This document discusses the need for a transformative approach to social protection in health. It argues that while existing social protection programs aim to provide access to healthcare, large groups remain excluded due to financial and structural barriers. A transformative approach would aim not just to provide services, but also challenge existing power imbalances and social inequities that cause vulnerability and exclusion. Adopting a framework focused on social transformation could help address the root causes of poor health outcomes and more effectively achieve health equity goals.
This document discusses financing primary health care in Cameroon. It notes that currently, household health financing is mostly done through out-of-pocket payments, which can lead to catastrophic health expenditures and push households into poverty. While Cameroon has social health insurance and community-based insurance programs, coverage remains low, with 62% of Cameroonians lacking access to quality healthcare. The document proposes studying alternative sustainable financing methods to improve access and reduce financial barriers to healthcare.
This document discusses primary health care financing reforms in Cameroon. It notes that Cameroon currently relies heavily on out-of-pocket payments for health care, which has led to high rates of catastrophic health expenditures and barriers to access. The document reviews Cameroon's socioeconomic context and history of health policies. It proposes developing a more sustainable financing method to improve access and reduce financial barriers. A literature review defines key concepts in health policy, financing, equity, efficiency, and expenditures to provide context for analyzing alternatives.
Influence of risk taking propensity among kenyan community health workersfredrickaila
This document discusses a study that examined how risk-taking propensity and entrepreneurial behavior among Kenyan community health workers influences various health indicators. The study found that community health workers with high risk-taking propensity, as an entrepreneurial trait, achieved better results for health indicators like facility delivery and water treatment compared to those with low entrepreneurial traits. Developing entrepreneurial skills in community health workers could help motivate them given challenges remunerating them through government budgets. The document provides background on community health workers, their important role in improving health access and coverage, and the potential for entrepreneurial activities and small businesses to stimulate rural development and thereby indirectly influence health status.
Monitoring progress towards universal health coverage at country and global l...The Rockefeller Foundation
A movement towards universal health coverage (UHC) – ensuring that everyone who needs health services is able to get them, without undue financial hardship – has been growing across the globe (1). This has led to a sharp increase in the demand for expertise, evidence and measures of progress and a push to make UHC one of the goals of the post-2015 development agenda (2). This paper proposes a framework for tracking country and global progress towards UHC; its aim is to inform and guide these discussions and assessment of both aggregate and equitable coverage of essential health services as well as financial protection. Monitoring progress towards these two components of UHC will be complementary and critical to achieving desirable health outcome goals, such as ending preventable deaths and promoting healthy life expectancy and also reducing poverty and protecting household incomes.
This paper was written jointly by the World Health Organization (WHO) and The World Bank Group on the basis of consultations and discussions with country representatives, technical experts and global health and development partners (3). A draft of this paper was posted online and circulated widely for consultation between December 2013 and February 2014. Nearly 70 submissions were received from countries, development partners, civil society, academics and other interested stakeholders. The feedback was synthesized and reviewed at a meeting of country and global experts in Bellagio, Italy, in March 2014 (4). The paper was modified to reflect the views emerging from these consultations.
This document provides an overview and comparison of major healthcare systems around the world. It begins by outlining the educational goals of identifying key healthcare models, comparing systems, and examining issues and possible solutions in the US system. The document then analyzes four main models - the Bismarck model found in Germany and others, the Beveridge model in the UK, the National Health Insurance model in Canada, and out-of-pocket systems in developing nations. It also reviews quality, access and costs of healthcare in countries like the US, UK, Canada and France.
This document discusses financing primary health care in Cameroon. It notes that currently, household health financing is mostly done through out-of-pocket payments, which can lead to catastrophic health expenditures and push households into poverty. While Cameroon has social health insurance and community-based insurance programs, coverage remains low, with 62% of Cameroonians lacking access to quality healthcare. The document proposes studying alternative sustainable financing methods to improve access and reduce financial barriers to healthcare.
This document discusses primary health care financing reforms in Cameroon. It notes that Cameroon currently relies heavily on out-of-pocket payments for health care, which has led to high rates of catastrophic health expenditures and barriers to access. The document reviews Cameroon's socioeconomic context and history of health policies. It proposes developing a more sustainable financing method to improve access and reduce financial barriers. A literature review defines key concepts in health policy, financing, equity, efficiency, and expenditures to provide context for analyzing alternatives.
Influence of risk taking propensity among kenyan community health workersfredrickaila
This document discusses a study that examined how risk-taking propensity and entrepreneurial behavior among Kenyan community health workers influences various health indicators. The study found that community health workers with high risk-taking propensity, as an entrepreneurial trait, achieved better results for health indicators like facility delivery and water treatment compared to those with low entrepreneurial traits. Developing entrepreneurial skills in community health workers could help motivate them given challenges remunerating them through government budgets. The document provides background on community health workers, their important role in improving health access and coverage, and the potential for entrepreneurial activities and small businesses to stimulate rural development and thereby indirectly influence health status.
Monitoring progress towards universal health coverage at country and global l...The Rockefeller Foundation
A movement towards universal health coverage (UHC) – ensuring that everyone who needs health services is able to get them, without undue financial hardship – has been growing across the globe (1). This has led to a sharp increase in the demand for expertise, evidence and measures of progress and a push to make UHC one of the goals of the post-2015 development agenda (2). This paper proposes a framework for tracking country and global progress towards UHC; its aim is to inform and guide these discussions and assessment of both aggregate and equitable coverage of essential health services as well as financial protection. Monitoring progress towards these two components of UHC will be complementary and critical to achieving desirable health outcome goals, such as ending preventable deaths and promoting healthy life expectancy and also reducing poverty and protecting household incomes.
This paper was written jointly by the World Health Organization (WHO) and The World Bank Group on the basis of consultations and discussions with country representatives, technical experts and global health and development partners (3). A draft of this paper was posted online and circulated widely for consultation between December 2013 and February 2014. Nearly 70 submissions were received from countries, development partners, civil society, academics and other interested stakeholders. The feedback was synthesized and reviewed at a meeting of country and global experts in Bellagio, Italy, in March 2014 (4). The paper was modified to reflect the views emerging from these consultations.
This document provides an overview and comparison of major healthcare systems around the world. It begins by outlining the educational goals of identifying key healthcare models, comparing systems, and examining issues and possible solutions in the US system. The document then analyzes four main models - the Bismarck model found in Germany and others, the Beveridge model in the UK, the National Health Insurance model in Canada, and out-of-pocket systems in developing nations. It also reviews quality, access and costs of healthcare in countries like the US, UK, Canada and France.
Generic working practices in adult social care (UK)Blaine Robin
Increasingly job roles in Adult Social Care settings are becoming generic. An example of this is the joint role of social work and occupational therapy is organising reablement services.
Generic working practices in adult social care (UK)Blaine Robin
How can Social Workers, Occupational Therapist and Nurses share skills in an effort to deal with higher volumes of services users. There is a global shortage of qualified Health and Social Care professionals which means a real challenge lays ahead as the ageing population in the West continues to rise.
