Political Economy Of Health Care Research Articles

National action on antimicrobial resistance and the political economy of health care

ABSTRACT Antimicrobial Resistance (AMR) is one of the biggest threats to human health in the twenty-first century. A key dimension of global governance in this domain consists of encouraging governments to create national action plans (NAPs) aimed at improving awareness of AMR, improving knowledge through surveillance and research, reducing infection, optimising the use of antimicrobial medicines, and investing in new drugs, vaccines and other interventions. The adoption and implementation of NAPs occur in the context of great political and institutional diversity across countries, and this article examines the consequences of different ways of financing health care. We expect the implementation of NAPs to be more successful in optimising antibiotics use when governments play a larger role in financing health care compared to private expenditure. An analysis of patterns of antibiotic consumption in 191 countries between 2000 and 2018 supports the hypothesis.

Assessment of Primary Health care Facilities on readiness for Antenatal Care and Childhood Immunization Services in Zamfara State, Nigeria

Effective maternal and child healthcare delivery centers on availability of essential medical equipment, drugs and trained medical personnel in health facilities. Poor funding, inadequate supply of physicians, essential equipment and drugs as well as mismanagement characterized healthcare delivery system in Nigeria. This study assessed public primary health care facilities on readiness of Antenatal Care (ANC) and childhood immunization services in Zamfara State, Nigeria. Based on theoretical orientation of Political Economy of Health Care, quantitative and qualitative data were used for the study. Descriptive statistic was used for quantitative data analysis using Statistical Package for Social Sciences (SPSS), while ATLASti8 software was used for qualitative data. The study found most of the visited health facilities offered various components of ANC and childhood immunisation services but did not comply with the current eight (8) ANC visits as recommended by WHO. Other essential services including hepatitis B tests, breast examination, Fansida for malaria prevention, free folic acid and iron supplements, insecticide treated nets, weight scale, ROTA vaccine and midwives were grossly inadequate in most health facilities. The study also found urban bias in terms of distribution of healthcare staff in Zamfara State. This study recommends that Zamfara State government, non-governmental organisations and donor agencies should urgently channel their efforts to PHC centers and address the challenges confronting primary health care centers in Zamfara State.

Political Economy of Healthcare and Forced Migration in Developing Countries: Assessment of Syrian Refugees’ Access to Healthcare in Jordan, Lebanon and Turkey

Political Economy of Healthcare and Forced Migration in Developing Countries: Assessment of Syrian Refugees’ Access to Healthcare in Jordan, Lebanon and Turkey

Are clinical leads clinical leaders? Optimising primary care-led commissioning and policy making

There is rising demand for general practitioners in the UK to fill leadership roles in clinical commissioning. Function can vary, from providing frontline insights, representing peers or patients, as well as adding credibility, or relationship-building for programme delivery. The term ‘clinical lead’ may, however, be misleading regarding responsibilities, which often lack the authority or strategic tenets defined in leadership. Much of the literature regarding medical managers focuses on single healthcare provider organisations that adopt shop-floor clinicians into a leadership structure. Population commissioning, however, demands additional technical skills in public health, statistical literacy, economics and even ethics, which, while learnable, are not innate to clinicians. Along with biases in the selection of leadership hierarchies, and limitations of traditional project management, further steps are necessary to nurture the competencies for coherent leadership that use implementation science and maximise opportunity for clinician-leaders to bridge the evidence-policy gap. Organisations need to learn to more effectively distribute authority across the political economy of healthcare to appropriate clinical-leaders in policy rather than continued concentrations of executive decision-making. This requires clinicians with the appropriate neutrality and minimum necessary competencies to be selected and developed for population commissioning.

