Waivers and exemptions for health services in developing countries

In response to shortages in public budgets for government health services, many developing countries around the world, have adopted formal, or informal systems of user fees for health care. In most countries, user fee proceeds seldom represent more than 15 percent of total costs in hospitals, and health centers, but they tend to account for a significant share of the resources required to pay for non-personnel costs. The problem with user fees is that the lack of provisions to confer partial, or full waivers to the poor, often results in inequity in access to medical care. The dilemma, then, is how to make a much needed system of user fees, compatible with the goal of preserving equitable access to services. Different countries have tried different approaches. Those which have carefully designed, and implemented waiver systems (e.g., Thailand and Indonesia) have had much greater success in terms of benefits incidence, than countries that have improvised such systems (Ghana, Kenya, Zimbabwe). Key to the success of a waiver system is its financing. Systems that compensate providers for the revenue forgone from granting exemptions (Thailand, Indonesia, and Cambodia) have been more successful than those who expect the provider to absorb the cost of exemptions (Kenya). Where waiver system exist, performance will improve with the timeliness of the reimbursement. Other success factors include the widespread dissemination among potential beneficiaries, about waiver availability, and procedures; the awarding of financial support to poor patients for non-fee costs of care, such as food and transportation (as in Cambodia); and, the existence of clear criteria for the granting of waivers, thereby reducing confusion, and ambiguity among those responsible for managing the system, and among potential recipients. The review examines various approaches taken by countries, but assessing their relative practical merits is difficult, as the evidence is scattered and mixed.Health Systems Development&Reform,Pharmaceuticals&Pharmacoeconomics,Health Monitoring&Evaluation,Public Sector Economics,Health Economics&Finance

The Great Climate Debate - A Developing Country Perspective

For over two decades, scientific and political communities have debated whether and how to act on climate change. The present paper revisits these debates and synthesizes the longstanding arguments. Firstly, it provides an overview of the development of international climate policy and discusses clashing positions represented by sceptics and supporters of action on climate change. Secondly, it discusses the market-based measures as a means to increase the win-win opportunities and to attract profit-minded investors to invest in climate change mitigation. Finally, the paper examines whether climate protection policies can yield benefits both for the environment and the economy. The paper suggests the possibility of building environmental and climate policies around development priorities that are vitally important for developing countries and stresses the need for using sustainable development as a framework for climate change policies.Climate change, Sceptic, Supporter, Developing country

The Great climate debate : A Developing country perspective

For over two decades, scientific and political communities have debated whether and how to act on climate change. The present paper revisits these debates and synthesizes the longstanding arguments. Firstly, it provides an overview of the development of international climate policy and discusses clashing positions represented by sceptics and supporters of action on climate change. Secondly, it discusses the market-based measures as a means to increase the win-win opportunities and to attract profit-minded investors to invest in climate change mitigation. Finally, the paper examines whether climate protection policies can yield benefits both for the environment and the economy. The paper suggests the possibility of building environmental and climate policies around development priorities that are vitally important for developing countries and stresses the need for using sustainable development as a framework for climate change policies.Climate change, Sceptic, Supporter, Developing country

INDEMICS: An Interactive High-Performance Computing Framework for Data Intensive Epidemic Modeling

We describe the design and prototype implementation of Indemics (_Interactive; Epi_demic; _Simulation;)—a modeling environment utilizing high-performance computing technologies for supporting complex epidemic simulations. Indemics can support policy analysts and epidemiologists interested in planning and control of pandemics. Indemics goes beyond traditional epidemic simulations by providing a simple and powerful way to represent and analyze policy-based as well as individual-based adaptive interventions. Users can also stop the simulation at any point, assess the state of the simulated system, and add additional interventions. Indemics is available to end-users via a web-based interface. Detailed performance analysis shows that Indemics greatly enhances the capability and productivity of simulating complex intervention strategies with a marginal decrease in performance. We also demonstrate how Indemics was applied in some real case studies where complex interventions were implemented

Global Risks 2015, 10th Edition.

The 2015 edition of the Global Risks report completes a decade of highlighting the most significant long-term risks worldwide, drawing on the perspectives of experts and global decision-makers. Over that time, analysis has moved from risk identification to thinking through risk interconnections and the potentially cascading effects that result. Taking this effort one step further, this year's report underscores potential causes as well as solutions to global risks. Not only do we set out a view on 28 global risks in the report's traditional categories (economic, environmental, societal, geopolitical and technological) but also we consider the drivers of those risks in the form of 13 trends. In addition, we have selected initiatives for addressing significant challenges, which we hope will inspire collaboration among business, government and civil society communitie

Interventions to Safeguard System Effectiveness During Periods of Emergency Department Crowding

This article summarizes the proceedings of a breakout session, “Interventions to Safeguard System Effectiveness,” at the 2011 Academic Emergency Medicine consensus conference, “Interventions to Assure Quality in the Crowded Emergency Department.” Key definitions fundamental to understanding the effectiveness of emergency care during periods of emergency department (ED) crowding are outlined. Next, a proposed research agenda to evaluate interventions directed at improving emergency care effectiveness is outlined, and the paper concludes with a prioritization of those interventions based on breakout session participant discussion and evaluation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/89510/1/j.1553-2712.2011.01219.x.pd

Strategies to Mitigate Information Technology Discrepancies in Health Care Organizations

