1) The document discusses a study examining the impact of extending social health insurance (SHI) to the poor in the Philippines on facility-based deliveries.
2) The study uses data from the Philippines' National Demographic and Health Surveys conducted before (2008) and after (2013) the implementation of the country's Universal Health Coverage policy in 2011, which expanded SHI coverage to the poor.
3) A differences-in-differences analysis is conducted using a linear probability model to determine the effect of SHI sponsorship on facility-based deliveries, while controlling for individual and community characteristics.
As the burden of NCDs increases, various countries have introduced new and innovative modes of managing them in primary healthcare setting. APO, in conjunction with Duke Kunshan University, China, conducted a 4-country study (Bangladesh, China, Nepal and Viet Nam) to understand the different approaches used in involving CHWs in preventing and managing NCDs. Access full publication here http://bit.ly/2XnWwcd
The Kingdom of Tonga has had one of the best overall levels of health within the Pacific as a result of a dramatic reduction in communicable diseases and maternal and child mortality since the 1950s. It is also on target to achieve the Millennium Development Goals (MDG) around maternal and child mortality. Adapting its strong primary health-care system to deal with the large financial burden associated with chronic and noncommunicable diseases and ensuring quality primary health-care services in remote areas are the main health sector challenges facing Tonga.
Healthcare Utilization and Self-assessed Health in Turkey: Evidence from the ...Economic Research Forum
Firat Bilgel - Okan University
Burhan Can Karahasan - Piri Reis University
ERF Workshop on The Economics of Healthcare in the ERF Region
Cairo, Egypt - May 23, 2016
www.erf.org.eg
Out of Health expenditure and household budget: Evidence from Egypt , Jordan ...Economic Research Forum
Reham Rizk - British university in Egypt
Hala Abou-Ali - Cairo University
ERF Workshop on The Economics of Healthcare in the ERF Region
Cairo, Egypt - May 23, 2016
www.erf.org.eg
Niek Klazinga | Performance reporting in OECD countriesSax Institute
Dr Niek Klazinga (Head of the Health Care Quality Indicators Project in the OECD Health Division) spoke with the HARC network in December 2014 about current developments in performance measurement and reporting.
HARC stands for the Hospital Alliance for Research Collaboration. HARC is a collaborative network of researchers, health managers, clinicians and policy makers based in NSW, Australia managed by the Sax Institute.
HARC Forums bring members of the HARC network together to discuss the latest research and analysis about important issues facing our hospitals.
For more information visit saxinstitute.org.au.
The revised OECD Health Systems Performance Framework: methodological issues ...Sax Institute
The OECD is a leading organization in the international measurement of health system performance. The OECD Expert Group on Health Care Quality Indicators (HCQI) has recently revised its performance framework, identifying core indicators and highlighting new directions. Although improving, the capacity of countries to deliver more accurate standardized indicators still needs to be fostered. A particular aspect that deserves attention is the design, planning and implementation of public performance reporting. Such activity, strictly interrelated to the capacity of the information infrastructure, also depends from cultural, organizational and political conditions that can be differently present at the international level. The applicability of standardized principles and the evidence of improved outcomes due to public reporting systems is still questioned to a large extent. A first international conference on the topic of hospital performance reporting has been organized in Rome, Italy in 2014, followed by a second event held in Seoul, South Korea, in 2015. In his talk, Fabrizio Carinci will present recent developments of OECD projects, including:
• state of the art in the definition of OECD performance indicators
• challenges emerging from OECD R&D studies
• transferability and use of definitions at sub-national and provider level
• applicability for hospital performance benchmarking and geographical variation
• limitations imposed by the legislation on privacy and data protection
• an overarching vision of “essential levels of health information”
Through practical examples drawn from his direct experience as Member of the Bureau of the HCQI and other relevant Boards, Prof. Fabrizio Carinci will discuss the state of the art, the role played by national governments (including Australia), and potential avenues for mutual collaboration.
As the burden of NCDs increases, various countries have introduced new and innovative modes of managing them in primary healthcare setting. APO, in conjunction with Duke Kunshan University, China, conducted a 4-country study (Bangladesh, China, Nepal and Viet Nam) to understand the different approaches used in involving CHWs in preventing and managing NCDs. Access full publication here http://bit.ly/2XnWwcd
The Kingdom of Tonga has had one of the best overall levels of health within the Pacific as a result of a dramatic reduction in communicable diseases and maternal and child mortality since the 1950s. It is also on target to achieve the Millennium Development Goals (MDG) around maternal and child mortality. Adapting its strong primary health-care system to deal with the large financial burden associated with chronic and noncommunicable diseases and ensuring quality primary health-care services in remote areas are the main health sector challenges facing Tonga.
Healthcare Utilization and Self-assessed Health in Turkey: Evidence from the ...Economic Research Forum
Firat Bilgel - Okan University
Burhan Can Karahasan - Piri Reis University
ERF Workshop on The Economics of Healthcare in the ERF Region
Cairo, Egypt - May 23, 2016
www.erf.org.eg
Out of Health expenditure and household budget: Evidence from Egypt , Jordan ...Economic Research Forum
Reham Rizk - British university in Egypt
Hala Abou-Ali - Cairo University
ERF Workshop on The Economics of Healthcare in the ERF Region
Cairo, Egypt - May 23, 2016
www.erf.org.eg
Niek Klazinga | Performance reporting in OECD countriesSax Institute
Dr Niek Klazinga (Head of the Health Care Quality Indicators Project in the OECD Health Division) spoke with the HARC network in December 2014 about current developments in performance measurement and reporting.
