Towards universal health coverage: achievements and challenges of 10 years of healthcare reform in China.

Universal health coverage (UHC) has been identified as a priority for the global health agenda. In 2009, the Chinese government launched a new round of healthcare reform towards UHC, aiming to provide universal coverage of basic healthcare by the end of 2020. We conducted a secondary data analysis and combined it with a literature review, analysing the overview of UHC in China with regard to financial protection, coverage of health services and the reported coverage of the WHO and the World Bank UHC indicators. The results include the following: out-of-pocket expenditures as a percentage of current health expenditures in China have dropped dramatically from 60.13% in 2000 to 35.91% in 2016; the health insurance coverage of the total population jumped from 22.1% in 2003 to 95.1% in 2013; the average life expectancy increased from 72.0 to 76.4, maternal mortality dropped from 59 to 29 per 100 000 live births, the under-5 mortality rate dropped from 36.8 to 9.3 per 1000 live births, and neonatal mortality dropped from 21.4 to 4.7 per 1000 live births between 2000 and 2017; and so on. Our findings show that while China appears to be well on the path to UHC, there are identifiable gaps in service quality and a requirement for ongoing strengthening of financial protections. Some of the key challenges remain to be faced, such as the fragmented and inequitable health delivery system, and the increasing demand for high-quality and value-based service delivery. Given that China has committed to achieving UHC and 'Healthy China 2030', the evidence from this study can be suggestive of furthering on in the UHC journey and taking the policy steps necessary to secure change

Health Problems Heat Up: Climate Change and the Public's Health

Examines the health effects of climate change, the needed public health response, concerns for communities at high risk, and state planning and funding for climate change assessments and strategies. Makes federal, state, and local policy recommendations

Connecting the dots: information visualization and text analysis of the Searchlight Project newsletters

This report is the product of the Pardee Center’s work on the Searchlight:Visualization and Analysis of Trend Data project sponsored by the Rockefeller Foundation. Part of a larger effort to analyze and disseminate on-the-ground information about important societal trends as reported in a large number of regional newsletters developed in Asia, Africa and the Americas specifically for the Foundation, the Pardee Center developed sophisticated methods to systematically review, categorize, analyze, visualize, and draw conclusions from the information in the newsletters.The Rockefeller Foundatio

Smart Computing and Sensing Technologies for Animal Welfare: A Systematic Review

Animals play a profoundly important and intricate role in our lives today. Dogs have been human companions for thousands of years, but they now work closely with us to assist the disabled, and in combat and search and rescue situations. Farm animals are a critical part of the global food supply chain, and there is increasing consumer interest in organically fed and humanely raised livestock, and how it impacts our health and environmental footprint. Wild animals are threatened with extinction by human induced factors, and shrinking and compromised habitat. This review sets the goal to systematically survey the existing literature in smart computing and sensing technologies for domestic, farm and wild animal welfare. We use the notion of \emph{animal welfare} in broad terms, to review the technologies for assessing whether animals are healthy, free of pain and suffering, and also positively stimulated in their environment. Also the notion of \emph{smart computing and sensing} is used in broad terms, to refer to computing and sensing systems that are not isolated but interconnected with communication networks, and capable of remote data collection, processing, exchange and analysis. We review smart technologies for domestic animals, indoor and outdoor animal farming, as well as animals in the wild and zoos. The findings of this review are expected to motivate future research and contribute to data, information and communication management as well as policy for animal welfare

Technology for Good: Innovative Use of Technology by Charities

Technology for Good identifies ten technologies being used by charitable organizations in innovative ways. The report briefly introduces each technology and provides examples of how those technologies are being used.Examples are drawn from a broad spectrum of organizations working on widely varied issues around the globe. This makes Technology for Good a unique repository of inspiration for the public and private sectors, funders, and other change makers who support the creation and use of technology for social good

Health systems analysis of eye care services in Zambia: evaluating progress towards VISION 2020 goals.

BACKGROUND: VISION 2020 is a global initiative launched in 1999 to eliminate avoidable blindness by 2020. The objective of this study was to undertake a situation analysis of the Zambian eye health system and assess VISION 2020 process indicators on human resources, equipment and infrastructure. METHODS: All eye health care providers were surveyed to determine location, financing sources, human resources and equipment. Key informants were interviewed regarding levels of service provision, management and leadership in the sector. Policy papers were reviewed. A health system dynamics framework was used to analyse findings. RESULTS: During 2011, 74 facilities provided eye care in Zambia; 39% were public, 37% private for-profit and 24% owned by Non-Governmental Organizations. Private facilities were solely located in major cities. A total of 191 people worked in eye care; 18 of these were ophthalmologists and eight cataract surgeons, equivalent to 0.34 and 0.15 per 250,000 population, respectively. VISION 2020 targets for inpatient beds and surgical theatres were met in six out of nine provinces, but human resources and spectacles manufacturing workshops were below target in every province. Inequalities in service provision between urban and rural areas were substantial. CONCLUSION: Shortage and maldistribution of human resources, lack of routine monitoring and inadequate financing mechanisms are the root causes of underperformance in the Zambian eye health system, which hinder the ability to achieve the VISION 2020 goals. We recommend that all VISION 2020 process indicators are evaluated simultaneously as these are not individually useful for monitoring progress

Modeling solutions to Tanzania's physician workforce challenge.

BACKGROUND:There is a great need for physicians in Tanzania. In 2012, there were approximately 0.31 physicians per 10,000 individuals nationwide, with a lower ratio in the rural areas, where the majority of the population resides. In response, universities across Tanzania have greatly increased the enrollment of medical students. Yet evidence suggests high attrition of medical graduates to other professions and emigration from rural areas where they are most needed. OBJECTIVE:To estimate the future number of physicians practicing in Tanzania and the potential impact of interventions to improve retention, we built a model that tracks medical students from enrollment through clinical practice, from 1990 to 2025. DESIGN:We designed a Markov process with 92 potential states capturing the movement of 25,000 medical students and physicians from medical training through employment. Work possibilities included clinical practice (divided into rural or urban, public or private), non-clinical work, and emigration. We populated and calibrated the model using a national 2005/2006 physician mapping survey, as well as graduation records, graduate tracking surveys, and other available data. RESULTS:The model projects massive losses to clinical practice between 2016 and 2025, especially in rural areas. Approximately 56% of all medical school students enrolled between 2011 and 2020 will not be practicing medicine in Tanzania in 2025. Even with these losses, the model forecasts an increase in the physician-to-population ratio to 1.4 per 10,000 by 2025. Increasing the absorption of recent graduates into the public sector and/or developing a rural training track would ameliorate physician attrition in the most underserved areas. CONCLUSIONS:Tanzania is making significant investments in the training of physicians. Without linking these doctors to employment and ensuring their retention, the majority of this investment in medical education will be jeopardized

Financing Universal Water, Sanitation and Hygiene Under the Sustainable Development Goals: UN-Water Global Analysis and Assessment of Sanitation and Drinking-Water (GLAAS) 2017 Report

This GLAAS 2017 report is the fourth periodic report, and first thematic report, following on from earlier reports in 2010, 2012, and 2014. It presents an analysis of the most reliable and up-to-date data from 75 countries and 25 external support agencies (ESAs) on the issues related to WASH financing and other elements of the enabling environment, including plans, targets, data availability and measures to reach vulnerable populations