This document discusses community-based health insurance (CBHI) in Nigeria, including its prospects and challenges. CBHI is advocated as a strategy to achieve universal health coverage, though uptake in Nigeria remains poor. The document examines different types of CBHI schemes, including those initiated by communities, healthcare providers, and governments. It notes that while CBHI could help reduce out-of-pocket costs that deter healthcare access, many schemes fail due to lack of sufficient contributions to maintain themselves financially. Government support may be needed for CBHI to be sustainable and benefit more Nigerians.
Health financing strategies uhc 27 09 12Vikash Keshri
This document discusses health financing strategies for universal health coverage. It begins by defining universal health coverage and providing historical perspectives. It then discusses the current state of health financing in India, including low public spending, high private out-of-pocket expenditures, and variations between states. The document outlines that achieving universal health coverage requires raising sufficient funds, removing financial barriers, and using resources efficiently. It examines strategies for generating more health resources, utilizing resources effectively to prevent waste, and proposes the key recommendations of India's High Level Expert Group on universalizing access to affordable healthcare.
This paper seeks solutions to improve maternal and newborn access to healthcare in Haiti following the 2010 earthquake. An action research approach is used to engage stakeholders in developing interventions. Recommended solutions include "bridgebuilder" positions like patient advocates, case managers, and wellness coaches to help address infrastructure and health worker shortages. These positions would provide education, self-management support, and help coordinate care using technologies, mobile clinics, and rural stations. The goal is to build sustainable programs and promote community self-reliance.
Universal Health Care: Perceptions, Values, and IssuesRenzo Guinto
From the workshop "Universal Health Care: The First Step to Global Health Equity" held last August 5-9, 2012 in Mumbai, India during the 61st General Assembly March Meeting of the International Federation of Medical Students' Associations (IFMSA). Brought to you by the IFMSA Global Health Equity Initiative (http://www.ifmsa.org/Activities/Initiatives/The-IFMSA-Global-Health-Equity-Initiative).
For more information about the workshop, visit http://www.scribd.com/doc/193822108/Universal-Health-Care-PreGA-Program
Programs for public health practitioners in the field, due to the profession is so dispersed in its work—from employment in private managed care organizations and clinics. The main purpose of this study is to analysis the relationship between law and ethics with public healthcare performance. The present study used a quantitative research design, specifically the descriptive survey design. This is because such design accurately and objectively describes the characteristics of a situation or phenomenon being investigated in a given study. It provides a description of the variables in a particular situation and, sometimes, the relationship among these variables rather than focusing on the cause-and effect relationships. Thus, this study used a questionnaire which was developed from previous research in order to measure the relationships among the investigated variables. This study was carried out in different healthcare centers located in Erbil, the total of 81 participants participated in this study. The researcher developed research hypothesis as follow; there is a positive and significant relationship between law and healthcare performance in Erbil. The finding of this study showed that the value of beta for law and ethics factor is .749 with the P-value .000 this means that the law and ethics will have positive and significant influence on healthcare performance; accordingly the main research hypothesis is supported.
The document discusses provisions of the Affordable Care Act that provide funding to address the primary care provider shortage in the United States. It notes that the ACA invests in expanding the primary care workforce through funding for medical education and support for nurses and nurse practitioners. In particular, it allocates grants and loan repayment programs to nursing schools to boost enrollment and support for students. The document argues this increased funding for primary care training and education is critical to fulfill the goals of the ACA to expand access and improve healthcare outcomes in the face of growing demand for primary care services.
Integrando los servicios sociales y sanitarios. Una vision desde la internati...Societat Gestió Sanitària
Ponencia a cargo del médico geriatra Marco Inzitari, director de Atención Intermedia, Investigación y Docencia del Parc Sanitari Pere Virgili, en el marco de la VI Jornada Right Care sobre Modelos avanzados en integración de servicios sociales y sanitarios, organizada por la Societat Catalana de Gestió Sanitària el 24 de mayo de 2019.
Universal health coverage means that everyone has access to health care services including preventive, promotive, curative and rehabilitative care when needed at an affordable cost. The key objectives of universal health coverage are to ensure equitable access to quality health services for all, regardless of ability to pay, and provide financial protection so that costs of care do not cause financial hardship. Universal health coverage aims to make health care available, accessible and affordable for entire populations.
Ageing is an important physiological phenomenon faced by all living individuals that is multifactorial and complex. The causation is still a matter of controversy. There is a lack of consensus regarding the appropriate age of ageing, though most of the countries uses chronological ages.
This presentation is regarding active ageing that builds up framework that will help the elderly mass to live a disease free active life with active participation and security in life.
This presentation also describes the different challenges faced by the elderly population for active ageing.
Government of India has been working for the aged population and there has been a number of policies and programmes that are solely dedicated to the elderly masses that has been also described here.
The document summarizes healthcare financing in India. It discusses that healthcare financing aims to ensure access to health services. The key principles are generating revenue, pooling funds for cross-subsidization between rich/poor and healthy/sick, and purchasing efficient services. In India, healthcare is financed primarily through out-of-pocket payments by households, while government expenditure is low compared to other countries. Reforms like NRHM and RSBY aim to increase public allocation to healthcare. Challenges include expanding coverage with limited resources and improving spending efficiency.
This document compares the concept of universal health coverage to the human right to health care. It analyzes authoritative definitions and interpretations of both to determine if universal health coverage can be considered a "practical expression" of the right to health care, as the WHO proposes. The analysis finds that while universal health coverage includes many aspects of the right to health care, it is missing one key element - an explicit confirmation that international assistance is essential, not optional, to fulfill the right. However, universal health coverage may still evolve to fully encompass the right to health care.
Michael Samuelson, Keynote,Wellness at Work Conference, June 14, 2010Delaware State Chamber
This document discusses wellness and primary prevention as the keystone to transforming healthcare. It outlines that the current healthcare system focuses more on sickness and disease management rather than prevention. A shift needs to occur towards prioritizing health promotion and preventing disease to lower costs. A five step strategic approach is proposed: 1) Organize the population by risk level, 2) Conduct a corporate health audit, 3) Adjust corporate culture, 4) Implement programs to keep low risk low and move high risk lower, 5) Evaluate, update and maintain programs. The document argues that wellness is not just an individual responsibility but a shared social contract between society and individuals with both rewards and penalties.
This document discusses public health campaigns for older people. It provides examples of campaigns in Ireland that address issues like elder abuse, fuel poverty, and physical activity. Successful campaigns are targeted, provide accurate information through clear messages, and offer additional support services. Governments play a key role by funding campaigns and organizations, but behavior change also requires engagement from stakeholders and the public. Ongoing monitoring and evaluation are important to measure a campaign's impact and inform future efforts.
This document provides an overview of healthcare financing in India. It begins with definitions of health care financing and outlines the key functions of accumulating, mobilizing, and allocating money for health needs. It then discusses the main mechanisms of healthcare financing globally and in India, including how money is raised through taxes, insurance contributions, and other means. It also addresses how funds are pooled and how health services are paid for. The document reviews India's current healthcare financing indicators and challenges, such as low public spending and high out-of-pocket costs. It concludes with initiatives by the Government of India and recommendations to improve healthcare financing in India.