HARC stands for the Hospital Alliance for Research Collaboration. HARC is a collaborative network of researchers, health managers, clinicians and policy makers based in NSW, Australia managed by the Sax Institute.
HARC Forums bring members of the HARC network together to discuss the latest research and analysis about important issues facing our hospitals.
For more information visit saxinstitute.org.au.
The revised OECD Health Systems Performance Framework: methodological issues ...Sax Institute
The OECD is a leading organization in the international measurement of health system performance. The OECD Expert Group on Health Care Quality Indicators (HCQI) has recently revised its performance framework, identifying core indicators and highlighting new directions. Although improving, the capacity of countries to deliver more accurate standardized indicators still needs to be fostered. A particular aspect that deserves attention is the design, planning and implementation of public performance reporting. Such activity, strictly interrelated to the capacity of the information infrastructure, also depends from cultural, organizational and political conditions that can be differently present at the international level. The applicability of standardized principles and the evidence of improved outcomes due to public reporting systems is still questioned to a large extent. A first international conference on the topic of hospital performance reporting has been organized in Rome, Italy in 2014, followed by a second event held in Seoul, South Korea, in 2015. In his talk, Fabrizio Carinci will present recent developments of OECD projects, including:
• state of the art in the definition of OECD performance indicators
• challenges emerging from OECD R&D studies
• transferability and use of definitions at sub-national and provider level
• applicability for hospital performance benchmarking and geographical variation
• limitations imposed by the legislation on privacy and data protection
• an overarching vision of “essential levels of health information”
Through practical examples drawn from his direct experience as Member of the Bureau of the HCQI and other relevant Boards, Prof. Fabrizio Carinci will discuss the state of the art, the role played by national governments (including Australia), and potential avenues for mutual collaboration.
Japan was one of the first countries to be hit by COVID-19 and declared a state of emergency by April 2020. Japan’s response to COVID-19 included the imposition of context-specific measures and restrictions based on local need to contain the spread of the disease. Containment measures were enacted under the Act on Special Measures for Pandemic Influenza and New Infectious Diseases Preparedness and Response. Citizens were requested to abide by containment measures that focused on avoiding the 3C’s: Closed spaces with poor ventilation; Crowded places; Close‐contact settings. Health infrastructure, workforce, and supply chain were strengthened, alongside social security interventions including financial support for citizens. Primary health centers were strengthened and were at the forefront of Japan’s COVID-19 response at the local level.
This publication presents the various measures that were put in place from the beginning of the outbreak until December 2020 to control COVID-19 transmission in the country. We aim to update this document as new policies and interventions are operationalized to respond to the outbreak.
Thailand was the first country outside of China that reported COVID-19 infection in January 2020. At the peak of transmission during March-April 2020, it was reporting close to 200 new cases per day and yet it has been able to control the outbreak with no laboratory confirmed local transmission reported for over 100 days as of 2 September 2020.
This publication attempts to identify in a systematic way, various policies and steps that were put in place from the beginning of the outbreak to control COVID-19 transmission in the country.
The November 2020 update builds on the previous document by focusing on the challenges of balancing opening up the country and protecting the population from COVID-19 as well as preparing for the potential second wave.
Health access for all Thailand’s. The Thai citizens gain universal access to essential health services at zero cost, and reap significant benefits as babies get healthier, workers increase productivity, and households reduce financial risk.
Japan has made numerous achievements in health most notably the world’s highest life-expectancy in the past two decades, since its founding Universal Health Insurance System in 1961. However, ageing population with low-fertility rates, stagnating economy, increasing burden of NCDs and growing use of expensive technologies pose the critical challenges in service delivery and financial stability in health. Japan HiT reports current health system reforms undertaken and also recent discussion on paradigm shift to the new system as proposed in Japan Vision: Health Care 2035.
This is primarily based on a chapter from our most recent publication.
I want to acknowledge the authors of the chapter:
Melisa Tan, Victoria Haldane, Sue-Anne Toh & Helena Legido-Quigley from NUS
Martin McKee from LSHTM
Summary of the current 4 main NCDs situation in Asia including risk factors
Examples of health system response
Challenges
The People’s Republic of China has made great achievements in improving health status over the past six decades, mainly due to the government’s commitment to health, provision of cost effective public health programmes, growing coverage of health financial protection mechanisms and investments in an extensive health-care delivery network.
This second edition of the health system review of Philippines shows the major changes that have occurred over the 7 years since the last review. Channelling of funds from sin tax to Health has shown unprecedented levels of finances are now available for UHC. PhilHealth has dramatically increased coverage of people as well as service providers that it works with from both government and non-government sectors. However major challenges remain; regional and socioeconomic disparities in the availability and accessibility of resources are prominent and there is a need to improve regulation of service providers. Philippines HiT reports on the current health system reforms undertaken including challenges of incorporating primary health care as in the overall health architecture of the country.
