstract:
Land-use/land cover maps constitute one of the key sources of information on urban space. To address the problems associated with the lack of timely and detailed land-use maps, the authors have developed a universal methodological approach for monitoring land use structure that is particularly useful in a rapidly evolving urban environment. Therefore, the main aim of this study was to develop a universal methodology for high-precision land-use analysis in urbanized areas in the context of large-scale mapping. The method uses geoinformation tools, photogrammetric data (orthophoto maps) as well as data acquired during a field inventory (involving a field survey and field mapping). The proposed approach is based on the modified existing approaches towards a detailed identification of land-use patterns while reducing the difficulties arising from the limitations of existing land use data sources. The methodology consists of several steps. First, the data sources for land-use analysis were selected. Subsequently, the classification of land-use categories in urban space was made. Finally, the method to high-precision land-use analysis for large-scale mapping was defined under the assumption that it is to be universal for use in countries with different levels of spatial and economic development. The proposed research method is based on an interpolation algorithm. It is highly valid, flexible, modifiable, accurate, and it can be applied to process publicly available and free sources of spatial data. Validation of the method on a test object (city of Ostróda, Poland) showed its high effectiveness, which is limited only by the type of data. The results obtained with the use of the proposed method not only supported the determination of the present land-use structure in the town but were also used to identify areas with the highest and lowest intensity and concentration of specific land-cover types.
16
Suryanto, Suryanto, Virginia Plummer, and Malcolm Boyle. "Financing Healthcare in Indonesia." Asia Pacific Journal of Health Management 11, no. 2 (July 1, 2016): 33–38. http://dx.doi.org/10.24083/apjhm.v11i2.185.
Abstract:
Introduction: There have been two major transitions for healthcare in Indonesia: the implementation of government decentralisation and universal health insurance. A universal public health insurance called Badan Penyelenggara Jaminan Sosial (BPJS) was launched in January 2014 and aims to cover all Indonesian people.
Objective: The objective of this paper is to discuss the funding of healthcare in Indonesia through a comparison with other South East Asian countries.
Methodology: A search for relevant literature was undertaken using electronic databases, Ovid Medline, ProQuest Central, and Scopus from their commencement date until December 2015. The grey literature from the Indonesian government, the WHO’s and World Bank’s website, has been included.
Results: There were nine articles from Ovid Medline, eight from ProQuest Central, and 12 from Scopus that met the criteria. Seventeen articles were duplicates leaving 12 articles to be reviewed. Nine documents have been identified from grey literature.
Discussion: Most people in Indonesia sought health services from the private sector and were out-ofpocket financially or did not receive the required care. The private sector delivered 62.1% of health services compared to 37.9% by the government. Despite some inappropriate use of previous health insurance, the BPJS is expected to have improved management and will cover all citizens by the end of 2019.
Conclusion: Indonesia has undergone a series of changes to health system funding and health insurance. There are lessons that can be learnt from other countries, such as Thailand, Cambodia, and Vietnam, so that Indonesia can improve its health funding.
Abbreviations: BPJS – Badan Penyelenggara Jaminan Sosial.
17
Tippett, Vivienne C., Ghasem (Sam) Toloo, David Eeles, Joseph Y. S. Ting, Peter J. Aitken, and Gerard J. FitzGerald. "Universal access to ambulance does not increase overall demand for ambulance services in Queensland, Australia." Australian Health Review 37, no. 1 (2013): 121. http://dx.doi.org/10.1071/ah12141.
Abstract:
Objective. To determine the impact of the introduction of universal access to ambulance services via the implementation of the Community Ambulance Cover (CAC) program in Queensland in 2003–04. Method. The study involved a 10-year (2000–01 to 2009–10) retrospective analysis of routinely collected data reported by the Queensland Ambulance Service (QAS) and by the Council of Ambulance Authorities. The data were analysed for the impact of policy changes that resulted in universal access to ambulance services in Queensland. Results. QAS is a statewide, publically funded ambulance service. In Queensland, ambulance utilisation rate (AUR) per 1000 persons grew by 41% over the decade or 3.9% per annum (10-year mean = 149.8, 95% CI: 137.3–162.3). The AUR mean after CAC was significantly higher for urgent incidents than for non-urgent ones. However projection modelling demonstrates that URs after the introduction of CAC were significantly lower than the projected utilisation for the same period. Conclusions. The introduction of universal access under the Community Ambulance Cover program in Queensland has not had any significant independent long-term impact on demand overall. There has been a reduction in the long-term growth rate, which may have been contributed to by an ‘appropriate use’ public awareness program. What is known about the topic? It is generally well accepted that the demand for emergency health services is increasing however the drivers for demand are poorly understood. In Queensland in particular, growth in demand for services exceeds that seen in other states and territories. Some commentators have pointed at service funding policy and costs to end users as potential reasons for excess demand for services. What does this paper add? The assumption that forced subsidisation creates a perception of entitlement amongst consumers is challenged in this paper. We are able to demonstrate that demand for emergency health services did not increase beyond what would have been expected under a mandatory subscription system known as Community Ambulance Cover (CAC). This paper contributes to the developing body of knowledge about drivers for emergency health service demand. What are the implications for practitioners? There is a need to continue analysis of the system to determine drivers for demand and develop an evidence base on which to formulate emergency health policy, including funding models, for the future. Purely economic drivers for service demand seem unlikely to hold up and policy makers need to understand the complex relationships between service systems; end user perceptions and health literacy; and the costs of services in order to effect policy reform.
18
Glied, Sherry A., and Phyllis C. Borzi. "The Current State of Employment-Based Health Coverage." Journal of Law, Medicine & Ethics 32, no. 3 (2004): 404–9. http://dx.doi.org/10.1111/j.1748-720x.2004.tb00150.x.
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American policymakers and health policy analysts have a love-hate relationship with job-based health insurance. The policy press routinely runs articles about the demise of the current system of voluntary employer-sponsored health insurance coverage. Conservatives argue that it ought to be replaced with individually-purchased insurance, such as tax-favored spending accounts (see Mark Pauly’s article this issue). Liberals assert that government insurance ought to supplant it.Meanwhile, as the debate rages on about the future of employer coverage, states and the federal government pass legislation buttressing and building on the existing employment-based system. Most recently, California has passed an employer mandate requiring employers to cover their workers (and many other states have contemplated similar legislation) and Maine has adopted a universal coverage initiative that includes a voluntary small employer insurance program offered through a state agency (Dirigo Health Care).
19
Dr. Suresh Naik V., Kiranmayi V. ,. "Performance Evaluation of Health Insurance: Ways for Winning Confidence." Psychology and Education Journal 58, no. 1 (January 15, 2021): 3955–64. http://dx.doi.org/10.17762/pae.v58i1.1438.
Abstract:
Health is a fundamental force that decides the overall quality of human life. The health of the population is a vital and essential issue for any country. The new National Health Policy of India (2017) emphasizes the growing burden of non- communicable diseases and corresponding growing expenditure. Indian Government announced the world's most massive health scheme, the Ayushman Bharat Yojana, in 2018, which is a significant step towards attaining universal health coverage in India. This scheme provides a cover of Rs.5 lakh per family per year for various medical procedures. Although India's Government is taking many such initiatives to improve public health, a lot more needs to be done to attain universal coverage. Out of pocket expenditure paid by individuals towards health care in India ranges at a high percentage over the years. Although health insurance premium has shown an increase over the years, there is no drop in this expenditure. This study shows the phenomenal growth achieved by health insurance, specifically after privatization, premium growth, and improvement in claims ratios. It is suggested that the insurance companies should modify the coverage of health insurance policies so that the uncovered expenses are reimbursed during hospitalization. Insurance companies also should shift their focus towards wellness instead of covering sickness to keep their businesses sustainable in the long run.