Patient safety in maternity: The Nigerian context

Background: The death of Folake Oduyoye at the Lagos University Teaching Hospital (LUTH), Nigeria on 13th December 2014 triggered a protest march against the hospital, by a coalition of civil society organizations and human rights activists, and a legal suit was instituted against the government. Although a Federal High Court ruled in 2018 to overturn Oduyoye's case on a technicality, this ruling is currently being appealed. Objective: To perform a sociological analysis of the Oduyoye/LUTH case and another managed in OAUTHC Ile-Ife; as a means of providing insight into the current state of patient safety in maternity, in Nigeria. Methodology: This sociological analysis was conducted using secondary data, sourced from a combination of detailed online searches of published literature, news items, and social media posts; along with personal observations and reviews of patient's records. Results: Patient safety issues in maternity are prevalent in Nigeria. Responsible macrosociological factors include lack of clarity regarding the political economy of healthcare in Nigeria, dubious justiciability of citizens' right to healthcare, poor resource allocation to healthcare, and dismal coverage of national health insurance, along with poor regulation of health services, and nonintegration of healthcare with partner social institutions. At the mesosociological and microsociological levels are lack of public confidence in Nigerian healthcare, gross infrastructural decay from chronic neglect, understaffing and inadequate training of personnel, lack of institutional risk management and clinical governance. Conclusion: The state of patient safety in maternity in Nigeria is quite worrisome. Various sociological factors were identified and viable solutions proffered.

Speculative Fiction and the Political Economy of Healthcare: Chang-Rae Lee's On Such a Full Sea.

Chang-Rae Lee's 2014 novel On Such a Full Sea uses the genre of speculative fiction to reflect on longstanding healthcare debates in the United States that have recently crystalized around the Affordable Care Act. The novel imagines the political economy of healthcare in a future America devastated by environmental illness. What kind of care is available and to whom? Who provides it? Who pays for it? What about distribution and access? The different healthcare systems governing each of three geo-social zones in Lee's future society represent exaggerated versions of the scenarios participants in the ACA debate claim their opponents' health policies would produce. The essay argues that Lee's novel ultimately favors a version of universal government-funded care over a system based on supposed free-market principles, even as the novel also tries to make room for conservative Americans' fears about the specter of so-called "socialized medicine." More broadly, the essay contends that the health humanities should devote more attention to literary and artistic engagements with healthcare as a system: a complex set of financial models, public and private institutions, government policies, and actors whose roles range well beyond patient and care provider.

An Assessment of Canada’s Healthcare System Weighing Achievements and Challenges

Canada’s healthcare system has gained great support in the country, but at the same time has sparked a big debate over its main challenges and sustainability. This article weighs both positive and negative aspects of the healthcare system, known as Medicare. It has three sections: the first presents a theoretical framework based on the political economy of healthcare, and a historical context, where the origins of Medicare are addressed. The second part assesses Medicare’s main achievements, and the third analyzes the system’s main challenges.

The New Political Economy of Health Care in the European Union: The Impact of Fiscal Governance.

We argue that the political economy of health care in the European Union is being changed by the creation of a substantial new apparatus of European fiscal governance. A series of treaties and legal changes since 2008 have given the European Union new powers and duties to enforce budgetary austerity in the member states, and this apparatus of fiscal governance has already extended to include detailed and sometimes coercive policy recommendations to member states about the governance of their health care systems. We map the structures of this new fiscal governance and the way it purports to affect health care decision making.

The Sticky Web of Medical Professionalism: Robert Herrick’s The Web of Life and the Political Economy of Health Care at the Turn of the Century