Universal Health Coverage (UHC) Day 12.12.14, NepalDeepak Karki
This presentation is made on the first ever Universal Health Coverage (UHC) Day 12.12.14 celebration in Nepal by Nepal Health Economics Association (NHEA).
The Thailand HiT reports that sustained political commitment to the health of the population since the 1970s has resulted in significant investment in health infrastructure, in particular primary health care, district and provincial referral hospitals, and strengthened the overall functioning of the Thai health system. After Thailand achieved universal health coverage in 2002, public expenditure on health significantly increased from 63% to 77% and out-of-pocket expense was reduced from 27.2% to 12.4% of the total health spending in 2011.
Researching Purchasing to achieve the promise of Universal Health Coverageresyst
This presentation was given by Professor Kara Hanson at the BMC Health Services Research Conference, in July 2014.
The presentation illustrates the important role that strategic purchasing can play in achieving effective health coverage, and how the topic is being studied by researchers. It highlights RESYST's multi-country study of purchasing arrangements that is currently taking place in Nigeria, Kenya, Tanzania, South Africa, India, Thailand and Vietnam.
This review outlines the main organizational, financing, human resources and service delivery features of the health-care system. Although there has been implement in overall health outcomes since the 1990’s the current levels are still below average for the country’s Pacific neighbors. The remoteness of the many rural communities has hampered improvements in health services. This is one of the major challenges that the country faces in order to achieve SDG heath targets by 2030. This Hits highlights steps taken to overcome challenges especially in the face of epidemiological change in disease burden that is slowly taking place in the country.
The Republic of Korea HiT notes that economic development and universal health coverage through national health insurance has led to a rapid improvement in health outcomes. Overall, the health status of the Korean population is better than that of many other Asian countries. Reducing inequality in health coverage outcomes, strengthening primary health care and improving coordination between hospitals and long-term care facilities to meet the needs of the aged population are the challenges facing the Government.
The Republic of Korea reported its first COVID-19 case on the 20th of January 2020. Since then, the country has reported 34,201 confirmed cases of COVID-19 and 526 deaths. The Republic of Korea’s COVID-19 response is characterized by its swift and broad 3Ts (test – trace – treat) strategy. Measures taken by the country demonstrate a collaborative effort between ministries, across levels of governance, with a focus on the implementation of essential public health measures to prevent and manage COVID-19 cases in the country. Systematic public health measures such as maintaining physical distance, with limited restrictions on mobility, strong health communication, rigorous implementation of isolation and quarantine measures, as well as monitoring and surveillance were key to containing the outbreak in the country.
The report presents the various policies and steps that were put in place from the beginning of the outbreak to control COVID-19 transmission in the country.
These slides present details from the more comprehensive COVID-19 HSRM on the Republic of Korea
The Solomon Islands HiT determines that the country’s health system has significant weaknesses but also considerable strengths. Despite the range and difficulty of issues facing policy-makers in the Solomon Islands, there have been significant achievements in health, including considerable progress in advancing population health status. The performance of the health system is positive, achieving high coverage, high satisfaction levels, and steady progress on health outcomes. Nonetheless, the country faces important health challenges that could undermine development gains made to date
Factors Associated with Enrolment of Households in Nepal’s National Health In...Prabesh Ghimire
Abstract
Background: Nepal has made remarkable efforts towards social health protection over the past several years. In 2016, the Government of Nepal introduced a National Health Insurance Program (NHIP) with an aim to ensure equitable and universal access to healthcare by all Nepalese citizens. Following the first year of operation, the scheme has covered 5 percent of its target population. There are wider concerns regarding the capacity of NHIP to achieve adequate population coverage and remain viable. In this context, this study aimed to identify the factors associated with enrolment of households in the NHIP.
Methods: A cross-sectional household survey using face to face interview was carried out in 2 Palikas (municipalities) of Ilam district. 570 households were studied by recruiting equal number of NHIP enrolled and non-enrolled households. We used Pearson’s chi-square test and binary logistic regression to identify the factors associated with household’s enrolment in NHIP. All statistical analyses were performed using IBM SPSS version 23 software.
Results: Enrolment of households in NHIP was found to be associated with ethnicity, socio-economic status, past experience of acute illness in family and presence of chronic illness. The households that belonged to higher socio-economic status were about 4 times more likely to enrol in the scheme. It was also observed that households from privileged ethnic groups such as Brahmin, Chhetri, Gurung, and Newar were 1.7 times more likely to enrol in NHIP compared to those from underprivileged ethnic groups such as janajatis (indigenous people) and dalits (the oppressed). The households with illness experience in 3 months preceding the survey were about 1.5 times more likely to enrol in NHIP compared to households that did not have such experience. Similarly, households in which at least one of the members was chronically ill were 1.8 times more likely to enrol compared to households with no chronic illness.
Conclusion: Belonging to the privileged ethnic group, having a higher socio-economic status, experiencing an acute illness and presence of chronically ill member in the family are the factors associated with enrolment of households in NHIP. This study revealed gaps in enrolment between rich-poor households and privileged-underprivileged ethnic groups. Extension of health insurance coverage to poor and marginalized households is therefore needed to increase equity and accelerate the pace towards achieving universal health coverage.
