Policy Making: The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures.Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.Politics: Activities concerned with governmental policies, functions, etc.European Union: The collective designation of three organizations with common membership: the European Economic Community (Common Market), the European Coal and Steel Community, and the European Atomic Energy Community (Euratom). It was known as the European Community until 1994. It is primarily an economic union with the principal objectives of free movement of goods, capital, and labor. Professional services, social, medical and paramedical, are subsumed under labor. The constituent countries are Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain, Sweden, and the United Kingdom. (The World Almanac and Book of Facts 1997, p842)Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health.Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level.United StatesEvidence-Based Medicine: An approach of practicing medicine with the goal to improve and evaluate patient care. It requires the judicious integration of best research evidence with the patient's values to make decisions about medical care. This method is to help physicians make proper diagnosis, devise best testing plan, choose best treatment and methods of disease prevention, as well as develop guidelines for large groups of patients with the same disease. (from JAMA 296 (9), 2006)Health Services Research: The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed)Organizational Policy: A course or method of action selected, usually by an organization, institution, university, society, etc., from among alternatives to guide and determine present and future decisions and positions on matters of public interest or social concern. It does not include internal policy relating to organization and administration within the corporate body, for which ORGANIZATION AND ADMINISTRATION is available.Policy: A course or method of action selected to guide and determine present and future decisions.Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea.Environmental Policy: A course of action or principle adopted or proposed by a government, party, business, or individual that concerns human interactions with nature and natural resources.
Chronic care: Chronic care refers to medical care which addresses pre-existing or long term illness, as opposed to acute care which is concerned with short term or severe illness of brief duration. Chronic medical conditions include asthma, diabetes, emphysema, chronic bronchitis, congestive heart disease, cirrhosis of the liver, hypertension and depression.Health policy: Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific health care goals within a society."World Health Organization.Opinion polling in the Philippine presidential election, 2010: Opinion polling (popularly known as surveys in the Philippines) for the 2010 Philippine presidential election is managed by two major polling firms: Social Weather Stations and Pulse Asia, and several minor polling firms. The polling firms conducted surveys both prior and after the deadline for filing of certificates of candidacies on December 1, 2009.European Union climate and energy package: The European plan on climate change consists of a range of measures adopted by the members of the European Union to fight against climate change. The plan was launched in March 2007, and after months of tough negotiations between the member countries, it was adopted by the European Parliament on December 2008.Great Lakes Environmental Research Laboratory: right|300px|thumb|Great Lakes Environmental Research Laboratory logo.Public Health Act: Public Health Act is a stock short title used in the United Kingdom for legislation relating to public health.List of Parliamentary constituencies in Kent: The ceremonial county of Kent,Bestbets: BestBETS (Best Evidence Topic Reports) is a system designed by emergency physicians at Manchester Royal Infirmary, UK. It was conceived as a way of allowing busy clinicians to solve real clinical problems using published evidence.The Final Decision: The Final Decision is an episode from season 1 of the animated TV series X-Men Animated Series.Canadian House of Commons Standing Committee on Environment and Sustainable Development: The Canadian House of Commons Standing Committee on Environment and Sustainable Development (ENVI) is a standing committee in the Canadian House of Commons.
(1/1177) Tobacco control advocates must demand high-quality media campaigns: the California experience.