Robert Herrick’s novel The Web of Life (1900), a self-proclaimed work of literary realism, opens a critical window onto an urban “web” of intersecting practices, institutions, and professional formations at a moment when key dimensions of the US health-care system as we know it today were first taking shape. At this fluid historical moment, Herrick stages a competition between two contrasting possibilities for what that system would, or should, look like in the new century. One possibility consists of a democratic profusion of health-care providers and options, all of which jostle against one another in a marketplace largely unregulated by any external authority. Herrick implicitly associates this energizing, though unsettling, model of US health care with both the labor movement (the novel is set in the same year as Chicago’s Pullman strike) and certain aspects of the New Woman movement. The second possibility the novel showcases, which is closer to the model that would historically prevail, envisions a health-care system that is centralized, rationalized, and directed from the top down by the so-called orthodox profession. Herrick aligns this model with powerful banks, trusts, and corporations. The book presents the competition between these alternative paradigms by following the shifting career choices and internal conflicts of its protagonist, Dr. Howard Sommers, as he strives to satisfy his own vision—at times itself contradictory—of medical professionalism. By the end of the novel, both Sommers and The Web of Life have been forced to acknowledge if not the desirability, then the practical necessity, of the orthodox profession’s monopoly on health care. This reluctant endorsement on Herrick’s part also offers an important perspective on why large-scale systemic reform in US health care has proven so difficult to achieve in the more than a century that has passed since the novel was written.

In The Wake Of The Supreme Court Decision, Many Stakeholders Still Support The Affordable Care Act

In the aftermath of the Supreme Court decision largely upholding the constitutionality of the Affordable Care Act, many stakeholders have renewed their commitment to health care reform. In fact, a new political economy of health care has emerged that is characterized by three dynamics. One is the "log-rolling" dynamic of distributive politics, as evident in mutually supportive efforts for maintenance and expansion of subsidies and other opportunities to advance the interests of stakeholders. A second is the cut-throat zero-sum politics of interest-group conflict, as evident in the intense competition among stakeholders for limited resources and authority. The third dynamic is the result of the emotional and ideological conflicts of resource redistribution. These new dynamics may make repeal of reform more daunting than expected.

The proliferation of stem cell therapies in post-Mao China: problematizing ethical regulation

Thousands of foreign patients have sought experimental stem cell therapies in China since 2001. Despite critical scrutiny from scientific experts and tightening guidelines on the conduct of translational medicine, stem cell clinics have continued to proliferate in contemporary China. This article delves beyond regulatory exteriors to provide an ethnographic account of why unauthorized stem cell clinics targeting foreign clients have flourished under “socialism with Chinese characteristics.” As the former emphasis on preventive care during Mao's era of collectivism has given way to a market-driven pursuit of high-tech interventions, changes in the political economy of healthcare have transformed China's urban medical system into a laboratory for entrepreneurial tactics. This article traces how medical entrepreneurs operate within and beyond the socialist market economy by co-opting public hospital facilities for private gain and capitalizing on the hope and hype over stem cell research to promote dubious procedures. Rather than producing biopolitical modes of governance, formal regulation in China often invites enterprising tactics and hybrid practices that ultimately remake the boundaries between public and private, as well as ethical and unethical.

Making breathing your business: enterprising practices at the margins of orthodoxy

Over the last 30 years there has been a gradual but nonetheless significant shift in the political economy of healthcare in developed countries. The health reforms that have accompanied this shift have had a significant impact upon medicine, nursing and a number of other orthodox health professions, but to date, little work has been done to explore the changing nature of physiotherapy practice. This study draws on Foucault's notion of governmentality to explore the enterprising practices of a new physiotherapy clinic established in Auckland, New Zealand. Drawing on a critical history of respiratory physiotherapy, which had previously been firmly anchored within the public health sector, we show that the actions and practices of the clinic's staff are testing the margins of orthodox physiotherapy practice and exploring the new market possibilities offered by consumer demand for optimal health. The study explores how the physiotherapists at the clinic are problematizing the practices, clinical spaces and clientele associated with orthodox practice, and, most notably, commodifying breathing, to create a space within which it is possible to think about physiotherapy otherwise. This study builds on the instability now surrounding the orthodox health professions and asks if exemplars like that offered in this article provide some meaningful insights into the future for healthcare practice.

A Political Economy of Health Care in Senegal, by Maghan Keita

A Political Economy of Health Care in Senegal, by Maghan Keita

The Political Economy of Health Care ‐ by Tudor Hart, J.

<i>The Political Economy of Health Care</i> ‐ by Tudor Hart, J.

The Political Economy of Health Care. A Clinical Perspective.