The purpose of this presentation is to equip audiences with the ability to:
Define universal health coverage (UHC) and understand the basic tenets of UHC
Identify how UHC fits in USAID’s health and poverty reduction strategies
Effectively communicate to country stakeholders how USAID can support a country’s progress towards UHC
Identify relevant UHC resources within the Office of Health Systems and USAID
The presentation is part of the “UHC Toolkit” and accompanies Universal Health Coverage: An Annotated Bibliography, and Universal Health Coverage: Frequently Asked Questions.
Japan was one of the first countries to be hit by COVID-19 and declared a state of emergency by April 2020. Japan’s response to COVID-19 included the imposition of context-specific measures and restrictions based on local need to contain the spread of the disease. Containment measures were enacted under the Act on Special Measures for Pandemic Influenza and New Infectious Diseases Preparedness and Response. Citizens were requested to abide by containment measures that focused on avoiding the 3C’s: Closed spaces with poor ventilation; Crowded places; Close‐contact settings. Health infrastructure, workforce, and supply chain were strengthened, alongside social security interventions including financial support for citizens. Primary health centers were strengthened and were at the forefront of Japan’s COVID-19 response at the local level.
This publication presents the various measures that were put in place from the beginning of the outbreak until December 2020 to control COVID-19 transmission in the country. We aim to update this document as new policies and interventions are operationalized to respond to the outbreak.
Thailand was the first country outside of China that reported COVID-19 infection in January 2020. At the peak of transmission during March-April 2020, it was reporting close to 200 new cases per day and yet it has been able to control the outbreak with no laboratory confirmed local transmission reported for over 100 days as of 2 September 2020.
This publication attempts to identify in a systematic way, various policies and steps that were put in place from the beginning of the outbreak to control COVID-19 transmission in the country.
The November 2020 update builds on the previous document by focusing on the challenges of balancing opening up the country and protecting the population from COVID-19 as well as preparing for the potential second wave.
Health access for all Thailand’s. The Thai citizens gain universal access to essential health services at zero cost, and reap significant benefits as babies get healthier, workers increase productivity, and households reduce financial risk.
Japan has made numerous achievements in health most notably the world’s highest life-expectancy in the past two decades, since its founding Universal Health Insurance System in 1961. However, ageing population with low-fertility rates, stagnating economy, increasing burden of NCDs and growing use of expensive technologies pose the critical challenges in service delivery and financial stability in health. Japan HiT reports current health system reforms undertaken and also recent discussion on paradigm shift to the new system as proposed in Japan Vision: Health Care 2035.
This is primarily based on a chapter from our most recent publication.
I want to acknowledge the authors of the chapter:
Melisa Tan, Victoria Haldane, Sue-Anne Toh & Helena Legido-Quigley from NUS
Martin McKee from LSHTM
Summary of the current 4 main NCDs situation in Asia including risk factors
Examples of health system response
Challenges
The People’s Republic of China has made great achievements in improving health status over the past six decades, mainly due to the government’s commitment to health, provision of cost effective public health programmes, growing coverage of health financial protection mechanisms and investments in an extensive health-care delivery network.
This second edition of the health system review of Philippines shows the major changes that have occurred over the 7 years since the last review. Channelling of funds from sin tax to Health has shown unprecedented levels of finances are now available for UHC. PhilHealth has dramatically increased coverage of people as well as service providers that it works with from both government and non-government sectors. However major challenges remain; regional and socioeconomic disparities in the availability and accessibility of resources are prominent and there is a need to improve regulation of service providers. Philippines HiT reports on the current health system reforms undertaken including challenges of incorporating primary health care as in the overall health architecture of the country.
Universal Health Coverage (UHC) Day 12.12.14, NepalDeepak Karki
This presentation is made on the first ever Universal Health Coverage (UHC) Day 12.12.14 celebration in Nepal by Nepal Health Economics Association (NHEA).
The Thailand HiT reports that sustained political commitment to the health of the population since the 1970s has resulted in significant investment in health infrastructure, in particular primary health care, district and provincial referral hospitals, and strengthened the overall functioning of the Thai health system. After Thailand achieved universal health coverage in 2002, public expenditure on health significantly increased from 63% to 77% and out-of-pocket expense was reduced from 27.2% to 12.4% of the total health spending in 2011.
Researching Purchasing to achieve the promise of Universal Health Coverageresyst
This presentation was given by Professor Kara Hanson at the BMC Health Services Research Conference, in July 2014.
The presentation illustrates the important role that strategic purchasing can play in achieving effective health coverage, and how the topic is being studied by researchers. It highlights RESYST's multi-country study of purchasing arrangements that is currently taking place in Nigeria, Kenya, Tanzania, South Africa, India, Thailand and Vietnam.
This review outlines the main organizational, financing, human resources and service delivery features of the health-care system. Although there has been implement in overall health outcomes since the 1990’s the current levels are still below average for the country’s Pacific neighbors. The remoteness of the many rural communities has hampered improvements in health services. This is one of the major challenges that the country faces in order to achieve SDG heath targets by 2030. This Hits highlights steps taken to overcome challenges especially in the face of epidemiological change in disease burden that is slowly taking place in the country.