20
Ergo, Alex, Thant Sin Htoo, Reena Badiani-Magnusson, and Rivandra Royono. "A new hope: from neglect of the health sector to aspirations for Universal Health Coverage in Myanmar." Health Policy and Planning 34, Supplement_1 (October 1, 2019): i38—i46. http://dx.doi.org/10.1093/heapol/czy110.
Abstract:
Abstract Myanmar’s health sector has received low levels of public spending since 1975. Combined with the country’s historic political and economic isolation, poor economic management and multiple internal armed conflicts, these limited resources have translated into low coverage of even the most basic services and into poor health outcomes with wide disparities. They have also resulted in out-of-pocket payments for health as a proportion of total health spending being among the highest in the world. The Government of Myanmar has now affirmed its commitment to moving toward Universal Health Coverage. This commitment is reflected in the National Health Plan 2017–2021. Drawing upon analysis of data from the Myanmar Poverty and Living Conditions Survey 2015 and using the country’s revised methodology to estimate poverty, this paper explores some of the consequences of Myanmar’s excessive reliance on out-of-pocket funding as the main source of health financing. Around 481 000 households in Myanmar experienced catastrophic health spending in 2015. Of this group, 185 000 households lived below the national poverty line. Households that experienced catastrophic health spending spent, on average, 54.7% of their total capacity to pay on health. Of all Myanmar households that went to a health facility in 2015, ∼28% took loans and ∼13% sold their assets to cover health spending. In that same year, ∼1.7 million people fell below the national poverty line due to health spending. The paper then discusses how ongoing reforms could help alleviate the financial hardship associated with care-seeking. With current political will to reform the health system, a conducive macro-economic environment, and the relatively limited vested interests, Myanmar has a window of opportunity to achieve significant progress towards UHC. Continued high-level political support and strong leadership will be needed to keep reforms on track.
21
Berger, Uri. "Introduction to the special issue: How nonclinical psychology research can inform clinical perspectives on disgust." Bulletin of the Menninger Clinic 87, Supplement A (March 2023): 1–4. http://dx.doi.org/10.1521/bumc.2023.87.suppa.1.
Abstract:
Disgust is a universal emotion that significantly impacts human behavior and psychological well-being. While clinical psychology researchers made great strides in understanding disgust in the context of psychopathology, nonclinical researchers have contributed valuable insights that can inform clinical perspectives on disgust. This special issue aims to bring together the latest nonclinical research that can shed light on the nature, causes, and consequences of disgust-related psychopathology. The five articles in this issue cover various nonclinical topics, including inhibitory learning, autobiographical memories, food preferences, and the perception of self and others. This issue also covers the role of disgust in specific clinical disorders, including anxiety disorders, obsessive-compulsive disorder, posttraumatic stress disorder, eating disorders, neurodegenerative disorders, and more. By showcasing novel approaches to researching clinical aspects of disgust, this special issue provides a comprehensive and up-to-date understanding of the complex phenomenon of disgust and future directions in research.
22
Pakoksung, Kwanchai. "Assessment of Soil Loss from Land Cover Changes in the Nan River Basin, Thailand." GeoHazards 5, no. 1 (January 4, 2024): 1–21. http://dx.doi.org/10.3390/geohazards5010001.
Abstract:
This study investigates soil loss erosion dynamics in the Nan River Basin, Thailand, focusing on the impact of land cover changes. Utilizing the Universal Soil Loss Equation (USLE) model, key factors, including rainfall erosivity, soil erodibility, topography, and land cover, are analyzed for the years 2001 to 2019. The findings reveal a substantial increase in human-induced soil erosion, emphasizing the pressing need for effective mitigation measures. Severity classification demonstrates shifting patterns, prompting targeted conservation strategies. The examination of land cover changes indicates significant alterations in the satellite image (MODIS), particularly an increase in Deciduous forest (~13.21%), Agriculture (~0.18%), and Paddy (~0.43%), and decrease in Evergreen Forest (~13.73%) and Water (~0.12%) cover types. Deciduous forest and Agriculture, associated with the highest soil loss rates, underscore the environmental consequences of specific land use practices. Notably, the increase in Deciduous forest and Agriculture significantly contributes to changes in soil loss rates, revealing the interconnectedness of land cover changes and soil erosion in ~18.05% and ~8.67%, respectively. This study contributes valuable insights for informed land management decisions and lays a foundation for future research in soil erosion dynamics. Additionally, the percentage increase in Agriculture corresponds to a notable rise in soil loss rates, underscoring the urgency for sustainable land use practices.
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Farhate, Camila Viana Vieira, Zigomar Menezes de Souza, Maurício Roberto Cherubin, Lenon Herique Lovera, Ingrid Nehmi de Oliveira, Marina Pedroso Carneiro, and Newton La Scala Jr. "Abiotic Soil Health Indicators that Respond to Sustainable Management Practices in Sugarcane Cultivation." Sustainability 12, no. 22 (November 12, 2020): 9407. http://dx.doi.org/10.3390/su12229407.
Abstract:
Soil quality (SQ) assessments are fundamental to design more sustainable land uses and management practices. However, SQ is a complex concept and there is not a universal approach to evaluate SQ across different conditions of climate, soil, and cropping system. Large-scale sugarcane production in Brazil is predominantly based on conventional tillage and high mechanization intensity, leading to SQ degradation. Thus through this study, we aim to assess the impact of sustainable management practices, including cover crops and less intensive tillage systems, in relation to the conventional system, using a soil quality index composed of abiotic indicators. Additionally, we developed a decision tree model to predict SQ using a minimum set of variables. The study was conducted in the municipality of Ibitinga, São Paulo, Brazil. The experimental design used was in strips, with four cover crops and three tillage systems. We evaluated three sugarcane cultivation cycles (2015/16, 2016/17, and 2017/18 crops). To calculate the SQ index, we selected five abiotic indicators: macroporosity, potassium content, calcium content, bulk density, and mean weight-diameter of soil aggregates. Based on our SQ index, our findings indicated that the soil quality was driven by the production cycle of sugarcane. Although a reduction of soil quality occurs between the plant cane and first ratoon cane cycles, from the second ratoon cane there is a trend of the gradual restoration of soil quality due to the recovery of both the soil’s physical and chemical attributes. Our study also demonstrated that the cultivation of sunn hemp and millet as cover crops, during the implementation of sugarcane plantation, enhanced soil quality. Due to the advantages provided by the use of these two cover crops, we encourage more detailed and long-term studies, aiming to test the efficiency of intercropping involving sunn hemp and millet during the re-planting of sugarcane.
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Sharma, Vijay, and Richa Sharma. "SUCCESS OF INDIAN NATIONAL HEALTH PROTECTION SCHEME NEEDS CREATIVE DESTRUCTION OF MINES OF HEALTHCARE CORRUPTION." EPH - International Journal of Business & Management Science 2, no. 1 (March 27, 2016): 15–25. http://dx.doi.org/10.53555/eijbms.v2i1.47.
Abstract:
We need Universal healthcare in India, Government has launched world’s biggest health insurance programme covering half billion population with risk cover of INR 500,000 ($ 7500). Free healthcare will take away one major worry of poor masses. Things are going to change over the years with better healthcare, less sickness, less work loss, no medical expenditure related bankruptcy, better economic prospects & more food availability. This scheme will lead to enhanced business activities at all level, will create the job at many levels, there will the expansion of healthcare industry, but later it will lead to increased pollution and climate change leading to the new spectrum of diseases, increased health care use and increased insurance expenditure. Major problem is that corruption involves various layers of the healthcare system, including care providers, pharmacies, laboratories, corporate hospitals, mom and pop hospitals, clinics, pharmaceutical and instrument companies. Policymakers should use all technologies based measures including artificial intelligence, block chain technology, universal biometrics in healthcare, global positioning system, digital monitoring, mobile applications, point of care technologies, system reforms, big data collection, nudging, mobile health, telehealth, mass education, culture change and strong laws to prevent corruption as well as illness. Avoidance of inspector policy is best. For the success of the programme mines of healthcare, corruption must be destroyed.
