Abstract
To propose a social-and-democrat health policy alternative to the current neoliberal one. The general failure of neoliberal health policies in low and middle-income countries justifies the design of an alternative to bring disease control and health care back in step with ethical principles and desired outcomes. National policies, international programmes and pilot experiments--including those led by the authors--are examined in both scientific and grey literature. We call for the promotion of a publicly-oriented health sector as a cornerstone of such alternative policy. We define 'publicly-oriented' as opposed to 'private-for-profit' in terms of objectives and commitment, not of ownership. We classify development strategies for such a sector according to an organisation-based typology of health systems defined by Mintzberg. As such, strategies are adapted to three types of health systems: machine bureaucracies, professional bureaucracies and divisionalized forms. We describe avenues for family and community health and for hospital care. We stress social control at the peripheral level to increase accountability and responsiveness. Community-based, national and international sources are required to provide viable financing. Our proposed social-and-democrat health policy calls for networking, lobbying and training as a joint effort in which committed health professionals can lead the way.
Highlights
Disease control programmes are performing poorly, whilst at the same time access to essential quality care in low and middle-income countries (LICyMIC) is limited
Our proposed social-and-democrat health policy calls for networking, lobbying and training as a joint effort in which committed health professionals can lead the way
We argued that the combination of government-operated disease control programmes together with privatised health care services constrained both programme performance and people’s access to care
Summary
Disease control programmes are performing poorly, whilst at the same time access to essential quality care in low and middle-income countries (LICyMIC) is limited. Health policy, disease control, health care services, integration We outline health system-specific strategies consistent with this policy, with the potential to improve both health care and disease control in LICyMIC.
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