The Republic of Korea HiT notes that economic development and universal health coverage through national health insurance has led to a rapid improvement in health outcomes. Overall, the health status of the Korean population is better than that of many other Asian countries. Reducing inequality in health coverage outcomes, strengthening primary health care and improving coordination between hospitals and long-term care facilities to meet the needs of the aged population are the challenges facing the Government.
The Republic of Korea reported its first COVID-19 case on the 20th of January 2020. Since then, the country has reported 34,201 confirmed cases of COVID-19 and 526 deaths. The Republic of Korea’s COVID-19 response is characterized by its swift and broad 3Ts (test – trace – treat) strategy. Measures taken by the country demonstrate a collaborative effort between ministries, across levels of governance, with a focus on the implementation of essential public health measures to prevent and manage COVID-19 cases in the country. Systematic public health measures such as maintaining physical distance, with limited restrictions on mobility, strong health communication, rigorous implementation of isolation and quarantine measures, as well as monitoring and surveillance were key to containing the outbreak in the country.
The report presents the various policies and steps that were put in place from the beginning of the outbreak to control COVID-19 transmission in the country.
These slides present details from the more comprehensive COVID-19 HSRM on the Republic of Korea
The Solomon Islands HiT determines that the country’s health system has significant weaknesses but also considerable strengths. Despite the range and difficulty of issues facing policy-makers in the Solomon Islands, there have been significant achievements in health, including considerable progress in advancing population health status. The performance of the health system is positive, achieving high coverage, high satisfaction levels, and steady progress on health outcomes. Nonetheless, the country faces important health challenges that could undermine development gains made to date
Factors Associated with Enrolment of Households in Nepal’s National Health In...Prabesh Ghimire
Abstract
Background: Nepal has made remarkable efforts towards social health protection over the past several years. In 2016, the Government of Nepal introduced a National Health Insurance Program (NHIP) with an aim to ensure equitable and universal access to healthcare by all Nepalese citizens. Following the first year of operation, the scheme has covered 5 percent of its target population. There are wider concerns regarding the capacity of NHIP to achieve adequate population coverage and remain viable. In this context, this study aimed to identify the factors associated with enrolment of households in the NHIP.
Methods: A cross-sectional household survey using face to face interview was carried out in 2 Palikas (municipalities) of Ilam district. 570 households were studied by recruiting equal number of NHIP enrolled and non-enrolled households. We used Pearson’s chi-square test and binary logistic regression to identify the factors associated with household’s enrolment in NHIP. All statistical analyses were performed using IBM SPSS version 23 software.
Results: Enrolment of households in NHIP was found to be associated with ethnicity, socio-economic status, past experience of acute illness in family and presence of chronic illness. The households that belonged to higher socio-economic status were about 4 times more likely to enrol in the scheme. It was also observed that households from privileged ethnic groups such as Brahmin, Chhetri, Gurung, and Newar were 1.7 times more likely to enrol in NHIP compared to those from underprivileged ethnic groups such as janajatis (indigenous people) and dalits (the oppressed). The households with illness experience in 3 months preceding the survey were about 1.5 times more likely to enrol in NHIP compared to households that did not have such experience. Similarly, households in which at least one of the members was chronically ill were 1.8 times more likely to enrol compared to households with no chronic illness.
Conclusion: Belonging to the privileged ethnic group, having a higher socio-economic status, experiencing an acute illness and presence of chronically ill member in the family are the factors associated with enrolment of households in NHIP. This study revealed gaps in enrolment between rich-poor households and privileged-underprivileged ethnic groups. Extension of health insurance coverage to poor and marginalized households is therefore needed to increase equity and accelerate the pace towards achieving universal health coverage.
The purpose of this presentation is to equip audiences with the ability to:
Define universal health coverage (UHC) and understand the basic tenets of UHC
Identify how UHC fits in USAID’s health and poverty reduction strategies
Effectively communicate to country stakeholders how USAID can support a country’s progress towards UHC
Identify relevant UHC resources within the Office of Health Systems and USAID
The presentation is part of the “UHC Toolkit” and accompanies Universal Health Coverage: An Annotated Bibliography, and Universal Health Coverage: Frequently Asked Questions.
Information about VThe Philippines. The dos and the dont's, business etiquette, general information about the country. The document was created for the project Info4migrants. Project number UK/13/LLP-LdV/TOI-615
Beryl Pilkington, RN, PhD, School of Nursing, Faculty of Health, York University in Toronto, presented at AMREF's Coffeehouse Speaker Series on global development on the intersection of health and development with specific focus on the community level in the Dadaab refugee camps. The coffeehouse speaker series looks at international development and global health, specifically focusing on Africa.
ECONOMIC ASSESSMENT OF THE LEVEL OF EFFECTIVENESS OF PRIMARY HEALTHCARE SERVI...JobOpue1
his study examined the level of effectiveness of primary healthcare services in Cross River State (CRS). The data generated were analyzed using the t-test of mean difference and the confidence interval analysis. The results showed that there was a disparity in access to healthcare services between the Northern and Central senatorial districts, while there was no disparity in the level of accessibility to healthcare services between the Northern and Southern and the Central and Southern districts. There was no disparity in the level of government funding and management of healthcare services between the three senatorial districts, but there was a disparity in the level of infrastructural amenities distributed among the three senatorial districts. The government should increase its budgetary allocation for healthcare in line with the World Health Organisation’s 15 per cent of the total budget benchmark to boost the effectiveness of primary healthcare services, among others was recommended.
