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| 1 |
ID:
133883
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2014.
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| Summary/Abstract |
Access to public health care has often been equated with health outcomes. Outcomes-based analysis often misunderstands the process of access to health. This article conceives access to health as a bundled concept and decomposes access into availability, affordability and acceptability. Access to health is determined by public provisioning as well as by socio-economic characteristics of households. It attempts to examine these dimensions across different regions of the Indian state of Uttar Pradesh (UP). It shows that there are variations across regions and socio-economic characteristics of households. A particular group from one region may not have the same degree of access as its counterpart in another region and at the same time there are variations across groups in the same region. The scale of development of regions also plays an important role in promoting or hindering access to health.
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| 2 |
ID:
130707
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2014.
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| Summary/Abstract |
In the wake of China's rapid ascendancy, are there any new rules made by the country in global health governance? This article examines China's emerging role in the Agreement on Trade Related Aspects of Intellectual Property Rights and finds that China adopts a pro-status quo stance on patented medicines. Aspiring to develop its own pharmaceutical sector to be capable to produce patented medicines on a par with the West, it has little appetite for using the prevailing rules or making new rules that are to the liking of the developing world. Undoubtedly, China is a new player in global health governance but has yet to have agenda-setting intent and capacity. This article argues that China's behavior and preferences can be explained by its dualistic national identities, the dominant position of realism in both the study of international relations and policy circles, and an underdevelopment of epistemic community in global health governance in the country.
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| 3 |
ID:
112937
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2012.
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Understanding the energy consumption and emissions associated with health services is important for minimizing their environmental impact and guiding their adaptation to a low-carbon economy. In this post-hoc analysis, we characterize the energy burden of North American emergency medical services (EMS) agencies and estimate the potential marginal damage costs arising from their emissions as an example of how and why health services matter in environmental and energy policy, and how and why environmental and energy policy matter to health services. We demonstrate EMS systems are energy intensive, and that vehicle fuels represent 80% of their energy burden while electricity and natural gas represent 20%. We also demonstrate that emissions from EMS operations represent only a small fraction of estimated health sector emissions, but for EMS systems in the United States the associated marginal damage costs are likely between $2.7 million and $9.7 million annually. Significant changes in the supply or price of energy, including changes that arise from environmental and energy policy initiatives designed to constrain fossil fuel consumption, could potentially affect EMS agencies and other health services. We encourage cross disciplinary research to proactively facilitate the health system's adaptation to a low-carbon economy.
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| 4 |
ID:
111212
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2012.
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| Summary/Abstract |
The survey aims to explore the attitudes of physicians, nurses, pharmacists, pharmaceutical representatives, and patients from two provinces of Turkey, Nevsehir and Istanbul, in context of ethical conduct within the health services and the relation between the health services and its suppliers, particularly the pharmaceutical industry. Quantitative and qualitative methods were used together. The questionnaire interviews were conveyed to a total of 1540 people and eight focus group discussions to 85 people during April-May 2009. The most common unethical acts in medical practice are "knife payment"/additional informal payment, self-referral, patient discrimination, discrediting other physicians, unnecessary tests-interventions-prescriptions, accepting promotion and demand for personal-household goods, preferring products that come along with promotion, getting cash per box, sponsored vacations in the form of medical congress. Eliminating monetary relationship between the physician and the patient; discouraging close contact of the physician and the healthcare institution with the pharmaceutical industry; implementing commissions in hospitals to supervise physicians for preventing patient discrimination and unnecessary interventions within the framework of good clinical practices; building a supreme board of medical journalism to prevent artificial demand for medical interventions and creation of false hopes, are the proposed precautions for corruption in health services.
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| 5 |
ID:
124957
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2013.
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| Summary/Abstract |
A safe, consistent blood supply in Pakistan is critical in combating maternal deaths due to haemorrhage. The dominant form of blood donation in Pakistan is a directed-replacement system. Complex sociocultural values influence from whom a recipient can receive blood. This focused ethnography aimed to investigate if, in this patriarchal society, the gender of the recipient influences who will donate blood. Data were collected from the district of Rawalpindi/Islamabad, Jhelum and Layyah in 2009 and 2012. Findings revealed that gendered notions of blood and blood donation construct reproductive blood loss as less serious than other types of blood loss. Husbands almost universally removed themselves from the process of blood procurement for their wives in the midst of a maternal health emergency. This was due to a combination of gender norms and beliefs about the power of blood, akin to the power of breast milk, to connect husbands and wives in a donor-recipient relationship that would lead to the negation of the marital contract. The inherent gendered devaluation of the lives of women was evident in the manner in which blood was procured for child-birthing women. These complex beliefs indicate that the idealized Euro-American blood system could be ineffective in this context.
