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Providing Family Planning Services at Primary Care Organizations after the Exclusion of Planned Parenthood from Publicly Funded Programs in Texas: Early Qualitative Evidence.
Health Services Research. 2017 Oct 20;OBJECTIVE: To explore organizations' experiences providing family planning during the first year of an expanded primary care program in Texas. DATA SOURCES: Between November 2014 and February 2015, in-depth interviews were conducted with program administrators at 30 organizations: 7 women's health organizations, 13 established primary care contractors (e.g., community health centers, public health departments), and 10 new primary care contractors. STUDY DESIGN: Interviews addressed organizational capacities to expand family planning and integrate services with primary care. DATA EXTRACTION: Interview transcripts were analyzed using a theme-based approach. Themes were compared across the three types of organizations. PRINCIPAL FINDINGS: Established and new primary care contractors identified several challenges expanding family planning services, which were uncommon among women's health organizations. Clinicians often lacked training to provide intrauterine devices and contraceptive implants. Organizations often recruited existing clients into family planning services, rather than expanding their patient base, and new contractors found family planning difficult to integrate because of clients' other health needs. Primary care contractors frequently described contraceptive provision protocols that were not evidence-based. CONCLUSIONS: Many primary care organizations in Texas initially lacked the capacity to provide evidence-based family planning services that women's health organizations already provided. (c) Health Research and Educational Trust.
Geneva, Switzerland, World Health Organization [WHO], 2006. 32 p. (Moving Towards Universal Coverage. Issues in Maternal-Newborn Health and Poverty No. 3)The aim of this paper is to provide a systematic review of the evidence of the impact on economic growth of investments in maternal--newborn health (MNH). The methodology used for the review includes a systematic search for published literature in relevant electronic databases. In the paper, we review five studies: four empirical and one theoretical. One of the empirical papers measures health by infant mortality. The study finds that a 1/1000-point reduction in the infant mortality rate leads to an increase in the level of State Domestic Product by Indian Rs 2.70 and an increase in the average growth rate per year of 0.145%. Similar results are reported for other health measures in other studies. Our main conclusion, however, is that the area lacks research and that considerably more is needed before any advice can be provided to policy-makers about the contribution to growth of investments in MNH. Specifically, first and foremost, studies are needed that explicitly analyse the impact of MNH on level and growth of output. Second, we suggest the use of more comprehensive MNH measures that consider the health of both mothers and newborns and aspects of ill-health other than death, such as measures of quality of life, functional limitations, mental health and sickness absenteeism. Third, estimates of the effects of MNH on growth need to be controlled for other health dimensions, i.e. aspects that may confound the impact of MNH. Fourth, studies are needed of the effects on determinants of growth in order to understand better the links between MNH and growth. Fifth, studies based on smaller geographical areas within countries and longer time series are needed, in order to obtain more precise estimates and also better estimates of the long-term growth paths. Finally, we suggest compilation of other data sets on microeconomic data, for example, to study effects at firm level of MNH on labour productivity through inability to work, disability, sick days, etc. (author's)
International Journal of Health Planning and Management. 2006 Oct-Dec; 21(4):297-312.After the break-up of the Soviet Union, the country of Georgia suffered from intense civil unrest and socio-economic deterioration, which particularly affected the health sector. To remedy the situation, the government initiated health sector reform, which introduced major changes in healthcare financing in Georgia: the previously free healthcare model was replaced by social insurance, and patients were required to pay out-of-pocket for services not covered by insurance. This paper is an attempt to determine if the health system of Georgia is reaching the WHO health system goals of improved health status, responsiveness to patients' needs (consumer satisfaction), and financial risk protection as a result of health reforms. (author's)
Women's Health Journal. 2003 Apr-Jun; (2):13-15.I feel that such opportunities are very important because in general the women's health movement has not been very involved in the analysis of neoliberal reforms in Latin America and the Caribbean. However, it is interesting to note that in the 1980s and 90s the women's movement -unlike the movement in defense of health- addressed the issue of health from a rights-based perspective, even though this term was not yet used. Those of us who were involved in the movement to defend health talked about how to apply the reform, how to improve it, but the issue of health as a right was not in our discourse. Based on this experience, it is important that organized women become involved in the analysis of the reform, At one point, the international agencies called together those of us specializing in gender and other key representatives of the women's movement to contribute a gender perspective to the neoliberal reforms. In hindsight, it is clear that we weren't on the same page: a perspective based on rights as the guiding principle for analyzing health was attempting to interface with an approach to health that has absolutely nothing to do with rights. In order to overcome this impasse, the women's movement needs to strengthen its alliances with other sectors critical of the neoliberal reforms and learn more about other non-neoliberal proposals for health sector reform such as that implemented in Brazil, for example. Of course, we must not forget Cuba's reform which was developed in the context of a revolutionary process. (excerpt)
Summary measures of population health in the context of the WHO framework for health system performance assessment.
In: Summary measures of population health: concepts, ethics, measurement and applications, edited by C.J.L. Murray, J.A. Salomon, C.D. Mathers and A.D. Lopez. Geneva, Switzerland, World Health Organization [WHO], 2002. 1-11.This volume addresses the conceptual, ethical, empirical and technical challenges in summarizing the health of populations. This is critical for monitoring whether levels of population health are improving over time and for understanding why health differs across settings. At the same time, it is also important to recognize that improving population health is not the only goal of health policy and to understand the way health improvements interact with these other goals. For that reason, we briefly review the World Health Organization (WHO) framework for assessing the performance of health systems and the role of summary measures of population health (SMPH) in this framework. Following the recent peer review of the methodology used for health system performance by WHO (Anand et al. 2002), this framework will continue to evolve in response to the detailed recommendations of the scientific peer review group and to ongoing scientific debates and research. (excerpt)