The document analyzes whether physically inactive citizens cost governments more than active citizens through healthcare expenditures. It finds that physical inactivity is linked to increased risk of diseases like diabetes, cancer and heart disease. Healthcare costs associated with treating diseases caused by inactivity account for billions spent annually in countries studied. The document recommends governments implement policies and programs to encourage physical activity, and allocate funding to build recreation facilities. Increased physical activity could save governments over three times the costs of implementing initiatives to promote activity.
Universal Health Coverage and Health Insurance - IndiaDr Chetan C P
Presentation is a case about cutting the risk fragmentation and having a universal pool for Health Insurance as one of the tools for achieving UHC in India.
This document contains QBasic commands to draw several shapes and objects:
1) Commands to draw a car with lines and circles.
2) Commands to draw a house with lines of different colors and thicknesses.
3) Commands to draw a cube with labeled lines connecting the vertices.
Generic working practices in adult social care (UK)Blaine Robin
Increasingly job roles in Adult Social Care settings are becoming generic. An example of this is the joint role of social work and occupational therapy is organising reablement services.
Generic working practices in adult social care (UK)Blaine Robin
How can Social Workers, Occupational Therapist and Nurses share skills in an effort to deal with higher volumes of services users. There is a global shortage of qualified Health and Social Care professionals which means a real challenge lays ahead as the ageing population in the West continues to rise.
This document discusses community-based health insurance (CBHI) in Nigeria, including its prospects and challenges. CBHI is advocated as a strategy to achieve universal health coverage, though uptake in Nigeria remains poor. The document examines different types of CBHI schemes, including those initiated by communities, healthcare providers, and governments. It notes that while CBHI could help reduce out-of-pocket costs that deter healthcare access, many schemes fail due to lack of sufficient contributions to maintain themselves financially. Government support may be needed for CBHI to be sustainable and benefit more Nigerians.
Health financing strategies uhc 27 09 12Vikash Keshri
This document discusses health financing strategies for universal health coverage. It begins by defining universal health coverage and providing historical perspectives. It then discusses the current state of health financing in India, including low public spending, high private out-of-pocket expenditures, and variations between states. The document outlines that achieving universal health coverage requires raising sufficient funds, removing financial barriers, and using resources efficiently. It examines strategies for generating more health resources, utilizing resources effectively to prevent waste, and proposes the key recommendations of India's High Level Expert Group on universalizing access to affordable healthcare.
This paper seeks solutions to improve maternal and newborn access to healthcare in Haiti following the 2010 earthquake. An action research approach is used to engage stakeholders in developing interventions. Recommended solutions include "bridgebuilder" positions like patient advocates, case managers, and wellness coaches to help address infrastructure and health worker shortages. These positions would provide education, self-management support, and help coordinate care using technologies, mobile clinics, and rural stations. The goal is to build sustainable programs and promote community self-reliance.
Universal Health Care: Perceptions, Values, and IssuesRenzo Guinto
From the workshop "Universal Health Care: The First Step to Global Health Equity" held last August 5-9, 2012 in Mumbai, India during the 61st General Assembly March Meeting of the International Federation of Medical Students' Associations (IFMSA). Brought to you by the IFMSA Global Health Equity Initiative (http://www.ifmsa.org/Activities/Initiatives/The-IFMSA-Global-Health-Equity-Initiative).
For more information about the workshop, visit http://www.scribd.com/doc/193822108/Universal-Health-Care-PreGA-Program
Programs for public health practitioners in the field, due to the profession is so dispersed in its work—from employment in private managed care organizations and clinics. The main purpose of this study is to analysis the relationship between law and ethics with public healthcare performance. The present study used a quantitative research design, specifically the descriptive survey design. This is because such design accurately and objectively describes the characteristics of a situation or phenomenon being investigated in a given study. It provides a description of the variables in a particular situation and, sometimes, the relationship among these variables rather than focusing on the cause-and effect relationships. Thus, this study used a questionnaire which was developed from previous research in order to measure the relationships among the investigated variables. This study was carried out in different healthcare centers located in Erbil, the total of 81 participants participated in this study. The researcher developed research hypothesis as follow; there is a positive and significant relationship between law and healthcare performance in Erbil. The finding of this study showed that the value of beta for law and ethics factor is .749 with the P-value .000 this means that the law and ethics will have positive and significant influence on healthcare performance; accordingly the main research hypothesis is supported.
The document discusses provisions of the Affordable Care Act that provide funding to address the primary care provider shortage in the United States. It notes that the ACA invests in expanding the primary care workforce through funding for medical education and support for nurses and nurse practitioners. In particular, it allocates grants and loan repayment programs to nursing schools to boost enrollment and support for students. The document argues this increased funding for primary care training and education is critical to fulfill the goals of the ACA to expand access and improve healthcare outcomes in the face of growing demand for primary care services.
Integrando los servicios sociales y sanitarios. Una vision desde la internati...Societat Gestió Sanitària
Ponencia a cargo del médico geriatra Marco Inzitari, director de Atención Intermedia, Investigación y Docencia del Parc Sanitari Pere Virgili, en el marco de la VI Jornada Right Care sobre Modelos avanzados en integración de servicios sociales y sanitarios, organizada por la Societat Catalana de Gestió Sanitària el 24 de mayo de 2019.
Universal health coverage means that everyone has access to health care services including preventive, promotive, curative and rehabilitative care when needed at an affordable cost. The key objectives of universal health coverage are to ensure equitable access to quality health services for all, regardless of ability to pay, and provide financial protection so that costs of care do not cause financial hardship. Universal health coverage aims to make health care available, accessible and affordable for entire populations.
Ageing is an important physiological phenomenon faced by all living individuals that is multifactorial and complex. The causation is still a matter of controversy. There is a lack of consensus regarding the appropriate age of ageing, though most of the countries uses chronological ages.
This presentation is regarding active ageing that builds up framework that will help the elderly mass to live a disease free active life with active participation and security in life.
This presentation also describes the different challenges faced by the elderly population for active ageing.
Government of India has been working for the aged population and there has been a number of policies and programmes that are solely dedicated to the elderly masses that has been also described here.
The document summarizes healthcare financing in India. It discusses that healthcare financing aims to ensure access to health services. The key principles are generating revenue, pooling funds for cross-subsidization between rich/poor and healthy/sick, and purchasing efficient services. In India, healthcare is financed primarily through out-of-pocket payments by households, while government expenditure is low compared to other countries. Reforms like NRHM and RSBY aim to increase public allocation to healthcare. Challenges include expanding coverage with limited resources and improving spending efficiency.
This document compares the concept of universal health coverage to the human right to health care. It analyzes authoritative definitions and interpretations of both to determine if universal health coverage can be considered a "practical expression" of the right to health care, as the WHO proposes. The analysis finds that while universal health coverage includes many aspects of the right to health care, it is missing one key element - an explicit confirmation that international assistance is essential, not optional, to fulfill the right. However, universal health coverage may still evolve to fully encompass the right to health care.