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Etiaba, Enyi, Obinna Onwujekwe, Ayako Honda, Ogochukwu Ibe, Benjamin Uzochukwu, and Kara Hanson. "Strategic purchasing for universal health coverage: examining the purchaser–provider relationship within a social health insurance scheme in Nigeria." BMJ Global Health 3, no. 5 (October 2018): e000917. http://dx.doi.org/10.1136/bmjgh-2018-000917.
Abstract:
BackgroundIn an attempt to achieve universal health coverage, Nigeria introduced a number of health insurance schemes. One of them, the Formal Sector Social Health Insurance Programme (FSSHIP), was launched in 2005 to provide health cover to federal government and formal private sector employees. It operates with two levels of purchasers, the National Health Insurance Scheme (NHIS) and health maintenance organisations (HMOs). This study critically assesses purchasing arrangements between NHIS, HMOs and healthcare providers and determines how the arrangements function from a strategic purchasing perspective within the FSSHIP.MethodsA qualitative study undertaken in Enugu state, Nigeria, data were gathered through reviews of documents, 17 in-depth interviews (IDIs) with NHIS, HMOs and healthcare providers and two focus group discussions (FGDs) with FSSHIP enrolees. A strategic purchasing lens was used to guide data analysis.ResultsThe purchasing function was not being used strategically to influence provider behaviour and improve efficiency and quality in healthcare service delivery. For the purchaser–provider relationship, these actions are: accreditation of healthcare providers; monitoring of HMOs and healthcare providers and use of appropriate provider payment mechanisms for healthcare services at every level. The government lacks resources and political will to perform their stewardship role while provider dissatisfaction with payments and reimbursements adversely affected service provision to enrolled members. Underlying this inability to purchase, health services strategically is the two-tiered purchasing mechanism wherein NHIS is not adequately exercising its stewardship role to monitor and guide HMOs to fulfil their roles and responsibilities as purchasing administrators.ConclusionsPurchasing under the FSSHIP is more passive than strategic. Governance framework requires strengthening and clarity for optimal implementation so as to ensure that both levels of purchasers undertake strategic purchasing actions. Additional strengthening of NHIS is needed for it to have capacity to play its stewardship role in the FSSHIP.
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Prinja, Shankar, Maninder Pal Singh, Lorna Guinness, Kavitha Rajsekar, and Balram Bhargava. "Establishing reference costs for the health benefit packages under universal health coverage in India: cost of health services in India (CHSI) protocol." BMJ Open 10, no. 7 (July 2020): e035170. http://dx.doi.org/10.1136/bmjopen-2019-035170.
Abstract:
IntroductionTo achieve universal health coverage, the Government of India has introduced Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB - PMJAY), a large tax-funded national health insurance scheme for the provision of secondary and tertiary care services in public and private hospitals. AB - PMJAY reimburses care for 1573 health benefit packages (HBPs). HBPs are designed to cover the treatment of diseases/conditions with high incidence/prevalence or which contribute to high out-of-pocket expenditure. However, there is a dearth of reference cost data against which provider payment rates can be assessed.Methods and analysisThe CHSI (Cost of Health Services in India) study will collect cost data from 13 Indian states covering 52 public and 40 private hospitals, using a mixed economic costing methodology (top-down and bottom-up), to generate unit costs for the HBPs. States will be sampled to capture economic status, development indicators and health service utilisation heterogeneity. The public sector hospitals will be chosen at secondary and tertiary care level. One tertiary facility will be selected from each state. At secondary level, three districts per state will be selected randomly from the district composite development score ranking. The private sector hospital sample will be stratified by nature of ownership (for-profit and not-for-profit), type of city (tier 1, 2 or 3) and size of the hospital (number of beds). Average costs for each HBP will be calculated across the different facility types. Multiple scenarios will be used to suggest rates which could be negotiated with the providers. Overall, the study will provide economic cost data for price setting, strategic purchasing, health technology assessment and a national cost database of India.Ethics and disseminationThe approval has been obtained from the Institutional Ethics Committee and Institutional Collaborative Committee of the Post Graduate Institute of Medical Education and Research, Chandigarh, India. The results shall be disseminated in conferences and peer-reviewed articles.
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Khan, Sheraz Ahmad, Kathrin Cresswell, and Aziz Sheikh. "CONTEXTUALISING SEHAT SAHULAT PROGRAMME IN THE DRIVE TOWARDS UNIVERSAL HEALTH COVERAGE IN KHYBER PAKHTUNKHWA, PAKISTAN." KHYBER MEDICAL UNIVERSITY JOURNAL 14, no. 1 (March 31, 2022): 63–70. http://dx.doi.org/10.35845/kmuj.2022.21481.
Abstract:
OBJECTIVES: To describe the evolution of the Sehat Sahulat Programme (SSP), a large-scale health insurance scheme launched by the provincial government of Khyber Pakhtunkhwa, Pakistan and to contextualise it in the national discourse around Universal Health Coverage (UHC).
METHODS: This review was based on peer-reviewed publications and publicly available grey literature over the last five years (2016-2020). We employed a combination of deductive and inductive approaches informed by the World Health Organisation's (WHO) UHC box framework.
REVIEW: SSP was launched on 15 December 2015. It has been implemented in four phases, with a gradual expansion in the population, services and cost coverage. In 2015, SSP covered the poorest 21% of the population in four pilot districts. On 20 August 2020, the coverage was expanded to 100% of the population of Khyber Pakhtunkhwa. SSP conferred free access to an expanding list of inpatient, secondary and tertiary care services. The scheme covered all expenditures during hospital admission, with a defined upper ceiling. The ceiling for secondary and tertiary care has improved, with marked changes in tertiary coverage, from PKR 0 in Phase1 – PKR 400,000 in Phase 4. Despite the progress, SSP did not cover key health-related targets under Goal 3 of the Sustainable Development Goals (SDGs) and partially covered Pakistan's UHC benefits package.
CONCLUSION: SSP coverage of population, disease and financial protection has expanded over five years. However, SSP coverage was not aligned with the national UHC priorities and the SDGs.
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Bayked, Ewunetie M., Mesfin H. Kahissay, and Birhanu D. Workneh. "Factors affecting the uptake of community-based health insurance in Ethiopia: a systematic review." International Journal of Scientific Reports 7, no. 9 (August 21, 2021): 459. http://dx.doi.org/10.18203/issn.2454-2156.intjscirep20213261.
Abstract:
<p class="abstract">The goal of health care financing in Ethiopia is achieving universal health care coverage by community-based health insurance which was expected to cover more than eighty percent of the population. The aim was to minimize catastrophic out-of-pocket health service expenditure. We systematically reviewed factors affecting the uptake of community-based health insurance in Ethiopia. We searched various databases by 09 to 10 March 2019. We included articles regardless of their publication status with both quantitative and qualitative approaches. The factors determining the uptake of community-based health insurance in Ethiopia were found to be demographic and socio-economic, and health status, and health service-related issues. Among demographic and socio-economic factors, the report of the studies regarding gender and age was not consistent. However, income, education, community participation, marriage, occupation, and family size were found to be significant predictors and were positively related to the uptake of the scheme.<strong> </strong>Concerning health status and health service-related factors; illness experience, benefit package, awareness level, previous out of pocket expenditure for health care service, and health service status (quality, adequacy, efficiency, and coverage) were significantly and positively related but the premium amount, self-rated health status and bureaucratic complexity were found to be negative predictors. To achieve universal health care coverage through community-based health insurance, special attention should be given to community-based intervention.</p>
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Nurlina, S. Kadir, A. Kurnain, W. Ilham, and I. Ridwan. "Analysis of soil erosion and its relationships with land use/cover in Tabunio watershed." IOP Conference Series: Earth and Environmental Science 976, no. 1 (February 1, 2022): 012027. http://dx.doi.org/10.1088/1755-1315/976/1/012027.