Medication errors increased 64.4% from 2015 to 2018 in the United States due to the use of computerized physician order entry (CPOE) systems and the inability to exchange information among health care facilities. Healthcare information exchange (HIE) and subsequent discrepancies resulted in significant medical errors due to the lack of exchangeable health care information using technology software. The purpose of this qualitative multiple case study was to explore the strategies health care business managers used to manage computerized physician order entry systems within health care facilities to reduce medication errors and increase profitability. The population of the study was 8 clinical business managers in 2 successful small health care clinics located in the mid-Atlantic region of the United States. Data were collected from semistructured interviews with health care leaders and documents from the health care organization as a resource. Inductive analysis was guided by the Donabedian theory and sociotechnical system theory, and trustworthiness of interpretations was confirmed through member checking. Three themes emerged: standardizing data formats reduced medication errors and increased profits, adopting user-friendly HIE reduced medication errors and increase profits, and efficient communication reduced medication errors and increased profits. The findings of this study contribute to positive change through improved health care delivery to patients resulting in healthier communities

The Role of an Ombudsman in Mitigating Conflict

Bullying behavior is a contributing factor to hostile work environments, and can cause human consequences that affect morale, performance, and productivity. The purpose of this qualitative exploratory case study was to identify the strategies that ombudsmen and human resource managers (HR) use in mitigating workplace conflict. Corporate social performance was the conceptual framework that guided this research. Nine HR managers, an ombudsman representative, and 8 ombudsmen located in New York City and in other states were interviewed based on their experience in conflict mitigation. Data extracted from the participants\u27 shared stories along with position description documents were synthesized thematically and analyzed for emergent themes. Six themes emerged through analysis: neutrality, trust, interactive coaching competencies, contrasting roles, preventive conflict mitigation strategies, and systemic and cultural analysis. The theme of trust emerged as a key strategy to resolve conflict. The implications for social change include increased organizational accountability, fairness, security, and reduction of discrimination as the work of ombudsmen indirectly lead to cultural changes within organizations

Protecting vulnerable families in Central Asia: Poverty, vulnerability and the impact of the economic crisis

Since the end of 2007, countries in Central Asia have been struck by two major consecutive shocks: the food and fuel price increase in 2007-08, and the global economic and financial crisis that began at the end of 2008. Households, both poor and not poor, are directly and adversely affected by the crisis. The multi-dimensionality of the crises and the volatile economic environment challenge the ability of vulnerable households to cope and to maintain their living standards. Social protection programmes play an important role in the response to a crisis. This paper provides an overview of the social and economic vulnerabilities of households with children in the five Central Asian countries, and assesses the ability of national social protection systems to address these, with the main focus on the role of non-contributory cash transfers financed from general government revenues. The paper concludes that the existing social cash transfer systems are not effective in addressing the needs of poor and vulnerable children and families in Central Asia. Limited coverage together with limited funding reduces the potential poverty reduction impact of the programmes. The paper discusses potential strategies for improving existing systems by consolidating and protecting government spending, streamlining existing benefits and transfers, improving the identification of beneficiaries and strengthening administration, monitoring and evaluation systems.social protection, social assistance, economic crisis, poverty reduction, Central Asia, Kazakhstan, Kyrgyz Republic, Tajikistan, Turkmenistan, Uzbekistan

Ethical Considerations in the Advent of 3D Printing Technology in Healthcare

The emergence of 3D printing technology in healthcare has ushered in a new era of personalized medical solutions. However, alongside its promises, this technology also introduces several critical challenges that demand attention. This research investigates the implications of 3D printing on patient safety, intellectual property, equity, data security, informed consent, and the roles of healthcare professionals. 3D printing has opened up remarkable opportunities in the creation of medical devices, implants, and prosthetics. Nevertheless, the potential for errors during the manufacturing process poses a significant concern. Ensuring the safety and reliability of 3D-printed medical products becomes paramount, as any defects or inaccuracies could have severe consequences on patient health and well-being. The accessibility of 3D printing technology raises apprehensions regarding intellectual property rights and regulatory standards. The possibility of replicating medical devices and pharmaceuticals may lead to patent infringements and pose difficulties in enforcing regulatory compliance. Striking a balance between innovation and protection of intellectual property becomes crucial in fostering a thriving 3D printing healthcare ecosystem. While 3D printing holds to democratize healthcare by offering personalized medical solutions, it also has the potential to exacerbate existing disparities in healthcare access. The cost of 3D printing technology and related services might prove prohibitive for certain communities, thereby widening the gap in access to advanced medical treatments. Addressing these disparities and ensuring equitable access to 3D printing healthcare solutions must be a priority for healthcare policymakers and stakeholders. The integration of 3D printing in healthcare necessitates the utilization and storage of sensitive patient data. However, ethical concerns emerge around the security and privacy of this data. Any breaches or misuse of patient information could not only compromise patient confidentiality but also erode trust in healthcare systems. Implementing robust data security measures and respecting patient privacy rights are essential to maintain public trust in 3D printing healthcare applications. As 3D printing enables the production of custom medical devices and implants, obtaining informed consent from patients becomes increasingly complex. Patients must comprehend the risks, benefits, and uncertainties associated with these personalized treatments to make autonomous decisions about their healthcare. Healthcare providers must develop comprehensive strategies to ensure adequate patient education and empowerment during the informed consent process