OBJECTIVE: To document efforts on the part of public officials in California to soften the media campaign's attack on the tobacco industry and to analyse strategies to counter those efforts on the part of tobacco control advocates. METHODS: Data were gathered from interviews with programme participants, direct observation, written materials, and media stories. In addition, internal documents were released by the state's Department of Health Services in response to requests made under the California Public Records Act by Americans for Nonsmokers' Rights. Finally, a draft of the paper was circulated to 11 key players for their comments. RESULTS: In 1988 california voters enacted Proposition 99, an initiative that raised the tobacco tax by $0.25 and allocated 20% of the revenues to anti-tobacco education. A media campaign, which was part of the education programme, directly attacked the tobacco industry, exposing the media campaign to politically based efforts to shut it down or soften it. Through use of outsider strategies such as advertising, press conferences, and public meetings, programme advocates were able to counter the efforts to soften the campaign. CONCLUSION: Anti-tobacco media campaigns that expose industry manipulation are a key component of an effective tobacco control programme. The effectiveness of these campaigns, however, makes them a target for elimination by the tobacco industry. The experience from California demonstrates the need for continuing, aggressive intervention by nongovernmental organisations in order to maintain the quality of anti-tobacco media campaigns. (+info)
(2/1177) Reforming the health sector in developing countries: the central role of policy analysis.
Policy analysis is an established discipline in the industrialized world, yet its application to developing countries has been limited. The health sector in particular appears to have been neglected. This is surprising because there is a well recognized crisis in health systems, and prescriptions abound of what health policy reforms countries should introduce. However, little attention has been paid to how countries should carry out reforms, much less who is likely to favour or resist such policies. This paper argues that much health policy wrongly focuses attention on the content of reform, and neglects the actors involved in policy reform (at the international, national sub-national levels), the processes contingent on developing and implementing change and the context within which policy is developed. Focus on policy content diverts attention from understanding the processes which explain why desired policy outcomes fail to emerge. The paper is organized in 4 sections. The first sets the scene, demonstrating how the shift from consensus to conflict in health policy established the need for a greater emphasis on policy analysis. The second section explores what is meant by policy analysis. The third investigates what other disciplines have written that help to develop a framework of analysis. And the final section suggests how policy analysis can be used not only to analyze the policy process, but also to plan. (+info)
(3/1177) Whose policy is it anyway? International and national influences on health policy development in Uganda.
As national resources for health decline, so dependence on international resources to finance the capital and recurrent costs is increasing. This dependence, combined with an increasing emphasis on policy-based, as opposed to project-based, lending and grant-making has been accompanied by greater involvement of international actors in the formation of national health policy. This paper explores the process of health policy development in Uganda and examines how major donors are influencing and conflicting with national policy-making bodies. Focusing on two examples of user fees and drugs policies, it argues that while the content of international prescriptions to strengthen the health system may not be bad in itself, the process by which they are applied potentially threatens national sovereignty and weakens mechanisms for ensuring accountability. It concludes by proposing that in order to increase the sustainability of policy reforms, much greater emphasis should be placed on strengthening national capacity for policy analysis and research, building up policy networks and enhancing the quality of information available to the public concerning key policy changes. (+info)
(4/1177) Overview: health financing reforms in Africa.
(5/1177) The fall and rise of cost sharing in Kenya: the impact of phased implementation.
The combined effects of increasing demand for health services and declining real public resources have recently led many governments in the developing world to explore various health financing alternatives. Faced with a significant decline during the 1980s in its real per capita expenditures, the Kenya Ministry of Health (MOH) introduced a new cost sharing programme in December 1989. The programme was part of a comprehensive health financing strategy which also included social insurance, efficiency measures, and private sector development. Early implementation problems led to the suspension in September 1990 of the outpatient registration fee, the major revenue source at the time. In 1991, the Ministry initiated a programme of management improvement and gradual re-introduction of an outpatient fee, but this time as a treatment fee. The new programme was carried out in phases, beginning at the national and provincial levels and proceeding to the local level. The impact of these changes was assessed with national revenue collection reports, quality of care surveys in 6 purposively selected indicator districts, and time series analysis of monthly utilization in these same districts. In contrast to the significant fall in revenue experienced over the period of the initial programme, the later management improvements and fee adjustments resulted in steady increases in revenue. As a percentage of total non-staff expenditures, fiscal year 1993-1994 revenue is estimated to have been 37% at provincial general hospitals, 20% at smaller hospitals, and 21% at health centres. Roughly one third of total revenue is derived from national insurance claims. Quality of care measures, though in some respects improved with cost sharing, were in general somewhat mixed and inconsistent. The 1989 outpatient registration fee led to an average reduction in utilization of 27% at provincial hospitals, 45% at district hospitals, and 33% at health centres. In contrast, phased introduction of the outpatient treatment fee beginning in 1992, combined with somewhat broader exemptions, was associated with much smaller decreases in outpatient utilization. It is suggested that implementing user fees in phases by level of health facility is important to gain patient acceptance, to develop the requisite management systems, and to orient ministry staff to the new systems. (+info)
(6/1177) Organisation of asthma care: what difference does it make? A systematic review of the literature.