Abstract:
Abstract Erosion is detrimental to the health of the watershed exclusively in the upstream area of the watershed because it causes a lack of soil fertility because of being carried away by water, while in the downstream, it will reduce the river’s capacity due to sediment deposits. This research aims to determine the annual rate of soil erosion and its relation to land cover using the Revised Universal Soil Loss Equation (RUSLE). Factors needed by RUSLE in estimating erosion include rain erosivity (R), Soil erodibility (K) length and slope (LS), land cover processing factor (CP), and the value of 0,61 as correction factors. We classify the result shows that the erosion rate in Tabunio watershed into five erosion classes, ranging from very light to very heavy classes. The erosion rate in the Tabunio watershed ranged from 0,000158 tons ha-1 year-1 to 9.453,6 tons ha-1 year-1. Very mild erosion occurred in 59.06% of the total area, mild erosion covered 18,80%, while moderate erosion occurred in an area 7,78%, the level of heavy erosion covers an area of 8,15%, while very heavy erosion occurred in an area of 6,21% of the total area of the Tabunio watershed. Forest dominates the erosion rate in the very mild class, the light class until the hefty class is dominated by plantation followed by settlement and mine. From this research, it is known that land cover and land use do not significantly affect the rate of erosion.
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Phaiyarom, Mathudara, Nareerut Pudpong, Rapeepong Suphanchaimat, Watinee Kunpeuk, Sataporn Julchoo, and Pigunkaew Sinam. "Outcomes of the Health Insurance Card Scheme on Migrants’ Use of Health Services in Ranong Province, Thailand." International Journal of Environmental Research and Public Health 17, no. 12 (June 19, 2020): 4431. http://dx.doi.org/10.3390/ijerph17124431.
Abstract:
In 2002, Thailand achieved Universal Health Coverage for all citizens; however, it remains the case that undocumented migrants are not fully covered. The Health Insurance Card Scheme (HICS) of the Ministry of Public Health is the key policy aiming to cover undocumented migrants. This study examined the impact of this policy on the utilisation rate of public health facilities among HICS beneficiaries including undocumented migrants. Facility-based individual records between 2011 and 2015 were purposively retrieved from one provincial hospital, one district hospital, and two health centres in one of the most densely migrant-populated provinces in Thailand. Poisson regression was conducted on inpatient (IP) utilisation, while negative binomial regression was conducted on outpatient (OP) utilisation. Of 74,722 admissions, 19.0% were insured by HICS. About 14.0% of the outpatient records were for HICS beneficiaries. Overall, the HICS utilisation rate in migrants was lower than in Thai patients. Being insured with the HICS significantly increased OP utilisation by 1.7%, and IP utilisation by 11.1% (relative to uninsured). Disease status was the most important factor that positively influenced the utilisation rate. Further studies that explore the differences in health service utilisation among HICS beneficiaries with diverse economic backgrounds are recommended
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Ophiyandri, Taufika, Bambang Istijono, Teguh Haria Aditia Putra, Aprisal, and Benny Hidayat. "Changes in land cover to reduce erosion and peak discharge of sub-watershed of Danau Limau Manis." E3S Web of Conferences 331 (2021): 03009. http://dx.doi.org/10.1051/e3sconf/202133103009.
Abstract:
Land cover change is a strategic issue in the Subwatershed of Danau Limau Manis. The community was triggered by the big earthquake of September 30, 2009, so people moved to the upper watershed. The problem is the increasing number of people, the damage to the watershed ecosystem. This damage can be seen from the erosion of river water and the availability of river water during the rainy season and dry season. An appropriate solution is needed to reduce erosion by modeling land cover. This study aims to determine the value of soil erosion and peak discharge. Erosion using a rational formula using the modified universal soil loss equation model based on land units and peak discharge. The land unit is an overlay of land cover maps, slope maps, and soil maps. Land units that produce erosion and exceed the tolerance limit are carried out with a land cover change scenario using the spatial multi-criteria analysis model. Scenario determination is also based on slope maps, land cover maps, soil maps, river flow density maps, forest area maps, erosion values , and the Padang city spatial plan. The study results explain that the erosion and peak discharge resulting from the existing land cover is quite large, namely 47.89 tons/hectares/year and 152.81 m3/sec. After scenario modeling, erosion decreased by 11.91 tons/hectares/year and peak discharge 15.26 m3/sec.
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Hajizadeh, Mohammad, and Sterling Edmonds. "Universal Pharmacare in Canada: A Prescription for Equity in Healthcare." International Journal of Health Policy and Management 9, no. 3 (October 28, 2019): 91–95. http://dx.doi.org/10.15171/ijhpm.2019.93.
Abstract:
Despite progressive universal drug coverage and pharmaceutical policies found in other countries, Canada remains the only developed nation with a publicly funded healthcare system that does not include universal coverage for prescription drugs. In the absence of a national pharmacare plan, a province may choose to cover a specific sub-population for certain drugs. Although different provinces have individually attempted to extend coverage to certain subpopulations within their jurisdictions, out-of-pocket expenses on drugs and pharmaceutical products (OPEDP) accounts for a large proportion of out-of-pocket health expenses (OPHE) that are catastrophic in nature. Pharmaceutical drug coverage is a major source of public scrutiny among politicians and policy-makers in Canada. In this editorial, we focus on social inequalities in the burden of OPEDP in Canada. Prescription drugs are inconsistently covered under patchworks of public insurance coverage, and this inconsistency represents a major source of inequity of healthcare financing. Residents of certain provinces, rural households and Canadians from poorer households are more likely to be affected by this inequity and suffer disproportionately higher proportions of catastrophic out-of-pocket expenses on drugs and pharmaceutical products (COPEDP). Universal pharmacare would reduce COPEDP and promote a more equitable healthcare system in Canada.
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Segal, Leonie. "Why it is time to review the role of private health insurance in Australia." Australian Health Review 27, no. 1 (2004): 3. http://dx.doi.org/10.1071/ah042710003.
Abstract:
The role of private health insurance (PHI) within the Australian health-care system is urgently in need ofcomprehensive review. Two decades of universal health cover under Medicare have meant a change in the function ofPHI, which is not reflected in policies to support PHI nor in the public debate around PHI. There is increasingevidence that the series of policy adjustments introduced to support PHI have served to undermine rather than promotethe efficiency and equity of Australia's health care system. While support for PHI has been justified to 'take pressure offthe public hospital system' and to 'facilitate choice of insurer and private provider', and the incentives have indeedincreased PHI membership, this increase comes at a high cost relative to benefits achieved. The redirection of hospitaladmissions from the public to private hospitals is small, with a value considerably less than 25% of the cost of thepolicies. The Commonwealth share of the health care budget has increased and the relative contribution from privatehealth insurance is lower in 2001-02, despite an increase in PHI membership to nearly 45% of the population,compared with the 30% coverage in 1998. The policies have largely directed subsidies to those on higher incomes whoare more likely to take out PHI, and to private insurance companies, private hospitals and medical specialists. Ad hocpolicy adjustments need to be replaced by a coherent policy towards PHI, one that recognises the fundamental changein its role and significance in the context of universal health coverage.
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Colpitts, David B., and Christian L. Freitag. "Organ Donation and Transplantation in the Canadian Healthcare System." Journal of Transplant Coordination 7, no. 2 (June 1997): 59–66. http://dx.doi.org/10.1177/090591999700700204.