Ρητορική και πολιτική στην Πρωτοβάθμια Φροντίδα. Η αναγκαιότητα μιας τεκμηριω...Evangelos Fragkoulis
Παρούσιαση μου στα πλαίσια του 13ου Health Policy Forum, με θέμα:
"Πρωτοβάθμια Φροντίδα Υγείας: Προϋποθέσεις Ανασυγκρότησης και Ανάπτυξης"
Αρχαία Ολυμπία, 15-17 Απριλίου 2016
http://www.healthpolicy.gr/13%CE%B7-%CF%83%CF%85%CE%BD%CE%AC%CE%BD%CF%84%CE%B7%CF%83%CE%B7-%CE%B1%CF%81%CF%87%CE%B1%CE%AF%CE%B1-%CE%BF%CE%BB%CF%85%CE%BC%CF%80%CE%AF%CE%B1-2016/
Evolution of National Family Planning Programme (NFPP) and National Populatio...Dr Kumaravel
This presentation discuss the evolution of India's National Family Planning Program and National Population Policy 2000, significant impact of 1994 Cairo conference on country's Reproductive health approach.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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Protonitazene (hydrochloride) CAS: 119276-01-6
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
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Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Couples presenting to the infertility clinic- Do they really have infertility...
Impact of SHI for the poor on FBD in the Philippines
1. Impact of extending Social Health
Insurance for the poor on facility-based
deliveries in the Philippines
카를로 파레데스
Karlo Paolo P. Paredes
karlo@snu.ac.kr
서울대학교 보건대학원
Seoul National University | Graduate School of Public Health
August 2015
COHRED | Global Forum on Research and Innovation for Health
2. Contents
• Introduction and Background of the Study
• Philippines’ Health System
• The UHC/KP policy
• Objectives
• Methods
• Key Messages
보건대학원 | Graduate School of Public Health
3. Background
• Channeling increased funding flows through the National Health Insurance schemes
offers the best avenue to improve (1) the supply of services, (2) access to health
services and (3) delivering quality health care, especially in low-income countries
(WHO, 2005)
• Strong calls for Universal Health Coverage has prompted countries to institute / expand
health insurance and prioritize health (WHO, 2008, 2010, 2013)
• However, recent studies have no consensus on the impact of health insurance
especially among the poor, with no strong evidence of an impact on utilization,
financial risks and health status (Acharya et al., 2013)
보건대학원 | Graduate School of Public Health
4. Background
• Philippines – premium sharing for the poor
(National and Local) has not increased
coverage under Philhealth (Before UHC/KP
policy) (Chakraborty 2013)
보건대학원 | Graduate School of Public Health
Extension of SHI for
the poor
Voluntary
Free
Discounted Fees
• Strategy in the Philippines has shifted from a premium sharing scheme for the
identified poor by LGUs (Pre-policy) to Full National Government subsidy to the
proxy-tested poor in 2011 (post-policy) (DOH 2011, Philhealth revised IRR, 2013).
• Since then, there has been a marked increase in the number of SHI indigent members
from 22% in 2010 to 46% in 2014 (More than the employed members at 40% in 2014)
(Philhealth, 2010, 2014)
Strategies in expanding SHI for the poor
5. Philippines’ Health System
• 1991 – Health System was Devolved
• Local Chief Executives (LCEs) role critical in Local Health
development after Devolution
• DOH – Remained (National Health Agency)
• DOH Regional Agency – Center for Health
Development Offices
• DOH Retained Hospitals / Specialty centers
• 1995 – Creation of the National Health Insurance
• 1999 – Health Sector Reform Agenda
• 2005 – FOURmula 1 for Health
(Financing, Service Delivery, Regulation & Governance)
• 2011 – UHC (Kalusugang Pangkalahatan)
Levels of Health Service Delivery
Source: Melgar, J. D. (2010). Organizing Health Services towards Universal Health Care. Acta
Medica Philippina, Volume 44 No. 4(Universal Health Care for Filipinos: A Proposal), 36-42.
보건대학원 | Graduate School of Public Health
6. UHC/KP policy in the Philippines
• Enrollment of 5.2 Million Poor Filipinos to the
National Health Insurance (Philhealth)
• Training and Mobilization of Community Health
Teams (CHTs) to increase utilization of health
services / use of Philhealth
• Reduction of unmet needs for Maternal and Child
Health
• Health Facilities Enhancement Program – to Improve
capacities of Health Facilities
보건대학원 | Graduate School of Public Health
3 Thrusts of UHC in the Philippines
Source: Kalusugan Pangkalahatan Execution Plan and Implementation Arrangements (2011).
Aquino Health
Agenda – Universal
health Care (2010)
Kalusugan
Pangkalahatan
(UHC) Framework
for Implementation
7. UHC/KP policy in the Philippines
보건대학원 | Graduate School of Public Health
National Household
Targeting System for
Poverty Reduction
(NHTS-PR)
Proxy Means Test
(PMT); Identification
of the poorest of the
poor Filipinos (5.2 M)
DOH / Philhealth
Enrollment to SHI
(Sponsored
category)
Poor household: How were they enrolled under the UHC/KP?
