29 research outputs found
Conforming to accreditation in Iranian hospitals
This paper examines the operation of an accreditation programme for hospitals in Iran. It explores the process of accreditation as a regulatory control system and analyses hospitals’ responses to this type of control. We draw on the notion of steering and argue that the accreditation system is transactional in nature. Our findings show that hospitals conform to the scheme, although they also resist some of its requirements. On a wider policy level, we suggest that accreditations offer the accreditor the opportunity to impact on how activities are undertaken, but hospitals require incentives in order to make the necessary organisational changes
Health sector spending and spending on HIV/AIDS, tuberculosis, and malaria, and development assistance for health: progress towards Sustainable Development Goal 3
Sustainable Development Goal (SDG) 3 aims to “ensure healthy lives and promote well-being for all at all ages”. While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to measure progress in financing the priority areas of SDG3, examine the association between outcomes and financing, and identify where resource gains are most needed to achieve the SDG3 indicators for which data are available
Health sector spending and spending on HIV/AIDS, tuberculosis, and malaria, and development assistance for health: progress towards Sustainable Development Goal 3
Background: Sustainable Development Goal (SDG) 3 aims to “ensure healthy lives and promote well-being for all at all
ages”. While a substantial effort has been made to quantify progress towards SDG3, less research has focused on
tracking spending towards this goal. We used spending estimates to measure progress in financing the priority areas
of SDG3, examine the association between outcomes and financing, and identify where resource gains are most
needed to achieve the SDG3 indicators for which data are available.
Methods: We estimated domestic health spending, disaggregated by source (government, out-of-pocket, and prepaid
private) from 1995 to 2017 for 195 countries and territories. For disease-specific health spending, we estimated
spending for HIV/AIDS and tuberculosis for 135 low-income and middle-income countries, and malaria in
106 malaria-endemic countries, from 2000 to 2017. We also estimated development assistance for health (DAH) from
1990 to 2019, by source, disbursing development agency, recipient, and health focus area, including DAH for
pandemic preparedness. Finally, we estimated future health spending for 195 countries and territories from 2018 until
2030. We report all spending estimates in inflation-adjusted 2019 US7·9 trillion (95% uncertainty interval 7·8–8·0) in 2017 and is expected to increase to 20·2 billion
(17·0–25·0) and on tuberculosis it was 5·1 billion (4·9–5·4). Development assistance for health was 374 million of DAH was provided
for pandemic preparedness, less than 1% of DAH. Although spending has increased across HIV/AIDS, tuberculosis,
and malaria since 2015, spending has not increased in all countries, and outcomes in terms of prevalence, incidence,
and per-capita spending have been mixed. The proportion of health spending from pooled sources is expected to
increase from 81·6% (81·6–81·7) in 2015 to 83·1% (82·8–83·3) in 2030.
Interpretation: Health spending on SDG3 priority areas has increased, but not in all countries, and progress towards
meeting the SDG3 targets has been mixed and has varied by country and by target. The evidence on the scale-up of
spending and improvements in health outcomes suggest a nuanced relationship, such that increases in spending do
not always results in improvements in outcomes. Although countries will probably need more resources to achieve
SDG3, other constraints in the broader health system such as inefficient allocation of resources across interventions
and populations, weak governance systems, human resource shortages, and drug shortages, will also need to be
addressed.
Funding: The Bill & Melinda Gates Foundatio
Tracking development assistance for health and for COVID-19 : a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050
Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US per capita, purchasing-power parity-adjusted US8. 8 trillion (95% uncertainty interval [UI] 8.7-8.8) or 40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that 13.7 billion was targeted toward the COVID-19 health response. 1.4 billion was repurposed from existing health projects. 2.4 billion (17.9%) was for supply chain and logistics. Only 1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe
Recommended from our members
Health sector spending and spending on HIV/AIDS, tuberculosis, and malaria, and development assistance for health: progress towards Sustainable Development Goal 3
Background
Sustainable Development Goal (SDG) 3 aims to “ensure healthy lives and promote well-being for all at all ages”. While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to measure progress in financing the priority areas of SDG3, examine the association between outcomes and financing, and identify where resource gains are most needed to achieve the SDG3 indicators for which data are available.