Abstract:
Healthcare in Canada differs significantly from that in the United States. All Canadians have access to healthcare, and all 10 provinces of Canada have universal healthcare insurance plans that cover hospitalization and physician care. Each province administers its own healthcare system financed on an equal basis with the federal government, and each provincial resident is issued a health card that must be presented at hospitals or physicians' offices whenever medical care is requested. Canadian healthcare provides coverage for organ and tissue donation, transplantation, and cyclosporine for life for all transplant recipients. Canadian healthcare encompasses four basic principles: (1) universal coverage, (2) comprehensive coverage, (3) accessible care for all Canadians, and (4) portability of care. Canada has no national organization for organ donation and transplantation. The organ donation rates in Canada have averaged 14.1 donors per million population over the last 5 years, and are unchanged from previous years.
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Kenneth Saikwo Sisimwo, Kezia Muthoni Njoroge, Musa Oluoch Ong’ombe, and Duncan Ndombi Shikuku. "Willingness to renew national hospital insurance fund among voluntary scheme members in Kajiado County-Kenya." International Journal of Science and Research Archive 7, no. 1 (October 30, 2022): 443–55. http://dx.doi.org/10.30574/ijsra.2022.7.1.0187.
Abstract:
Objective: This study established determinants for readiness to renew the NHIF (national hospital Insurance fund) among informal sector national scheme members in Kenya for universal health coverage (UHC). Methods: This was a cross sectional survey on 394 purposively sampled national health insurance members in Kajiado County. Data was collected through questionnaires rated on a 5-point Likert scale. Binary logistic regression was used to establish the significant determinants associated with the willingness to renew the insurance covers. P-values of less than 0.05 were considered statistically significant. Results: Majority of the participants were male (n=266, 67.5%), over 36 years of age (n=330, 83.7%), married (n=200, 50.8%) and lived in large households of over 3 people (n=358, 90.9%). Overall, respondents showed high willingness to continue paying the insurance premiums and renew their insurance covers for health services (Median: 3.86, IQR 0.75). Controlling for all factors, married (AOR 15.6, 2.3-106.4), large household sizes with more than 3 people, low household income per month (less than KSh. 5000), awareness of NHIF fund services (AOR 13.2, 3.1-55.5), service provider factors (AOR 109, 14.8-803.8) and adverse selection on willingness to renew (AOR 0.043, 0.009-0.202) were significant determinants of willingness to renew the insurance cover (p<0.05). Conclusion: Individual factors - married, belonging to larger household, and lower income group, awareness of NHIF services and system/external factors - service provider’s factors and adverse selection on the other hand influenced willingness to renew insurance covers. There is need to increase the community’s awareness on the health insurance risk-benefits through member education and improve access to quality health services in the health facilities to enhance renewal of the NHIF covers by members.
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Chen, Jiaqi, Song Xu, and Jing Gao. "The Mixed Effect of China’s New Health Care Reform on Health Insurance Coverage and the Efficiency of Health Service Utilisation: A Longitudinal Approach." International Journal of Environmental Research and Public Health 17, no. 5 (March 9, 2020): 1782. http://dx.doi.org/10.3390/ijerph17051782.
Abstract:
In 2009, China launched a new health care reform as it endeavoured to develop a tiered system of disease diagnosis and treatment to promote the integration of medical resources. This was important for improving service capacity and building medical alliances that would eventually lead to improved health service utilisation efficiency. However, while the 2009 reform aimed to provide universal health insurance coverage to all citizens, its overall effect on health service utilisation efficiency remains unclear. We aimed to examine the new health care reform’s mixed effect by applying a longitudinal study using China Health and Nutrition Survey (CHNS) data and the difference-in-difference (DID) method to estimate the health reform’s impact on health insurance coverage rate. Then, we studied whether the increase in health insurance coverage rate affected health service utilisation efficiency in China. Our results showed that the increase in insurance coverage rate has indeed made expensive medical services available to low-income individuals. However, it also increased the likelihood of use of hospitals rather than primary care facilities, since there is more insurance cover for outpatient visits, which has led to an increased demand for quality services. This effect has generated a negative impact on health care utilisation which directly pertains to systemic inefficiency. This study thus indicates that China’s latest health reform requires further policies to improve its overall efficiency.
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Alexandersen, Nina, Anders Anell, Oddvar Kaarboe, Juhani S. Lehto, Liina-Kaisa Tynkkynen, and Karsten Vrangbaek. "The development of voluntary private health insurance in the Nordic countries." Nordic Journal of Health Economics 4, no. 1 (April 26, 2016): 68–83. http://dx.doi.org/10.5617/njhe.2718.
Abstract:
The Nordic countries represent an institutional setting with tax-based health care financing and universal access to health care services. Very few health care services are excluded from what are offered within the publically financed health care system. User fees are often non-existing or low and capped. Nevertheless, the markets for voluntary private health insurance (VPHI) have been rapidly expanding. In this paper we describe the development of the market for VPHI in the Nordic countries. We outline similarities and differences and provide discussion of the rationale for the existence of different types of VPHI. Data is collected on the population covered by VPHI, type and scope of coverage, suppliers of VPHI and their relations with health providers. It seems that the main roles of VPHI are to cover out-of-pocket payments for services that are only partly financed by the public health care system (complementary), and to provide preferential access to treatments that are also available free of charge within the public health care system, but often with some waiting time (duplicate).Published: April 2016.
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Aslam, Muhammad, Beenish Hafiz, Saba Parveen Soomro, Hafiz Muhammad Dawood, Akmal Khurshid Bhatti, and Farhana . "Health Insurance Coverage and its Determinants among Middle-Income Households in Urban." Pakistan Journal of Medical and Health Sciences 17, no. 3 (April 20, 2023): 334–36. http://dx.doi.org/10.53350/pjmhs2023173334.
Abstract:
Background: Health insurance usually covers the expenditure during patient hospitalization. To achieve universal health coverage, it is mandatory to cover the middle-income groups under the government health insurance scheme. According to the review of literature, there is very limited knowledge present on health insurance and the factors determining its coverage among this group. Objective: The study was conducted to analyze the coverage of health insurance and its factors among the middle class households in urban areas. Study design: It is a community based study. This study was conducted on 210 participants attended the community medicine department of our hospitals for the duration of one year from November 2021 to October 2022. Material and Methods: The study was conducted on 210 participants. The written consent was taken from the participants and they were fully aware of the study. Interviews were conducted to find the issues and the point of view of clients and health insurance providers. It was also evaluated that what factors are liked by clients about the health insurance scheme. Results: There were three categories made to find the client’s perspective. One of them was lack of awareness. Then there were monetary issues. There were 28% participants that reported that they have recently insured themselves. There were 62% participants already insured in the past and 62% said that they have never insured themselves. Conclusion: Middle income families had better health insurance coverage than lower middle class. High premium charges, poor financial condition, lack of guidance, lack of knowledge about benefits of health insurance are some of the factors that lower the prevalence of health insurance. Keywords: Health insurance and financial condition.
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Sharma, Sumit, Rohit Verma, and Ankita Sharma. "Health and Wellness Centre Mentoring By Medical College in a Hilly District of Himachal Pradesh." IAR Journal of Medical Sciences 3, no. 01 (January 30, 2022): 75–80. http://dx.doi.org/10.47310/iarjms.2022.v03i01.017.