8. 보건대학원 | Graduate School of Public Health
Health Insurance Theories
Theories of Health
Insurance
Demand for Health
insurance
Moral Hazard
Risk-Sharing
Adverse Selection
Ex-ante
Post-ante
Informal vs. Health
Insurance
Economic Model of
Demand; (Besley 1989)
“The sick pays more for
health”
Demand for Health -> demand for
health care -> demand for health
insurance
Change in lifestyle of the insured
individuals exist
Increased consumption/use of
health services
Are the increase beneficial?
(Nyman, 1999)
Reliance on informal risk-sharing;
Lack of trust to institutions
Arrow (1963);
Pauly (1968)
*Figure based on author’s illustration
9. 보건대학원 | Graduate School of Public Health
Value of Health Insurance
Nyman (1999): Value of Health Insurance
Health
Insurance
Risk Aversion Value
Access Value
The access value of health insurance is related to the
value of the consumer of medical care that the person
would not otherwise be able to afford.
“If the insurance is the only way to gain access to
expensive health care, then the value of insurance for that
care is the expected consumer surplus from health care
that would otherwise be inaccessible”
Moral Hazard as otherwise implied, is not necessarily
inefficient if the increase in health service use was brought
by the access value of insurance to necessary services
that were previously inaccessible.
In the context of low-income countries, where levels of
unmet needs tends to be substantial, increased in
consumption are not necessarily problematic (Jowett,
2004)
10. 보건대학원 | Graduate School of Public Health
Related studies
Studies measuring SHI impact to the poor (targeted)
Country Study objectives Results
Colombia
(Trujillo, Portillo, &
Vernon, 2005)
Measurement of the impact of the subsidized
health insurance for the poor in Colombia (PSM
and IV Estimations)
The subsidized health insurance program greatly
increased medical care utilization among the poor
Colombia
(Miller, Pinto, and
Vera-Hernandez,
2009)
Determination of how the SR enrollment is
associated with financial risk protection and
efficiency in health service use (IV estimation)
The SR has been successful in financially protecting
the poor from financial risk associated with medical
costs of unexpected illnesses; Increase in utilization of
the previously underutilized preventive services.
Vietnam
(Wagstaff, 2010)
Measuring the impact of VHCFP on health
service use and financial risk protection using
VHLS surveys (Difference-in-differences)
VHCFP had no impact on use of health services. ATT
of health insurance did not show statistically significant
results for out-patient or in-patient visits; VHCFP
substantially reduced OOP spending.
11. 보건대학원 | Graduate School of Public Health
Related studies
Studies measuring SHI impact to the poor (targeted)
Country Study objectives Results
Vietnam
(Axelson et al, 2009)
Evaluation of the short-term impacts of VHCFP
on utilization and out of pocket expenditure using
VHLS survey (PSM and double differencing)
Small, positive impact on overall healthcare
utilization; statistically significant result in out-patient
strong negative impact on out-of-pocket expenditure;
the insured had lower OOP expenditure for in-patient care
Georgia
(Bauhoff, Hotchkiss,
and Smith, 2011)
Measuring the impact of the medical insurance
for the poor using a dedicated survey of 3500
households (RDD estimation)
There was no impact seen on utilization; lower
expenditure was only seen on the elderly group, all others
with no robust evidence. Lower expenditure among the
insured for inpatient care.
Georgia
(Zoidze, Rukhazde,
Chkhatarashvili, and
Gotsadze, 2013)
Mix-method study of Georgia’s health insurance
for the poor, using secondary data analysis and
health expenditure and utilization surveys of
2007-2010 (DID)
MIP has positive impact in terms of reduced
expenditure for IP services; Consequently, the MIP had
almost no significant effect on health services
utilization.
12. Did health insurance made health services more
accessible to the poor?
보건대학원 | Graduate School of Public Health
13. 보건대학원 | Graduate School of Public Health
Methods
3.1 Research Design SHI Impact and Health
Service Utilization
I. Quasi-Experimental
- Impact of extending
SHI for the poor
Data Source Description Percentage of Insured HH (Income
quintile 1&2)
NDHS 2013 (Post-policy) NHDS survey data conducted in the Philippines after the
UHC/KP policy in 2011
44.24% of total households covered
NDHS 2008 (Pre-policy) NDHS survey data conducted in the Philippines before the
initiation of the UHC/KP policy in 2011
15.75% of total households covered
Department of Health /
Philhealth / National
Statistical Board
Information about regional/provincial community-level variables
to be used in the analysis
Wealth Index: Samples are categorized
using an index which is equal to 1 for the
poorest to 5 for the richest
14. 보건대학원 | Graduate School of Public Health
Methods
Why NDHS?