Michael Samuelson, Keynote,Wellness at Work Conference, June 14, 2010Delaware State Chamber
This document discusses wellness and primary prevention as the keystone to transforming healthcare. It outlines that the current healthcare system focuses more on sickness and disease management rather than prevention. A shift needs to occur towards prioritizing health promotion and preventing disease to lower costs. A five step strategic approach is proposed: 1) Organize the population by risk level, 2) Conduct a corporate health audit, 3) Adjust corporate culture, 4) Implement programs to keep low risk low and move high risk lower, 5) Evaluate, update and maintain programs. The document argues that wellness is not just an individual responsibility but a shared social contract between society and individuals with both rewards and penalties.
This document discusses public health campaigns for older people. It provides examples of campaigns in Ireland that address issues like elder abuse, fuel poverty, and physical activity. Successful campaigns are targeted, provide accurate information through clear messages, and offer additional support services. Governments play a key role by funding campaigns and organizations, but behavior change also requires engagement from stakeholders and the public. Ongoing monitoring and evaluation are important to measure a campaign's impact and inform future efforts.
This document provides an overview of healthcare financing in India. It begins with definitions of health care financing and outlines the key functions of accumulating, mobilizing, and allocating money for health needs. It then discusses the main mechanisms of healthcare financing globally and in India, including how money is raised through taxes, insurance contributions, and other means. It also addresses how funds are pooled and how health services are paid for. The document reviews India's current healthcare financing indicators and challenges, such as low public spending and high out-of-pocket costs. It concludes with initiatives by the Government of India and recommendations to improve healthcare financing in India.
The document analyzes whether physically inactive citizens cost governments more than active citizens through healthcare expenditures. It finds that physical inactivity is linked to increased risk of diseases like diabetes, cancer and heart disease. Healthcare costs associated with treating diseases caused by inactivity account for billions spent annually in countries studied. The document recommends governments implement policies and programs to encourage physical activity, and allocate funding to build recreation facilities. Increased physical activity could save governments over three times the costs of implementing initiatives to promote activity.
Universal Health Coverage and Health Insurance - IndiaDr Chetan C P
Presentation is a case about cutting the risk fragmentation and having a universal pool for Health Insurance as one of the tools for achieving UHC in India.
This document contains QBasic commands to draw several shapes and objects:
1) Commands to draw a car with lines and circles.
2) Commands to draw a house with lines of different colors and thicknesses.
3) Commands to draw a cube with labeled lines connecting the vertices.
This document summarizes art projects from the author's first two-dimensional art class at the University of Rhode Island, which focused on black and white designs. The class concentrated on symmetrical and asymmetrical patterns, positive and negative space, and object placement. Several pieces are described that explore these concepts through circles, collages, and patterns using objects of interest to the author.
This document provides study tips for graduates, including utilizing class resources like attending lectures and asking questions, engaging with core texts by creating learning frames and linking topics, taking effective notes, reading additional materials to analyze and evaluate, revising through creating study schedules and using various techniques, and preparing for and taking exams. The tips emphasize active learning strategies over passive ones like highlighting to help students learn and apply course concepts.
This document summarizes drawings created for a Drawing I class at the University of Rhode Island. The drawings were created using pencil, charcoal, and chalk on white and colored paper. Techniques for accentuating shadows, highlights, and depth were practiced to create three-dimensional black and white drawings. The drawings included styrofoam spheres, intersecting paper, rolled paper, American flags, popcorn, and a cow skull. The final project was a drawing of part of a plant from the URI greenhouses.
This document summarizes a portfolio piece from a Computer Aided Design class where the student was assigned to design patterns based on a rave theme inspired by Ultra Music Festival in Miami. The portfolio piece included patterns for clothing, furniture, and a room that were created using CAD software for the class assignment.
World conference on entrepeneurship 2014Jane Leonard
Entrepreneurs use Twitter to develop weak ties outside their normal networks, which can provide new knowledge and opportunities. A study found entrepreneurs use Twitter for making time and scheduling assistance as well as social sharing. Developing effectual thinking allows entrepreneurs to better leverage unanticipated opportunities from their Twitter networks. Next steps include running workshops on effectual thinking and training start-ups to develop flexible strategies responsive to contingencies outside their control.
LinkedIn now has the right to use members' names and photos in social advertising without consent unless they opt out. The document provides steps to opt out of social advertising and tips for customizing LinkedIn profiles, including turning off broadcast settings when making changes, using keywords, customizing the public profile URL, and customizing the website listing. Members are encouraged to make their profiles look more professional.
Program tahunan mata pelajaran bahasa Inggris kelas VII SMP ini mencakup kemampuan mendengarkan, berbicara, membaca dan menulis teks fungsional sangat sederhana terkait lingkungan terdekat. Materi yang diajarkan meliputi percakapan transaksional dan interpersonal, teks lisan dan tulis fungsional pendek, serta monolog deskriptif dan prosedural.
Abstract for International Conference on Small BusinessJane Leonard
Does Twitter likely to spark effectual thinking in entrepreneurs. Are online interactions really capable of helping entrepreneurs use effectual thinking. What is the role of networks and week or strong ties
Alvarion is a global leader in broadband wireless technology with over 15 years of experience. It has over 1000 employees, 300+ WiMAX deployments in over 100 countries, and has sold over 3 million units. Alvarion offers a full range of fixed, portable, and mobile WiMAX and wireless solutions for licensed and license-exempt spectrum bands.
This document summarizes a fashion design student's final collection which combined her passions for art and fashion. The collection was inspired by floral patterns, contradictions, and the artwork of Monet, Picasso, Mondrian, and Fairey. It provides the student's contact information as a graduating senior having earned a B.S. in Textiles, Merchandising & Design from the University of Rhode Island.
The center for human rights and constitutional lawraymondmin
The Center for Human Rights and Constitutional Law is a non-profit dedicated to protecting civil, constitutional, and human rights of immigrants, refugees, children, and the poor. They provide legal representation for over 130 individuals per year and operate a homeschool for homeless youth. The organization aims to give disadvantaged individuals a fair chance in court and access to education through litigation, advocacy, and social services. Funding and volunteers are needed to continue their important work defending those who cannot otherwise afford legal counsel.
Bruce Tuckman developed a 5 stage model of group development: forming, storming, norming, performing, and adjourning. The model describes how groups change and develop tasks over time. At each stage, the document outlines typical group behaviors and the role of the trainer in facilitating the group's progression through the stages.
Inequalities in health comparison in Nigeria.pptxMbereobong
There are significant health inequalities between different populations and socioeconomic groups. Factors like where one lives, grows up, works, and ages all impact health. Disadvantaged groups have less access to healthcare and suffer worse health outcomes. National policies aim to address these inequalities, but they persist due to socioeconomic, governmental, and wealth disparities between populations. Effective policies require action on social determinants of health like income, education, housing, and transportation in addition to access to healthcare services.