Abstract:
Background: Government of India has launched an ambitious programme – Ayushman Bharat for achieving Universal Health Coverage (UHC). Ayushman Bharat has two pillars, one being PradhanMantri Jan ArogyaYojna (PM-JAY) and the other Ayushman Bharat – Health and Wellness Centres (ABHWC). PM-JAY aims to provide financial protection for secondary and tertiary care and PM-HWC aims to achieve delivery of Universal Comprehensive Primary Health Care. Methodology: Mentoring hub was established at PSM department of IGMC Shimla. A pair of HWC-PHC and HWC-HSC was selected so that selected Subcentre falls under selected PHC. A team consisting of 1 Consultant, 1 SR, 1 JR from PSM was formed. The team conducted at least 1 visit every month and the team would cover 1 pair of HWCs in 1 visit. The MO PHC-HWC accompanied the team while visiting HWC HSC under that PHC.NHM provided list of 10 HWCs every year to be mentored by each of the MC in consultation with Distt. Reports were submitted to NHM for planning of strengthening of capacities of various primary health care teams across the state as and when required. Results: The team visited the 5 HWC HSCs and 5 HWC PHCs for consecutive 5 months. They interviewed the CHOs, ANMs, MPWs and Medical Officers on the basis of checklist. For evaluation of skills the hands-on was also conducted. The gaps were identified as High, Medium and Low. Corrective measures were identified and responsibility was fixed for the gap closure. The report was submitted to National Health Mission, H.P.
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Birault, François, Stéphanie Mignot, Nicole Caunes, Philippe Boutin, Emilie Bouquet, Marie-Christine Pérault-Pochat, and Bérangère Thirioux. "The Characteristics of Care Provided to Population(s) in Precarious Situations in 2015. A Preliminary Study on the Universal Health Cover in France." International Journal of Environmental Research and Public Health 17, no. 9 (May 9, 2020): 3305. http://dx.doi.org/10.3390/ijerph17093305.
Abstract:
Background: The French Universal Health Cover (CMU) aims to compensate for inequalities between precarious and non-precarious populations, enabling the former to access to free healthcare. These measures rely on the principle that precarious populations’ health improves if healthcare is free. We designed a study to examine whether CMU fails to compensate for inequalities in reimbursed drugs prescriptions in precarious populations. Material and method: This retrospective pharmaco-epidemiological study compared the Defined Daily Dose relative to different reimbursed drugs prescribed by general practitioners (GPs) to precarious and non-precarious patients in France in 2015. Data were analysed using Mann–Whitney tests. Findings: 6 out of 20 molecules were significantly under-reimbursed in precarious populations. 2 were over-reimbursed. The 12 remaining molecules did not differ between groups. Interpretation: The under-reimbursement of atorvastatin, rosuvastatin, tamsulosine and timolol reflects well-documented epidemiological differences between these populations. In contrast, the equal reimbursement of amoxicillin, pyostacine, ivermectin, salbutamol and tiopropium is likely an effect of lack of compensation for inequalities. Precarious patients are more affected by diseases that these molecules target (e.g., chronic bronchitis, bacterial pneumonia, cutaneous infections). This could also be the case for the equal and under-reimbursement of insulin glargine and metformin (targeting diabetes), respectively, although this has to be considered with caution. In conclusion, the French free healthcare cover does not fail to compensate for all but only for some selective inequalities in access to reimbursed drugs prescriptions. These results are discussed with respect to the interaction of the doctor–patient relationship and the holistic nature of primary care, potentially triggering burnout and empathy decrease and negatively impacting the quality of care in precarious populations.
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Sijenyi, Salome, William Omoro, and Jeremiah Laktabai. "'Hospitals Are Medicine and More….' An Assessment of Subsidised Health Insurance Beneficiaries' Experience in Western Kenya." East African Journal of Health and Science 7, no. 1 (February 23, 2024): 142–49. http://dx.doi.org/10.37284/eajhs.7.1.1773.
Abstract:
Financial protection remains an important hurdle to overcome if Universal Health Coverage is to be achieved in sub-Saharan Africa. An innovative model of subsidised health insurance to vulnerable households was implemented in one level four and two primary health care facilities in Western Kenya. The project aimed to determine whether reduced insurance costs, socioeconomic empowerment, and the availability of drugs would improve patients' experience and encourage them to co-pay. This was a secondary analysis of a mixed methods study with a cross-sectional household survey consisting of 18 semi-structured interviews conducted with NHIF subsidy program beneficiaries. Most beneficiaries accessed care as a result of the program. However, challenges of stockouts and inadequate healthcare workers persisted and discouraged some of them from going to the participating facilities. Community Health Promoters were very instrumental in enlightening the community on the cover and getting the sick beneficiaries to go to the hospital. The socioeconomic empowerment programme was beneficial but was mostly long-term and required financial input from the community members before they could sell the poultry or agricultural produce. Most community members were willing to pay after receiving health services using the cover. The study recommends contextualisation of socioeconomic empowerment programs, which are very important in enabling families to generate income to pay for health insurance. Additionally, improving the service delivery experience is important by reducing stockouts, having sufficient healthcare workers, and eliminating facility-related delays, which would improve the confidence of communities in public health facilities, thus retaining health insurance
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Mlangeni, Nosimilo, Karen Du Preez, Moses Mokone, Molebogeng Malotle, Sophia Kisting, Jonathan Ramodike, and Muzimkhulu Zungu. "HIV and TB Workplace Program for Street Vendors: A Situational Analysis." NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy 32, no. 1 (December 27, 2021): 30–39. http://dx.doi.org/10.1177/10482911211069621.
Abstract:
In South Africa, 15 percent of informal economy workers are street vendors. The organization of occupational health services in the country is fragmented and does not cover informal workers. Conditions of work make informal workers extremely vulnerable to human immunodeficiency virus (HIV) and tuberculosis (TB) exposure. In this study, a qualitative risk assessment was conducted among street vendors, followed by focus group discussions. Interpretation of data was according to major themes extracted from discussions. Workers are exposed to several occupational health hazards identified during the risk assessment. There is a lack of workplace HIV and TB services and overall poor access to healthcare. Street vendors, especially females, are at higher risk of HIV, due to gender inequalities. Comprehensive gender-sensitive training on occupational health and safety, HIV, and TB should be prioritized. To reach Universal Health Coverage and achieve the Sustainable Developmental Goals’ targets, the health system should improve services for informal economy workers.
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Thomas, Peter E. "Reflections on the role of less-than-comprehensive (exclusionary) private health insurance hospital products in the Australian healthcare system." Australian Health Review 36, no. 3 (2012): 273. http://dx.doi.org/10.1071/ah10989.
Abstract:
The number of people in Australia that are currently covered by a hospital private health insurance product continues to rise every quarter. In September 2010, for the first time since the introduction of the public universal social insurance scheme, Medicare, more than 10 million persons in Australia are covered by private health insurance. Although the number of persons covered by private health insurance continues to grow, the quality and level of cover that members are holding is changing significantly. In an effort to limit premium rises and to reduce the benefits paid for treatment, private health insurers have introduced, and moved a large number of existing members to, less-than-comprehensive private health insurance policies. These policies, known as ‘exclusionary’ policies, are changing the dynamics of private health insurance in Australia. After examining the emergence and prevalence of these products, this commentary gives three different examples to illustrate how such products are changing the nature of private health insurance in Australia and are now set to create a series of policy issues that will require future attention.
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Mekonne, Abel, Benyam Seifu, Chernet Hailu, and Alemayehu Atomsa. "Willingness to Pay for Social Health Insurance and Associated Factors among Health Care Providers in Addis Ababa, Ethiopia." BioMed Research International 2020 (April 14, 2020): 1–7. http://dx.doi.org/10.1155/2020/8412957.