DHS Year Total Households
Covered
Total population
(Women, Children,
Household Members)
Total Women
Respondents
Total number of
Children <5
% of Poor and next
poor samples (Q1 &
2)
2013 14,804
(43% in Q1&2)
70,100
(45% in Q1&2)
16,155
(40% in Q1&2)
7,216
(54% in Q1&2)
40% of total sample
2008 12,469
(45% in Q1&2)
60,901
(45% in Q1&2)
13,594
(40% in Q1&2)
6,572
(55% in Q1&2)
40% of total sample
15. 보건대학원 | Graduate School of Public Health
Methods
Measuring impact of sponsored SHI on health service use (Facility-based delivery)
Impact of Health insurance to
Service Utilization
Level 2: Community-level
characteristics
(1) Women (Q1&2) who
delivered in the last 24 months
(NDHS 2013)
Insured under UHC/KP
(treatment)
Uninsured (control)
16. 보건대학원 | Graduate School of Public Health
Methods
Determination of the impact of SHI for the poor
will be determined controlling both for
individual and community factors.
Variable Name Coding Definition
Dependent Variable
fbd - Women who last delivered
in a facility (Facility-Based
Delivery)
0, 1 Identified women who delivered in a health facility (government / private)
Dependent variable in a binary form
Facility Delivery
(Q1 & Q2)
Year
2008 2013
Yes 290 (24%) 679 (51%)
No 928 (76%) 651 (49%)
17. 보건대학원 | Graduate School of Public Health
Methods
Model: DID under Linear Probability Model
(LPM), with cluster-robust standard errors
Interaction terms in the DID model using a
Non-linear model will not be able to show
the ATT of the interaction variable (A &
Norton, 2003; Athey & Imbens, 2006)
Difference-in-Differences Estimation
18. 보건대학원 | Graduate School of Public Health
Methods Model: DDD under Linear Probability Model
(LPM), with cluster-robust standard errors
Identification of post-policy effect of SHI on
utilization with consideration of urban/rural
community types
Assumption: individuals from urban
community types have more access to
health facilities
Triple Differences Estimation
19. 보건대학원 | Graduate School of Public Health
Results
MLR HLM
Interaction variables Model 1 Model 2 Model 3 Model 4 Model 5 Model 6 Model 7 Model 8 Model 9 Model 10
Interaction (DD) -0.07 -0.01 -.09 -0.02 -0.07 -0.01 -0.01 -0.09 -0.03 -0.03
Interaction (DDD) 0.05 0.01 0.08 0.04 0.04
Insured 0.06 0.06 0.07* 0.06 0.05 0.05 0.05 0.06 0.05 0.05
Post-policy 0.29* .26 * 0.31* 0.28 0.30* 0.27* 0.26* 0.33* 0.30* .30 *
Insured*postpolicy -0.07 -0.01 -.09* -0.02 -0.07 -0.01 -0.01 -0.09 -0.03 -0.03
Community Type 0.14* 0.08 .13* .08* .08*
Community Type * Post
policy -.10* -0.08 -0.13* 0-.12* -.13*
Insured*Community Type 0.02 0.04 0.00 0.02 0.03
Independent Variables (x)
Education 0.08* .08 * 0.08 0.08 0.08* 0.08*
Number of HH Members -0.01* -.01 * -0.01 -0.01* -0.01 -0.01*
Head of HH Sex -0.04 -0.04 -0.04 -0.04 -0.04 -0.04
Head of HH Age 0.00* 0.00 * .002301 * 0.00* 0.00* .00*
Wealth Index Decile (5
decimals) 1.45e-06*
1.36e-06
* 0.00 1.20e-06*
1.21e-06
*
1.17e-06
*
Total number of Children -0.01* -.01 * -0.01 -.01 * -0.01 -0.01
Union Status -0.04 -0.03 -0.02 -0.02 -0.02 -0.02
Partners' Educational
Attainment .06* 0.06 0.05 .05* 0.05* 0.05
Age group 0.00 0.00 0.00 0.00 0.00 0.00
Level 2 Variables (Regions)
MD to Population Ratio 0.00 0.00
RN to Population Ratio 0.00 0.00
MW to Population Ratio 0.00 0.00
Number of Government
Hospitals -0.01* -0.01*
Number of Private Hospitals -0.01* -0.01*
Number of RHUs / Lying-in 0.00 0.00
Number of Philhealth
Accredited Hospitals 0.01 .01 *
n=2,257
• The models yielded insignificant
results.
• This suggests that despite the fact
that FBDs increased (2008-2013),
there is no significant evidence to
say that the increase was brought by
the “insured” status of the poor
(from UHC/KP policy).
20. 보건대학원 | Graduate School of Public Health
Key Messages
1. Measuring the impact of the recent policy change in the Philippines, insuring
the poor does not seem to have an immediate effect of increasing use of
health services.
2. Further studies to explore other barriers to health use despite the
“insured” status of the poor should be further investigated which may be
related to the following:
• Availability of health facilities (for delivery) where the poor is located
• Awareness of the nationally sponsored poor of their health insurance benefits
• Ease of Use (of insurance benefits) in facilities
• OOP payments above insurance coverage (from patient experience), etc.
21. 보건대학원 | Graduate School of Public Health
Key Messages
3. Many countries now are using subsidies to achieve UHC – it is important
therefore to note that while health insurance is important to enable the
poor to access services, other supply- / demand-side barriers beyond
financing services should be considered.
4. Medium- and long-term evaluation is recommended for thorough policy
evaluation and future health policy development.
22. 보건대학원 | Graduate School of Public Health
Thank You!
Maraming Salamat!
감사합니다!
Karlo Paredes
karlo@snu.ac.kr
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