Prospects and challenges of implementing a sustainable national health insura...Alexander Decker
This document summarizes a study that assessed the National Health Insurance Scheme (NHIS) in Ghana and examined sustainability challenges. The study was conducted in the Cape Coast Metropolis. Key findings include:
1) The NHIS has increased access to healthcare by reducing out-of-pocket costs and self-medication, but issues like maintaining membership, timely provider payments, and institutional capacity need attention for long-term sustainability.
2) Interviews were conducted with insured and uninsured individuals, pharmacy operators, and NHIS staff to understand impacts and challenges from multiple perspectives.
3) For the NHIS to be sustainable, membership retention and expansion, consistent provider reimbursements, and strong management capacity are critical issues
Policy Brief: What Steps Are Countries Taking To Implement Pro-Poor Universal...HFG Project
Universal health coverage (UHC)—ensuring that everyone has access to quality, affordable health services when needed—can be a vehicle for improved equity, health, financial well-being, and economic development. In its 2013 report, Global Health 2035: A World Converging within a Generation, the Commission on Investing in Health made the case that pro-poor pathways towards UHC, which target the poor from the outset, are the most efficient way to achieve both improved health outcomes and increased financial protection (FP). Countries worldwide are now embarking on health system changes to move closer to achieving UHC, often with a clear pro-poor intent.
Much has been written about what steps countries have taken and are currently taking to: (1) set and expand guaranteed services, (2) develop health financing systems to fund guaranteed services and ensure FP, (3) ensure high-quality service availability and delivery, (4) improve governance and management of the health sector, and (5) strengthen other aspects of health systems to move closer to UHC. As background for a meeting on UHC implementation, held at the Rockefeller Foundation’s Bellagio Center, Italy, from 7–9 July 2015, we reviewed this body of literature, and conducted interviews with global UHC implementers and researchers. In this short policy brief, we synthesize the key messages from the literature and interviews.
Community Health Financing as a Pathway to Universal Health Coverage: Synthes...HFG Project
Community-based health insurance (CBHI) emerged in West Africa the 1990s as a grassroots response among rural and poor communities to fees charged by private and public clinics and hospitals. Three countries – Ghana, Senegal, and Ethiopia – have leveraged CBHI in different ways to expand publicly funded coverage to the informal sector in rural and urban settings. This paper synthesizes the experiences from these three countries to illustrate the role that CBHI can play in UHC.
Name Ibrahim ZirekogluProfessor David CoiaCourse .docxniraj57
Name: Ibrahim Zirekoglu
Professor: David Coia
Course: ENG 115
Date: 2/1/2014
Heath is one of the basic needs that require a lot more attention in terms of public recognition. There are people in the world who cannot access quality and affordable health care. The
[DAC1]
move by some governments to introduce medical schemes to make healthcare esily accessible is good. However, the majority of the population in the middle and lower classes cannot benefit from this scheme despite its many advantages. For one to subscribe, they have to overlook a number of potential factors. Medical insurance providers operate on very strict rules and regulations that govern their daily transactions (Green & Rowell, 2013). These include timely payment of premiums and the prescribed amount for the insured. The organization-Trust Free Care Centre-has developed a plan to give attention to those who cannot get medical care due to poverty and related issues. The opening of a clinic in the area to cater for the less privileged financially will be a major breakthrough in the area for the natives
[DAC2]
.
Economic issues
The capacity to afford healthcare is dependent on the economic independence of a person. The introduction of medical insurance, on the other hand, is a major problem tom the poor. This is because those who cannot potentially afford to pay for the premium find themselves in horrible situations when sickness occurs (Green & Rowell, 2013). Therefore, when one faces an important and unavoidable need, a reliable source of income is necessary. Unemployment comes as a threat to them because it could deprive them of the ability to pay. This is because it is a permanent and very uncompromising situation. When people lacks money, they suffer a number of ailments from psychological to mental illness.
There are people who are actively in employment but earn little.
[DAC3]
This makes them languish in a class where everything they yearn to do becomes a nightmare. With the ever-increasing healthcare costs, medical insurance companies also hike their premiums. Therefore, potential insured cannot access this scheme to help them when they are sick. They become unable to meet the minimum requirements to join the insurance sector that can improve their lives. This makes them shun even seeking medical attention when the need arises. These important economic factors discussed above hinder people for living simple worth lives. The organization
[DAC4]
has the capacity to consolidate all the available economic factors to make the program a success. This will
[DAC5]
include the need to doing all possible things to ensure that all people can afford health care. In addition, this will be beneficial as it will enhance lowering of the poverty levels.
[DAC6]
Needs of the population
The population in question for this benefit has health as their core special need. This translates to having an instance in which medical care affordability in reach for everyone.
[DAC7]
The .
Prompted by the 20th anniversary of the 1993 World Development Report, a Lancet Commission revisited the case for investment in health and developed a new investment frame work to achieve dramatic health gains by 2035. Our report has four key messages, each accompanied by opportunities for action by national governments of low-income and middle-income countries and by the international community.
Extending social health insurance to the informal sector in kenyaDr Lendy Spires
This paper analyzes factors affecting demand for health insurance among informal sector workers in Kenya by assessing their perceptions, knowledge, and concerns regarding the National Hospital Insurance Fund (NHIF). Focus group discussions with informal sector workers found that the primary barrier to NHIF enrollment is a lack of knowledge about enrollment options and procedures. While some cited inability to pay, most expressed interest in health insurance and a willingness to pay for it. In sum, the determinants of NHIF demand were found to be less complex than expected and could be addressed through awareness raising, improving insurance design, and setting affordable contribution rates.
Concept and definitions
Health education
Beliefs and approaches in health promotion
Health promotion strategies and priority actions
Public health, social movement, health inequity and millennium goals
Canadian experience in health promotion
Conclusion
Improving Efficiency to Achieve Health System Goals in Botswana: Background P...HFG Project
Health outcomes have improved in Botswana over the last few decades. These successes have come at the same time as overall macroeconomic growth, with annual Gross Domestic Product (GDP) growth averaging around 6 percent between 2010 and 2015 (IMF 2015), and Human Development Index ranking above the regional average. These improvements originate in a strong health service delivery system. In 2008, Botswana’s public health system included 338 health posts and 277 health clinics, sufficient to ensure that at least 80 percent of the population has coverage of essential, high-impact services. Management of these services was initially done by the Ministry of Local Government but has been transferred to district health teams under the Ministry of Health (MOH). As of 2008, Botswana’s public health system also had 17 primary hospitals, 14 district hospitals, two referral hospitals, and one mental health hospital; these hospitals are managed by the central government.
This document provides an overview of health systems strengthening. It defines key concepts including health systems, health system strengthening, and the four main functions of a health system: stewardship, financing, human and physical resources, and service delivery. It then discusses each function in more detail, including how policies and programs can influence health outcomes through strengthening different parts of the health system. The goal is to help organizations and implementers understand health systems and how their work can benefit from health systems approaches.