Abstract:
Background. Cost sharing between beneficiaries and government is critical to attain universal health coverage. The government of Ethiopia introduced social health insurance to improve access to quality health services. Hence, HCP are the ultimate frontline service provider; their WTP for health insurance could influence the implementation of the scheme directly or indirectly. However, there is limited evidence on willingness to pay (WTP) for social health insurance (SHI) among health professionals. Methods. A cross-sectional study was conducted in Addis Ababa, Ethiopia, from May 1st to August 15th, 2019. A total sample of 480 health care providers was selected using a multistage sampling method. The collected data were entered into Epi Info version 7.1 and analyzed with SPSS version 23. Binary and multiple logistic regression analysis was carried out to identify the associated factor outcome variable. The association was presented in odds ratio with 95% confidence interval and significance determined at a P value less than 0.05. Result. A total of 460 health care providers responded to the questionnaire, making a 95.8% response rate. Of the respondents, only 132 (28.7%) were WTP for SHI. Higher educational status [AOR=2.9, 95% CI (1.2-7.3)], higher monthly income [AOR=2.2, 95% CI (1.2-4.3)], recent family illness [AOR=2.4, 95% CI (1.4-4.4)], and a good awareness about SHI [AOR=4.4, 95% CI (2.4-7.8)] showed significant association with WTP for SHI. The main reasons for not WTP were thinking the government should cover the cost, preferring out-pocket payment and the provided SHI scheme does not cover all the health care costs health care providers lost interest in pay for SHI. Conclusion and Recommendation. The majority of health care providers were not willing to pay for the introduced SHI scheme. The provided SHI scheme should be clear and provide special consideration for health care providers as the majority of them receives free health care service from their employer health care institution. Also, the government, health professional associations, and other concerned stakeholders should provide awareness creation programs by targeting low and middle-level health professionals in order to increase WTP for SHI among health care providers.
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Korelstein, Leonid, and Eduardo Pereyra. "Universal Gas-Liquid Flow Pattern Map and Its Use on Closure Relationship Selection." E3S Web of Conferences 397 (2023): 01002. http://dx.doi.org/10.1051/e3sconf/202339701002.
Abstract:
Mechanistic modelling is a common approach to predict design parameters such as flow pattern, pressure drop, or liquid holdup in gas-liquid flow in pipes. This approach starts with the application of continuity and momentum balance and required supplementary relationships to close the system of the equations. These additional equations are also called closure relationships which are developed with experimental results for given conditions. These relationships evolved with time as researchers acquired experimental data under different conditions. Unfortunately, new closures are developed for the new conditions rather than universal relationships that can cover a wider set of conditions. This situation generates the need for a methodology that allows the inclusion of newly develop closures to increase the accuracy of the unified mechanistic models. This paper starts with a description of all the available two-dimension maps that can facilitate the visualization of the data. This allows the determination of regions where a particular set of closures minimize the discrepancy between calculated and measured parameters. This paper proposes a simplification of a modern solution to provide a simpler way to visualize the regions corresponding to a set of equations. The final proposed solution reveals a substantial reduction of the average discrepancy of the unified mechanistic model by selecting the most appropriate closures.
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Annida. "Kebijakan Pembiayaan Kesehatan terhadap Masyarakat Miskin dalam Pencapaian Universal Health Coverage di Kabupaten Banjar." Jurnal Kebijakan Pembangunan 15, no. 2 (December 15, 2020): 219–29. http://dx.doi.org/10.47441/jkp.v15i2.131.
Abstract:
Achievement of Universal Health Coverage (UHC) is achieved through the participation of JKN - Health BPJS by all Indonesians. Not all poor people were the premium assistance beneficiary, while since 2020 regional health insurance was abolished. The study aims to determine the UHC achievements of the governments, particularly in health financing for the poor. This research uses an Analytic-qualitative approach with the cross-sectional method and was conducted in 2019. Data collection through in-depth interviews with purposive sampling at the Regional Public Health Office, Regional Planning and Development Office, and Social Service in Banjar Regency. The stages for Analysis consist of data reduction, presentation, and data collection. Banjar Regency government involves CSR at TKPKD forum to cover health financing for the poor and underprivileged outside the premium assistance beneficiary, but there were gaps in the unified database synchronization, which can be an obstacle in projecting the health financing and budgeting. The government needs to increase the premium assistance beneficiary quota. The mid-income people or people who can afford health insurance should join the independent universal healthcare participants, so that premium assistance beneficiary is designated only for the poor. Coordination across sectors and programs must be integrated into SLRT.
Keywords: Financial Policy, Health Financing, Universal Health Coverage, JKN-BPJS.
ABSTRAK
Pencapaian Universal Health Coverage (UHC) diwujudkan melalui kepesertaan pada JKN-BPJS Kesehatan oleh seluruh rakyat Indonesia, tanpa terkecuali. Masyarakat miskin dan tidak mampu yang didaftarkan oleh pemerintah daerah berdasarkan Basis Data Terpadu (BDT), dibayarkan oleh pemerintah daerah sebagai peserta Penerima Bantuan Iuran (PBI). Namun tidak semua masyarakat miskin dan tidak mampu masuk dalam daftar PBI. Disamping itu, di tahun 2020 kebijakan jaminan kesehatan daerah (Jamkesda) telah dihapus, sehingga masyarakat miskin bukan PBI tidak dapat lagi memperoleh bantuan pembiayaan kesehatan dari pemerintah. Penelitian ini dilakukan di Kabupaten Banjar untuk mengetahui langkah yang diambil oleh pemerintah daerah dalam menuju pencapaian UHC, yang diutamakan pada kebijakan pembiayaan kesehatan terhadap masyarakat miskin dan tidak mampu. Penelitian ini bersifat analitik dengan desain cross sectional, dilaksanakan pada pertengahan tahun 2019. Metode penelitian secara kualitatif. Pengumpulan data secara indepth interview. Informan penelitian adalah pemerintah daerah yang ditentukan secara purposive sampling, dari Dinas Kesehatan Kabupaten Banjar, Bappeda Kabupaten Banjar, dan Dinas Sosial Kabupaten Banjar. Analisis data dilakukan secara deskriptif dengan tahapan reduksi data, penyajian data dan penarikan kesimpulan. Kabupaten Banjar melalui forum Tim Koordinasi Penanggulangan Kemiskinan Daerah (TKPKD) telah mewacanakan keterlibatan Corporate System Responsibility (CSR) dalam pembiayaan kesehatan masyarakat miskin dan tidak mampu yang berada diluar BDT atau bukan PBI, meskipun diperkirakan belum dapat membiayai masyarakat miskin secara keseluruhan. Namun masih terjadi permasalahan dalam sinkronisasi BDT masyarakat yang tergolong miskin dan tidak mampu tersebut yang dapat menjadi hambatan bagi Dinas Kesehatan dalam memperhitungkan anggaran pembiayaan kesehatan tersebut. Perlu diwacanakan penambahan kuota alokasi anggaran PBI sebagai salah satu solusi untuk dilaksanakan oleh pemerintah daerah. Disisi lain, masyarakat yang telah mampu secara ekonomi harus didorong untuk menjadi peserta BPJS mandiri, sehingga pembiayaan mereka yang semula PBI dapat dialihkan pada masyarakat miskin, diluar peserta PBI. Koordinasi lintas sektor maupun lintas program terintegrasi dalam SLRT, antara lain Dinas Kesehatan, Dinas Sosial, Dinas Kependudukan dan Catatan Sipil, dan Bappeda sehingga masyarakat miskin dan tidak mampu mendapatkan hak yang sama dalam memperoleh kesehatan. Rekomendasi dan strategi yang dilakukan oleh Kabupaten Banjar ini dapat diimplementasikan pada kabupaten/kota dengan kondisi dan permasalahan yang sama.
Kata Kunci: Kebijakan Finansial, Pembiayaan Kesehatan, JKN-BPJS
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Subramanyam, S. G., and Arun B. Kilpadi. "A Novel Method of the Use of a Tubular Polythene Cover for Arms and Forearms as a Part of Universal Precautions." Tropical Doctor 32, no. 4 (October 2002): 242. http://dx.doi.org/10.1177/004947550203200425.