The Political Economy of Health Care. A Clinical Perspective.

Social Justice and the Political Economy of Health Care in Nigeria: Some empirical observations

This paper evaluates the level of social and/or spatial justice in the Nigerian health sector. It argues that since the steady progress of the Nigerian health sector from a purely capitalist colonial orientation to a more or less indigenous capitalist orientation, the most significant factors responsible for the spatial pattern of health care in the country relate more to the spatial power structure rather than a strict adherence to the principle of social justice through welfare considerations. This argument is adjudged valid, given the empirical instance of health facility distribution vis-a-vis the national population. Using a Gint coefficient, the study evaluates the regional distribution pattern of health care resources in the country and concludes that the observed pattern is an empirical justification of Hart’s inverse care law hypothesis, which states that the availability of medical care varies inversely to the population. The study concludes that except private individuals and communities have direct access to care provision and/or the health care sector is significantly depoliticized, the idea of social or spatial justice may remain only in principle.

Books Reviews

Book reviewed in this article:Zadek, Simon. The civil corporation: The new economy of corporate citizenshipRecent books: Côté, Daniel (ed.). Les holding coopératifs: Évolution ou transformation définitive?ICFTU (International Federation of Free Trade Unions). Annual survey of violations of trade union rights 2001Zhou, Huizhong (ed.). The political economy of health care reforms.New ILO publications: Thirteenth Asian Regional Meeting, August 2001, Report of the Director‐General: Decent work in Asia: ILO activities in the regionGuidelines on occupational safety and health management systems, ILO‐OSH 2001. Geneva, 2001Social security: A new consensusThe construction industry in the twenty‐first century: Its image, employment prospects and skill requirements. Report for discussion at the Tripartite Meeting on the Construction Industry in the Twenty‐first Century: Its Image, Employment Prospects and Skill Requirements

To Boldly Go? Place, Metaphor, and the Marketing of Auckland's Starship Hospital

In this paper, we place the naming of the Starship Children's Hospital in Auckland, New Zealand, within the context of increasingly consumer-oriented health care provision. This use of metaphor alludes to the hospital's distinctive design features and represents an attempt to de-emphasise connotations associated with institutionalised medicine, thus normalising the place for children. However, those naming the hospital had more than children in mind. Rather, there was a dual intent: to market the hospital as a distinctive place for monetary donors, as well as promoting a more therapeutic environment for youthful users. Through the vehicle of our case study, we raise questions concerning the competition by health care services for public and private funds. We conclude that there is a need to move beyond viewing hospitals as service entities and equating health care consumption with utilisation behaviour. Rather, a merging of insights from the political economy of health care and new cultural geography literatures can aid the development of more finely textured understandings of the meaning of contemporary health care, and the role of metaphor and marketing in selling places of health care consumption.

The Political Economy of Health Care in Senegal: The Integration of Traditional and Modern Health Care Revisited

AbstractIn 1978 in the city of Alma Ata of the former Soviet Union, the World Health Organization declared its intention to provide "health for all by the year 2000." In the third world, this was to be achieved through the integration of "traditional and modern medicine." In the case of Senegal, the prescription was ahistorical. It did not take into account several centuries of integration in all areas, including health care. The central argument here is that four centuries of activity have made integration an historical fact for the peoples of Senegambia. The results of that integration are manifested in the inadequacies of the current health care system which evolved through the contestations of various political economic polities for control of the Senegambian region.

The Political Economy of Health Care in Senegal

In 1978 in the city of Alma Ata of the former Soviet Union, the World Health Organization declared its intention to provide for all by the year 2000. In the third world, this was to be achieved through the integration of traditional and modern medicine. In the case of Senegal, the prescription was ahistorical. It did not take into account several centuries of integration in all areas, including health care. The central argument here is that four centuries of activity have made integration an historical fact for the peoples of Senegambia. The results of that integration are manifested in the inadequacies of the current health care system which evolved through the contestations of various political economic polities for control of the Senegambian region.