Running Head UNIVERSAL HEATH CARE1UNIVERSAL HEATH CARE.docxtoltonkendal
Running Head: UNIVERSAL HEATH CARE
1
UNIVERSAL HEATH CARE
5
Universal Healthcare
Tasha Smith
Zachary Martin
04/16/2016
Universal Health Care
Universal healthcare has had significant reforms. One of the significant changes is the provision of free healthcare. It is an undeniable fact that the provision of free health services has some benefits. The benefits of provision of free universal healthcare include improved health care to people. Universal healthcare provides accessible health services to the population in different regions in the world. Universal health care has reduced high poverty levels. Poor people can access specialized treatment such as cancer.
Universal health care has seen the majority population seek preventive care to avert the occurrence of diseases such as cancer. Another advantage is that universal health care coverage promotes equality and fairness. Irrespective of income or wealth, every person can access health care services in any part of the world. Universal health care coverage leads to decrease in healthcare administrative costs. This is a positive impact on the healthcare organizations. A single body has undertaken all administrative activities such as billing and insurance payouts.
Universal healthcare has led to economic growth and better living standards since population does not spend much money paying for health care services. The money that could have been used for healthcare services have been put in income generating activities such as business resulting in economic growth and development and improved standards of living of the general population.
However, they are various disadvantages of having universal health care. Several experts have studied the cons of universal healthcare. They argue out that universal healthcare reduces standards of healthcare. The paper presents an argument that denies the notion that universal health care should be available and free to every person. Universal healthcare coverage should not be provided to all patients because it results in adverse implications such as long waiting time, socialism state as well as an increased government time.
Long Wait Time
This type of healthcare system results in patients waiting for long to be served by medical practitioners. The numbers of patients are many, congesting hospitals, clinics, sanatoriums, and dispensaries. The system then becomes slow and tedious for the few hospital workers. Long wait time causes weak submission of services, poor sanitation and hence degrading overall value of health care. A patient may go the emergency room with an emergency but kept waiting because of a patient who came earlier with a less severe medical condition, for example, the flu. (Niles, 2014)
Leads to Socialism State
A socialism state refers to a state whereby people work and are forced to share their earnings with people who may not be working. Universal health care would require the government to raise ...
Universal health coverage (UHC)—ensuring that everyone has access to quality, affordable health services when needed—can be a vehicle for improved equity, health, financial well-being, and economic development. In its 2013 report, Global Health 2035, the Commission on Investing in Health (CIH) made the case that progressive (“pro-poor”) pathways towards UHC, which target the poor from the outset, are the most efficient way to achieve both improved health outcomes and increased financial protection (FP). Countries worldwide are now embarking on health system changes to move closer to achieving UHC, often with a clear pro-poor intent. While they can draw on guidance related to the technical aspects of UHC (the “what” of UHC), such as on service package design, there is less information on the “how” of UHC—that is, on how to maximize the chances of successful implementation.
Motivated by a shared interest in helping to close this information gap, a diverse international group of 21 practitioners and academics, including ministry of health officials and representatives of global health agencies and foundations, convened at The Rockefeller Foundation’s Bellagio Center for a three-day workshop from July 7–9, 2015. The participants shared their experiences of implementing UHC and discussed the limited evidence on how to implement UHC, focusing on a set of seven key “how” questions from across five domains of UHC.
The health of a people to a very large extent determines their productivity and wealth. The 2010
Population and Housing Census indicates that a significant proportion of the Bunkpurugu-Yunyoo District in
Ghana (over 75%) are living below the poverty line of GH¢228.00 per annum (approximately US $120 per
annum). It then implies that approximately the same proportion or even a little above that might not be able to
access health care under the ‘cash and carry’ system. Inability to access health care will lead to poor health
status of the residents and thus lower their productivity.
This document provides an overview of universal health coverage. It defines universal health coverage as access for all to quality health services without financial hardship. The document discusses why moving toward universal health coverage is important for health, economic, and political benefits. It also examines how countries can accelerate progress through health financing reforms and by raising sufficient funds, pooling resources, and purchasing health services. Key challenges around measuring and achieving equity in universal health coverage are also addressed.
This document introduces a proposed local project ("Live Sustainably – Live Well") to support attainment of the UN Sustainable Development Goals and WHO Health 2020 policy framework through local action. It recommends developing local guidance and monitoring of health and sustainability indicators. This could inform decision-making and have local benefits similar to the Transition Network's REconomy Project. The document outlines the UN and WHO policies and argues local action can help achieve their aims through increased participation and informed decisions made at the appropriate local level.
Well-designed social protection systems can improve the lives of people and r...DRIVERS
Policy brief produced by the DRIVERS project, aimed at practitioners and policy makers. Provides information about how income & social protection are important for health and health inequalities, solutions to improve health equity, and opportunities to advocate at the national and European levels.
Public health policy development in developing countries Ruby Med Plus
Public Health policy development in developing countries is addressed by four policy questions:
1. Does the introduction of a health policy at national, international level imply corresponding improvement in the quality of health of a country/population?
2. For effective health systems with efficient outcome: should health related policies be locally/nationally or internationally motivated (initiated)?
3. Should developing countries rely on the West for changes in the health of their population?
4. What is the impact of health policies adopted at the international scene on the health of populations in developing countries?
Similar to Tmih Michielsen Et Al. (2010) Transformative Social Protection In Health (20)
Public health policy development in developing countries
Tmih Michielsen Et Al. (2010) Transformative Social Protection In Health
1. Tropical Medicine and International Health doi:10.1111/j.1365-3156.2010.02529.x
volume 15 no 6 pp 654–658 june 2010
Editorial
Social protection in health: the need for a transformative
dimension
Joris J. A. Michielsen1, Herman Meulemans1, Werner Soors2, Pascal Ndiaye2, Narayanan Devadasan3,
Tom De Herdt4, Gerlinde Verbist5 and Bart Criel2
1 Research Centre for Longitudinal and Life Course Studies, University of Antwerp, Belgium
2 Unit of Health Policy and Financing, Institute of Tropical Medicine, Antwerp, Belgium
3 Institute of Public Health, Bangaluru, India
4 Institute of Development Policy and Management, University of Antwerp, Belgium
5 Herman Deleeck Centre for Social Policy, University of Antwerp, Belgium
keywords social protection, social transformation, social exclusion, health inequity, health policy,
health care economics and organisation
Today, Social Protection in Health (SPH) is commonly citizenship, in most developing countries, it typically did
understood as an arrangement safeguarding income and not cover more than a few fortunate groups because of
financial support in case of sickness and ensuring that all financial and labour market-related constraints (DESA
people in need have effective access to adequate care of 2007). Similarly, tax-funded public provision of health care
sound quality (ILO 2008). Yet, for many people world- services also turned out to be problematic in the developing
wide, affordable health care of good quality remains world and was rarely achieved in terms of coverage and
elusive. Especially in developing countries, large groups of quality. Financial constraints and liberalisation led to a
citizens remain uncovered by adequate mechanisms for steady rollback in public provision of health care and social
SPH of any kind. For the excluded, illness jeopardises more protection. The introduction of user fees for health care in
than just their health. Their predicament often boils down the 1980s prompted the initiation of private non-profit
to the uneasy choice between forgoing treatment and Community Health Insurance (CHI) by non-government
getting trapped in a downward spiral of impoverishment organisations (Criel et al. 2008). Alongside CHI and other
because of high health care expenses (Whitehead et al. private savings-account schemes, there has also been a shift
2001). According to the International Labour Organiza- to means-tested safety nets, implying targeting (DESA
tion (ILO), 80% of the world population remains excluded 2007, 2009). In most developing countries, the picture
from adequate social protection (Pal et al. 2005). The today is one of a rich variety of organisational arrange-
World Health Organization (WHO) (2004) estimates that ments of SPH [SHI, private-for-profit health insurance,
each year 178 million people suffer financial catastrophe as CHI, maternity benefit schemes, Health Equity Funds
a result of out-of-pocket health payments while 104 (HEF), conditional cash transfers and health vouchers
million are forced into poverty simply because of health amongst others], but with, unfortunately, poor results.
