Role of Health Economics Research in Implementing Saudi Arabia’s Health Sector Transformation Strategy Under Vision-2030

Health economics analyses play a crucial role in providing health policy makers and planners with the relevant information required to maximize the use of available resources. Health system reforms introduced in Saudi Arabia have recognized the application of health economic theories in making policy decisions and many of the health system strategies proposed under the Saudi vision-2030 have health economic ramifications. Since the health system has undergone a rapid transition leading to new set of health problems related to non-communicable diseases and life style disorders, the country needs more cost-effective strategies to improve maximum health gains and reduce future financial burden of the government. The paper highlights some reflections on the role and relevance of health economics and health economic research in implementing various strategies proposed under the vision. The paper also provides implications of developing health economics knowledge among physicians and how such knowledge can be applied to evidence based decision making on the use of health resources. It recommends the need for creation of opportunities for development of health economics and integration of health economics discipline into medical education curriculum in Saudi Arabia. Keywords: health economics, health resources, Saudi vision-2030, transformation strategy DOI: 10.7176/JESD/10-18-12 Publication date:September 30th 2019

Unregulated Private Health Sector: India’s Challenges in Realizing Universal Health Coverage

Since India’s independence in 1947, private health sector has witnessed a rapid growth. Today, private sector occupies a major share of health entities, health workforce and medical education institutions in the country. This paper provides an overview of private health sector in India, factors contributing to its growth, and major public policy implications in achieving universal health care based on extensive review of literature and other relevant descriptive information. The findings reveal that private health sector provides 80% of out-patient care and 60% of inpatient care in the country. There are 1.35 million private health entities delivering health services in the country, out of which 0.74 million are own account enterprises run by individual practitioners. About 76% of all private sector entities are allopathic facilities. This sector is largely unregulated with diversity of providers varying in qualifications, physical infrastructure, standards of care, technical knowledge, which are unfavorably affecting costs and quality of care. Strict implementation of regulations to influence private provider behavior in improving quality, reducing cost, appropriate use of medical technology, and accountability along with a huge investment in the public health sector are necessary to guarantee the availability, accessibility, acceptability, and quality of health services for every individual. Keywords: private health sector, public health sector, health workforce, health insurance DOI: 10.7176/PPAR/10-3-07 Publication date:March 31st 202

Out-of-Pocket Expenditure on Delivery Care in Public and Private Health Sectors – A Study in a Rural District of Pakistan

Pakistan witnessed a significant improvement in maternal health outcomes during the past two decades. However, persistent urban-rural and socio-economic inequalities exist in access to maternal healthcare services across the country. The objective of this study was to estimate out-of-pocket expenditure (OOPE) on delivery care by women in the public and private health sectors in RajanPur district. This was a cross-sectional study conducted, among 368 randomly selected mothers who had childbirths from 1st October to 31st December 2020. The study applied multi-stage random sampling technique to select the study participants. The results showed that about two-thirds of mothers preferred public hospitals for most recent delivery. The percentage of cesarean deliveries conducted in private hospitals (43.8%) was 4.7 times higher than in public hospitals (9.3%). About 99% of mothers incurred OOPE during delivery care, and the mean OOPE incurred during delivery care was PKR 2840 (US$17.75) in public hospitals and PKR 25596 (US$159.9) in private hospitals. OOPE on cesarean delivery in private hospitals (PKR 39654.7, US$247.8) was 2.5 times higher than the public hospitals (PKR16111.9, US$100.69), whereas OOPE incurred on normal delivery care in private hospitals (PKR14339, US$89.62) was 9.5 times higher than OOPE in public hospitals(PKR 1501.4, US$9.38).To conclude, the findings and recommendations drawn from the research would provide some insights to health policymakers and planners in developing an integrated and viable maternal healthcare program in Pakistan

Correlates of Social, Demographic and Behavioral Factors affecting Adolescent Sexuality in a Traditional Society in India: Perspectives and Challenges

Background: Adolescent risk behavior is a major concern.Objectives: The study assessed the effect of school background, personal, social and other deviant behavior on school going adolescent sexual behavior. Material and Methods: The sample covered 3069 randomly selected adolescents (students) from 9th to 12th standard in various governments, private and missionary run schools from two districts namely; Aizawl being state capital and Champhai being distant under developed district.Summary: School background, leisure and entertainment practices, influence of taking alcohol, tobacco, drug, peer influence were found to be the major risk factor for indulgence in unsafe sex practices among adolescents. About 10% accepted involvement in premarital sex and majority of them (70%) of them had premarital sex between age group 15-19 years. The schools lacked in organizing awareness program and counseling activities on consequences of adolescent sex. The ARSH Program needs to synergize with school health program for desired results. Conclusions: Adolescent sexual risk behavior is a part of overall deviant behavior and can be managed in holistic manner

Convergence of PPTCT with RCH Services in a District Hospital, Haryana

Background: The integration of PPTCT and RCH activities is an important strategy for universal screening of ANC mothers through available government health infrastructure in a district. The objective of this study was to understand process and analyzing outcome of convergence of PPTCT & RCH services in a District Hospital. Methods: The study was a descriptive study conducted in district hospital, Gurgaon. Results: In the district hospital Gurgaon percentage of women counseled at ICTC has increased from 77% to 89.4% and percentage of women tested has increased from 75% to 87.8% during 2010 and 2011. However, not all women tested positive delivered at hospital. Only 6.7% women were knowing about transmission of HIV from mother to baby. About 60% ANC registration are delayed primarily due to lack of family support (71%). Majority of ANC women got HIV screening at district hospital due to non-availability of facility at CHC/PHC levels. About 58% of Institutional deliveries in the State are in private hospitals, but they still need to be involved in PPTCT. Conclusion: Currently, convergence of PPTCT and RCH services seems to be fragmented and at initial stage. Convergence need to be taken up at policy, planning, implementation, capacity building, resource mobilization and monitoring for success of the initiative in the state