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Moulion Tapouh Jean Roger, Djanteng Seuji Priscille, Dongmo Fomekong Sylviane, Nwatsock Joseph Francis, Onana Yannick Richard, Mbede Maggy, Maleu Mbah Félicité, and Moifo Boniface. "Mammography supply for breast cancer screening at the eve of Universal Health Coverage in Yaounde city (Cameroon, Central Africa)." Journal Africain d Imagerie Médicale (J Afr Imag Méd) Journal Officiel de la Société de Radiologie d’Afrique Noire Francophone (SRANF) 16, no. 2 (June 18, 2024): 51–56. http://dx.doi.org/10.55715/jaim.v16i2.590.
Abstract:
RÉSUMÉ Introduction : Le cancer du sein reste le cancer le plus répandu chez les femmes dans le monde. Le Cameroun a adopté une politique annuelle de dépistage par mammographie pour les femmes âgées de 40 ans et plus. Objectif : Évaluer la capacité de l'offre actuelle de mammographie à répondre aux besoins de dépistage du cancer du sein dans la ville de Yaoundé. Méthodes : Etude transversale ciblant les services de radiologie comportant une unité de mammographie dans la ville de Yaoundé (Cameroun, Afrique Centrale) de janvier 2021 à juin 2021. Nous avons collecté la géolocalisation, le nombre de mammographies réalisées par mois et le coût d'une mammographie de dépistage dans chaque service radiologie. La capacité était définie comme le nombre d'unités de mammographie disponibles pour 10 000 femmes âgées de 40 ans et plus. Résultats : A Yaoundé, 37,78% (17/45) des services de radiologie disposaient d'un appareil de mammographie, et 76,47% (13/17) de ces appareils étaient en état de fonctionnement au moment de l'étude. Le nombre médian de mammographies réalisées par mois dans chaque service était de 15 [8-60], et le coût médian d'une mammographie de dépistage était de 53.55 US dollars [48.68 - 64.9]. Les unités de mammographie étaient principalement situées dans le centre administratif, mais elles étaient accessibles à moins d'une heure de route depuis n'importe quel endroit de la ville. La capacité était estimée à 0,32 pour 10 000 femmes âgées de 40 ans, ce qui suffisait à peine à couvrir 19,54 % des besoins en mammographie de dépistage chez les femmes éligibles. Conclusion : L'offre de services de mammographie dans la ville de Yaoundé était insuffisante pour couvrir les besoins en matière de dépistage du cancer du sein en 2021. Les unités de mammographie fonctionnelles étaient accessibles mais sous-utilisées. Des recherches supplémentaires sont nécessaires pour identifier les obstacles au dépistage par mammographie et la rareté des unités de mammographie à Yaoundé. ABSTRACT Background: Breast cancer remains the most common cancer among women worldwide. Cameroon has adopted an annual mammography screening policy for women aged 40 years and over. Objective: To evaluate the capacity of the current mammography supply to meet the needs for breast cancer screening in Yaounde City. Methods: Cross-sectional study targeting radiology departments containing a mammography unit in Yaounde (Cameroon, Central Africa) from January 2021 to June 2021. We collected the geolocation, number of mammograms performed per month, and cost of a screening mammogram for each radiology service. We calculated mammography capacity as the number of mammography units per 10,000 women aged 40 and above. Results: In Yaounde, 37.78% (17/45) of radiology departments had a mammography unit, and 76.47% (13/17) of these units were in operating condition at the time of the study. The median number of mammograms performed per month in each service was 15 [8 - 60], and the median cost of a screening mammogram was 53.55 US dollars [48.68 - 64.9]. Mammography units were mainly located in the administrative center, but they were accessible within an hour's drive from any location in the city. The capacity was estimated to be 0.32 per 10,000 women aged 40, which was only enough to cover 19.54% of the needs for screening mammography in eligible women. Conclusion: Mammography service supply in Yaounde was critically insufficient to cover breast cancer screening needs in 2021. Functional mammography units were accessible but underutilized. Further research is needed to identify the barriers to mammography screening and the scarcity of mammography units in Yaounde.
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De Sousa, Gustavo Celeira, Rodrigo Luiz Martins Pantoja, Ana Carolina De Castro Ribeiro Cabeça, Kleber Pinto Ladislau, Ramona Carvalho Barros, and Emanuel de Jesus Soares De Sousa. "Implementation of Telemedicine Specialized Appointment in Eastern Amazon State of Pará." Latin American Journal of Telehealth 6, no. 2 (December 19, 2019): 126–36. http://dx.doi.org/10.32443/2175-2990(2019)301.
Abstract:
Introduction: Telemedicine program was first implemented in Brazil in 2007, by Health Ministry Decret, in which was set the goals of the program: permanent education and changes in medical work. After some reformulations of the program it was also included primary health care based specialized medical consultations, through the guarantee of health services such as teleconsultancy, telediagnosis and tele education; centered at universities and major health centers, after what it became to be known as Nacional Program Telehealth Brazil Network. Brazil’s North Region is the largest amongst all of its regions (3 853 676,948 km²) but with the smaller demographic density (4,72 hab./km²), also with irregular populational distribution, which is concentrated at shore or riverside urban centers. Telemedicine was implemented as a way in trying to provide universal health access to the whole population. Method: Various Municipal Health Secretariats underwent agreements in order to establish a integrated and specialized medical consultancy network, using teleconference technologies and online pronctuary to accomplish it, allowing a specialized doctor located at the capital to guide and observe a generalist medic through the physical examination and therapeutic conduction. The system kept register of consultations to the ones who had its secret passwords. Results/Discussion: Telemedicine system was able to cover an area of up to 36.133.135 km2, allow up to 674.770 people to have access to specialized health, perform 1125 medical consultations in seven months; which diminished the queue from five years to three months of waiting for clinical examination. In addition, the consultations have kept a good quality for the whole health team and the patients, who could receive correct diagnosis on the first consult most of the times, as well as received longitudinal attendance. Conclusion: Telemedicine is an effective, secure and revolutionary alternative to grant universal health access to distant populations.
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Kebede, Seifu, and Fekadu Fufa. "Estimation of average annual soil loss rates and its prioritization at sub-watershed level using RUSLE: A case of Finca’aa, Oromiya, Western Ethiopia." Environmental Health Engineering and Management 10, no. 1 (February 27, 2023): 41–50. http://dx.doi.org/10.34172/ehem.2023.05.
Abstract:
Background: Because of natural and anthropogenic phenomena, most mountain areas experience significant soil loss. It is critical for watershed management to identify high soil loss rates and prone areas. Therefore, the present research aimed to estimate spatial annual soil loss rates and prioritize soil erosion prone areas of the Finca’aa watershed at sub-watershed level. Methods: The revised universal soil loss equation (RUSLE) model, the extension of geographic information system based on five parameters: rainfall erosivity (R), soil erodibility (K), slope length and slope steepness (LS), vegetation cover (C), and conservation techniques (P), was applied. This study also used weather data, a soil type map, a digital elevation model (DEM), and land use land cover, which were all analyzed using ArcGIS 10.4. Results: Annual soil loss rates ranged from negligible to 234 t ha-1 yr-1. The average rates of soil loss was 33.3 t ha-1 yr-1. Approximately 63.36% of the catchment was within and 36.64% of the catchment was above the maximum permissible level, respectively. Approximately 1.96% were in critical condition. Agricultural practices were the primary cause in the watershed’s mountain and hilly areas. Conclusion: The outcome is critical for planners and resource managers interested in long-term watershed management. Also, it is very important for sustainable growth development of 2030 agendas.