Justice in health care and global inequalities in health: the case of official development aid

Life expectancy at birth is the average number of years that a group of people born in the same year should live. The estimate for those born in 2010 is 80.2 years for Italy. On the other side of the chart are a number of countries in sub Saharan Africa. Haiti is in last place: children born in this country in 2010 have a life expectancy by an average of even 30 years, fifty in less than peers born in Italy. From a bioethical point of view, the first question that arises is: Is it right? Is it right that there is such inequality in health? The answer is simple: it is not right. But if we ask ourselves what are the best solution to remedy this situation, the answers become more than one. The differences in life expectancy depends on many factors, including no doubt the effectiveness of health systems. The scope of this work is precisely that of justice in health care and how the different general concepts related to it can be applied in health care settings with very limited financial and human resources. The first chapter describes the main inequalities in global health. The second discusses the main theories of justice. In the next chapter we reason on official development assistance and health cooperation. In the fourth we analyze the contribution of theories of justice through such issues as equity in health, the right of access to health services and right to health. In the fifth chapter the aim is to reason about global justice, the role of health in this context and how the official development assistance in health can contribute

Italy's contribution to global health : the need for a paradigm shift

This paper reviews Italian Development Assistance for Health and overall contribution to Global Health from 2001 to 2012. It analyses strategies and roles of central and decentralized authorities as well as those of private non-profit and corporate actors. The research illustrates a very low and unstable official contribution that lags far behind internationally agreed upon objectives, a highly fragmented institutional scenario, and controversial political choices favouring "vertical" global initiatives undermining national health systems, and in contrast with Italian deep-rooted principles, traditional approaches and official guidelines.Italy's contribution to global health goes beyond official development aid, however. The raising movement toward Universal Health Coverage may offer an extraordinary opportunity for a leading role to a country whose National Health System is founded on the principles of universal and equitable access to care. At the same time, the distinctive experience of Italian decentralized cooperation, with the involvement of a multiplicity actors in a coordinated effort for cooperation in health with homologous partners in developing countries, may offer - if adequately harnessed - new opportunities for an Italian "system" of development cooperation. Nevertheless, the indispensable prerequisite of a substantial increase in public funding is challenged by the current economic crisis and domestic political situation. For a renewed Italian role in development and global health, a paradigm shift is needed, requiring both conceptual revision and deep institutional and managerial reforms to ensure an appropriate strategic direction and an efficient and effective use of resources

Elementi di salute globale. Globalizzazione, politiche sanitarie e salute umana

Lo studio degli effetti della globalizzazione sulla salute umana è l'oggetto di una disciplina emergente che viene individuata con il nome di salute globale. L'approccio è interdisciplinare e affronta il tema in una dimensione globale, dove i determinanti sociali, economici e politici siintersecano con crescenti complesità al di là dei confini e delle relazioni bilaterali e multilaterali tra gli Stati nazionali al cui controllo sono sempremeno soggetti

Elementi di salute globale: globalizzazione, politiche sanitarie e salute umana

Lo studio delle interazioni tra il processo di globalizzazione e la salute umana è l'oggetto di un'area di ricerca, formazione e di pratiche interdisciplinari consolidatasi negli ultimi quindici anni, che diversi autori ormai individuano come "Salute Globale" differenziandola dai più tradizionali studi di "sanità pubblica internazionale". Il testo, che si propone di iniziare allo studio della salute globale, guarda alla salute nella sua accezione più ampia, non solo come condizione fisica e mentale dell'individuo, ma anche nella sua correlazione con lo stato di benessere sociale. L'approccio quindi è interdisciplinare: affronta il tema in una dimensione transnazionale e globale, dove i determinanti sociali, economici e politici si intersecano tra loro con crescenti complessità al di là dei confini e delle relazioni bilaterali e multilaterali tra gli Stati nazionali al cui controllo sono sempre meno soggetti

Teaching global health in a faculty of Sociology: introducing a multidisciplinary, trans-cultural approach

The chapter describes the experience of Global health education at the Faculty of Sociology of the Milano-Bicocca University in Milano and the unique transcultural experience of a course dictated in Italian and Spanish with both Italian and Latin American students and Facult

Global health governance and policy: an introduction

This is an interdisciplinary textbook on Global Health, mainly focusing on governance and policy, but offering a wider perspective on global determinants of health and related issue

Evaluating the appropriateness of elective surgery: the case of spinal fusion (arthrodesis)

Introduction: Appropriateness is an essential element of quality of care. Several methods and tools have been developed to measure the appropriateness of care, however, none of these could be used to systematically support providers in keeping the appropriateness under control. Our study aimed to develop a framework to evaluate the appropriateness of care that took into account four dimensions of appropriateness: clinical dimension, equity, service delivery model, outcome. Methods: We employed mixed-method approaches. These included a retrospective analysis of administrative data collected from Kinetika Sardinia (Italy) and a qualitative analysis of stakeholders’ experiences and perspectives aimed at supporting data collection, identification of improvement actions and definition of performance indicators. We used arthrodesis as a paradigmatic example of potentially inappropriate elective surgery. Results: We collected data from 2,584 patients that underwent arthrodesis between January 1, 2010 and April 30, 2015. Based on the analysis and the exchanges with professionals, we identified 11 improvement actions. Monitoring and evaluation actions were finally conducted for 171 patients that underwent spinal fusion during the first semester of 2016 in order to assess if the improvement actions identified were put into practice and acquired desirable outcomes. Conclusions: Our work provides a definition of appropriateness that goes beyond the clinical perspective and includes other perspectives (equity, service delivery and outcome); develops a framework and an approach that can be a valid help to systematically assess the appropriateness of elective surgery, adopt improvement actions, and monitor their impact; discusses what are the competencies necessary for measuring the appropriateness

G8 Summit 2009: what approach will Italy take to health?

In the past decade, the G8 played an important part in the establishment or support of global health initiatives that are at risk today of becoming part of the problem rather than the solution for granting health coverage to disadvantaged populations. The fragmentation of financing for global health and increased transaction costs contrast with the need for efficient and effective health systems, and underline the need for a review of quick-fix and selective approaches

Percorsi Diagnostico Terapeutici e Assistenziali (PDTA) per il Linfoma non Hodgkin

Il rapporto presenta e confronta gli esiti dell'analisi in sette aziende sanitarie Italiane dei PDTA (percorsi diagnostico terapeutici e assistenziali) per la diagnosi e la cura del linfoma non hodgkin. Lo studio ha anche confrontato i costi medi di PDTA nelle realtà analizzat