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| 6 |
ID:
125309
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2013.
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| Summary/Abstract |
By 2015, we will have nearly eradicated extreme poverty and hanger throughout the world by halving the proportion of people living on under $1.25 per day. We will have achieved universal primary education worldwide, reduced child mortality rates by two thirds, and halted and reversed the spread of HIV/AIDS, malaria and other diseases. We will have promoted gender equality, improved maternal health, and ensured environmental sustainability. Or at least, this is the promise that we made to ourselves, and to each other, almost 15 years ago.
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| 7 |
ID:
131795
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2014.
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| Summary/Abstract |
Increasing participation in decision-making processes by service users is one of the objectives of decentralisation reforms in Tanzania. The argument is that decentralisation enhances participation by all sections of the community, and by women in particular, and results in decisions that better reflect local needs. This paper examines the impact of decentralisation reforms on service users' participation for delivery of water and health services in rural Tanzania, using a gender perspective and principal-agent theory. The paper investigates how decentralisation has fostered spaces for participation and how men and women use these spaces, and identifies factors that constrain or encourage women's participation. It shows that decentralisation reforms have created spaces for service users' participation at the local level. Participation in these spaces, however, differs between men and women, and is influenced by the socio-cultural norms within the household and community. Men have gained more leverage than women to exercise their agency as principals. Women's participation is contributing to addressing practical gender needs, but strategic gender needs have been less adequately addressed because gendered power relations have been largely untouched by the reforms.
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| 8 |
ID:
133181
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2014.
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| Summary/Abstract |
In this paper, we investigate the causal effect of education on health using an instrumental variable approach. The instruments we employ consist of two institutional changes in China that generated discontinuities in educational attainment among individuals. To ensure the validity of the instruments and obtain prudent conclusions, we adopt more restrictive identification tests than previous studies. The results indicate no causal impact of education on either perceived health or anthropometric health. With regard to the impact of education on male health behavior, namely smoking, we cannot provide conclusive results due to a violation of the exogeneity of our instruments. Nevertheless, we can confirm that education has no causal effect on female health behavior. To overcome the widely documented shortage of quasi-experimental identification, we also employ spouse's education as an alternative instrument to examine the causal effect of education. Identical results are obtained, with the exception that the impact of education on the reduction of overweight among women becomes significant. We conclude that this provides some evidence of a causal impact of education on health.
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| 9 |
ID:
130007
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2014.
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Conventional wisdom holds that although at the time of Kerala state formation in 1956 the northern region (Malabar) lagged behind the southern region (Travancore-Cochin) in development indicators, inter-regional disparities reduced considerably in ensuing decades. The reduction in regional disparities is typically attributed to modern Kerala's welfare policy regime, which emphasized greater growth of infrastructure facilities in Malabar. This study presents evidence for health that suggests that while disparities in outcomes reduced over time, disparities in key infrastructural inputs did not reduce. These differing trends for infrastructure and outcomes are consistentwith a diminishing returns argument that may have little to do directly with the Kerala regime. Rather, the potency of the Kerala regime lays in its ability to increase development inputs throughout the state (albeit without favoring the lagging region) and consolidate the conditions for "public action" to effectively demand and utilize these inputs.
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| 10 |
ID:
131010
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| Publication |
2014.
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| Summary/Abstract |
We address the consequences of corruption within a state on the extent to which populations have shortened life expectancy due to political corruption. Using three variables to estimate corruption, the results support the expectation that corruption increases average disability shortened life years (DALY). The results persist when estimating the model including measures of deaths from civil war and the number of bordering states experiencing civil war, both previously shown to have an effect on DALY, although these two variables are not statistically significant in our models. While the estimated effects of the corruption variables continue to capture much of the variation in DALY for a global group of nations, they completely fail to explain any variation in Sub-Saharan African states, probably because of the devastating effects of AIDS and malaria in that region. Finally, we discuss why this failure occurs and discuss the implications of our results.
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| 11 |
ID:
130708
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| Publication |
2014.
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| Summary/Abstract |
The Global Alliance for Vaccines and Immunization provides a most interesting example of effective cooperation between international organizations-especially the World Health Organization, the UN Children's Fund, and the World Bank. Based on extensive research and interviews, this article examines how and why this cooperation came about. The role of the Gates Foundation in providing massive financial support was certainly crucial. An adequate explanation must, however, involve more than what might be called "buying cooperation"; trust played a crucial role. By studying this particular case in detail, this article raises some interesting theoretical issues about the role of trust in global governance.
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