29,854 research outputs found

    Under-Utilization of Community Health Centers in Purworejo Regency, Central Java

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    The basic strategy of the Ministry of Health to achieve Health For All In Indonesia 2010 is through health paradigm, decentralization, professionalism and health service management. Community health centers play an important role to achieve the goal. Unfortunately, underutilization of community health centers is still a problem in Purworejo. The purpose of this study was to know the utilization of community health centers using a sociological health approach. Qualitative research by observation, in-depth interview and focus group discussion were done among different types of group. The study was done in Purworejo District on February and March 2000. The main problems related to under-utilization of community health centers are mostly on administration (less quality services, un-efficient, long hours waiting), strong bureaucratic system (physician has a dominant power, overlapping programs, poor coordination and integration with other divisions) and cultural behavior of the community (labeling/stigma, self-care dominant, lack of community participation). To overcome under-utilization of community health centers the administration and bureaucracy should be changed into more efficient, not bureaucratic management. In addition social changes of the community culture is needed. As a consequence through these changes the staff of the health centers will be more efficient and effective. &nbsp

    Decentralization and Public Delivery of Health Care Services in India

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    This paper examines delivery of public health care services in India, in the broader context of decentralization. It provides an overview of the basic features and recent developments in intergovernmental fiscal relations and accountability mechanisms, and examines the implications of these institutions for the quality of public service delivery. It then addresses recent policy proposals on the public provision of health care, in the context of decentralization. Finally, it makes suggestions for reform priorities to improve public health care delivery

    ISLAMIC PSYCHOLOGY IN TREATING VICTIMS OF CHILD SEXUAL ABUSE (Family Therapy and Story Telling Therapy) IN TREATING VICTIMS OF CHILD SEXUAL ABUSE

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    The purpose of this study was to describe the changes experienced by the subjects after family therapy and storytelling therapy. This research used descriptive qualitative study with Curative Therapy methods and the Observational Analysis. Subjects of the research were two children in their middle childhood (6-8 years) who were chosen through purposive sampling, their families were included in the therapy, and live in Semarang. Islamic Psychological approach were applied through family therapy in the form of understanding of the nature of sexual identity of children, understanding puberty, giving family support, as well as doing of Islamic religious ritual by reviewing the interpretation on the Qur'an and Sunnah with the child and planting the moral and beliefs in the family. Those efforts were accompanied by storytelling therapy based on Islamic psychology approach, namely through the implementation of Islamic siroh through storytelling and role playing. The results shows that the impact of sexual violence to the subjects are reluctant to go to school, have a sense of inferiority, tend to withdraw from society, experience irritability and aggressiveness. When the subject and family participate in the therapy for 6 months, it can be seen that those children showed a noticeable progress in their behavior by getting back to school, showing their happiness, starting to play with their friends although the intensity was still less than usual. Another finding in the study is the formation of family cohesiveness. Treatment will continue until the next 1-2 years, and it is expected that it will become a habit in the family

    The growth of public health expenditures in OECD countries: do government ideology and electoral motives matter?

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    This paper empirically evaluates whether government ideology and electoral motives influenced the growth of public health expenditures in 18 OECD countries over the 1971-2004 period. The results suggest that incumbents behaved opportunistically and increased the growth of public health expenditures in election years. Government ideology did not have an influence. These findings indicate (1) the importance of public health in policy debates before elections and (2) the political pressure towards re-organizing public health policy platforms especially in times of demographic change.public health expenditures, health policies, government ideology, partisan politics, electoral cycles, panel data

    Welfarist and Non-Welfarist Conceptions of \"Health Promotion”

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    Although \"health promotion\" programs account for only a small proportion of health spending in OECD countries (OECD, 2000), their components (anti-smoking, pro-exercise and vaccination campaigns, for example) are often highly visible instruments of health policy. Furthermore, the case for increased spending on such programs is likely to intensify if evidence of (i) their effectiveness; and (ii) diminishing returns to spending on other categories of health services (e.g., curative and acute medical services), grows. Economists\' contributions to the literatures on, inter alia, (i) rational addiction; (ii) (licit and illicit) drug use; (iii) health production; and (iv) health sector economic evaluation; are pertinent to this health sub-sector. However, no integrated economic conception of the field of health promotion has been produced. This paper provides such an account: the instruments and targets of health promotion are analysed in an integrated framework by drawing on concepts from the public economics and health economics literatures. The analyses emphasise the material differences in welfare outcomes that can arise, depending on whether the objective of a health promotion program is to maximise welfare, or to pursue another, e.g. health-stock, objective.economic analysis, health promotion, welfare.