payments. These deficits in social protection were well Still, there is room for hope. At least in the international
documented before the current financial crisis and are policy sphere, the strong relationship between health and
likely to become worse if no appropriate action is poverty was recognised by the inclusion of three specific
undertaken (ILO/WHO 2009). Today, ILO estimates that health objectives amongst the eight Millennium Develop-
30–36% of the world population (and more than 74% of ment Goals. From 2004 on, a consortium led by the
the population in developing countries) has no effective German Gesellschaft fur Technische Zusammenarbeit
¨
access to basic medical services (ILO 2010). (GTZ), ILO and WHO has made a plea for the extension
In most developing countries, formal SPH is of recent of SPH in developing countries (ILO/GTZ/WHO 2007). In
origin. In the early independence years, Social Health 2005, ILO experts calculated that basic social protection –
Insurance (SHI) – a European public construct geared to a including health – would be affordable in poor countries,
model of industrial labour – was the norm. While, in within a reasonable timeframe (Pal et al. 2005). In 2008,
principle, SHI aims at universal entitlement based on the WHO Commission on Social Determinants of Health
654 ª 2010 Blackwell Publishing Ltd
2. Tropical Medicine and International Health volume 15 no 6 pp 654–658 june 2010
J. J. A. Michielsen et al. The need for transformative social protection in health
called for global action on the social determinants of health existing inequities and intensify exclusion, but they can
with the aim of achieving health equity in a generation and also serve as arenas to challenge and overcome inequities
stressed universal social protection as a necessary living and foster empowerment and inclusion. SPH is no excep-
condition (CSDH 2008). The subsequent World Health tion: it can be an oppressive or an emancipative tool.
Report put forward universal coverage and protection as A comprehensive framework for analysing the power
core components of action (WHO 2008). From 2009 on, dynamics of SPH would benefit from the concept of
the United Nations Chief Executives Board has been transformative social protection as developed by Devereux
making a plea for a social protection floor, a minimum and Sabates-Wheeler (2004). In a reaction to the over-
package of essential services and social transfers meant to emphasis on economic vulnerability in mainstream social
counter the economic crisis and its negative impact on protection frameworks, Devereux and Sabates-Wheeler
human development, including health (ILO/WHO 2009). pointed out the need for social protection as a set of public
At country level, national governments increasingly and private initiatives, both formal and informal, that
reassume responsibility for SPH. The cases of Ghana and provide: ‘social assistance to extremely poor individuals
India are illustrative. Ghana initiated its National Health and households; social services to groups who need special
Insurance Scheme in 2003, as one effort amongst others to care or would otherwise be denied access to basic services;
reach the Millennium Development Goals (Agyepong & social insurance to protect people against the risks and
Adjei 2008). The federal Indian government started the consequences of livelihood shocks; and social equity to
publicly subsidised national health insurance scheme protect people against social risks such as discrimination or
Rashtriya Swasthya Bima Yojana for below poverty line abuse’ (Devereux & Sabates-Wheeler 2004). Accordingly,
families in 2008 (Devadasan & Swarup 2008). While these they extended ILO’s provision-prevention-promotion
initiatives are not without challenges, they do indicate a framework (Van Ginneken 1999), including also transfor-
pendulum shift towards renewed government involvement. mative measures to challenge existing power imbalances
that actually cause social vulnerability and exclusion.
When applied to health, the key hypothesis of this
The need for a framework: transformative social
expanded social protection framework resonates with the
protection in health
call for action of the WHO Commission on Social
Given the myriad of current SPH arrangements and the fact Determinants on Health: ‘Tackle the inequitable distribu-
that exclusion is still widespread, it is legitimate to question tion of power, money, and resources – the structural
what adequate SPH should entail. The current perspective drivers of the conditions of daily life – globally, nationally,
on SPH is largely technical: i.e. it zooms in on the benefits and locally’ (CSDH, 2008).
offered and the population coverage achieved by specific
We propose to adopt the transformative social protec-
SPH interventions. Without minimising the importance of
tion framework in the study of SPH. We argue that to be
appropriate technical designs, we argue that the impact of
effective, SPH interventions also need to address the
SPH arrangements is also related to the extent to which
structural determinants of power imbalances and social
they succeed in transforming those socio-political and
exclusion in health. We suggest conceptualising transfor-
institutional elements that create and sustain people’s
mative SPH as three overlapping functions with one
vulnerability when falling ill.
crosscutting dimension:
Combining a capability approach to poverty (Sen 1999)
and a social exclusion approach (Vranken 2009), Basti- • The function of provision: providing relief from
aensen et al. (2005) argued that poverty-reduction strate- deprivation caused by limited access to healthcare
gies cannot be dissociated from the local institutional (e.g. social assistance, health vouchers, HEF, abolition
context in which they are developed. They need to take of user fees for the extreme poor);
into account this context to promote empowerment • The function of prevention: preventing deprivation
through well-considered provision of entitlements and and impoverishment caused by health-related expen-
capabilities and eventually to be effective. If social diture or loss of resources during illness (e.g. SHI,
inequities are not carefully taken into consideration, the CHI, total abolition of user fees);
interventions run the risk of reproducing or even rein- • The function of promotion: enhancing real incomes
forcing exclusion. Mackintosh and Tibandebage (2004) and capabilities (e.g. an increase in economic pro-
pointed to the same complexity in the domain of health. ductivity because of better health, abolition of school
Health systems are social constructs that reflect the social fees in exchange for health service utilisation);
inequities and exclusions that exist in the society in which • The dimension of transformation: transforming the
they are embedded. Health systems can thus reinforce social and institutional context of the health system to
ª 2010 Blackwell Publishing Ltd 655
3. Tropical Medicine and International Health volume 15 no 6 pp 654–658 june 2010
J. J. A. Michielsen et al. The need for transformative social protection in health
counteract exclusion and deprivation of the right to change that providers did not necessarily like as it
health and quality care. challenged existing power hierarchies: ‘Les mutualistes
´ ´ `
ont un agent bien determine a les defendre efficacement.