OBJECTIVES: To evaluate the effectiveness of different forms of organisation (delivery) of asthma care. METHODS: A systematic review of the published evidence of effectiveness organisational methods of asthma management. Searches on computerised databases including Medline, CINAHL, and HELMIS, and relevant citations and letters to experts were used to identify relevant studies. RESULTS: 27 studies were identified that evaluated different organisational methods of delivery across both primary and secondary sectors, such as shared care, general practice asthma clinics, outpatient programmes, inpatient admissions policies, and the use of specialists. Only one third of the studies used a randomised controlled trial and many had small sample sizes. No conclusive evidence was found to favour any particular organisational form, although limited evidence would suggest that specialist care is better than general care and that shared care can be as effective as hospital led care. CONCLUSIONS: There is little good published research evaluating different ways of organising the delivery of asthma care. There is need for quality research on organisational methods of delivery of asthma care that could be used to inform policy makers, in particular examining whether patients treated by healthcare professional with expertise and interest in asthma will experience better outcomes. (+info)
(7/1177) HMOs and the efficiency of healthcare delivery.
HMOs and other forms of managed care continue to grow rapidly and remain the centerpiece of this nation's policies for health system reform. Despite a growing public and legislative backlash at managed care, there is no comprehensive theory of HMOs to guide policymakers and analysts. It is not yet clear whether managed care improves society's allocation of resources to and within the health sector. After examining HMOs within the context of Coase's theory of the firm, I argue that HMOs share characteristics with collective goods. This framework, and the expanded agency role of physicians under managed care, is used to evaluate the equity and efficiency characteristics of a system of competing HMOs. Other concerns that are increasingly associated with managed care also are addressed. (+info)
(8/1177) Eradicating guinea worm without wells: unrealized hopes of the Water Decade.
At the start of the United Nations International Drinking Water Supply and Sanitation Decade in the 1980s, guinea worm disease was targeted as the major indicator of the success of the Decade's efforts to promote safe water. By the late 1980s, most of the guinea worm endemic countries in Africa and South Asia had established guinea worm eradication programmes that included water supply as one of their main technical strategies. By surveying the water supply situation in Ifeloju Local Government Area (LGA) in Oyo State, Nigeria, in June 1996, as a case study, it was possible to determine the role that water supply has played in the eradication effort. Although two major agencies, the former Directorate for Food, Roads and Rural Infrastructure and UNICEF, provided hand dug and bore-hole wells respectively in many parts of the LGA, coverage of the smaller farm hamlets has been minor compared to efforts in the larger towns. This is ironic because the farm hamlets served as a reservoir for the disease in the 1980s, such that when the piped water system in the towns broke down, guinea worm was easily reintroduced into the towns. The survey of 188 ever-endemic hamlets with an estimated population of 23,556 found that 74.3% of the people still drink only pond water. Another 11.3% have wells that have become dysfunctional. Only 14.4% of this rural population has access' to functioning wells. Guinea worm was eliminated from 107 of the hamlets mainly by the use of cloth filters and chemical treatment of ponds. While this proves that it is possible to eradicate guinea worm, it fails to leave behind the legacy of reliable, safe water supplies that was the hope of the Water Decade. (+info)