    Decentralization and Public Delivery of Health Care Services in India

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    This paper examines delivery of public health care services in India, in the broader context of decentralization. It provides an overview of the basic features and recent developments in intergovernmental fiscal relations and accountability mechanisms, and examines the implications of these institutions for the quality of public service delivery. It then addresses recent policy proposals on the public provision of health care, in the context of decentralization. Finally, it makes suggestions for reform priorities to improve public health care delivery.federalism, decentralization, intergovernmental relations, accountability, service delivery, health care

    Ethnoveterinary plants of Ankober District, North Shewa Zone, Amhara Region, Ethiopia

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    Background: Traditional herbal preparations for addressing veterinary problems have been applied in Ankober District, Ethiopia, for generations. However, the millennia-old ethnoveterinary knowledge of the community, and the plants are subjected to loss without being scientifically documented due to anthropogenic and environmental threats. Hence, this study aims at providing a comprehensive documentation on ethnoveterinary plant knowledge of the people in order to preserve the fast-eroding knowledge and resources of the area. Methods: Semi-structured interviews, focus group discussions, participant observation and walk-in-the-woods methods were used to gather ethnoveterinary data. Informant Consensus Factor (ICF) and Fidelity level (FL) values were calculated using quantitative approaches so as to check the level of informants' agreement on plant use and healing potential of ethnoveterinary medicinal plant species, respectively. Indigenous knowledge on use of medicinal plants for ethnoveterinary purposes among different informant groups was compared using One-way ANOVA and t-tests. Results: A total of 51 plant species representing 50 genera and 35 botanical families used in the treatment of 33 different ailments were identified. Medicinal plant species belonging to families Asteraceae, Asclepiadaceae, Euphorbiaceae and Ranunculaceae were reported to be of frequent use in the local ethnoveterinary medical system. Roots (65%, 33 species) were most often utilized for remedy preparation. Highest ICF values were recorded for gastro-intestinal (0.71) ailments depicting best agreement on knowledge of medicinal plants used to treat aliments in this category. Embelia schimperi Vatke showed highest fidelity level value (90%) to treat gastro-intestinal diseases showing conformity of knowledge on this species' healing potential. Significant difference (P<0.05) was observed in average number of therapeutic plants reported by senior members of the community than younger groups. Embelia schimperi Vatke and Rubus steudnerii Schweinf. were the most-preferred species to treat diarrhoea. Conclusion: The study indicated that indigenous knowledge on ethnoveterinary medicinal plant use is still rich and active in the District. Species with recorded highest consensus for curative role are a useful pool for further phytochemical and pharmacological validation for better utilization. Declining wild medicinal flora of the area calls for implementation of a coordinated complementary in situ and ex situ conservation strategy

    Comparing cost-sharing practices for pharmaceuticals and health care services among four central European countries

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    The paper reviews the existing cost-sharing practices in four Central European countries namely the Czech Republic, Hungary, Poland and Slovakia focusing on patient co-payments for pharmaceuticals and services covered by the social health insurance. The aim is to examine the role of cost-sharing arrangements and to evaluate them in terms of efficiency, equity and public acceptance to support policy making on patient payments in Central Europe. Our results suggest that the share of out-of-pocket payments in total health care expenditure is relatively high (24–27%) in the countries examined. The main driver of these payments is the expenditure on pharmaceuticals and medical devices, which share exceeds 70% of the household expenditure on health care. The four countries use similar cost-sharing techniques for pharmaceuticals, however there are differences concerning the measure of exemption mechanisms for vulnerable social groups. Patient payment policies for health care services covered by the social health insurance are also converging. All the four countries apply co-payments for dental care, some hotel services or in the case of free choice of physician. Also the countries (except for Poland) tried to extend co-payments for physician services and hospital care. However, their introduction met strong political opposition and unpopularity among public

    EPCRA\u27s Collision With Federalism

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