´
The transformative dimension cuts across the functions of Il nous bouscule suffisamment chaque fois qu’un
provision, prevention and promotion and may occur at all `
mutualiste n’est pas mis a l’aise ...’ (Criel et al. 2005).
levels within a health system (Michielsen et al. 2009): the Leverage through social workers is not exclusive to CHI: in
micro-level of the household and community, i.e. the HEF experiences in Cambodia (Noirhomme et al. 2007)
individual distribution of resource ownership, access and Mauritania (Criel et al. 2010), the involvement of
and use; the meso-level, i.e. the interaction of individuals and social workers provided the poorest with a continuum of
groups with service providers and local institutions; and the care they were formerly deprived from. Nor is the effect of
macro-level, i.e. regional, national and international policy- CHI necessarily transformative; it can also be a-transfor-
making circles and the broader society. The following mative or even anti-transformative. In Cinzana, Mali,
examples, which come from our own field experience with moral hazard of the health care provider towards CHI
CHI and HEF, illustrate possible transformative dynamics in members – and the CHI management being unaware of
different contexts in Africa and Asia. this problem – initially increased the CHI members’
At the micro-level data from focus group discussions in dependency by increasing the cost of medical care (Soors &
Nongon, Mali suggest that membership of the local CHI Criel 2009).
scheme improves the social position of women within the Recent publications on SPH arrangements other than
household. Apart from prevention against health-related CHI and HEF implicitly recognise the presence of trans-
impoverishment, female members also seem to acquire formative (and a-transformative) elements at micro- and
more power in the decision-making process over health. meso-level. Conditional cash transfer programmes (CCTs)
They become less dependent on their husband: ‘Si tu es are a case in point. CCTs are a particular form of social
dans la mutuelle, meme si ton mari n’accepte pas t’amener
ˆ assistance that transfer funds to members of a targeted
au centre, tu peux partir te faire soigner avec le petit population provided they follow a specified course of
morceau d’argent que tu as’ (Ndiaye et al. 2008). In a action (Barrientos 2009). Transformation through a CCT
different context, a decrease in dependency is also visible at is documented in Nicaragua’s Red de Proteccion Social
´
community level. Analysis of some CHI schemes in Indore (RPS), in operation from 2000 until 2005 and with
and Agra, India, shows a drop in the level of loans from important health components. Evaluation of RPS revealed
informal moneylenders taken up by the insured. These that the programme had gradually improved self-esteem
schemes therefore not only provide economic protection, and bargaining power of the women in the targeted
but also reduce the need to enter patronising relationships households (Moore 2009). A-transformation through a
(Agrawal 2008). CCT is documented in Mexico’s Oportunidades – one of
At the meso-level of the interface between patients and the most publicised CCTs to date – in operation since
providers, SPH interventions could improve the access to 2002, and also with substantial health components. An
quality health care by combining upgrading of the avail- early internal evaluation expected to find evidence of
able health infrastructure with the generation of both decreased child labour – because of increased school
formal and informal accountability mechanisms. Data attendance – but had to admit that no decrease in child
from focus group discussions in Pune, India, illustrate how labour had taken place (Escobar & Gonzalez de la Rocha
´
such dual accountability by way of a CHI scheme can 2003). Reviewing CCTs in six countries, Bastagli (2009)
improve quality of health care used by female slum identifies how different institutional arrangements in CCTs
dwellers. Formally, the CHI scheme monitors the technical can lead to opposing outcomes. In a recent and compre-
quality of the health care providers. It also fosters hensive review of initiatives for poverty reduction (DESA
interpersonal quality through social workers, who mediate 2009), the authors point to the questionable assumption of
between CHI members and hospital staff in case of CCTs that poor people do not have the capacity to
perceived maltreatment. The engagement of social workers understand what is in their best health interest, implying an
has an informal empowering effect on the female slum intrinsic absence of empowerment in most CCTs.
dwellers: ‘Doctors are afraid of us. They think we are At the macro-level of policy-making, West African
social workers, if we complain, they will lose their job; so federations of CHI schemes – such as the Union Technique
they treat us properly’ (Michielsen et al. 2009). A similar de la Mutualite Malienne in Mali and the Coordination
´
emancipative effect was noticed in the Guinean CHI Regionale des Mutuelles de Sante de Thies in Senegal – play
´ ´ `
scheme of Maliando, where patients gained voice and an important role in lobbying for pro-poor decisions
confidence in claiming their right to good quality care – a (Fonteneau & Galland 2006), such as developing a
656 ª 2010 Blackwell Publishing Ltd
4. Tropical Medicine and International Health volume 15 no 6 pp 654–658 june 2010
J. J. A. Michielsen et al. The need for transformative social protection in health
regulatory framework for health insurance and developing Criel B, Ba AS, Kane F, Noirhomme M & Waelkens MP (2010)
ˆ
proper accountability measures of insurance organisations. Une Experience de Protection Sociale en Sante pour les Plus
´ ´
Demunis : Le Fonds d’Indigence de Dar-Naım en Mauritanie.
´ ¨
Studies in Health Services Organisation & Policy, 26, ITGPress,
Conclusion Antwerp.
CSDH (2008) Closing the Gap in a Generation: Health Equity
We argue that SPH, in addition to important provision,
Through Action on the Social Determinants of Health. Final
prevention and promotion functions, also needs to address Report of the Commission on Social Determinants of Health.
the structural determinants of health-related social vul- World Health Organization, Commission on Social Determi-
nerability. In other words, it needs to be transformative. nants of Health, Geneva.
We advocate the use of a transformative social protection DESA (2007) Report on the World Social Situation (2007) The
framework in the study and evaluation of SPH. Taking Employment Imperative. United Nations, Department of
stock of transformative, a-transformative and anti-trans- Economic and Social Affairs, New York.
formative elements of any SPH arrangement is essential to DESA (2010) Report on the World Social Situation 2010:
understand and maximise its contribution to health and Rethinking Poverty. United Nations, Department of Economic
and Social Affairs, New York.
development. We are aware that the prism of transforma-
Devadasan N & Swarup A (2008) Rashtriya Swathya Bima
tive SPH needs more empirical testing. This should also
Yojana: an overview. Insurance Regulatory and Development
contribute to fine-tuning a still incipient tool. The use of Journal IV, 33–36.
the framework will hopefully contribute to the orientation Devereux S & Sabates-Wheeler R (2004) Transformative Social
of the design, implementation and evaluation of SPH in the Protection. Institute for Development Studies. Working Paper
direction of sustainable empowerment of the excluded, in 232, Brighton.
health and beyond. Escobar A & Gonzalez de la Rocha M (2003) Evaluacion Cua-
´ ´
To put it bluntly: SPH will be transformative, or will not litativa del Programa de Desarrollo Humano Oportunidades.
be social. And transformative SPH leads to more effective Serie Documentos de Investigacion Secretaria de Desarrollo
´
social protection. The time is now. Social, 3, Mexico.
Fonteneau B & Galland B (2006) The community-based model:
mutual health organizations in Africa. In: Protecting the Poor A
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Corresponding Author Joris J. A. Michielsen, Research Centre for Longitudinal and Life Course Studies, University of Antwerp,
Belgium. E-mail: joris.michielsen@ua.ac.be
658 ª 2010 Blackwell Publishing Ltd