Methods
We estimated domestic health spending, disaggregated by source (government, out-of-pocket, and prepaid private) from 1995 to 2017 for 195 countries and territories. For disease-specific health spending, we estimated spending for HIV/AIDS and tuberculosis for 135 low-income and middle-income countries, and malaria in 106 malaria-endemic countries, from 2000 to 2017. We also estimated development assistance for health (DAH) from 1990 to 2019, by source, disbursing development agency, recipient, and health focus area, including DAH for pandemic preparedness. Finally, we estimated future health spending for 195 countries and territories from 2018 until 2030. We report all spending estimates in inflation-adjusted 2019 US7·9 trillion (95% uncertainty interval 7·8–8·0) in 2017 and is expected to increase to 20·2 billion (17·0–25·0) and on tuberculosis it was 5·1 billion (4·9–5·4). Development assistance for health was 374 million of DAH was provided for pandemic preparedness, less than 1% of DAH. Although spending has increased across HIV/AIDS, tuberculosis, and malaria since 2015, spending has not increased in all countries, and outcomes in terms of prevalence, incidence, and per-capita spending have been mixed. The proportion of health spending from pooled sources is expected to increase from 81·6% (81·6–81·7) in 2015 to 83·1% (82·8–83·3) in 2030.
Interpretation
Health spending on SDG3 priority areas has increased, but not in all countries, and progress towards meeting the SDG3 targets has been mixed and has varied by country and by target. The evidence on the scale-up of spending and improvements in health outcomes suggest a nuanced relationship, such that increases in spending do not always results in improvements in outcomes. Although countries will probably need more resources to achieve SDG3, other constraints in the broader health system such as inefficient allocation of resources across interventions and populations, weak governance systems, human resource shortages, and drug shortages, will also need to be addressed
Recommended from our members
Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050
Background
The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020.
Methods
We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US per capita, purchasing-power parity-adjusted US8·8 trillion (95% uncertainty interval [UI] 8·7–8·8) or 40·4 billion (0·5%, 95% UI 0·5–0·5) was development assistance for health provided to low-income and middle-income countries, which made up 24·6% (UI 24·0–25·1) of total spending in low-income countries. We estimate that 13·7 billion was targeted toward the COVID-19 health response. 1·4 billion was repurposed from existing health projects. 2·4 billion (17·9%) was for supply chain and logistics. Only 1519 (1448–1591) per person in 2050, although spending across countries is expected to remain varied.
Interpretation
Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all
Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050
Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US per capita, purchasing-power parity-adjusted US8. 8 trillion (95% uncertainty interval UI] 8.7-8.8) or 40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that 13.7 billion was targeted toward the COVID-19 health response. 1.4 billion was repurposed from existing health projects. 2.4 billion (17.9%) was for supply chain and logistics. Only 1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd
A comparison of microbial contamination on sheep/goat carcasses in a modern Indian abattoir and traditional meat shops
The microbial load on sheep/goat carcasses was investigated in Deonar abattoir and traditional meat shops in Mumbai. A total of 96 swab samples from carcass sites were collected and analysed from the abattoir, while 144 swab samples from carcass sites were analysed from three meat shops. These samples were processed for total viable count (TVC) and differential counts. The average TVC after flaying, evisceration and washing in the abattoir was 5.51 ± 0.36, 6.06 ± 0.53 and 5.13 ± 0.58 CFU/cm2, respectively. Pooled average TVC in the shops after flaying, evisceration and washing was 5.83 ± 0.42, 6.48 ± 0.27 and 6.17 ± 0.41 log CFU/cm2, respectively. Statistical analysis revealed a highly significant difference (P < 0.01) among TVC counts after washing between abattoir and the shops. The highest prevalence of Micrococcus spp. and S. epidermidis was noticed during various operations in both the abattoir and the shops. Although Salmonella spp. could not be isolated from any of the carcass sites in the abattoir, in the shops it showed 16.4% prevalence at all the sites irrespective of operations. Overall study revealed that level of contamination in the traditional meat shops was significantly higher compared to the abattoir. However, the microbial contamination in the abattoir is also high if we compare these results to the reports from developed countries and do not conform to EU specifications. The findings of this study reflect the hygiene status of meat production in the developing world. © 2006 Elsevier Ltd. All rights reserved